Fluid Pocket Top of Abdomen

I had my 3-week checkup last Wednesday and asked my surgeon if the spongy spot just below my breasts in the middle of my abdomen was because they pulled the skin so tight that I could see my gastric bypass pouch.  Uh, duh - stupid question - he didn't say that, but now I know it.  So he told me no it wasn't my pouch showing through and had me lay down, then raise my head and shoulders up to tighten the ab muscles up, poked me a lot and said it was a fluid pocket.  He said he could aspirate it right then and take out the fluid or we could give it a few weeks and see if it reabsorbed on its own.  Stupid me was all for waiting for it to reabsorb. 

But then we got to talking about how well my recovery and incision are doing and he decided that since I'm feeling so good and my incision is really healing well, that I didn't need to come in until my 2-month date - so we set my next appointment for January 6.  So now I won't be going in in a couple weeks like we originally talked about and he was going to aspirate if it was still there at that time.

Okay - so will this really reabsorb?  It's above where the binder goes, so it's not under any compression at all.  In my 3-week pics I posted, you can see it - it looks like a white bruised area in the mid-upper abdomen.  Except today for some reason I decided to pull my binder up under my breasts and tighten it down so it covers it.  I've been wondering all day if I should call Monday and get in to see him again and have him stick the needle in.  My DH told me halfway home that he would have preferred I let him do it right then.  I asked why he didn't say anything while we were there and he said I looked so scared when he said he could put a needle in right then and drain it.  I was afraid of the needle ***** - geez, after a tummy tuck I'm afraid of a needle!!

HI There,

Well first off I hope you are taking it easy-  I was warned immediately after they removed my drains that I would probably be feeling really good 9Yes I am) and you will want to more than you should (Yes I do) but DON'T they said if you do too much it will create those fluid pockets and they will have to drain them- I have some fluid build up as well but my doc said they would absorb on their own too... I say just take it easy watch it and if it starts to bother you or seems to get worse call and go right in.

Best Wishes hope it all goes away

Cheers
MO

Thank you, Mo!!  LOL - yep, I also feel really good and am way overdoing it.  I keep trying to rest, but then think of just one more thing I need to do before I forget (which I forget things very quickly nowadays!) and am off and running again.  I've rested all day today, plan on doing that tomorrow.  Will be at work on Mon, Tues & part of Wed, then have four days in a row off to rest (can rest on Thanksgiving at my mom's, too).  Thanks for the advice and for letting me know your doc said the same thing to you - I really appreciate it and feel much better now!

I keep an ultrasound in my office, and it really taught me a lot about fluid collections. First, I learned that they are really common after WLS and a lot of times they are there but the "poking" will not reveal them.

Second, I found that the amount of fluid in them is not as important as the height of them, and my height cutoff for aspiration is 2cm.  In other words, one that goes from hip to hip but is not thick may well resolve.  One that is narrow but tall may not.

Once they have been there over a month, they develop a lining called a pseudobursa which will prevent the skin form laying down as tight as we want...I will drain them to hopefully prevent that from happening.

Upper abdominal collections generally go away better than lower ones, and leg seromas are an entirely different situation altogether.

Usually I drain them through a numb part of the skin. 90% of the time my patients feel nothing !

Wow, Dr. L, I really want to thank you for replying to my post.  I sure wish I lived in Houston so I could come see you for the rest of my work!!!!  I completely trust you and your opinion after watching you on TV and reading your replies to people on here and it's so obvious you really care about your patients and everyone else going through this journey!!

My pocket is kind of the shape and size of a lemon.  I just talked to my husband about this after reading your reply and we've decided that on Monday I'm going to call and get back in to have it drained.  Mostly to alleviate my concerns and because I don't want to wait until my next appointment because that will be at my 2-month point and I don't want to chance having a pseudobursa developing before we get this taken care of.  Best to take care of it now while it's not a month old yet.

Again, thank you for your help!!! 

Hi Lizzy. I agree.  If they need drainage, I stay on them and may see patients every week for evaluation. 

I hope yours will be an "easy" one, but be patient.  

I'd be curious if its dark fluid (old blood) that comes out vs golden colored fluid (true seroma).  My personal experience is that the old blood collections are more common above the belly button.

This is a very informative post.  Thanks for sharing!