Pseudo seroma 11 months post op. Is there a risk in not removing it?

A chronic seroma has created a “pseudo bursa” which means a capsule which will prevent the skin to get attached to the abdominal wall.
After you have developed a capsule it is needed to be removed and do quilting stitches to allow the skin to reattach the skin towards the abdominal fascia.
The only good thing about the capsule is: it will not create any further or serious complication. It will remain there forever.
Hugs.
Dr. Cárdenas

Hello Modest206393. Thank you for your question regarding the pseudo seroma 11 months after your tummy tuck.

It’s not uncommon for a seroma to develop after a tummy tuck, and in some cases, a small amount of fluid can persist even after multiple drainages. The fact that you have a small seroma and thick scar tissue, as confirmed by an ultrasound, is something to keep an eye on, but it’s not necessarily harmful.

Your plastic surgeon’s advice to leave it alone is likely based on the fact that your body may eventually absorb the remaining fluid and that the thickened scar tissue isn’t causing significant problems. However, if the seroma isn’t causing pain, discomfort, or any other symptoms, many plastic surgeons would agree that it can be left alone and monitored over time.

There is usually a low risk associated with leaving a small, stable seroma untreated, especially if it isn’t growing or causing any issues. However, if it does start to cause discomfort or grow larger, it might require further attention. In some cases, a small seroma may resolve on its own, but if you’re feeling concerned, it’s important to keep the conversation open with your plastic surgeon and monitor any changes.

If you’re unsure or uncomfortable with leaving it untreated, it may be worth seeking a second opinion to ensure you’re getting the best possible advice for your situation.

Sincerely,

Dr. J. Timothy Katzen, MD, FASMBS, FICS

You likely have a chronic seroma cavity. This means scar tissue formed around the seroma area and it will stay that way indefinitely. There is little to no risk in leaving it alone. Theoretically it could get infected but that is HIGHLY unlikely. Your risk would be a lot higher trying to remove it because you could have wound problems, infection, anesthesia complications, a whole slew of things. If your surgeon recommended against removing it and it doesn't bother you that much I would agree with that plan.

The area has probably developed into a chronic seroma which is not likely to ever resolve at this point. Probably no risk to leaving it except the persistent lump. Unfortunately, the only way to resolve it now is to surgically excise it, which involves a surgical exposure similar to the tummy tuck dissection that you originally had. Removal may also result in a contour deformity--a depression where the lump is--which you might like even less than the lump. Hope that helps and good luck!

Seroma fluid can become infect but very small collections are less likely to do so. Scar tissue may have developed in that area because of the seroma or because of the serial draining. Seromas are fluid collections that your body makes after surgery. You must do the following post op in order to avoid one: restrictions in your diet - no salt or seasoning on your food post op until 2 weeks after your drains are removed. At one week post op as long as your vitals are within normal limits, restrict all oral fluid intake to under 1500mL per day, no twisting at the waist, tight compression 23h + per day and continue lymphatic massages/endermologie until your doctor clears you to stop. The lump from the scar tissue could possibly improve with steroid injection (but that has its own risk/side effects). Doing lipo in that area again can break up the scar tissue and make a fresh wound bed for things to heal again. BUT you may develop a seroma again after that since your body has already been know to do that. Unfortunately, seroma is known entity after a tummy tuck especially when liposuction is done in combination.

This seroma is now organized and will probably not go away on its own. If it is not bothering you, it can be left in place. Otherwise, it will need to be excised, including the wall of its cavity and drain used again.

Without having some reference to the size of the fluid collection, we can’t really make an assessment. At this point the only treatment option is to redo the tummy tuck. You may not need muscle tightening again, but do you really want to go through that surgery twice to remove a fluid collection that’s probably not going to affect your results.
It sounds like your surgeon has been treating you correctly and appropriately. Without seeing proper before and after pictures, we can begin to make an assessment regarding your outcome.
from what you described I see no reason to go through a major revision operation.
Best,
Mats Hagstrom, MD