Is this a seroma? Psudobursa? Help (Photo)

Question

I had a mommy makeover in April 2023, initially very happy with my results. I went abroad for surgery (yes I know stupid decision) so there is no after care really. At about 3 months post op I noticed a “pouch” and it was noticeable through clothing so I sent pictures to the clinic and they said it was swelling that would go down so I left it. It’s gotten worse and just doesn’t seem to be going. Any advice appreciated

Jeffrey M. Darrow, MD · Answer

A physical examination, and possibly an ultrasound would be required to determine exactly what is causing this bulge. If this is a seroma, it has been there since April and the seroma cavity may require some form of treatment to eliminate it.  If this is a diastasis of your muscles, resuturing of the muscles would be needed.  Check with your plastic surgeon about the best way forward. Best wishes.

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding whether this is a seroma or a pseudo-bursa.  Thank you for your history and your pictures.  Congratulations on your mommy makeover.  From your pictures, it appears that you have a seroma.  It is probably not a pseudo-bursa, but rather an organized seroma.  This is not uncommon and can be one of the potential complications for surgery done in the US and abroad.
Unfortunately, surgery done outside the country, as you have discovered, may not allow for significant aftercare, follow-up, and treatment.  Regarding the current treatment of your seroma, this should include needle aspiration.  Needle aspiration for a seroma should be done every 48 to 72 hours.  If needle aspiration is not effective after two months, you may consider inserting a drain.  If drain insertion does not resolve the seroma, you may require injection of a sclerosant to help scar down the walls of the seroma.  Alternatively, suppose you are considering other surgeries and are in the operating room.  In that case, a small incision can be placed over the area, and the area can be surgically removed, including the walls of the seroma.  A drain would be placed, and the seroma would be corrected.  All these, of course, are added expenses.  For the most definitive care and quickest treatment, I would suggest surgery with resection of the seroma and its walls and inserting of a drain.  Since you had a prior seroma, it increases your chances of future seromas, though not by much.  I would still embark upon a seroma cavity removal, even with a prior history.  Good luck.  I hope this helps answer your question regarding whether you have a seroma or a pseudo-bursa three months after a tummy tuck performed abroad.  If you have any more questions regarding tummy tucks, abdominoplasties, or abdominal liposuction, contact an experienced plastic surgeon.  Since the tummy tuck surgery is a big procedure, please seek an experienced, board-certified plastic surgeon with significant experience in performing tummy tucks.  Do your research.   If you cannot find an experienced tummy tuck plastic surgeon in your neighborhood, consider traveling out of state.  Sincerely, Dr. Katzen, MD, MBA, FACS, FICS. ( Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)

Bianca Knoll, MD · Answer

a seroma is diagnosed by physical exam or by ultrasound. Often a seroma is sucessfully treated by aspiration. Wearing a compression garment and to limit physical activity supports the process. In some cases repeated aspiration is warranted. If a patient has developed a pseudobursa, the seroma will continue to come back. In that case a surgical exision of the pseudobursa is needed. Therefore it helps, to address seromas early on.

Azita Madjidi, MD, MS, FACS · Answer

It is hard to give your an answer without physical exam. This far from surgery, it is unlikely that it is a seroma. It could be old hematoma creating lumpy scar. If you find a plastic surgeon who is willing to do the after care, then by putting a large needle and aspirating, if there is any fluid, it will come out but if it is a scar formation, it has to be revised  in the OR.

Ira H. Rex lll, MD · Answer

From the photographs, it seems as if you have a seroma.  These are treated in many different ways.  When it is long-standing, as yours, it may need to be excised and removed through the old incision.  This sometimes leaves a contour problem.  Another drain will probably be needed.  This may sometimes be improved with liposuction.

Vishnu Rumalla, MD · Answer

Thanks for your inquiry and excellent pictures.  At nine months post-op this probably no longer just represents swelling, but without an exam it is hard to advise.  I suggest you reach back out to your surgeon to be examined.  This could be a pseudo-bursa, chronic seroma, thick flap, etc.  Imaging like an ultrasound may be required to get answers.  Good luck

Is this a seroma? Psudobursa? Help (Photo)

Answers (11)

Answer: Bulge after tummy tuck

Answer: Bulge after tummy tuck

Answer: Seroma after tummy tuck

Answer: Seroma after tummy tuck

Answer: Persistent swelling

Answer: Persistent swelling

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Is this a seroma? Psudobursa? Help (Photo)

Answers (11)

Answer: Bulge after tummy tuck

Answer: Bulge after tummy tuck

Answer: Seroma after tummy tuck

Answer: Seroma after tummy tuck

Answer: Persistent swelling

Answer: Persistent swelling

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Everything you need to know about Mommy Makeover

Our mission is to create a world where every investment in modern beauty is Worth It.