Do Seromas Go Away on Their Own?

Seromas can resolve without any intervention. The body is capable of absorbing the fluid over time, but it may take several weeks or even up to a year. However, if the seroma is large or causing discomfort, waiting for it to naturally disappear may not be necessary.

A seroma can develop after surgical procedures that involve the removal of tissue, such as lumpectomy or abdominoplasty. It is the result of clear bodily fluid collecting in the empty space left by the removed tissue. Although it may feel unusual, a seroma is not a medical emergency. If it bothers you, you can consult your healthcare provider. They can drain the fluid to alleviate any discomfort. It is important to inform your healthcare team if the bulge becomes painful, causes illness, or increases in size. Although rare, seromas can lead to infections.

Causes of Seroma

• Lumpectomy
• Mastectomy
• Lymph node removal
• Abdominoplasty
• Breast reconstruction
• Abdominal wall reconstruction
• Hernia repair
• Removal of thyroid tumors
• Body-contouring
• Liposuction

Identifying a Seroma

A seroma can manifest as a lump in the weeks following a procedure. If drainage tubes were inserted during surgery, the seroma may develop after their removal. It may feel as though there is a fluid-filled cyst under the surgical site.

• Hearing fluid movement
• Clear fluid leakage from the wound

It is important to differentiate between a seroma and a hematoma. Hematomas occur when blood collects under the skin after surgery and usually cause more pain than seromas.

Risk Factors for Seroma Development

While the exact cause of seroma formation is unknown, certain factors may increase the likelihood of developing one:

• Obesity
• Extensive or prolonged surgery
• Removal of numerous lymph nodes

Additional research suggests that individuals with high blood pressure, those above the age of 45, and those undergoing procedures involving significant skin removal are at a higher risk of developing seromas. Furthermore, males undergoing breast cancer surgery may have a higher chance of developing seromas compared to females.

Are Seromas Dangerous? Complications and Symptoms

Seromas themselves do not pose significant health risks. However, they can prolong the healing process and delay subsequent treatments, particularly after breast cancer surgery. Complications associated with seromas may include:

• Infections
• Wound opening
• Impaired blood flow to tissue
• Pain

Seromas can also increase the risk of developing lymphedema, a condition characterized by swelling in various body parts due to lymph tissue involvement.

When to Seek Medical Attention

If the area surrounding the seroma becomes red, warm, or tender, it may indicate an infection, warranting immediate medical attention. Additionally, consult your doctor if you experience:

• Increased fluid accumulation
• Pressure at the surgical site
• Progressive swelling (possible lymphedema)
• Fever of 100.4°F or higher (potential infection)
• Fluid with blood (potential hematoma)

If you cannot determine the cause of your swelling, it is advisable to consult your healthcare provider.

Treating a Seroma

For small seromas, waiting for the body to absorb the fluid may be sufficient. However, if necessary, healthcare professionals can employ the following methods:

• Draining the fluid using a needle and syringe
• Repeated fluid drainage procedures
• Applying pressure to the swollen area
• Administering a collapsing and sealing injection (sclerotherapy)

If these treatments are ineffective, surgical removal of the seroma may be required.

Preventing Seromas

Although there is no foolproof method to prevent seromas from forming, surgeons may utilize various techniques to reduce the risk:

• Drainage tubes: Tubes are inserted during surgery to drain excess fluid. They may remain for a few weeks after the procedure to aid in the healing process. Proper guidance is provided by healthcare providers on emptying and removing the tubes.
• Dead space closure: Surgeons close the empty space left by tissue removal using absorbable stitches. Techniques such as quilting or progressive tension sutures may be employed.
• Fibrin glue: The use of sealants like fibrin glue, in combination with quilting, has shown promising results in reducing seroma occurrence, although further research is required.
• Postoperative shoulder immobility: Limited shoulder movement after mastectomy could potentially reduce the risk of seromas, but further research is needed to confirm this possibility.

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Sources: Breastcancer.org, Molecular and Clinical Oncology, International Surgery Journal, Eplasty, The Canadian Journal of Plastic Surgery, UW Health, The Journal of Urgent Care Medicine, Annals of Medicine Surgery, International Journal of Surgery Case Reports, The American Surgeon, Plastic and Reconstructive Surgery, Journal of Breast Cancer, Future Oncology, Archives of Gynecology and Obstetrics, International Journal of Surgery, Asian Pacific Journal of Cancer Prevention, Johns Hopkins Medicine, The Chinese Medical Journal, Archives of Plastic Surgery, Aesthetic Surgery Journal

• Medical Reviewer: Carol DerSarkissian, MD