No Drainage when Seroma Was Aspirated? (photo)

If a seroma is present, it is generally best to drain it promptly.

Occasionally it can be difficult to access the fluid.  There can be bits of blood, protein, etc. which can clog a needle.  However it is best to drain it or it can become infected, delay healing, etc.  It is better for healing if old blood and proteinaceous material is removed, and often a needle doesn't do the trick.

This can often be accomplished by opening a small opening in the central incision; sometimes a small drain is also placed, especially if the patient has to travel or lives very far away. The drain is removed once the fluid stops forming, and the patient packs the area with a small gauze for a short period of time.  It usually heals very well, and can prevent repeat frustrating visits.

Hello Emily. Some seromas can be difficult to access without imaging. An easy way to image the seroma would be using ultrasound. The catheter can also be placed by the radiologist or they can mark the location and size of the seroma so your surgeon can do it in the office. If your clinical condition worsens then talk it over with your PS sooner as opposed to later. Best wishes, Dr. Aldo

If it feels like a water bag when you move back and forth then it is a seroma.  Surprisingly they can be difficult to find and drain by needle aspiration.  The layer can be really thin or deep.  If your plastic surgeon was unsuccessful then your next bet would be to have the radiologist do an ultrasound directed aspiration and placement of a drainage catheter.  If you do not drain the seroma it will develop a life of its own with a thickened seroma wall.   

Sermomas can occur after a tummy tuck and drain removal.  Aspiration with a needle usually addresses the issue.  If the skin flap is too thick, a regular length needle may not be long enough to drain the fluid.  Discuss ultrasound guided aspiration of a larger seroma with your surgeon and possibly replacement of a seroma catheter. These approaches should help resolve the matter.  Best the wishes.

If you do indeed have a seroma and move the fluid side to side most feel a drain is best. If aspiration did not work, then a drain placed through a point in the incision certainly will. If the presence of a seroma is in doubt, an ultrasound will clear things up.

Sorry to read about your seroma. If another attempt fails, the next step would be to aspirate under ultrasound guidance, usually done by interventional radiologists.

Considering how difficult it was the first time, I would be thinking about placing a drain at the next attempt whether in the office or in the radiology suite. 

All the best. 

Thank you for your question. It can often be difficult to aspirate seromas especially if they are small.It sounds as a your surgeon is concerned and is following you up appropriately. If the seroma is larger it may be easier to aspirate at your next appointment. In some cases ultrasound localization may also be helpful. Be sure to continue to follow-up with your plastic surgeon.

Hi

 

Seromas after TT's are a well recognized problem and unless they are very small they should be drained. If they are left they can 'organize' and heal with an irregular contour.

Often syringe aspiration is all that is needed but if this is not successful then ultrasound confirmation that a seroma is present should be considered. The radiologist could drain the collection under ultrasound guidance at the same time.