How Soon Should I See my Doctor After Finding a Seroma?

17 days post op, drain removed 8 days after surgery after well appropriate minimal amount of drainage. 9days later I have noticed what has been described as "wavelike symptoms". I believe I have a "Seroma". It is located below my breast and above my navel to the left.

I see my PS in 19 days. Is it appropriate to wait till that visit for possible change in "seroma", or should I get in to see him sooner? When is too late? Just found today so I'm frustrated because I have done everything my PS say.

Doctor Answers 11

You do have a seroma, and you should have it aspirated ASAP!

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Aspiration with a needle is necessary to allow the tissue layers to once again "touch" and heal this cavity shut. If a seroma is allowed to persist, a pseudobursa forms, and the longer it remains undrained, the less likely the "slick" surfaces of the pseudobursa will adhere and heal. So waiting is bad. If repeated aspiration is not successful in "encouraging" your body to close off this cavity, then a drain may need to be reinserted (local anesthesia--not a big procedure at all) so that sclerotherapy can be performed via the drain.

Sclerotherapy involves placing a solution via the drain into the cavity to cause irritation and inflammation of the pseudobursa lining--in essence, making it "sticky"--so that tissue adherence and healing is stimulated. Sclerotherapy can also be repeated several times and this almost always works at sealing off these seroma cavities. Tetracycline (the antibiotic, but used as a solution, not as an oral pill) is a common sclerosant used by surgeons of several specialties.

If sclerotherapy doesn't do the job, then re-operation may be necessary. That is both a big deal, and a costly one (especially for a high location seroma), so tending to ANY seroma promptly and repeatedly (aspiration) or promptly and continuously (drain reinsertion) is really in your best interests. Most patients don't want a drain reinserted, and most surgeons would rather not have to do even a small procedure if not absolutely necessary, but if aspiration doesn't seem to rapidly decrease the amount of fluid at each session (best done every few days, not every week or two), I'd recommend a drain so that continuous removal of the fluid keeps the tissue layers in contact with one another for healing (and allowing sclerotherapy to "jump-start" the process). Good luck; now go call your surgeon for an immediate appointment, not next week! Best wishes! Dr. Tholen

Fluid collections after surgery

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when you notice things like this they should be addressed right away. If you wait too long the seroma may become stable with a thickened shell which is very hard to treat without going to surgery. I would contact your doctor and move your appointment up

Jeffrey Kenkel, MD
Dallas Plastic Surgeon

Seromas should be treated immediately

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Your description is typical for the formation of a seroma. You should contact your plastic surgeon immediately and arrange for an examination and aspiration if it is indeed a seroma. The longer it is present untreated, the more difficult or longer it takes to successfully treat. Furthermore, these can become chronic problems that require surgery to remove not just the fluid but also a sac that has formed.

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How Soon Should I See my Doctor After Finding a Seroma?

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Sounds like you are correct in your diagnosis - seroma. I recommend immediate drainage or aspiration. Waiting 19 days is inappropriate. Please seek medical care. 

Contact your plastic surgeon for seroma after a tummy tuck

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Dear Maumelle4008,

I am sorry to hear about your condition. It certainly sounds like you may have developed a seroma. I would contact your plastic surgeon to discuss your condition. Aspiration may be necessary. 19 days is certainly too long to wait.

Best of luck,

Larry Fan, MD

Larry Fan, MD
San Francisco Plastic Surgeon

Treatment of seroma after abdominoplasty

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Treatment of a seroma should generally be performed as soon as is practical, and repeated as necessary to allow for resolution.  The presence of a seroma after abdominoplasty prevents adherence of the subcutaneous fat to the fascia and, if prolonged, can result in the formation of a scar capsule (pseudo-bursa) around the cavity and persistence of the seroma.  Once established, the capsule may require surgery to correct. 

Contact your plastic surgeon to discuss your findings.  Examination by the surgeon will generally be required to determine if a seroma is present and if it is significant enough to require treatment.

Good luck.

How soon should I see my plastic surgeon if I suspect a seroma?

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You should see your plastic surgeon as soon as you can. If a seroma is not aspirated it can form a layer called bursa. Once that layer is formed, the skin will not heal to the deep layers and the seroma can persist. Once you find a seroma, it should be aspirated frequently till it disappears. In case it comes back a seroma catheter can be inserted and left in. See you plastic surgeon so he can take care of all these things and good luck.

The sooner the better

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Seromas should be aspirated sooner rather than later.  The longer a seroma stays in the body the higher the likelihood that a pseudo bursa may form.  Either needle aspiration or a drain can be used.  Before, during, and after the aspiration the abdominal binder should be worn tightly and all times.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 170 reviews

Tummy talk recovery

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You should be seen by your plastic surgeon as soon as possible for evacuation of the seroma.  You should also be aware that multiple aspirations are often necessary before this seroma  resolves-  sometimes  a drain may need to be replaced.

Best wishes.

Tummy tuck seroma

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Please contact your doctor right away to imform them about your condition.  Likely, they will move you appointment up and address your condition right away.  Waiting 19 days for your next appointment would be inappropriate.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.