Postoperative Lymphatic Drainage and Seroma Prevention after Abdominoplasty: A Comparative Study and Literature Review

Abstract: Postoperative seroma is a common complication following abdominoplasty. Manual lymphatic drainage (MLD) is widely used to reduce edema and prevent seroma, but its effectiveness remains debated. Recent studies have questioned the benefit of compression garments and revealed modifications in lymphatic drainage patterns after surgery. To assess the impact of manual lymphatic drainage on postoperative outcomes after abdominoplasty and to compare our clinical experience with current international evidence. We conducted a prospective observational study including 60 patients who underwent abdominoplasty between January 2022 and May 2025. Thirty patients received early postoperative MLD sessions (starting day 2 post-op), and 30 did not. Outcomes included seroma rate, duration of drainage, total volume of fluid drained, and degree of abdominal wall edema assessed clinically. Results were compared to recent literature data. The MLD group had a significantly lower incidence of seroma (10% vs. 33%, p = 0.032), reduced mean drain output (430 mL vs. 700 mL), and faster drain removal (6.2 vs. 9.1 days). Patients in the MLD group reported better comfort and satisfaction. Our findings were consistent with studies highlighting lymphatic changes post-abdominoplasty and questioned the routine use of compression garments due to increased intra-abdominal pressure and venous stasis. Manual lymphatic drainage significantly improves postoperative recovery after abdominoplasty by reducing seroma risk and edema. Understanding the altered lymphatic drainage pathways is crucial for optimizing MLD protocols. Routine compression garments may not be necessary in all cases and should be individualized.