Bad case of seroma. Should I have it drained, or wait for my next appointment in Sept? (Photo)

Unfortunately, seromas can happen with or without drains, and they happen to all plastic surgeons if they do enough adominoplasties.Most plastic surgeons will drain a seroma when it first appears, and that single draining cures the majority of abdominal seromas.  A less common type of seroma requires multiple drainings or the use of a indwelling catheter and suction bulb.  In the rarest of all post abdominoplasty seromas requires reopening the abdominoplasty and surgically excising the walls of the seroma.  The longer the seroma exists, the greater chance a reoperation will be necessary.  As an adjunct to the middle category requiring repeated drainings, many plastic surgeons will use an irritant to cause the seroma wall to collapse on itself.  This irritant is placed in the seroma pocket once the fluid has been removed.  Some of the irritants that have been used in the past are ethyl alcohol, tetracycline, or corticosteroids.  This irritant plus pressure dressings often gets rid of the seroma pocket.  At this point, it is appropriate for you to contact your plastic surgeon ASAP.  It would not be inappropriate to ask if a draining might not be of some value. 

It's impossible to say from the photograph whether you have a seroma. You should visit your plastic surgeon. Seromas are best treated aggressively to Foreshorten Their course.

A seroma, or fluid collection, needs to be drained. Very small collections will usually go away on their own, but best to have is drained with a needle. If a seroma persists for a while, it will become a chronic collection and may lead to infection, cosmetic deformity, and the need for a corrective surgery. If your seroma has been there for 3 1/2 months, that is about 3 months too long in my opinion. You need to see your surgeon immediately to have this taken care of. You may need weekly aspirations, placement of a drain, or surgery.

Dear 57,Thank you for your post.  Seromas can be painful and cause a cosmetic deformity, as well as sometimes leak.  The whole point of drains is to keep a seroma from happening in the first place.  If a drainless procedure was performed, and you had a seroma, or you had drains that were pulled and you subsequently had a seroma, then you should be drained, otherwise a capsule builds around the fluid making it permanent.  If a capsule builds around the seroma (pseudo bursa or encapsulated seroma) then the only way to remove the seroma is to surgically open the areas and excise the capsule, and close over drains to prevent another seroma from happening.  If the seroma is encapsulated and is tight and painful, then it can be confused with just swelling or fat.  An ultrasound is useful in distinguishing these and identifying the extent of the seroma. If the seroma is not yet encapsulated, then it is usually loose and has a 'fluid wave' or water bed type feel.  Occasionally, a seroma can also become infected, especially if a permanent braided suture was used.  This will have a hot, red appearance, and will eventually open up.Best wishes,Pablo Prichard, MD 

its your surgeon's responsibility to examine you to make sure you don't have one.  If you do and its been this long since its been aggressively treated, its likely a procedure will be needed to remove the cavity and fluid.  Do not wait until September if you have not been evaluated.  If you have and there was no seroma, then its mostly swelling that will take longer to resolve.

without an examination it is difficult to answer the question. I would recommend you return to see your surgeon. They know you best.

I think that it will be in your best interests to inform your plastic surgeon of your concerns. More than likely he/she will want to see you before your scheduled appointment. Best wishes.

Hard to tell just from the photo.Your doctor can usually tell whether it is a tiny seroma which will go away or a large one that needs drainage.Sometimes an ultrasound is helpful to determine both size and exact location.You should contact your doctor,sounds like sooner would be better than later due to your concerns