How Can You Tell if You Have a Seroma or Just Swelling? I Had a TT 17 Days Ago and Very Puffy Under my Incision

Question

Richard J. Bruneteau, MD · Answer

It’s not
unusual for patients to develop swelling following abdominoplasty surgery. This swelling is easily differentiated from
seroma formation on physical examination.When seromas are present they’re usually accompanied by a fluid wave.Most swelling resolves in six to
eight weeks, but small amounts of swelling may persist for up to a year.Patients can minimize swelling with compression
garments, massage and limitations on physical activities.It’s important to remember that swelling is a
normal part of wound healing and should resolve with time.Occasionally seromas develop
following abdominoplasty surgery.In
most cases, seromas resorb without intervention.When larger seromas are encountered serial
aspirations may be necessary in combination with compression garments.If you’re concerned about this
issue, it’s important to contact your plastic surgeon.Your surgeon should be able to differentiate
these conditions and institute appropriate treatment.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding how you can tell if you have a seroma or just swelling. Basically, the safest thing to do is to visit with your plastic surgeon. Physical examination is usually the best test. Often, plastic surgeons look for what is called “fluid wave”. To do a fluid wave test, you tap on one specific area of the mass in question. If you see fluid propagate or move to another area (like a wave in the pool), then that typically, means there is fluid underneath the mass. This would mean that you have a fluid collection or seroma. If you have a seroma, serial needle aspiration or an insertion of the drain is required. Please consult with your experienced, board-certified plastic surgeon. I hope that I have answered your question regarding the presence of a seroma or just swelling. If you have any more questions, please contact my office. 
  
Sincerely, 
  
Dr. Katzen

Michael J. Weinberg, MD · Answer

Seromas used to be more common with drain usage. The no-drain suturing tummy tuck has made this problem way less common.A seroma usually shows up as a bulge, of varying size that gets bigger each day and feels “swooshy”.It best that you go and see your Doctor. They will be able to tell right away.

Steven L. Ringler, MD, FACS · Answer

Thank you for your question.  You are still fairly early in your recovery process so having some swelling is normal at this stage.  As others have mentioned, if the area moves in waves rather than being more stationary it may be a seroma.  You should give your plastic surgeon a call to be on the safe side. If it is a seroma, these can often be fairly easily drained in an office procedure.  Best of luck to you.

Yucel Sarialtin, MD · Answer

thank you for your question, It is very normal for you to have a seroma after the surgery, it is still very early; but what I can advise you is to visit your plastic surgeon and he will give you the instructions to follow.
good luck.

Vishnu Rumalla, MD · Answer

Please discuss this with your surgeon, he should be able to tell you and reccomend treatment as indicated, good luck.

Michelle Spring, MD, FACS · Answer

Your surgeon is the best person to consult - you need a physical exam. Swelling below the incision line or in the pubic area is fairly common following tummy tucks, and this may take a while to completely resolve (but it will!)

Miguel Delgado, MD · Answer

A fluid wave is what we use to determnine a free fluid collection. It is difficult to determine if you are not trained in this clinical exam. You must go to your plastic surgeon and he can tell immediately. If a seroma he will need to remove the fluid.

S. Tyler Elkins-Williams, MD · Answer

A good physical exam is the best and fastest way to tell the difference between edema (swelling) and a seroma (fluid collection). Checking in with your surgeon should enable him or her to make the determination fairly quickly. 
Swelling is normal and expected at 17 days after a Tummy Tuck. This will get better with time, but it will take several more weeks at least. Often, small or even medium seromas will improve just with time and use of compression. Sometimes, there is benefit from draining a seroma, but that is a decision that you and your surgeon would need to make together.

Stephen M. Davis, MD, FACS · Answer

Thanks for writing,A agree with my peers. The decision can be made on physical exam or if its questionable than an ultrasound examinaction is easy and very helpful if it’s necessary to drain the fluid. I hope this helps, Good LuckStephen M. Davis, MD, FACS Board Certified Plastic Surgeon Member: American Society for Aesthetic Plastic Surgery Member: American Society of Plastic Surgeons

How Can You Tell if You Have a Seroma or Just Swelling? I Had a TT 17 Days Ago and Very Puffy Under my Incision

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Answers (20)

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