Abdominoplasty Complications: A Comprehensive Approach for the Treatment of Chronic Seroma with Pseudobursa

Abstract

Abdominoplasty is an extensive surgical operation, often followed by a significant number of local and general complications. Some studies indicate that the risk of severe complications, including mortality, ranges from 1 in 617 to 1 in 2,320 cases. Seroma is one of the serious consequences that follows each type of abdominal contour surgery, from suction-assisted lipoplasty to standard and limited abdominoplasty. A case of a 46-year-old women who underwent standard abdominoplasty and liposuction during the same procedure is presented. In the follow-up examination, a chronic seroma with pseudobursa was observed. The pseudobursa was evacuated multiple times under ultrasound control. During one evacuation, 2,010 ml of seroma was evacuated. Because of the prolonged Seroma formation, the pseudobursa grew, creating a tumor-like effect in the front abdominal wall. In a second operation (miniabdominoplasty), the pseudobursa was completely excised, and the material was sent for analysis. Progressive tension sutures were placed in additional lines to decrease the dead space, and to decrease movement between the abdominal flap and the musculoaponeurotic layer, as suggested by Saltz and Matarasso. Suction drainage with a compressive girdle was maintained for 2 weeks after the second operation. The follow-up assessment, performed 3 months after the second operation, showed no infection, skin necrosis, hernia formation, or new chronic seroma with pseudobursa.