Seroma sac removed but area is still filling up with fluid (7 mo post-op) - is this normal? (photo)

Question

I had liposuction on my inner thigh 7 months ago and developed a seroma which was hard as a gulf ball. My surgeon drained it multiple times and injected it one time with steroids but it stills keep filling and it’s been almost a month that the sac was removed. The incision is pretty much healed but it stills keep filling up and has about 20mls or more of serous fluid. Is this normal to have the sac removed but the area to still filling up with fluid?

Daniel Barrett, MD · Answer

Dear Gisel16,
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

Connie Hiers, MD, FACS · Answer

Seromas of the legs can be very pesky and persistent. You may need a small drain placed to keep the sac empty to let it heal.

Camille Cash, MD · Answer

I'm sorry to hear of the issues you are having from your liposuction procedure.  What you are experiencing is not common.  It is best that you visit with your surgeon to help determine what may be the cause of the area refilling.

Douglas Taranow, DO, FACOS · Answer

Dear Gisel,
I am sorry you are having such an issue after such a common procedure.  
It is abnormal to have a fluid collection 7 months post liposuction and certainly not after surgical  excision.  Difficult to determine the cause, but serial (three time a week) drainages with low dose steroid injections weekly or bi monthly should be a consideration.  A concern would be a lymphatic structure injury (very rare so not my first thought).  You should continue to follow up with your surgeon at least twice weekly for drainage.  A fluid culture is in order.
Best wishes.
Dr. Taranow

Mats Hagstrom, MD (license on probation) · Answer

In order to close the potential space from fluid buildup and drain needs to be placed when removing a seroma capsule.

This prevents the space from forming.

Once healed up without a fluid collection the drain is removed.

When I seroma forms it needs to be drained on a daily basis immediately upon detection before it becomes encapsulated. This is the only way to stop them from becoming chronic.

Providers are sometimes not aggressive enough about treating these and allow fluid to build up which is very counter to having them go away.

Once encapsulated it can only be removed with direct open surgical excision.

I would anticipate the seroma coming back after surgical excision if a drain is not placed.

At this point depending on how long ago your surgery was you can either have it aspirated on a very regular basis preferably daily, open the incision and place a drain or open the incision to allow it to drain to the outside like an open wound.

Follow up with your provider or schedule in person second opinion consultations.

Best,

Mats Hagstrom MD

Seroma sac removed but area is still filling up with fluid (7 mo post-op) - is this normal? (photo)

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