Should my seroma be removed surgically? (photos)

I had a TT with MR on 3-22-16. My drains were removed 10dpo and I developed a seroma 13dpo. It was drained 2x and seemed to go away but I was never as flat as prior to the seroma. I was given the okay to start exercising at 10wpo. Within a week a very hard, large, softbatull sized lump appeared the same area as my previous seroma. I saw my PS and he said it was a seroma. I've had it drained 3x so far. I'm back to wearing compression and restricted activity. What is the correct treatment? Thanks

Doctor Answers 10

Post op seroma

it is important to completely drain the seroma. Aspiration is a very logical technique but at this point it needs aggresive almost daily aspirations along with compressive dressings. However, if the seroma persists, usually surgery is required to remove the capsule or scar tissue surrounding the seroma and another drain is placed. 


San Diego Plastic Surgeon
5.0 out of 5 stars 4 reviews

Management of seromas

can be challenging.  But when this long out from your procedure, most surgeons would attempt sclerosing the cavity that is now well established and if this failed, then you are looking at returning to the OR for a formal repair that would involved removing as much of the cavity wall and anchoring sutures.  Best of luck...

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Recurrent Seroma

Hello,

This is a problem. I would attempt at least two weeks of aspirations, possible every 48 hours. If the seroma doesn't shrink and subside, You may need a surgery to remove the capsule that may have formed. If you did decide to have surgery, I would make sure that the surgeon doesn't use a drain again, but instead plicating sutures to obliterate the cavity. 

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

Recurring seroma should be removed

I would say that you did the right things for wearing a compression garment. You suppose to wear it for a year along with go follow up with your PS. Supposing that you have a seroma, you suppose to drained it again. It suppose to be smaller every time you get it removed.

Recurrent seroma

Hi there mis_tee75,
Yours is a tough problem. Seromas usually respond to the aspirations you describe. Recurrent, recalcitrant seromas present a more difficult problem. I would agree with the course of management you have embarked upon but you may require the injection of a sclerosing agent into the cavity to allow it to seal up. Alternatively you may require an operation to open up the part of your scar adjacent the seroma for a formal de-cortication procedure. Either which way there is a solution to your problem. You would be be served to revisit your plastic surgeon to discuss these options.
Kind regards,
James

James Southwell-Keely, MD, FRACS
Sydney Plastic Surgeon
5.0 out of 5 stars 16 reviews

The seroma and the treatment.

Hello,  thank you for your question.   Try to avoid exercising until you get out of this issue.  Seromas is the most common minor complication after a surgery like yours.  In your case I would definitely try once again to aspirate with a syringe the site of the seroma. Opening the incision  will not guarantee you that the seroma will not come back.   Instead that would only put you at risk of having others complications.  Have a nice day and best of luck. 

Derby Sang Caputo, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 62 reviews

Seroma after abdominoplasty

Seroma commonly form after abdominoplasty especially if the individual is more active within two weeks of the surgery.  The space under the skin where the abdominal skin flap was elevated takes time to adhere and close.  This can be shortened with internal stitches but still takes time for the abdominal skin to adhere.  The seroma needs to be drained and continuous compression via a girdle needs to keep the fluid from coming back.  If the individual is active the fluid will reform. 

Benjamin Chu, MD, FACS
Honolulu Plastic Surgeon
4.8 out of 5 stars 84 reviews

Should my seroma be removed

Each surgeon has there own approach to a seroma's. At this point over 10 weeks post op, if it recurs again, your surgeon could try placement of a drain for a week or so, but usually by this time a sac has formed around the seroma and usually the sac needs to be removed except in very small seroma collections.

Rick Rosen, MD
Norwalk Plastic Surgeon
5.0 out of 5 stars 20 reviews

Seroma after Abdominoplasty

A seroma is the most common complication after a tummy tuck procedure.  Usually serial aspirations (drainage) will resolve the problem.

At this point if you were my patient I would continue with the drainage in the office to help this resolve.  Compression in that area after the drainage is very important, as is restricting your activity between the office visits and drainage.

In very rare circumstances, the drainage will not resolve the issue and it may require a trip to the operating room to removed/excise the seroma cavity.

Hope that helps.  I would suggest you continue on and follow your surgeons guidance.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 72 reviews

Seroma

For seromas that do not improve with serial drainage, excision of the seroma cavity is indicated.  It is a trip to the OR so you may want to try serial drainage a bit more before doing the procedure.  Best wishes, Dr. T. 

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