Is this a seroma, hematoma or just regular swelling due to the stitches? What should I do about it? (Photo)

Question

I am 18 and had gynecomastia surgery 3 weeks before. Is this seroma, hematoma or just regular swelling due to the stitches? What should I do about it?

Jed H. Horowitz, MD, FACS · Answer

A collection of fluid under the skin occurs occasionally during the postoperative period. Aspiration of the fluid with a needle is frequently helpful. Secondary surgery is rarely necessary.

Bruising and #swelling are normal and usually increase slightly after the removal of any tape or foam. The bruising will decrease over 3-4 weeks, but may last as long as 6 weeks. The majority of the swelling will be gone within the first 3-4 weeks. However, it may take 6-9 weeks to disappear completely.

Also, as you heal, the area may feel “lumpy” and irregular. This, too, decreases with time, and massaging these areas will help soften the scar tissue. The #compression garment helps reduce the swelling, and the longer it is worn, the more quickly you will #heal. It can also assist in the retraction of the skin.

If you have any concerns about #healing, its best to ask questions of your surgeon or their nursing staff.

Ronald Schuster, MD · Answer

It's really hard to tell from the photo but it just looks like some swelling. Usually a seroma would be more full and rounded and act like a water bed effect. It looks like you are getting a crease so you might want to check with your surgeon on ways to reduce it.

Steven Wallach, MD · Answer

Usually if the surgery was jsut performed and you had a direct excision, if you feel fluid it may represent blood. If you had lipsuction it may be fluid. Best to be seen in person.

Philip E. Fleming, MD · Answer

Making a diagnosis of postoperative infection, seroma, or hematoma is best made in-person by your operating surgeon. I encourage you to see your surgeon to discuss your concerns. Here are a few basic guidelines. If you have fluid that moves like a wave under the skin, you may have a seroma. If you have a hard painful swelling with some overlying bruising, you may have a hematoma. Redness, swelling, drainage, and fever are signs of infection.

Jeffrey Zwiren, MD · Answer

If you feel fluid swishing about under your skin then this is a seroma and will need to be needle aspirated.

Stephen Salerno, MBBS, FRACS · Answer

Hello and thanks for the questions and photographs.

	It is difficult to make an accurate comment with only one photo and no preoperative views.  I think the wound looks a little red at the moment which is normal for this period of time post operative.

	If it is a seroma then it will move around and you may hear a splash as you move and it will continue to get larger.  If it is a haematoma then it will get small er with time and start to bruise over the skin.  It may also get quite tender as the swelling increases.

	You should make an appointment with your plastic surgeon and have it seen to get a more accurate answer.

George J. Beraka, MD (retired) · Answer

Hi.

	You should get a sonogram.  Seroma needs to be aspirated.  I am also worried about all the redness which is not normal at three weeks and suggests an infection.  See your surgeon!

Is this a seroma, hematoma or just regular swelling due to the stitches? What should I do about it? (Photo)

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