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Its Been 1 Year Since my Tummy Tuck and I Still Have a Swelling Above Scar. Ps Said It Was Lymphodaema. Think Its Pseudobursa?

i had a seroma which was aspirated about 6 times. the swelling can be palpated above the scar almost like a 'filling or padding'. surgeon said it was lymphodaema and would settle but it hasnt. i think it may be a pseudobursa. when i said this to him he said it wasnt, however he did say that should there be a need for any further treatment for example a scan then i would be liable to pay. im really worried about this. could you advise. thankyou in anticipation

Doctor Answers (6)

Swelling one year after?

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An exam would be needed and if a fluid wave is present, another aspiration could confirm what you have.  If your surgeon isn't helpful (like he should be) then get a second opinion.  Your surgeon should be your advocate and be looking out for your interests, but there are always exceptions to this rule.

Redding Plastic Surgeon
4.5 out of 5 stars 17 reviews

Bursa Likely

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Impossible to tell without exam but the story sounds like a bursa. If it has been a year and the area is persistently swollen and full it may be worth a return to the OR to remove it. Work with your surgeon.

David Shifrin, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 56 reviews

Causes of swelling

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I agree that either lymphedema or a residual seroma could cause what you describe.  An ultrasound test would be easy and reliable. It would most likely be covered by insurance. If not perhaps there is a lower price the radiologist could charge you for self pay. Discuss it with their business manager.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 31 reviews

Swelling 1 Year After Tummy Tuck

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Either lymphedema or a seroma is possible.  An ultrasound is a quick and easy way to find out.  A seroma and it's surrounding pseudobursa will show as a distinct cavity on ultrasound.  Lymphedema has it's own appearance.

I would suggest you get the ultrasound.  It is fairly inexpensive even if you or the surgeon pays for it.  There are also hand-held units that your plastic surgeon may be able to access for a quick check.  Good luck to you.

Al Rosenthal, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 3 reviews

Ps Said It Was Lymphodaema. Think Its Pseudobursa?

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SInce you have a history of seroma, I would be suspicious of a pseudobursa. An imaging study would help make the diagnosis. Fluid would be seen as likely would be a thickened wall around the seroma. If there is still fluid at a year, this is a pseudobursa, and surgical excision is probably the only way to resolve the problem.

A photo would help!.

Thanks for your question, all the best. 

And untreated seroma can lead to pseudo-bursa formation.

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And untreated seroma generates inflammation that leads to fairly the capsule. Only surgical excision is the best treatment for this.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 11 reviews

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