Calcified seroma - is it OK to leave the capsule alone?

After the seroma is resolved there will be thickness in the area. The radiologist is right. Just leave it alone and it will gradually soften up

Thank you for your question regarding a calcified seroma capsule after surgery. Based on your description, it sounds like your seroma has significantly reduced in fluid volume over time, which is a good sign. Here’s what you need to know about leaving the capsule intact and alternative approaches to consider.

Understanding Seroma Capsules:
When a seroma forms, the body may develop a capsule of fibrous tissue around it. Over time, this capsule can harden or calcify. A calcified seroma capsule is generally harmless unless it causes discomfort, restricts movement, or affects the appearance of the treated area. If your seroma has stabilized and the capsule isn’t causing significant issues, many surgeons recommend leaving it alone.

When It’s OK to Leave the Capsule:

If the fluid volume has significantly decreased, as in your case (down to 13 cc), and is no longer increasing.
If the capsule doesn’t cause pain, tightness, or functional limitations.
If it isn’t visibly distorting the treated area.
It’s important to continue monitoring the area for any changes, such as increased tightness, pain, or fluid reaccumulation.

Managing Tightness:
You mentioned that your stomach feels tight. This tightness could be from scar tissue, residual fluid, or the capsule itself. Gentle massage, lymphatic drainage techniques, or ultrasound therapy may help improve the tightness. Always consult your plastic surgeon or a qualified specialist before trying these therapies.

Surgical Removal of the Capsule:
Surgical removal of the capsule may be recommended in rare cases where:

The seroma recurs persistently.
The capsule causes discomfort, restricts movement, or affects appearance.
The area is at risk of infection or other complications.
Next Steps:
Since your seroma is resolving and your fluid levels are low, it’s likely that the capsule will not cause significant problems. However, it’s still important to follow up with your plastic surgeon, even if they are far away, to ensure no additional intervention is needed.

Leaving the capsule alone is often a safe option, but close monitoring and open communication with your surgeon will provide the best guidance for your situation. I hope this helps to address your concerns, and I wish you a smooth recovery moving forward.

Sincerely,
Dr. Katzen

Thank you for your question about seroma post op tummy tuck.

For specific questions like this and about your recovery in general, it is best to speak directly with your doctor or doctor’s representative – such as his or her nurse, or the physician on call for the practice.

You will likely get many differing opinions from members of the RealSelf Community, but they have not personally seen or examined you. Nobody should know you or your unique set of circumstances better than your doctor.

If you feel you are not being listened to or you are doubting your doctor’s recommendations, then it is certainly within your rights to seek a second opinion and get the advice from another board certified physician. This should be done through an in-person consultation with a thorough evaluation, including a review of your history, review of all prior treatment and with a physical examination.

Best Wishes.

Dear Lily2013,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

If the capsule is flat and soft and small, it can be left in place and may slowly absorb. If it is actually calcified, it will need to be removed. It is probably too soon for it to have calcified.

It should be okay to leave the seroma capsule alone unless it is causing other issues. However, it is best that you visit with a board certified plastic surgeon near you for an in person evaluation since you are unable to meet with your surgeon.

Unfortunately interventional radiologists are not plastic surgeons and typically do not have good long-term follow up with their patients.
I think your interventional radiologist lacks experience and long-term follow up or would not be as confident in their ability to definitively treat a chronic seroma.
I am yet to date see a chronic encapsulated seroma be successfully treated with anything other than direct surgical excision.
There’s a golden opportunity to have these treated early after surgery by daily aspiration or placement of a drain as soon as it’s identified. once encapsulated it can no longer be treated with aspirations successfully or at least I have never seen it happen.
My best guess is with time it will recur the way it was before your first aspiration.
There is no reason to believe it will not recur. The surfaces will not stick together while the capsule or fluid is present.
I do not recommend patients travel long distances for elective surgical procedures especially not major operations like a full tummy tuck.
Patients seem to not appreciate the importance of having proper in person consultations well in advance of surgery, the importance of postoperative care, the number of patients who have issues or concerns or we need revisions after surgery or the complications actually do happen.
At this point I guess you’ll have to simply wait and see what happens but my best guess is your seroma will recur.
Please let us know if it doesn’t because it’ll be a new one for me.
I suggest following up with your provider if possible if not schedule an in person second opinion consultation with another local board-certified plastic surgeon.
You may also want to let the interventional radiologist know how you do long-term so that they can alter their communications and expectations.
Best,
Mats Hagstrom MD

Hi and welcome to our forum!As the drainage appears to be decreasing, a conservative course is recommended at this time. Hopefully, the trend will continue. Once the drainage has ceased, surgery would be indicated if there is a residual mass at the site of the previous seroma. Otherwise, I would leave it alone.Best wishes...