Do you need to be standing to tell if you have a seroma?

Question

I know that is seroma is waterbed-like but my question is does it matter if you are laying down or standing up to check? When I'm standing, it seems pretty firm with no water bed effects but when I'm laying down, there is the waterbed effect. When I went for a two-week check-up, the nurse told me I needed to be standing to tell. Is this accurate or should I be concerned?

S. Larry Schlesinger, MD, FACS · Answer

There are many ways to tell if one has a post abdominoplasty seroma.  The usual method most plastic surgeons use is to have the patient lie down, tap the area where the seroma is thought to exist, and if you see fluid waves, then very likely it is either a seroma or a hematoma.  Since seroma fluid is less viscous, if the fluid wave travels quickly, then it probably is a seroma.Very often, many plastic surgeons including myself, make a definitive diagnosis by numbing the area and placing a needle into what is thought to be a seroma, and if serous fluid comes out, then it is determined to be a seroma.  I understand your question is a serious question and I have answered it in a serious fashion.  However, there is a part of me that wants to tell that nurse "are you kidding me?".  I have been practicing plastic surgery for a very long time and I have never heard that you can only diagnose a seroma when the patient is  standing.  The answer to your question is NO, you do not need to be standing to diagnose a seroma.

Wayne I. Yamahata, MD · Answer

Depending on the location of seromas, they may sometimes be easier to detect when standing. Gravity may cause the fluid to collect in the lower abdomen and make it more apparent. Let your surgeon know if you suspect a seroma as there may be some benefit to early treatment.

Dallas Buchanan, MD · Answer

Thank you for your question. A exam would be very helpful. Detection of a seroma can depend on many factors including space of the seroma, how full of fluid the space is, etc. You should be able to detect it both standing and when laying down, but the characteristics may change depending on the position of the fluid. It is best to go back to your plastic surgeon for an exam and discussion about how to best manage the seroma. Best of luck!

Peter Hyans, MD · Answer

A seroma may be evident standing or lying down.  If you feel a waterbed effect you should see your plastic surgeon for evaluation.  A simple ultrasound test may give you the answer.  Best of luck.

Bram Kaufman, MD · Answer

Thanks for asking such an insightful question. Seromas can be evident in any position, but in my experience it is easiest in the standing position. This is because the abdominal muscles are tighter in the standing position as they are used to help stabilize your core. That provides a firm base beneath the skin flap and potential seroma to help localize it. When laying down, the muscles relax and create too soft and base to easily discern a seroma. Soft muscle and fat have very similar feels to fluid (i.e. seroma). I hope this helps. Good luck and happy new year. Bram

Aldo Guerra, MD · Answer

Thanks for this question. The fluid wave can be seen standing and sitting. Symptoms of a seroma include swelling, bloating, and pressure. I suggest you speak with your plastic surgeon if you have any of these symptoms. Good luck. Dr. ALDO

Scott D. Green, MD · Answer

Thanks for your question. You do not necessarily need to be standing to determine if you have a seroma or not. In some cases it may be easier to detect, but a board certified plastic surgeon should be able to tell either way. I would suggest follow up with your surgeon to be examined to know for sure. 
Good Luck

Curtis Wong, MD · Answer

are much more accurate when standing as gravity pulls down anything you have to the bottom and your muscles help provide a firmer platform on which the fluid rests.  When on your back, its more challenging to be certain, especially if a small seroma.  If you can see it when on your back, its going to be a pretty big one.

Nicholas A. Flugstad, MD · Answer

You may detect a seroma in any position. It may not be something you can self diagnose. Ways to prevent a seroma include wearing prescribed compression and being compliant with activity restrictions (not overdoing it early). If you do think you have a seroma, it's best to see your plastic surgeon and be checked for fluid in person. If a seroma is present, Removal of the fluid with a small needle or a drain is usually what is needed.

Tom J. Pousti, MD · Answer

No,  it doesn't matter. Seromas may be palpable or visible in the laying or standing position (sometimes more easily diagnosed in certain positions, depending on the specific patient). If you remain concerned, have your plastic surgeon evaluate you. Best wishes.

Do you need to be standing to tell if you have a seroma?

Answers (10)

More Tummy Tuck Questions

WE SEND PRETTY
EMAILS

Answers (10)

More Tummy Tuck Questions

3 weeks post TT and severe sharp shooting stabbing pain in abdominal, localized. Advice?

Am I making a mistake not getting MR with my TT. I have had three c sections but NO diastasis.

What are the lifting restrictions after having a tummy tuck with muscle repair?

How soon can I smoke after surgery?

Just TT and Lipo will help butt to look big or do you think I also need a BBL? (photos)

Can I take off my compression garment the day of my surgery to wash it? 1 day post TT.

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS