Massage for Reducing Swelling from Seroma?

What is the correct way to do the massage for reducing or prevent the swelling from a seroma? after TT

Doctor Answers 11

Seroma after TT

Seromas are collections of fluid under the skin.

Seromas should be drained, and not be allowed to resorb on their own.

If left untreated, seromas can become permanent and form a capsule that needs to be removed surgically.

They can also become infected.

There are various methods of reducing swelling, primarily by reducing activity levels, applying compressing, avoiding prolonged sitting, and lymphatic massage. However these are treatments for surgical swelling, not seroma.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 119 reviews

Seroma is not a swelling

A seroma is a fluid collection in an area following a surgical procedure. This is different from swelling. Swelling will respond to massage but seroma will responds to either compression or aspiration.

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 17 reviews

Massage after tummy tuck

Thanks for the great question -

Massage is not likely to prevent seroma but can be useful as a technique to reduce swelling.

Your lymphatics remove excess fluid from your tissues and return it to your circulation. After surgery some of these channels are cut and time is needed to allow regrowth of these pathways.

Massage can be an effective way to reduce swelling by recruiting other lymphatic channels to reduce some of the fluid.

I hope this helps.

Massage does not prevent or treat seromas very well.

Thank you for your post. Seromas can be painful and cause a cosmetic deformity, as well as sometimes leak. The whole point of drains is to keep a seroma from happening in the first place. If a drainless procedure was performed, and you had a seroma, or you had drains that were pulled and you subsequently had a seroma, then you should be drained, otherwise a capsule builds around the fluid making it permanent. If a capsule builds around the seroma (pseudo bursa or encapsulated seroma) then the only way to remove the seroma is to surgically open the areas and excise the capsule, and close over drains to prevent another seroma from happening. If the seroma is encapsulated and is tight and painful, then it can be confused with just swelling or fat. An ultrasound is useful in distinguishing these and identifying the extent of the seroma. If the seroma is not yet encapsulated, then it is usually loose and has a 'fluid wave' or water bed type feel. Occasionally, a seroma can also become infected, especially if a permanent braided suture was used. This will have a hot, red appearance, and will eventually open up. I have never seen an infection from sterile aspiration of fluid. If seromas continue despite multiple aspirations over an extended period of time, then you need to start thinking about re-openning the incision and excising the entire capsule, both from and back walls, to treat the seroma. Drains need to be placed, internal sutures placed, possibly using a tissue glue or irritant to encourage the tissues to grow together.
Best wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 37 reviews

Seromas after a tummy tuck (abdominoplasty) are aspirated, not massaged.

There is no role for massage in the treatment of a seroma.  This is a collection of fluid under the skin and fat not uncommon after abdominopasty.  Treatment is serial aspiration.  Massage has no role in treatment.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 16 reviews

Massage and seromas

Massage does not typically reduce a seroma. Massage works very well for generalized swelling following surgery, however a seroma is a collection of fluid and massaging this does nothing to improve resorption. Typically, drains are used to prevent these collections from forming and are complimented with compression wraps or support garments. If a seroma persists, removal of the fluid (often several times) via a small needle and syringe may work. In chronic situations, the seroma cavity may form a wall and need a secondary procedure to correct.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 13 reviews

Reducing swelling after a tummy tuck

Probably the best technique is manual lymphatic drainage also known as MLD or the Vodder technique.

This promotes drainage to the regional lymph nodes and encourages diminished swelling (also known as edema) which may help to optimize oxygen delivery to the healing tisssues.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 58 reviews

Massage can help!

When abdominoplasty patients develop swelling in the post-operative period, massage can be very helpful. In contrast, when patients develop seromas, drainage is usually always indicated. Seromas are well formed collections of fluid that won’t respond to massage. Failure to drain a seroma can result in secondary complications.

How to Reduce a Seroma

A seroma is a collection of fluid underneath the skin. In some cases drains are used after surgery to prevent to occurance of seromas, as well as compression garments which also address issues with swelling. Massage does not typically help rid of a seroma, although it does help with swelling. To remove/reduce a seroma you will need to have it drained by your surgeon - otherwise you could end up with an infection. If you are experiencing complications such as a seroma, I would recommend calling your surgeon right away.

Massage for reducing seroma

Tummy tucks are an extremely popular and effective way to contour the abdomen. Like all surgery, they have attendant risks. One risk is the development of a seroma. This is the collection of extra fluid underneath the skin. In many cases, this can be prevented with the use of abdominal drains. If you develop a seroma after the drain has been removed, your surgeon may opt to drain the seroma with a needle and a large syringe. To prevent a stroke for coming back, compression is the best technique. Compression will encourage your overlying skin to stick onto the underlying muscle. Your surgeon should recommend a tight compression garment to encourage this to happen. Massage may not be recommended until your tissue has adhered tightly to the underlying muscle. Otherwise, this space may return and fill with additional fluid.

To learn more about tummy tucks, see photos, and help you decide which one is best for you, please visit us at the link below:

Pat Pazmino, MD
Miami Plastic Surgeon
4.5 out of 5 stars 67 reviews

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.