Its Been 1 Year Since my Tummy Tuck and I Still Have a Swelling Above Scar. Ps Said It Was Lymphodaema. Think Its Pseudobursa?

i had a seroma which was aspirated about 6 times. the swelling can be palpated above the scar almost like a 'filling or padding'. surgeon said it was lymphodaema and would settle but it hasnt. i think it may be a pseudobursa. when i said this to him he said it wasnt, however he did say that should there be a need for any further treatment for example a scan then i would be liable to pay. im really worried about this. could you advise. thankyou in anticipation

Doctor Answers 6

Swelling one year after?

An exam would be needed and if a fluid wave is present, another aspiration could confirm what you have.  If your surgeon isn't helpful (like he should be) then get a second opinion.  Your surgeon should be your advocate and be looking out for your interests, but there are always exceptions to this rule.

Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Bursa Likely

Impossible to tell without exam but the story sounds like a bursa. If it has been a year and the area is persistently swollen and full it may be worth a return to the OR to remove it. Work with your surgeon.

David Shifrin, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 165 reviews

Swelling 1 Year After Tummy Tuck

Either lymphedema or a seroma is possible.  An ultrasound is a quick and easy way to find out.  A seroma and it's surrounding pseudobursa will show as a distinct cavity on ultrasound.  Lymphedema has it's own appearance.

I would suggest you get the ultrasound.  It is fairly inexpensive even if you or the surgeon pays for it.  There are also hand-held units that your plastic surgeon may be able to access for a quick check.  Good luck to you.

Al Rosenthal, MD
Lawrenceville Plastic Surgeon
5.0 out of 5 stars 6 reviews

Causes of swelling

I agree that either lymphedema or a residual seroma could cause what you describe.  An ultrasound test would be easy and reliable. It would most likely be covered by insurance. If not perhaps there is a lower price the radiologist could charge you for self pay. Discuss it with their business manager.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.9 out of 5 stars 77 reviews

Ps Said It Was Lymphodaema. Think Its Pseudobursa?

SInce you have a history of seroma, I would be suspicious of a pseudobursa. An imaging study would help make the diagnosis. Fluid would be seen as likely would be a thickened wall around the seroma. If there is still fluid at a year, this is a pseudobursa, and surgical excision is probably the only way to resolve the problem.

A photo would help!.

Thanks for your question, all the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

And untreated seroma can lead to pseudo-bursa formation.

And untreated seroma generates inflammation that leads to fairly the capsule. Only surgical excision is the best treatment for this.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

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