A seroma is a collection of clear fluid under the skin after surgery. It is the most common complication of body contouring, it is not dangerous, and it is usually managed in the rooms with a needle.
It matters because it is also the thing patients most often mistake for something going badly wrong — or, worse, ignore in the hope it settles.
Why it happens
Lifting a large area of skin leaves a space underneath. The body fills that space with fluid. Drains and a compression garment exist to stop that space persisting long enough to fill. Where fluid accumulates faster than it is cleared, or after the drains come out, a seroma forms.
It is more likely after large excisions, in patients who have lost a great deal of weight, and where activity is resumed too early.
What you would notice
- A soft, fluid-feeling swelling in one area, often the lower abdomen
- A sensation of sloshing or rippling when you move or press it
- Tightness, and the garment suddenly feeling tighter over one area
- A swelling that is getting larger rather than smaller, typically in weeks two to four
- Usually no fever, no spreading redness and no severe pain — if those are present, ring rather than wait
How it is treated
- Aspiration. The fluid is drawn off with a needle in the rooms. It takes a few minutes and is not especially uncomfortable.
- Repeat aspiration. Seromas commonly refill once or twice before settling. More than one visit is normal, not a sign of failure.
- Compression. Wearing the garment properly between visits is a large part of the treatment.
- A drain is occasionally reinserted for a persistent collection.
- Surgery is rarely needed, for a chronic seroma that has formed a lining.
Why it should not be left
An untreated seroma keeps the skin lifted off the tissue beneath, so that area heals poorly or not at all. Over time the cavity can form a lining, which is much harder to resolve. Left long enough it can also distort the contour permanently — the opposite of what the operation was for.
Ringing about a swelling that turns out to be ordinary post-operative oedema costs you nothing. Leaving a seroma for a month costs a good deal.
Reducing the risk
- Wear the garment day and night for the full six weeks
- Keep to the activity timeline — two weeks off, gradual return over four, full clearance at twelve
- Keep the drains in until Dr Kumar’s nurses say the output is low enough
- Attend the one-week and six-week reviews, which is when most are picked up
When to call
Ring Dr Kumar’s nurses on 1300 267 726 about a swelling that is enlarging, a sloshing sensation, a garment that has become tight over one area, or fluid leaking from the wound. Also ring for fever, spreading redness or increasing pain — those suggest infection rather than a seroma, and need attention sooner.
Common questions
Is it dangerous? Not usually. It is a nuisance that needs managing rather than an emergency.
Will it go on its own? Small ones often do. Larger ones generally need aspirating.
Does aspiration hurt? Most patients describe pressure and relief rather than pain.
Will it affect my result? Treated promptly, usually not. Left, it can.
Can it come back after aspiration? Commonly, once or twice. That is expected.
Next step
If something has changed since your last review, ring rather than wait for the next appointment. The nurses who prepared you for surgery are the same ones who see you afterwards. Call 1300 267 726. More about recovery week by week and the risks of surgery.
The initial consultation with Dr Kumar is $400, with a Medicare rebate of approximately $88 where you have a GP referral. Surgical fees are quoted individually after your consultation, in a written itemised quote.
All surgery carries risks, and individual results will vary. Read more about the risks of surgery here. A GP referral is required to see Dr Kumar.
Dr Rohit Kumar (MED0001630444) Registered medical practitioner, specialist plastic surgeon (specialist registration in surgery – plastic surgery).
