A seroma is a collection of tissue fluid or lymph - essentially blood without the blood cells. It will be generated by inflammatory or healing tissue and is not the result of bleeding. The other cause is when lymph vessels are cut and drain into the wound.
A seroma presents a few days after surgery as a fluctuant swelling. It may become uncomfortable if it becomes tense or infected. The treatment is drainage needle aspiration or by the insertion of a drain. The production of fluid abates as the wound heals leaving no raw surfaces or the severed lymphatic vessels join up again.
Aspiration may need to be repeated at several days interval if the fluid reaccumulates. Usually, the amount of aspirated reduces with time. A drain can be removed when it has almost stopped draining. The longer the seroma is not treated the longer it takes to recover and then there is a risk that there will be some unevenness.
Certain operations run the risk of seromas and sometimes they can be avoided. A big culprit is ultrasound liposuction, of which Vaser is the best known. This is one of several reasons why we would not recommend this technique. We have never seen a seroma in the 3,000+ cases of standard and water assisted (Body-Jet ) liposuction, which we have performed at the Cadogan Clinic
Operations on areas where there a lot of lymphatics or lymph nodes can be difficult and may well require a drain left in the wound at the time of surgery. These areas are the armpit (axilla), the neck and the groin.
The abdominal reduction (Abdominoplasty, Tummy Tuck) leaves a raw space under the skin and also divides the number of lymphatics. We do however have a much-improved technique called the Brazilian Abdominoplasty where this and other risks are reduced, drains are avoided and we can still treat you as a day case.
This month Consultant Dermatologist Dr Susan Mayou discusses rosacea with Heart.co.uk, and talks to the Daily Mail about the latest skincare craze, chlorophyll.