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.