I had RNY and as a result I maintained a 135 lbs weight loss. 1/31/14 I had abdominoplasty & pannectomy. 5 weeks ago I developed a seroma. The 1st drainage results in 450 cc's; 2nd last week was 250 cc's. 3 days later it is back. The PS wants me to leave a drain in but I am afraid of infection and he indicated that I may have to have it surgically removed. Is that a lot of fluid to be draining so long after surgery? is it wise to put in a drain? How invasive is the seroma removal surgery?
May 4, 2014
Answer: Seroma after body contouring It is not unusual to have the seroma after body contouring when someone has had massive weight loss. It is very wise to place the drain. This is going to potentially eliminate the seroma. Drain removal is simply done in the office.Earl Stephenson, Jr MD, DDS, FACS
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May 4, 2014
Answer: Seroma after body contouring It is not unusual to have the seroma after body contouring when someone has had massive weight loss. It is very wise to place the drain. This is going to potentially eliminate the seroma. Drain removal is simply done in the office.Earl Stephenson, Jr MD, DDS, FACS
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Answer: Seromas after Tummy Tuck 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. I have never seen an infection from sterile aspiration of fluid. If seromas continue despite multiple aspirations over an extended period of time, then you need to start thinking about re-openning the incision and excising the entire capsule, both from and back walls, to treat the seroma. Drains need to be placed, internal sutures placed, possibly using a tissue glue or irritant to encourage the tissues to grow together.Best wishes,Pablo Prichard, MD
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Answer: Seromas after Tummy Tuck 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. I have never seen an infection from sterile aspiration of fluid. If seromas continue despite multiple aspirations over an extended period of time, then you need to start thinking about re-openning the incision and excising the entire capsule, both from and back walls, to treat the seroma. Drains need to be placed, internal sutures placed, possibly using a tissue glue or irritant to encourage the tissues to grow together.Best wishes,Pablo Prichard, MD
Helpful 1 person found this helpful
