7 months post-op & seroma complications, they pulled 30ccs in 5 days, what could be the cause?

Question

I'm 7 mos post op from lipo. I've been dealing w/ seromas on both lower abdominal areas. I've been having them aspirated biweekly and weekly since 10 days po. Left side finally closed round 5 months & the right was really almost closed as well. but 2 months later, now it's all of the sudden sore, tingly, & accumulating more fluid. I've only had to have it drained 2 times in 2 months and both times were less than 10 ccs. Now all of the sudden they pulled 30ccs in 5 days. What could be the cause?

Krishna Vyas, MD, PhD, MHS · Answer

A sudden increase in seroma fluid 7 months after liposuction could be caused by factors such as inflammation or scar tissue. It may also indicate the formation of a bursa, which is a fluid-filled sac that can develop in response to irritation or friction. Physical strain or irritation might trigger the fluid buildup, disrupting the normal healing process. It’s important to get an ultrasound/imaging and fluid analysis, check for a bursa and ensure proper compression. Management varies from a drain with or without sclerosing agent to surgical excision. Consulting your plastic surgeon will help determine the best course of action.
Krishna Vyas, MD, PhD, MHSHarvard, Hopkins, & Mayo Clinic Trained Aesthetic Plastic SurgeonNew York, New York

Camille Cash, MD · Answer

Seromas can be difficult to resolve and are more common with abdominal surgeries.  If aspirations and compression aren't working you may need to have a drain placed.  If that doesn't work surgical intervention may be necessary.

James Knoetgen, III, MD · Answer

Seven months post-liposuction with seroma complications and a recurring 30cc of fluid in 5 days could result from various factors. Some potential causes include:
1. Chronic Seroma Formation
•	Persistent cavity: The seroma cavity may not have fully healed or closed, leading to ongoing fluid accumulation.
•	Fibrous capsule: A capsule can form around the seroma site, which can perpetuate fluid collection.
2. Residual Inflammation
•	Inflammation from the procedure or repeated aspirations can cause local irritation, leading to continued serous fluid production.
3. Inadequate Drainage or Compression
•	Insufficient compression: If compression garments were not worn consistently post-op or not properly fitted, it could contribute to persistent fluid collection.
•	Drain removal: If drains were removed too early, the seroma cavity may not have had adequate time to close.
4. Movement or Activity
•	Excessive or vigorous activity post-op can disrupt healing, preventing the seroma from resolving.
5. Infection or Underlying Conditions
•	Although rare at this stage, a low-grade infection could cause fluid build-up.
•	Health conditions: Systemic factors such as diabetes or immune issues could delay healing.
6. Lymphatic Disruption
•	Liposuction disrupts lymphatic channels, which might cause ongoing issues in draining fluid from the affected area.
Recommendations:
•	Consult Your Surgeon: Follow up with your surgeon for an in-depth evaluation. Imaging such as an ultrasound may be helpful to assess the seroma cavity and surrounding tissues.
•	Compression Garments: Ensure you are using proper post-op compression to help prevent fluid accumulation.
•	Consider Sclerotherapy: If the seroma is persistent, your surgeon might suggest injecting a sclerosing agent to close the cavity.
•	Rule Out Infection: Look for signs like redness, warmth, fever, or worsening pain, which could indicate infection.
Persistent seromas are relatively rare but manageable with the right approach. Your surgeon can determine the best course of action tailored to your situation.

Connie Hiers, MD, FACS · Answer

Your seroma is old enough that it probably has developed a wall of scar tissue around it. This will need to be removed and redrained to be successful.

Daniel P. Markmann, MD · Answer

Thank you for your question.  Sorry to hear that you are having this issue.   Seromas are the number one complication of liposuction.  Having drains usually prevents this from occurring.    When you have a chronic seroma it usually means that your body has formed a layer of scar tissue around the fluid.  There are 2 ways of fixing this issue.  One is sclerosing agents where a medication is injected which irritates the lining of the pocket, and allows it to seal shut.   The second is to surgically remove the scar tissue pocket.  The surgical option is the most reliable treatment.

7 months post-op & seroma complications, they pulled 30ccs in 5 days, what could be the cause?

Answers (6)

Answer: Seroma

Answer: Seroma

Answer: 7 months post-op & seroma complications, they pulled 30ccs in 5 days, what could be the cause?

Answer: 7 months post-op & seroma complications, they pulled 30ccs in 5 days, what could be the cause?

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7 months post-op & seroma complications, they pulled 30ccs in 5 days, what could be the cause?

Answers (6)

Answer: Seroma

Answer: Seroma

Answer: 7 months post-op & seroma complications, they pulled 30ccs in 5 days, what could be the cause?

Answer: 7 months post-op & seroma complications, they pulled 30ccs in 5 days, what could be the cause?

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