Is a seroma a seroma if no liquid can be syringed from it?

Question

2.5 weeks ago: mastoplexy (pre existing implants retained) now 1 breast has become particularly swollen after a smooth recovery process. PS has syringed the bottom of my breast to see if a hemotoma or seroma had developed but no liquid could be drawn. Although my PS believes there is no infection i have antibiotics and anti flammitories which i have taken for 5 days now. I have been signed off work for a week and told to rest. The swelling isnt going down and im getting nervous now. Any ideas?

Jeffrey Swail, MD · Answer

It’s not always possible to aspirate a seroma with a syringe. This is especially true if there’s a reason to be extra careful with the needle like an underlying implant. Infection is almost always very apparent on exam so chances are good that if your surgeon doesn’t think there’s an infection then you don’t have one. Seromas frequently resolve on their own and your best bet is to try to be patient, keep taking anti-inflammatory medication, and avoid heavy activity or arm movements on the affected side. Your surgeon will want to keep a close eye on things and they may have another attempt at draining it.

Daniel Barrett, MD · Answer

Dear maxwilkie,
seroma is a fluid collection. If there was no fluid drained, you can get ultrasound to be sure that there is no fluid collection inside the breast 
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gregory Lakin, MD · Answer

Thank you for your question. If it is not swelling which would go away in a few weeks, you may have a seroma hidden behind the implant which may be confirmed with an ultrasound. Good luck!

Thomas Fiala, MD, FACS, FRCSC · Answer

You could have a seroma that was missed by needle aspiration, either because it is small, or in a difficult to reach location - but it might show up if you had an ultrasound of the breast.  A hematoma that was still solid clot wouldn't aspirate either. So, an ultrasound would be the next diagnostic step

Jan Hochtritt, BSc, MD · Answer

Thank you very much for this question. First a seroma is a collection of fluid, therefore if you find it you will be able to remove it with a syringe. If the plastic surgeon is not able to extract any fluid that can be either because it is not a seroma or he just simply  is unable to locate it maybe because he wants to be careful to protect the implant.  You are already under the guidance of your surgeon and it sounds like things are starting to get better.  I know that when you experience a complication that sometimes can be quite frightening so I understand that you are worried, but you took the most important step already.  I am sure everything will be fine. Have a wonderful rest of the day to greetings from the beautiful island of Jamaica.

Is a seroma a seroma if no liquid can be syringed from it?

Answers (5)