Seroma treatment? What are my options? (Photo)

Question

I have developed a seroma in my upper abdomen (12 wks PO) and am looking at options for treatment. My doctor is very far but has advised me of some options. Tight compression, aspiration and surgical removal. It is fairly new and soft so I am attempting compression first, of course. Is it likely it may reabsorb using this method or should I just seek help somewhere with aspiration?

Daniel Barrett, MD · Answer

Dear grivera0086,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Christopher Pannucci, MD, MS · Answer

Hi grivera0086,
My initial thought would be for you to see your surgeon for an aspiration, which is the preferred way to address an accessible seroma. But re-reading your post, it sounds like you are physically distant from your surgeon. If its a few hours drive, its probably worth returning to see him/her in clinic. If a flight (eg medical tourism), then perhaps not.
If you can't access your surgeon, I would suggest trying to see another plastic surgeon closer to you. While no surgeon is thrilled to manage another surgeon's complications, and while you should expect to pay for that surgeon's time/experience/input, I think that watchful waiting with compression at 12 weeks is unlikely to definitively manage the problem.
Hope this helps.
Best,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

Connie Hiers, MD, FACS · Answer

Aspiration with compression is the best to do now. Just compression does not prevent more fluid collecting nor remove this fluid. It is best to drain the area so that thick scar walls do not form and make a more permanent seroma pocket.  If you cannot find a plastic surgeon to take over your care and do this for you, you can have a radiologist drain this area.

Richard Pecunia, MD, FACS · Answer

Seroma development after tummy tuck is very common. I agree with your doctor that compression, aspiration, and surgical removal are good options. In my experience, compression alone generally is not enough to resolve the seroma unless the body also absorbs it itself. My recommendation is to try to find someone who would be willing to aspirate this for you to remove it. It may take several times but that may avoid additional surgery

Camille Cash, MD · Answer

Larger seromas are typically treated with aspiration and compression.  It is not uncommon that several aspiration treatments are necessary before the seroma fully resolves.  See a board certified plastic surgeon near you for treatment.

Darryl J. Blinski, MD · Answer

I would try multiple sessions of needle aspiration first with tight binder. Must stop all activities also . Fee for needle aspiration is $500/session.

Douglas Taranow, DO, FACOS · Answer

I treat all seroma with serial (once, twice or three times a week) aspiration, use a steroid injection, and compression. This triad almost always resolves them.  If you wait too long (12 weeks is a long time already) the seroma forms a lining (capsule ) and can be one permanent

Mats Hagstrom, MD (license on probation) · Answer

I consistently recommend patients not travel Long distances for elective surgical procedures. Patients do not appreciate the importance of having in person consultations, the number of people who need postoperative care, will end up needing a revision or that complications actually happen.

A seroma requires intervention or it will become a chronic seroma that can only be treated with surgical excision.

At 12 weeks your seroma may already be encapsulated and may already be chronic.

The textbook answer is to aspirate the seroma on a daily basis until fluid no longer forms.

The more time is spent between aspirations the less effective they become.

An alternative treatment is the place a drain in the seroma pocket which is somewhat challenging but could be done by an interventional radiologist.

Somebody needs to manage your Cerrma. Your surgeon is responsible for your outcome and you’re responsible for choosing that surgeon.

Consider consulting with local plastic surgeons to see if someone is willing to help you manage this.

There are no non-surgical ways of making a fluid collection go away. The longer you wait the more it becomes encapsulated.

Best,

Mats Hagstrom MD

Seroma treatment? What are my options? (Photo)

Answers (8)

More Tummy Tuck Questions

Cotinine test before surgery - how sensitive are the tests? Will I pass?

What procedure is this? More than just a tummy tuck?

What procedures are recommend for me? I know I would like a tummy tuck, bbl and possibly an arm lift (photos)

Which procedure should I get after weight loss? (Photo)

7 months after TT, should I still be swollen? (Photo)

Regular Tummy Tuck or extended - which procedure(s) should I get? (photos)

WE SEND PRETTY
EMAILS