What is a Seroma?
What Is a Seroma?
A seroma is a pocket of clear, serous fluid that accumulates in a concentrated location at the surgical site. This fluid is produced by the body in response to the trauma of surgery. It primarily consists of lymphatic fluid and blood plasma. Seromas develop under the skin, and cause swelling, discomfort, and sometimes pain, especially when compressed.
How Do Seromas Form After Surgery?
Seromas can form after a wide range of surgical procedures, including breast surgery, liposuction, abdominal surgery, and sometimes following traumatic injuries that did not involve surgery. The process of seroma formation typically involves the following steps:
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Disruption of Lymphatic and Blood Vessels: During surgery, the lymphatic and blood vessels around the surgical site can be damaged, leading to a leakage of lymphatic fluid and blood plasma under the skin.
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Accumulation of This Fluid: This fluid leakage accumulates in the space created by the surgery, forming a seroma. This accumulation can vary in size and may become noticeable within a few days or weeks after the procedure.
Preventing Seromas:
Manual Lymphatic Drainage and Compression
The prevention of seromas primarily involves strategies to manage post-surgical fluid accumulation. Two key methods for preventing seromas are manual lymphatic drainage and compression:
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Manual Lymphatic Drainage (Lymphatic Massage): Manual lymphatic drainage is a gentle and specialized technique that stimulates the lymphatic system. This technique helps facilitate the removal of excess fluid from the surgical area, reducing the risk of seroma formation. Certified Lymphedema Therapists are trained to perform lymphatic massage safely and effectively. Very few massage therapists are Certified Lymphedema Therapists. Shannon Goins-Blair is a LANA Certified Lymphedema Therapist, which is the highest level of lymphatic credentialling.
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Compression Garments: The use of compression garments, like fajas or specialized surgical bras, can help prevent seroma formation by applying pressure to the surgical site. This pressure minimizes the potential for fluid accumulation and aids in maintaining proper tissue alignment. Compression garments should be fitted by a professional fitter. People who run faja stores are not trained in post-operative compression (they are retail workers); by contrast Certified Lymphedema Therapists have this training.
Treatment of Established Seromas
If a seroma forms after surgery and does not dissipate on its own within a few days to a week, medical intervention may be required:
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Aspiration: A medically licensed professional, such as a surgeon or radiologist, can drain the seroma using a needle and syringe. This procedure is known as aspiration and involves carefully removing the accumulated fluid from the seroma cavity. BEWARE of massage therapists and “body contourists,” (an unlicensed and unregulated profession in many states) offering to drain seromas or stick needles in you for ANY reason. This is highly illegal, is practicing medicine without a license, and it could bring you to harm – including death from sepsis (blood poisoning). (Please read this article about illegal actions being performed by non-medically licensed people.)
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Compression and Immobilization: Following aspiration, compression and immobilization are often recommended to prevent a recurrence. Compression garments or bandages may be utilized, and limiting excessive movement at the surgical site can help reduce the likelihood of fluid re-accumulation.
Recurring Seromas
In some cases, seromas may reoccur even after aspiration and treatment. Recurrent seromas are not uncommon, particularly in cases with extensive tissue disruption or a high risk of lymphatic damage. These patients may require multiple aspirations and vigilant monitoring by their medical professionals.
