abdominoplasty and seroma

[ladyniblett]

Hello, I am two weeks post a full tummy tuck with a small amount of liposuction. They removed about 5lbs of fat. I live on an island and flew quite a ways to have this procedure done. I healed beautifully and came home with the only precaution being to keep my wounds sterile, finish out my antibiotics, watch for infection, and have my navel stitches removed. I was told I would likely develop seroma and that my doctor could drain it. My drains were removed 48 hours post operation.

I am aware that the body reabsorbs fluid. My question is this: my practitioner is not comfortable draining the fluid I have. This is a military installation. My only other option is going to the local ER where none of the doctors speak English and paying for it fully out of pocket. That is quite costly for something so simple. But this is quite a bit of fluid--2 or more cups even. Is it necessary? I have read up on seroma and I don't think there is a woman I could find with so much fluid that was not having it aspirated. Yet the condition is benign...would it be harmful to do nothing at all? I can live with the discomfort, but of course I want to heal well!

My surgery was ideal in healing other than this. I did not even require pain medication and I get around fine--no pain at all.

[Dr. Safaa Mahmoud]

Hello,
A seroma is a collection of serous fluid in surgical wounds in the postoperative period forming a pocket like swelling.

They may be resolve spontaneously as the body absorbs this serous fluid over time, which may be in weeks. However, if it is large, surgeons may prefer to drain the fluids to fasten the recovery and avoid complications although others do not recommend doing so.

The critical point is the fact that it is a good media for bacterial growth and if infection occurs an abscess will be formed. This would mandate a different treatment approach with antibiotics and possibly surgical drainage. And in this case the wound may heal in a non desirable cosmetic result.

I would advise you to seek direct medical consultation. Meanwhile try to carefully follow strict local antiseptic measures and if your doctor has prescribed you an antibiotic course, please follow his instructions taking the full course.

Please keep us updated.
Best regards.

[ladyniblett]

Thank you for your quick response. I went to the Emergency Room in order to find a doctor willing to look at the seroma. He said it could be left alone or he could aspirate it. I wanted it aspirated obviously since I was in a lot of discomfort.

Upon attempting to aspirate it he discovered it was a hematoma. They removed 490 cm (aproximately 17 fl oz or just above 2 cups) of blood. This did a lot to improve my mobility though afterwards the empty space is surprisingly painful.

Other than that the scars and swelling look great. My incision is almost invisible, the healing is remarkable for only 16 days post op. I hope this helps anyone who may have had a similar problem. The hematoma is apparently not a problem at all.

Of course it will more than likely return, but the doctor said in not such a great quantity. I will only have it aspirated again if I experience similar discomfort. Otherwise I will let it absorb. Thanks again for your response.

[Dr.M.Aroon kamath]

Hi,
The post surgical seroma is better aspirated than be left alone especially if it is large to obviate super added infection.Good luck.