Getting a Seroma Drained by Someone Other Than my Plastic Surgeon?

Question

Had a TT in the Dominican republic because my insurance would not cover it after my 135 lb weight loss. Surgeon removed my drain after a week. I have been home now 2 weeks and am sure I have a seroma. My insurance probably will not cover cost to aspirate and I cant fly back to the DR so now I am stuck. Would a local Doctor even get involved with me? What would a cash cost be on average for each aspiration? I am scared that no one will see me. I know I cant leave this for too long. C from NJ

Remus Repta, MD · Answer

Hello,

	Thank you for the question.  It is sometimes difficult to get these issues addressed when surgery is performed elsewhere but it is doable.  You will want to meet with a plastic surgeon and agree on a price to have him or his/her nurse assess you for a seroma and drain the seroma every few days until it no longer collects.

	All the best,

	Dr Remus Repta

Jourdan Gottlieb, MD · Answer

This is a common problem presented to this website. It would not surprise me if you have some trouble finding a surgeon. Your primary physician can assist in finding someone if need be. 

	From a surgeon's point of view, medicare and other carriers occasionally will divide the fees between operative and post-operative care. 80 % is allotted to pre-op and operative care, and 20% to post-op care. I find it reasonable to charge a fee equal to 20% of my professional fee to take on a post-op patient of another surgeon. I find that to be quite reasonable in that I would be only be seeing someone with a complication and therefore a more complex postop course is assured. That fee would include aspirations and drain placement, but not anything requiring a trip to the operating room.

	If emergency room fees in NJ are like those here, that would be a choice of desperation only. Best wishes.

David S. Martin, MD · Answer

I sympathize with your situation.  Your circumstances reveal one (fortunately not too serious) example of what may happen if a patient chooses to leave the US for a less-expensive alternative for surgery.  Board Certified plastic surgeons have not only a legal but an intense professional commitment to being available to assist in the postoperative care of their patients upon whom they perform surgery.  Human nature being what it is, you can imagine why a surgeon in your community might not be eager to provide assistance now while another surgeon elsewhere received payment for your procedure.

	      Having said that, you may be able to persuade a caring surgeon nearby to help you out.  I'd call their offices, explain the situation, see if they'd agree to see you and perhaps get an idea on the cost for the first aspiration.  (As you know, it is very common for seromas to need repeated aspiration to resolve).  Then keep your fingers crossed that things resolve easily and quickly and that you don't encounter further setbacks that could leave you in even more desparate circumstances.  Hopefully, you'll easily find someone who will help.  Good luck!

Armin Moshyedi, MD · Answer

I am sorry to hear about your difficult situation. You are experiencing one of  the dreaded outcomes of Plastic Surgery Tourism. Even in the most qualified and experienced hands, complications can happen after surgery. When your surgeon is in another country, the complication is even harder to accept. The best person to handle a complication is the original surgeon as only he/she knows exactly what's been done to you. Furthermore, no one cares more about you than your original surgeon. When an American Board of Plastic Surgery certified surgeon has a complication, we go to great lengths to get our patient through it (typically without further charges or minimal charges to the patient).

	 

	The best place for you to start with is to ask your primary care physician to help you find a surgeon. Unfortunately, the money you saved in going to the Dominican Republic for surgery will be lost to paying for the complication. Most surgeons will be compassionate to your condition, but also expect to be compensated. Hopefully you can find a surgeon who will treat you for a nominal fee (enough not to be insulted or reminded that you chose not to pay them full price originally in favor of flying to a developing country). I would charge $50 per aspiration, others may charge up to $250 or more. If you need an indwelling catheter (drain) to be placed, I would charge $250 for its placement, others may charge up to $1000. Call ahead and ask.

	 

	Good luck.

John Whitt, MD (retired) · Answer

You have hit upon one of the major problems with medical tourism. It can become a case of "penny wise, pound foolish". Your seroma will probably require multiple asirations. You most likely can find someone willing to help you, but the costs will be out of pocket.

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