My Incision Won't Close Due to Persistent Seroma. I'm I Getting the Right Advice?

Question

I am over 2 months post calf implant surgery. My incision has completely opened twice due to persistent seroma and shows no signs of letting up. (no infection). My surgeon says to keep the incision open until the seroma stops on its own. So i have just been using tons of gauze and cleaning the area regularly. The problem is that I have a giant hole in the back of each knee. How long should I wait until I ask to try something different? Is there a possibility that my seroma will never stop?

Ryan A. Stanton, MD · Answer

In general, an open wound, an implant, and a peresistent seroma is a bad combination. Typically the implant must come out in order for the situation to resolve. It may be worth getting a second opinion at this point from another board certified plastic surgeon that specializes in this procedure. Glad to help... @DRRYANSTANTON

Kenneth Hughes, MD · Answer

This would be hard to comment without examining you.  The safest thing would be to take them out and replace them once healing was complete.  Kenneth Hughes, MDLos Angeles, CA

Marc DuPéré, MD · Answer

Thank you for your question. Calf augmentation that is complicated with chronic seroma is a serious issue, not mentioning the open wounds. Calf implants are foreign material that are prone to infection. When the seroma is sterile and NOT associated with an open wound, a revision procedure can be attempted with a mesh repair and post-op drainage and compression. The closure of the capsule itself should not be attempted alone as the closure will be too tight and will reopen, hence the need for a mesh. I've had great success twice with my only 2 chronic seromas (same patient, highly athletic, 4 months post-op) (out of approximately 60 patients). Now in your case, you have chronic open wounds and implants; the implants are likely in communication with the 'exterior' and I think they will likely need to be removed. Then one wait 3-6 months and a second attempt at augmenting your calves, with 2 new implants, might be attempted. I would be happy to help if you need further advise! dupere@visageclinic.com Dr. Marc Dupere, Toronto

My Incision Won't Close Due to Persistent Seroma. I'm I Getting the Right Advice?

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