Is my pain a reoccuring seroma?

Question

I had seroma about 2 weeks after my tt, my drain was taken out too early before draining under 25cc. I've been aspirated twice and the last time nothing came out. They say I don't have it anymore but I still have tht "waterbed" feeling when I touch my lower stomach. A month later I been having stabbing pains along my incision, is it a seroma complication? I also developed a pouch because of the seroma will my belly eventually flatten out after the seroma is gone or am I stuck with this forever?

Vincent N. Zubowicz, MD · Answer

Large seromas are usually easy to diagnose and treat. Smaller seromas may be difficult to find in can be confusing when there is significant coincidence soft tissue swelling.

Pablo Prichard, MD · Answer

Thank you for your post.  Seromas can be painful and cause a cosmetic deformity, as well as sometimes leak.  The whole point of drains is to keep a seroma from happening in the first place.  If a drainless procedure was performed, and you had a seroma, or you had drains that were pulled and you subsequently had a seroma, then you should be drained, otherwise a capsule builds around the fluid making it permanent.  If a capsule builds around the seroma (pseudo bursa or encapsulated seroma) then the only way to remove the seroma is to surgically open the areas and excise the capsule, and close over drains to prevent another seroma from happening.  If the seroma is encapsulated and is tight and painful, then it can be confused with just swelling or fat.  An ultrasound is useful in distinguishing these and identifying the extent of the seroma. If the seroma is not yet encapsulated, then it is usually loose and has a 'fluid wave' or water bed type feel.  Occasionally, a seroma can also become infected, especially if a permanent braided suture was used.  This will have a hot, red appearance, and will eventually open up.  I have never seen an infection from sterile aspiration of fluid.Best wishes,Pablo Prichard, MD

Jeffrey Zwiren, MD · Answer

It is possible that your seroma has completely resolved and you have some degree of soft tissue swelling which is not unusual after an abdominoplasty. Continue to follow up with your plastic surgeon and at the 4 -6 months you may need to be re-evaluated possibly for some touch up liposuction.

Victor Ferrari, MD, FACS · Answer

Thank you for the questions.  If you feel fluid sloshing around when you roll around in bed, it is likely you do have a seroma.  Seromas should be drained 2-3 times per week until they resolve.  If seroma fluid is left too long, the body will form a scar tissue capsule around the fluid and form a permanent water pocket.  This scar tissue capsule will then need to be surgically removed.  Hope this helps.

Is my pain a reoccuring seroma?

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Is my pain a reoccuring seroma?

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