What are my options in regards to a lower back seroma, 7 months post op?

Question

I had full body liposuction back in July. My PS says she took a lot out of my lower back and that it was stubborn hard fat that just wouldn't come out. . I developed a seroma probably a week post op and it is now 6 months and I am still being aspirated. it's about 35 cc's every 6 days. Will this seroma ever go away? and what are the other options. I am a very active person and have put off my running to try and resolve this seroma but I am feeling like it's never going away. Please help

Vincent N. Zubowicz, MD · Answer

A chronic seroma can develop  basic capsule overtime which is best treated by excision. You should discuss this with your surgeon.

John Michael Thomassen, MD · Answer

Ask your plastic surgeon for options to possibly inject a sclerosant into the seroma cavity to allow it to scar down and eliminate the potential space that fills up with fluid.  Otherwise, excision of the seroma cavity is in order.

Neal Handel, MD · Answer

Chronic seromas, such as yours, generally result in formation of a relatively
thick bursa (a lining or sac like structure) around the fluid and it is hard to
eradicate them without excising (cutting out) the bursa. You may require a
small surgical procedure to cure the problem. Discuss the possibility of a “bursectomy”
with your surgeon.

Mats Hagstrom, MD (license on probation) · Answer

Seromas do form and can persist.The most important part of getting a seroma to go away is draining it frequently early on. This is why some surgeons use drains after surgery. Drains continuously remove the fluid tissue. Surfaces can be in contact with each other at all times. At six months, it may not be possible to have the seroma resolved by simple aspiration.When fluid builds up after surgery inside the body, the body creates a membrane or capsule to try to seal off the fluid collection. In the early healing process, separated tissues stick together with early scar tissue formation. The longer a space is present, the less likely for the tissue surfaces to adhere to one another. After liposuction, there are hundreds of spaces that interconnect, leaving the possibility of seroma formation.Every surgeon deals with seromas based on their own knowledge and skill sets.I have personally had a few cases with persistent seromas that required revision surgery.When surgically removing a seroma, all membranes of the seroma cavity need to be removed. It's almost always necessary to place a drain to keep the tissue surfaces touching each other so no fluid buildup can occur. Sometimes it's necessary to suture the surface areas together.Some surgeons have tried a substance called fibrin glue.See the link below.I'm glad you are being treated by a plastic surgeon.One of the issues that can occur when doctors not trained in plastic surgery perform liposuction is the inability to take care of complications.As plastic surgeons, we are trained to get ourselves out of just about every complication.Had your procedure been done by a doctor not formally trained in surgery, they may not have the skill set or privileges in an operating room to properly take care of your situation.Continue to follow up with your plastic surgeon. You may want to ask her if an excision of your seroma is warranted. Some people live with seromas for the rest of their lives. If they're very small, they are inconsequential for the most part.Best of luck,Mats Hagstrom, M.D.

Frederic H. Corbin, MD (license restricted) · Answer

Sorry for your complication but at this point if the seroma has persisted it may need to be respected, removing the persistent seroma membraneDr Corbin

What are my options in regards to a lower back seroma, 7 months post op?

Answers (5)

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