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Plastic Surgery/Pseudo bursa after tummy tuck

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Question
In May I had a tummy tuck and developed a pseudo bursa in July. My PS had done some drainage of the Seroma that had developed right after the TT but it wasn't sufficient to stop the development of the pseudo bursa. It took till Oct till I was able to have sclerosing by an interventional radiologist. This was this  past Tues and already it seems like the fluid has returned. It is located just above my belly button. I am very depressed and not sure what is going to happen now. I read that the sclerosing should be done three times in a row to be successful. Does it really work?? Is the only other option surgery? Will I have to pay for it again? Should I just live with it? Please advise

Answer
from Dr. Alan Engler
www.bodysculpture.com

Hi Caryl,

I'm sorry for the problem you're having.

It is obviously not possible for me to make an absolute determination on what needs to be done or to direct your care via this forum.  That being said, I would probably favor a surgical intervention to remove the scar tissue as long as you're sure there's a pseudoburssa.  Sometimes diffuse swelling can mimic the actual physical structure of the bursa.  Did an ultrasound show the fluid and surrounding scar tissue?  Were they able to inject some radio-opaque dye that demonstrated the scope of the cavity?  And/or did an MRI or CT Scan show the cavity clearly?  If so, then I'm not sure that sclerosing it - which leaves the bursa in place even if it occludes the cavity - will be satisfactory.  There is little harm in trying the sclerosing again, but since you indicate that that's already been tried once and it failed, I would conclude that a surgical procedure may be necessary.  If it's a small area it may not be that significant a procedure, although I realize that that's easy for me to say.  Certainly, if it's relatively minor and you are comfortable leaving it alone, that would be another option.

Payment for treatment of surgical complications is always a challenging issue.  Most plastic surgeons have in place, via standardized nationally-used consent forms, a modified fee structure in the event that a second procedure is required.  Insurance may or may not be an option, depending partly on what the problem is, when it occurs, and specifics of the insurance policy.  Surgeons will, in general, try very hard to accommodate their patients and work to achieve the originally-intended results.  At least, in my experience.

I hope that this helps and, again, I'm sorry for this problem,

Dr. E

Plastic Surgery

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Alan M. Engler, MD, FACS

Expertise

Dr. Engler has answered over 6400 questions on social media sites, including over 3500 on AllExperts alone. His expertise includes breast surgery (breast enlargement with implants, breast reduction, breast lifts), liposuction, eyelid surgery, tummy tucks, facelifts, lipomas, skin cancers, cysts, etc. Dr. Engler has been listed as one New York`s Top Doctors, and as "One of the World's Most Famous Aesthetic Surgeons" (Aesthetic Surgery, TASCHEN Books, Angelika Taschen, Editor). He is the author of 4 books, including "BodySculpture" (a best-selling plastic surgery book on breast surgery, liposuction and tummy tucks), "EyeScapes" (Plastic Surgery of the Eyelids), "Restylane," and "The Slim Book of Liposuction." Dr. Engler has two US Patents for surgical instruments that he's designed, and has appeared on numerous television shows, including The Tyra Banks Show, The Ricki Lake Show (four times), the Dr. Keith Ablow Show and Jerseylicious. Videos of his appearances are available on YouTube (search for "DR. ENGLER"), and his discussion of breast implants, also on YouTube is "How to Choose a Breast Implant." His website is www.bodysculpture.com. Follow Dr. Engler: @AlanEnglerMD

Experience

Dr. Alan Engler is a board-certified plastic surgeon in New York and the author of BodySculpture - Plastic Surgery of the Body for Men and Women (ISBN 0966382749) one of the top-selling plastic surgery books on amazon.com, barnesandnoble.com, as well as EyeScapes - Plastic Surgery of the Eyelids.

Education/Credentials
Dr. Engler graduated from Yale University (BA, Russian Studies) and the Columbia University College of Physicians and Surgeons (MD). He did his residency training in General Surgery and, after that, Plastic Surgery, at the Montefiore Medical Center in New York. He is on the faculty of the Albert Einstein College of Medicine in New York in the Departments of both Surgery (Plastic Surgery) and Medicine (Dermatology), and is a Special Lecturer in the Department of Dermatology at Columbia University in New York. He has admitting privileges at Beth Israel Medical Center and Montefiore Medical Center, both in New York.

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