Seroma 9 Months After Tummy Tuck?

Question

My seroma has not gotten any smaller and my PS has never attempted to drain it. He's had me apply heat and wear compression, and I've been going in every 2 weeks for an RF treatment (he uses it to get heat to the seroma to try to break it up). If I still have it at 12 months he'll use a lipo machine to go in there and get it out. This treatment seems uncommon so I'm wondering what other PSs think. Also, my weight is 6lbs higher than norm since the procedure - wondering if that's the seroma.

Vincent N. Zubowicz, MD · Answer

A seroma persisting for nine months by definition is chronic. In this situation a capsules formed around the fluid and can be several millimeters in thickness. The best choice is to remove this capsule and obliterate the dead space.

Jourdan Gottlieb, MD · Answer

By this time, the seroma usually has a thick wall and needs open surgery to excise the cavity and get it behind you. 

	A simpler thing that might work is sclerosis. The cavity needs to be aspirated dry, usually with drain insertion and then a sclerosing agent (Betadine, tetracycline, alcohol) is injected, allowed to dwell, and then the drain opened. Sometimes several treatments will work if the first does not. 

	All the best.

Curtis Wong, MD · Answer

are difficult to treat and resolve. Most doctors attempt to sclerose the cavity if truly a classic seroma. I am not familiar with what your doctor is attempting. If you seroma has lasted this long, sometimes surgery is needed to remove the lining of the seroma and to freshen the wound edges to allow adherence of tissue. Good luck.

Richard J. Brown, MD · Answer

If you indeed do have a seroma there are many treatments that an be done. The best treatment is to drain them in the office. If they return I commonly will then place a catheter into the cavity at the time of the recurrence. This will allow the compartment where the fluid collects to collapse and the scar to close. Once a few months go by and you continue to have a pocket of fluid that was not drained you will form what is called a pseudocapsule. Once this capsule has formed the only viable option is to excise the capsule and allow the new fresh layers to scar together. You could try to have a catheter placed even this far out and just see if the pocket will collapse.

Gregory Park, MD - Account Suspended · Answer

After 9 months without spontaneous resolution of your seroma, it is extremely unlikely that any external treatments such as heat, compression, and RF treatment will make your seroma go away. You can have your surgeon try serial aspirations (needle drainage), but it probably will not work. The standard treatment at this point in time ( 9 months out) generally involves opening up the seroma pocket, removing the seroma capsule, and placing drain(s). Perhaps liposuction is a new modality that I have not heard about for the treatment of chronic seromas. However, this is something that I have not used in the past for the management of seromas. Thank you for your question. Best of luck.

Seroma 9 Months After Tummy Tuck?

Answers (5)