Old seroma that doesn't go away - Is this scar tissue? How can i get rid of it? (photos)

Question

I had lipo 360 and had a seroma from day 1 that was drained a few times. It decreased a lot, but now at my 6wk PO appt a nurse tried to drain it thinking there was a bit of fluid left, and there was NOTHING in it. It’s just a bump now, not hard at all. Just soft bump. Ive compressed a ton, and don’t know what else could work. Any recommendations on what to do? It’s literally the only imperfection on my skin. Is this scar tissue? How can i get rid of it? Please help.

Alan Gonzalez, MD, FACS · Answer

Hello @Sky147, thank you for your question. It may be a scarring consequence of the seroma. In this case, an ultrasound can be performed to determine how the area is internally. If you would like more information and options, I would recommend consulting one or several board certified plastic surgeons. Best wishes! Alan Gonzalez MD FACS

Ben Lee, MD · Answer

Thank you for your question. Seromas after liposuction are rare but are appropriately managed by drainage, sometimes more than once. At 6 weeks, there is still swelling of the tissues and you are a long ways from complete recovery. There is a tendency to think of liposuction as a fairly minor procedure, when in fact, the wound underneath the surface is quite large. It therefore takes much more time to recover from the surgery than most patients realize. You have several weeks to go before the lasting results can be assessed.

Gianfranco Frojo, MD · Answer

You need to see a board-eligible or board-certified plastic surgeon who has ultrasound technology in their office to further evaluate the area.

Zoran Potparic, MD · Answer

Irregularietis of this kind are frequent after liposuction even without history of seroma. Based on your description, this may be area of fat necrosis, seroma capsule, scar. Massage, worm compreses may help. Since that is not so visible, give it at least 6-8 months to settle. Ultrasound exam may help to rule out chronic seroma. You should discuss isue of treatment with your surgeon as well. Good luck.

Daniel Barrett, MD · Answer

Dear Sky147,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Omer Sagir, MD · Answer

Hello dear,
I strongly recommend you to have an ultrasound so that you can have an idea about the tissue inside. As your nurse stated if there is no fluid inside and the bump is still there, looking inside the bump will tell you what it is. Then you can take it from there with a professional doctor. 
Be safe, be happy

Camille Cash, MD · Answer

Seromas will typically resolve with draining, compression, and massage.  I encourage you to return to your surgeon for an ultrasound to determine if any specific interventions are necessary to aid your body in healing the area.

Douglas Taranow, DO, FACOS · Answer

Dear Sky,
Have a sonogram performed. If it is indeed a seroma, have it drained.  If organized tissue (fat or scar) have a touch up liposuction. 
Dr. Taranow

John J. Obi, MD · Answer

Thank you for your inquiry and photo.  Since there was a seroma post op, the most likely thing is that the lump you are feeling / seeing is an encapsulated seroma.  Typically these are somewhat firm but the capsule may still be in development / maturation.  If there is a question about it, the easiest way to get an answer would be to have an ultrasound of the area.  That could determine what, if anything, would be recommended for treatment.  Good luck.

Mats Hagstrom, MD (license on probation) · Answer

Postoperative seromas need to be treated aggressively as soon as diagnosed. Seromas should be drained on a daily basis until they no longer form. any amount of time spent with a fluid accumulation increases the chance of the seroma not resolving on its own. fluid buildup stops the surfaces from staying in contact which is required for the space to close up.
The other alternative is the placement of a drain which can be done by interventional radiologist.
Failure to drain the fluid on a regular basis in an aggressive manner early on causes the seroma to become chronic. chronic seromas are encapsulated and once a capsule membrane has formed the seroma is no longer treatable by simply draining it.
And encapsulated seroma can only be treated by direct surgical excision with placement of a drain. with surgical excision all seroma capsule needs to be removed.
At six weeks you’ve most likely already developed a capsule and it’s uncertain if this can now be treated by it simply draining it on a regular basis.
Why is your surgeon not seeing you when you have a postoperative complication?
If you have a seroma and want to try to treat this without needing surgery then I suggest you consider asking for a referral to an interventional radiologist for a placement of a subcutaneous drain.
All board-certified plastic surgeons should be trained and competent in managing seromas.
Best,
Mats Hagstrom MD

Old seroma that doesn't go away - Is this scar tissue? How can i get rid of it? (photos)

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