Is a seroma that is 9.3x1.7x8.9 cm considered big or small? Is there a reason why it might not drain with a needle and syringe?

Question

My extendedTT was performed in a different state from where I live on Nov12 of this year and today is Dec16. Given the size, as indicated in the ultrasound (done on Dec9), will it go away on it's own? I see the waterbed effect when I touch it, but I'm not sure if it is a minor seroma. I noticed the waterbed effect at about two weeks post op (it could have been there earlier but I'm not sure) and I can't tell whether the waterbed movement is decreasing or the same, but I know it hasn't increased.

Christian Subbio, MD · Answer

When it comes to seromas, sizes as “small, moderate, large,
etc.” are a subjective thing. A 9 cm
seroma ina woman who weighs 115 pounds can be quite large, but may be in
visible in a woman who weighs 200 pounds.Regardless, a seroma with the measurements you described can be aspirated
with a needle and syringe.Seromas can
occur after an abdominoplasty in areas where the fat has not healed down to the
muscle wall.Typically, they can be drained
with the patient standing up in the office through an area of the skin which is
still numb.Oftentimes, more than one aspiration may be necessary, but the
likelihood of recurrence decreases with each aspiration.I would certainly express your concerns to
the plastic surgeon who performed her procedure.best of luck!Dr. Subbio

Jed H. Horowitz, MD, FACS · Answer

Hi, thank you for your question. You are concerned about a seroma which has been monitored. I recommend that you consult with your PS to seek his/her opinion. In my opinion, it is large enough to be drained via syringe. Please contact your PS for follow up care. Best Wishes!#seroma  #syringe  #drain

Deborah Sillins, MD · Answer

From your description of a water bed movement and the size of your seroma it should be aspirated. Your surgeon can do this in the office or the radiologist could aspirate it as well.

Ciro Adamo, PhD, MD · Answer

Ideally, you should get in touch with your surgeon, and ask him/her to refer you to a colleague near you. It is easy to drain a seroma and you should get it done.

Sugene Kim, MD, FACS · Answer

Hi, posey91.The size of the seroma that you indicated should be able to be aspirated.Since you noticed seroma 2 weeks ago and it has not resolved, you need to follow up with your plastic surgeon or a plastic surgeon near you. Best regards.

Stephen E. Zucker, MD (retired) · Answer

Whether you consider it big or small is less important than how
long it has been there and whether it is getting larger or getting
smaller.If it is not gone by about six
weeks postop, you may benefit by having an interventional radiologist place a
percutaneous drain connected to a collection system to enable it to resolve.This has the added advantage of permitting
sclerotherapy to be done if the fluid collection does not resolve on its own.

Is a seroma that is 9.3x1.7x8.9 cm considered big or small? Is there a reason why it might not drain with a needle and syringe?

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