Very large seroma? (photo)

Question

I had a tummy tuck with muscle repair 2 weeks and 3 days ago. I can see and feel a large seroma that starts at the bottom of my rib cage and extends to below my incision. My plastic surgeon is out of town. I saw his colleague (not a PS) last week and he was unable to find the pocket of fluid to extract anything. I'm worried because the seroma keeps getting larger each day. Is such a large seroma bad? Should I go back to the non-PS? I don't know what to do.

J. Timothy Katzen, MD, FACS · Answer

I am sorry you have developed a seroma after surgery. Seromas are uncommon. Seromas are more common in larger abdominoplasties or tummy tucks. Seromas  are also more common in total body lifts or 360 circumferential body lifts. Typically drains minimize the incidence of Seromas. I usually wait for the drain output to be less then 25 mL per drain over a 24 hour.  From the information you have provided, it sounds like you have a seroma. If the Seroma is indeed this large, you probably need a drain inserted. If I were you, I would insist on your plastic surgeon staff contacting your plastic surgeon. If that is unavailable, I would then request to your non-plastic  surgeon (covering for the plastic surgeon) that an ultrasound be performed by a radiologist. This will confirm the presence of a seroma. In addition, under ultrasound guidance, the radiologist can insert a drain at the same time. Good luck.

Eric Pugash, MD · Answer

It is difficult to imagine how a large seroma could not be at least partially drained in the office, at least by a plastic surgeon who is familiar with the operation. I recommend you try to see your operating surgeon asap or, if he or she is going to be absent for some time, to see a plastic surgeon colleague who will be able to care for you. All the best.

Darryl J. Blinski, MD · Answer

If truly an expanding seroma/.hematoma you need surgical drainage asap. Seek other avenues to address than a non PS . You need a surgeon whether a GS or PS to attend to you...

Jonathan Fisher, MD · Answer

A Serona is a very rare occurrence that might occur on extreme cases but you should ask your surgeon to drain it for you, using an Ultrasound Drain they can get to the hard to reach pockets and do a more precise  job.

Richard P. Rand, MD, FACS (retired) · Answer

If the other person couldn't get the seroma drained you could ask them to order an ultrasound guided aspiration of the fluid.  With ultrasound, they won't miss the pocket.

Very large seroma? (photo)

Answers (5)

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