Could This Be a Seroma? (photo)

         It’s not unusual for
patients to develop seromas when drains are removed prematurely. Your picture
suggests fullness in your upper abdomen which is characterized by a rounding
which suggests a fluid collection. If this fluid is under tension it would not
be expected to have a fluid wave.

 

         Confirmation of this
diagnosis can be made with an ultrasound or a diagnostic aspiration. Seromas
should be drained to avoid long term complications. In most cases, compression
garments should be used to avoid recurrence. It’s important that you contact
your surgeon as soon as possible to avoid secondary complications. 

A good way to assess that would be to start with an ultrasound.  it looks like fluid that would be easily treated with needle aspiration.  I recommend waiting until your surgeon returns but notifing the office of the situation. 

Yes it looks like a seroma. it is not an emergency but return to your surgeon when he gets back to town. He will be able to aspirate it with a needle. Not to worry.

Thank you very much for your question and your pictures.  Based on the information you provided and your pictures, my assumption is that you are correct.  This certainly looks like a seroma.  Your team of consultants from Real Self pretty much agree that your doctor probably has another plastic surgeon on call while he or she is out of town.  I recommend you make an appointment asap to see this plastic surgeon and deflate this seroma before it becomes chronic. 

Swelling can be very normal 13 days following a tummy-tuck, especially if accompanied by liposuction. Compression is helpful. Close follow-up with physical examination with your Plastic Surgeon is essential to make sure that it is nothing more serious such as a seroma or hematoma. If you doctor is out of town, ask to be seen by the nurseing staff or the doctor on call. Best of luck.

Dr. Lyos

Houston, Texas

I would agree this is most likely a seroma based on what you describe and in reviewing your photos.  I would follow up with your plastic surgeon for aspiration.  It also may help to wear a compression garment or abdominal binder if your plastic surgeon has had you wearing this after surgery.

A seroma can be often difficult to diagnose if the classic sign of fluid wave under the skin is not seen.  Sometimes, a diagnostic tap is done with a needle to check for fluid.  Be examined by your plastic surgeon or a surgeon who is covering for him or her as soon as you can.  Earlier the diagnosis and treatment, the better in most cases.

While it could be a seroma, it could also be that you popped a few of your muscle plication sutures. Did you have any pulling/cramping pain in this area? Did you feel that you may have stretched too far or feel that you have been too active? The muscles will often spasm after abdominoplasty. Aleve may help with your muscle aches that worsen throughout the day. Be sure you clear the medication with your surgeon's office first. Even if your surgeon is out of town, someone in the office and/or a covering surgeon should be able to answer your questions. Best of luck to you!

It certainly appears to be a seroma. Probably not a blood collection (hematoma) because there is no bruising. If this appeared after your drains were removed then would be consistent with seroma. An ultrasound is an excellent way to determine it's nature, but expensive.
Needle aspiration works very well, but you should wait on your surgeon for that one. Another rare possibility is that the suture line for the muscle repair may have torn, but I am betting on the seroma. Good luck.

Swelling is obviously normal after an abdominoplasty.  This can be either soft tissue swelling or a collection of fluid under the skin.   It really requires an examination to understand the issue at hand.  This type of lower abdominal swelling can take up to 3 months to resolve.