What should I do about my seroma/hematoma after it's already been drained twice? (Photos)

Question

Got top surgery November 28th, I end up getting seroma or hemotoma. I’ve gone to my surgeon twice to drain it but it still looks the same. What should I do

Rukmini S. Rednam, MD, FACS · Answer

Hello,it can be really frustrating dealing with a seroma after surgery because once you develop one it may require multiple treatments for it resolve.  If after two drainage attempts you still have such a significant fluid build up then placement of a drain or seroma catheter may be indicated along with compression.  If serums remain in place for too long they can become an issue since your body you make a small cavity which keeps feeding into the issue and may require additional surgery.  Be sure to talk with your plastic surgeon about your concerns so s/he can address them and offer their treatment plan if serial drainage does not seem to be working.Best of Luck with your Healing!Dr. Rednam

Anthony Deboni, MD · Answer

Thanks for your question and photo.  Sometimes placement of a drain can be helpful.  If the seroma persists after several drainage attempts, it may require surgery to remove the seroma capsule.  Continue followup with your surgeon.  Best Regards.Dr Deboni@drdeboni

Richard A. Bartlett, MD · Answer

Dear rp_baller23, Thank you for your question. I suggest keeping in contact with you Board Certified Operating surgeon and let them know that the fluid is still having build up, and they can keep draining it or put a draing back in. Best of luck to you!

Tracy Kayan, MD · Answer

If a fluid collection has been long standing, your body may form a capsule around it. The capsule is lined with very smooth tissue, therefore even if it is drained, the tissue will not heal together and obliterate the potential space, so it may fill up with fluid again. If this is the case, and this keeps recurring after needle drainage in the office, you may need to consider going back for a procedure to remove or score the capsule, leave a drain, compress tightly again and allow the two sides of tissue to heal together. You will also want to limit your activities and range of motion on that side for a full 6 weeks after any type of surgery.

Babak Dadvand, MD · Answer

Hi rp_baller,Thanks for the post and photos. Given that you have a significant recurrence of fluid despite two aspirations, you may need to have a drain placed. Seromas can take a while to completely resorb. The other issue with seromas are that if they persist for a while, your body can develop a capsule within that space that will make it very difficult for the fluid to go away completely and this capsule would need to be surgically removed. I recommend you keep in close contact with your surgeon. Sincerely,Dr. Dadvand

Alexes Hazen, MD · Answer

HI!
A seroma and hematoma are different things - both are fluid and create swelling but generally a seroma occurs after the drains are out, and a hematoma usually only occurs shortly after the surgery and can be painful, and is accompanied with bruising.  With that said, this sounds like a seroma, and if it looks swollen and full, go back to your doctor and get it drained again! Hope this helps!

Anthony J. Wilson, MD · Answer

Thank you for your question. Seromas can be very challenging for both the patient and the surgeon. I recommend you follow up with your surgeon and potentially have a drain placed and left for several days. Sometimes if the seroma has been present fo a long period of time the site needs to be opened and the cavity cleaned out. Your surgeon should be able to help you with this, it will get better!

What should I do about my seroma/hematoma after it's already been drained twice? (Photos)

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