Could this be a seroma? (Photos)

Question

I went for another check up yesterday still dealing with a lot of fluid draining yesterday in a space that opened in the incision where drainage was coming out they put a wic in it to keep it open continue to drain. This morning changing the wic I got a good bit of blood that came out. They also started me on another antibiotic (keflex) as we see some goo on the bandages, last night when pressing bump of fluid out (I’d guess 80-11cc) even some of this puss stuff came out the wic hole.

Yannis Alexandrides, MD, FACS · Answer

This could be a seroma or infection because the skin looks very red. In my opinion, this looks more like an infection.

J. Timothy Katzen, MD, FACS · Answer

Hello, and thank you for your question regarding whether you have a seroma.  Thank you for your history and your pictures.  What you are describing sounds like a seroma.  A seroma is a cavity full of serous fluid.  Serous fluid is the fluid your body makes to seal wounds.  Serous fluid is like your body's natural superglue.  Serous fluid glues the surfaces of a cavity together.  Serous fluid is important in the healing of surgical wounds.  Serous fluid is important in the healing process, whether it's a tummy tuck, brachioplasty, thigh lift, or 360 circumferential lower body lift.  However, usually the body makes too much serous fluid in reaction to a surgery.  Therefore, drains are often used to absorb the excess serous fluid.  If drains are not used or if the drains are removed too early, serous fluid can collect and a seroma can develop.  The clear fluid that you describe is probably serous fluid.  However, the thicker, dairy cream-like fluid could be an infection.  Therefore, that is why your plastic surgeon wisely prescribed antibiotics.  You mentioned that "blood came out the hole."  Blood inside a body cavity is called a hematoma.  Blood that has been in a cavity for 48 hours or more typically will be dark red.  If you are acutely bleeding, the blood will be bright red.  The color difference is due to the oxygenation of the blood.  Fresh blood is highly oxygenated and therefore bright red.  Blood that has been out of circulation for approximately 48 hours will lose oxygen and become dark and purple.  There are many treatments for seromas.  One treatment for seroma includes needle aspiration.  During needle aspiration of seroma, a needle is inserted and the excess serous fluid is removed.  This needle aspiration process repeats every 48 hours till the seroma is gone.  Another treatment of seromas includes what you describe.  Mainly, a wick is inserted in the seroma cavity, and the serous fluid constantly drains from the hole until the seroma eventually collapses and goes away.  A third treatment of seroma includes insertion of a drain.  The drain needs to stay in place for however long the excess serous fluid is secreted.  However, one drawback of the drain is that it can cause continued stimulation of serous fluid production.
Concerning your history and pictures, your plastic surgeon appears to be treating your seroma appropriately.  Thank you for your interesting question regarding whether you have a seroma.    If you have any questions regarding a seroma, thigh lift, thigh reduction, vertical thigh lift, medial thigh lift, spiral thigh lift, crescent thigh lift, or thigh lipo, please contact a thigh lift expert.  Please seek an experienced, board-certified plastic surgeon with significant experience performing thigh lifts.  Do your research.  Make sure your chosen plastic surgeon has performed at least 150 thigh lifts.  Make sure they have the before and after pictures to prove it.  Thigh lifts are difficult; thigh lift revisions are even more difficult than the initial or primary thigh lift.  Since thigh lift revision surgery is difficult, choose an experienced plastic surgeon. Please carefully review their before and after pictures and check their reviews on RealSelf.   Consider traveling if you cannot find a thigh lift or reduction specialist.  Sincerely, Dr. Katzen.  (Plastic Surgeon, President of the American Society of Bariatric Plastic Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery, and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Adam Tattelbaum, MD · Answer

Thanks for your question and the photo. It looks as though you are draining some serous fluid.  This does not necessarily mean infection, but bears watching with your PS. Fluid collections under the skin can delay healing and sometimes become infected which is likely why your PS put you on an antibiotic. The collections often stop on their own, but sometimes need help or drainage so best to stay in touch with your personal PS.Best wishes.

Nick Masri, MD, FACS · Answer

Thanks for your question, nicolboiseau.
It could be an infection, which is why you’re put on antibiotics right now. Just continue following the advice of your reputable and board-certified plastic surgeon and you’ll be fine.
Good luck!

Could this be a seroma? (Photos)

Answers (4)

Answer: Seroma

Answer: Seroma

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Could this be a seroma? (Photos)

Answers (4)

Answer: Seroma

Answer: Seroma

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Everything you need to know about Thigh Lift

Our mission is to create a world where every investment in modern beauty is Worth It.