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Understanding Seroma: Signs, Causes, and Treatments

Updated: Jan 26


Seroma, a common complication following plastic surgery, is generally not considered dangerous. In many cases, the body can naturally reabsorb a small seroma without requiring any specific treatment. However, clinical intervention becomes necessary when a seroma becomes sizable, progressively enlarges, and causes increased discomfort for the patient.

What exactly is a seroma, and why does it develop?

According to the National Health Institute (NIH), a seroma is the accumulation of serous fluid—clear fluid with a yellowish-white color—in the tissue, organ, or bodily cavity near a surgical site. While the body typically absorbs this fluid buildup, the postoperative seroma formation may persist for several months to a year. Surgeons may recommend specific treatments for patients experiencing seroma.

Seromas are commonly associated with breast cancer surgery, as well as aesthetic or reconstructive procedures like liposuction and tummy tuck. Surgeons may employ drainage tubes following surgery to minimize the risk of seroma formation, though these complications can still arise weeks after the intervention.

Observing any changes in the seroma is crucial, as its formation inevitably extends the recovery period. Here are some images of what a seroma looks like to offer a visual representation.

Causes of Seroma Formation:

While the medical community understands what a seroma is, the precise causes of its formation still need to be discovered. Despite this, specific explanations and identified risk factors suggest why seromas may occur after surgical procedures. Let's delve into the plausible causes of seroma formation following surgery.

Creation of Empty Space or Cavity

A 1998 publication in the Aesthetic Surgery Journal reported that the emergence of seromas may be attributed to "shearing forces." In the conducted study, researchers performed an abdominoplasty, commonly known as a tummy tuck. They observed that the skin flap and underlying abdominal muscles experienced divergent forces post-surgery, resulting in the formation of dead space, ultimately leading to a seroma. To counteract this, they implemented sutures to secure the skin flap to the muscles, successfully preventing seroma occurrence.

Surgeries involving the complete or partial removal of skin and tissue pose an elevated risk of seroma development. The necessity to sever blood vessels and lymphatic vessels during these procedures may cause fluids to infiltrate the void left behind, leading to the accumulation of a seroma. According to the Cancer Treatment Centers of America (CTCA), the fluid is sourced from the lymphatic system or is a combination of lymph and serum (blood plasma without clotting factors).

Inflammatory Response Triggered by Surgical Trauma

Another theory posits that seromas form as a consequence of the trauma induced by the surgery itself. Fluid accumulation around the surgical site is attributed to the body's inflammatory response. A randomized trial documented in Plastic and Reconstructive Surgery indicated that administering anti-inflammatory medications could reduce post-surgery seroma accumulation.

Risk Factors Associated with Seroma Formation

Several identified risk factors contribute to the likelihood of seroma formation after surgery. The presence of one or more of these factors increases the individual's susceptibility. These risk factors include:

  • Hypertension or high blood pressure

  • Advanced age (over 45)

  • Extensive removal of skin and fat, along with a sizable surgical area

  • Prolonged surgical duration

  • Elevated body mass index (BMI)

Discussing these risk factors with your surgeon before the procedure is imperative to gain a comprehensive understanding of what to anticipate in the postoperative period.

Indicators of Seroma Presence

A seroma manifests as a noticeable lump beneath the skin, characterized by swelling, tenderness, and a soft, yielding texture. Its onset may occur days or weeks following surgery. If a seroma persists and enlarges, heightened pain and discomfort may accompany the condition. Recognizing these signs is crucial when understanding what a seroma entails.

When to Seek Urgent Medical Attention

Understanding the nature of a seroma, immediate medical attention is warranted if you experience any of the following issues:

  • Discharge from the surgical site

  • Elevated fever

  • Rapid heartbeat

  • Bleeding and persistent pain

  • Wound dehiscence, involving the reopening of the surgical incision

Prompt intervention is essential to prevent potential harm to the surgical outcomes.

Facilitating Seroma Reabsorption

For smaller seromas, the body may naturally reabsorb them, and specific measures can expedite this process:

Apply Heat

Under the guidance of your doctor, heat application, in conjunction with medications, may be recommended. This method is particularly effective for smaller seromas. Utilizing a heating pad or warm compress can expedite reabsorption and alleviate pain. Caution should be exercised to avoid excessive heat application, which could exacerbate the seroma. It's imperative to seek approval from your surgeon before using compressors.

Wear Compression Garments

Many surgeons advocate for the use of compression garments for several weeks post-surgery. As suggested in a study published in Breast Cancer, the rationale behind this practice is that compression garments mechanically seal the dead space beneath the skin. Additionally, research in the Journal of Reconstructive Microsurgery posits that compression garments may act as barriers against shearing forces, reducing the risk of seroma formation. While conclusive evidence is lacking, adherence to your surgeon's recommendations is paramount.

Maintain Skin Hygiene

Ensuring cleanliness around the seroma site is crucial to prevent infection. Infection of the seroma increases the risk of abscess formation. Thorough handwashing is essential before handling the seroma. When applying heat, use a clean compress. Avoid applying substances like fragrant lotions that may irritate the skin. Top of Form

Treatment of Seromas

Recognizing the nature of a seroma and its appearance is crucial for early detection, prompting timely consultation with your doctor. In addition to a physical examination, the surgeon may utilize ultrasound or computerized tomography (CT) for precise diagnosis. Subsequently, various treatment options will be discussed based on your specific case.

Medications such as antibiotics may be prescribed for small seromas to prevent potential complications. The rationale behind avoiding needle aspiration for small seromas lies in the risk of infection associated with puncturing the skin.

In the case of a large and notably painful seroma, the following treatment measures may be necessary:

Aspiration Procedure

To undergo this procedure, a visit to the clinic is necessary. The doctor will administer local anesthesia to ensure you experience no pain or discomfort. A fine, thin needle is then used to extract fluid from the seroma.

Frequent drainage sessions may be required, possibly more than once a week for several months. Maintaining cleanliness in the surgical area during treatment is essential to prevent infections. It's crucial to be aware that seromas can reoccur even after drainage.

Preventing Seroma

Surgical drains are employed to prevent seromas, accompanied by additional precautionary measures. Wearing a compression garment as instructed by the surgeon, usually for 4-6 weeks post-surgery, is crucial. Following the prescribed medication regimen is essential. Limiting physical activity, particularly shoulder movement after breast surgery, is advised to mitigate the risk of seromas. Maintaining good personal hygiene is vital for infection prevention. Understanding what constitutes a seroma aids in its prevention.

Potential Complications of Seroma

Immediate attention is necessary if a seroma is significant and worsening. Left untreated, seromas can lead to lasting complications, impacting health directly. The stretched skin over a large seroma may sag, causing dissatisfaction after cosmetic surgery. Seromas can diminish blood supply to surrounding tissues, leading to permanent damage. Fibrous tissue may encapsulate an untreated seroma, hardening its surface and complicating fluid drainage. Infections can occur, potentially forming an abscess. Calcification of surrounding tissue may persist even after fluid reabsorption, affecting mammogram results. Timely treatment is crucial to address these complications.

Reach Out To Luviacure Today For Seroma Treatment

When it comes to effective and reliable seroma treatment, Luviacure stands out as a trusted partner in your healthcare journey. By combining advanced medical expertise with a commitment to patient well-being, Luviacure ensures a comprehensive and personalized approach to seroma management. Don't let the potential complications of untreated seromas impact your health and satisfaction post-surgery. Reach out to Luviacure today, where compassionate care and specialized treatment converge to pave the way for your optimal recovery. Your well-being is their priority, and with Luviacure, you can trust that your seroma treatment is in capable and caring hands.

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