After 4 Weeks Discovered I Had a Seroma

600cc is a lot. 4 weeks after surgery is late to find this out. You should probably be returning to office even twice a week to get a handle on this. If it doesn't dramatically improve within 2 weeks I would put in a drain. If a seroma is not adequately treated the undersurface of the skin may never "stick" back down, in which case you may always have a bit of fluid, and therefore fullness which remains.

One of the more common complications after any body contouring operation is a seroma.  Seromas are fluid collections that develop because of the potential space that can arise secondary to undermining.  Most plastic surgeons treat seromas with serial aspiration (with a needle and a large syringe) in the office, often on a weekly basis.  For large seromas (more than a couple hundred cc's) a drain is sometimes inserted in the office or the operating room.  Some surgeons will also try to speed the process by injecting a sclerosing agent into the cavity.  As you can imagine, each plastic surgeon is different.  Most of the time there aren't any long term negative effects.

Hello. Thank you for presenting us your case . You have what we call a chronic seroma . You must have patience with this and have good communication with your PS . The number of punctures is not the most important issue. You have to be sure that your PS is draining the seroma every time you go to his office. Remember to use your compression garment to avoid more seromas. Good luck.

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.Best wishes,Pablo Prichard, MD

If you have a  bulge at 5 weeks after your surgery it is either, a seroma, a hematoma, residual fat or muscle bulge.  Your plastic surgeon is in the best position to help decide what the problem is and how to correct it.  If the fluid keeps collecting then a drainage tube may have to be re-inserted.