I had an abdominoplasty a year and half ago resulting in a seroma 10x15 cm. Is there a solution after this time to remove it without surgery?
Seroma After Tummy Tuck - Non Surgical Removal?
Doctor Answers (16)
Seroma and Tummy Tuck
Pablo Prichard, MD
Seroma after a tummy tuck
This sounds to me like you will need another operation to correct the seroma cavity since the cells lining it are probably still producing fluid and need removal. Best wishes
Seroma one year after a tummy tuck
A tummy tuck is a safe and effective procedure to contour the abdomen, create a tight waist, and remove extra skin, fat, and stretch marks. Patients should expect a significant recovery process after the surgery. However developing a seroma one year after your surgery can be unusual. At this stage, your best bet is to return to your board-certified plastic surgeon and let him evaluate your abdomen and this new collection. They will appreciate the opportunity to help you achieve a great result. Depending on the size and location of the seroma, your surgeon may recommend percutaneous drainage, a small incision and drainage or a small procedure to remove the tissue that is creating this fluid. Be sure to bring in the compression garment that you have used after the surgery as applying immediate and constant compression after your surgeon removes this collection is essential to prevent the recurrence of this seroma.
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Non-surgical treatment of Seroma
Non-surgical treatment of the serma could be carried out with placement of a seromacath or having the interventional radiologists place an indwelling seroma catheter and/or considering slcerotherapy.
Seroma & pseudobursa
It sounds like you have a "pseudobursa", which is a fluid-filled sac beneath the skin. These can happen with long-standing seromas. The only answer I know to fix this is to operate, fully excise the sac, and place drains, or do internal quilting sutures.
Seromas seem to be more common in tummy tuck patients that also have liposuction of the abdomen or flank areas, and in the massive-weight loss population.
Treating an established seroma
Seromas (fluid collections) occur in ~ 5% of abdominoplasty patients. Generally, they can be treated with needle aspirations in the office followed by wearing compression garments. Rarely, seromas persist several months. If they do, often surgical removal is the only option as the lining that forms the fluid cavity needs to be removed. Another nonsurgical option is to place a drain in the fluid cavity and inject a sclerosing agent that may help the lining scar in place and collapse the space.
Seroma long after tummy tuck.
While seromas can occur after a tummy tuck, most are self limiting and respond to serial aspirations and continuing the abdominal binder. Once they have persisted as long as your has, there is a lining to the seroma which prevents it from resolving. The next least invasive procedure would be to place a drain and try to sclerose the lining of the pocket with a concentrated antibiotic solution. If this does not resolve it, surgery may be needed to remove the lining.
Seroma after one year
If you have a seroma after a tummy tuck one year after surgery, you probably have a pseudobursa that has formed and will need sugery to remove it.
Treating the established seroma
Once the pocket has had time to line itself with tissue like the inside of an oyster, there is no treatment that will resolve a seroma other than surgery. Prior to that, serial aspiration and sometimes secondary drain placement is necessary.
Seroma after Tummy Tuck
At a year and a half after tummy tuck, it is unlikely for your seroma to resolve on its own. By this point, the seroma has formed a capsule that will need to be resected to allow the cavity to collapse.
If seroma is recognized in the immediate postoperative period, it is important to consider percutaneous needle drainage and compression garments to prevent recurrence. If this fails to treat the problem after repeated attempts, I recommend insertion of a seroma catheter and possible injecting a sclerosing agent to help collapse the seroma cavity wall. If all of the above fails, surgery may be indicated to remove the capsule and prevent longterm sequelae.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.