What is the course of treatment for a seroma?

Question

I'm a 65 year old woman 12 weeks post tummy tuck with a possible seroma in the area of the belly button. CT has been ordered but not done yet. I'm curious about the usual treatment if the test is positive. I did have a seroma at the site of the drainage tube

Erik Miles, MD, FACS · Answer

A seroma is a sterile fluid collection that can accumulate in the surgical space below the abdominal skin flap. It is typically a clinical diagnosis. A CT or ultrasound study is rarely indicated. The treatment is to aspirate the fluid using a needle through the skin. Aspiration is typically done in the office with very little pain. Sometimes multiple aspirations are necessary.  Wearing a compressive garment after aspiration can theoretically help to reduce recurrence.

Gary Lawton, MD, FACS · Answer

I drain my postoperative serums in the office using a needle.  It may take multiple drainages at weekly intervals.  I have never ordered a CT scan to diagnose a serum.

Joel Patrick Maier, MD · Answer

In my experience, seromas are relatively common after tummy tuck but usually fairly easy to treat. I aspirate them weekly in the clinic until they dry up which is around 6 weeks. I can usually detect them on exam and do not need a ultrasound or CT. But if there is a bulge or you have pain that has no fluid on needle aspriation, then radiological assistance is a good avenue for diagnosis. Good luck and it sounds like you are in good hands. Thanks for sharing.

Vincent N. Zubowicz, MD · Answer

Seromas should be drained as soon as recognized in often to prevent accumulation. If this is done religiously the office it usually resolves in a few weeks.

Tom J. Pousti, MD · Answer

Thank you for the question.Seromas are a relative frequent occurrence after tummy tuck surgery.  Often seromas require several aspiration treatments. The presence of the seroma  does not necessarily affect the end results of your tummy tuck surgery. I hope this helps.

Patrick L. Basile, MD · Answer

Once a seroma has been identified it can usually be drained without the need of any imaging. If it persists after several drainings then your doctor may elect to place a small seroma catheter that can collect the seroma into a small bag and keep the pocket decompressed. Wearing a binder and having the catheter in usually works, but if it still persists there are several medications that can be injected retrograde through the catheter that will cause a local reaction and hasten the seroma pocket to scar down. While these last two treatments are not common they are modalities if needed.

Vincent D. Lepore, MD (retired) · Answer

In most cases a seroma can be treated with needle aspiration.  The aspiration may need to be repeated if the seroma recurs.  Be careful to avoid excessive fluid and salt intake as these can contribute to seroma formation.  But, don't worry, seromas are not uncommon after a tummy tuck and do eventually resolve.

What is the course of treatment for a seroma?

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