Seromas and plastic surgery

It's medical terminology time. Today's word is "seroma". Read this, and impress your friends with your knowledge!

A seroma is a fluid collection which may show up after surgery. Different than a hematoma, (which is a collection of blood within the tissues) a seroma is typically a watery, yellow-colored fluid pocket that has accumulated in one main area beneath the skin. Seroma fluid looks a lot like the fluid you would see inside a large blister. Seromas are considered a minor complication - more of an annoyance, really - after surgery.

Surgeries in which large dissection pockets are created, such as a tummy tuck, a body lift operation, a mastectomy, or certain types of breast reconstructions have a higher rate of developing these fluid accumulations. It can happen after liposuction, too. Some times the patient just notices the area getting larger without any particular symptoms, sometimes seromas cause a low-grade burning sensation in the area.

We try to prevent these annoying seromas by several methods: compression, use of surgical drainage tubes, or internal "quilting" sutures. Each surgeon has their favorite method, and there is still debate at plastic surgery meetings about which technique is best. For example, the drain tubes used after a tummy tuck help to prevent a seroma from accumulating, allowing the tissue layers to heal back together correctly.

How do you know if you have a seroma? In the classic case, we look for a "fluid wave" during the post-operative check-up. This is where we lightly tap on the skin in one area, and see or feel the skin moving back and forth (like an ocean wave) somewhere nearby. Big seromas can look like a water balloon jiggling beneath the skin. Ultrasound scans can also be used to detect seromas.

The treatment is to aspirate the fluid. Usually this can be easily done with a needle and syringe, and a little local anesthesia. Once the fluid is out, it looks and feels better.

Seromas seem to occur more frequently in our body lift / gastric bypass patients, but can happen to anyone. Fortunately, for most people, after an aspiration or two, they go away and don't typically cause any long term issues.