Is it a seroma?

 How do you know when you have a seroma?  I have a pocket of swelling right above my incision to the right of the midline.  The right drain came out first at 1 week.  I totally sympathize with the "Ken Doll" post before, because the swelling around my incision is of that variety.  
I can press the swollen area with my thumb and leave an indentation, but it does not ripple far across my tummy.  I would estimate that it is between 2 and 3 cm in diameter.
If it is a seroma, how are they aspirated?  Does the needle go in far, and does the surgeon stick it in perpendicular to the skin or run it in more at an angle?  Just curious, sounds painful.  
And, if it is a small pocket, what is the harm of letting it resorb?  I am on a high dosage of Clindamycin, so risk of infection should be controlled.  When I asked the nurse at my surgeons, she said that they wanted the skin to be smooth.   But I am so swollen everywhere that nothing is smooth yet!
Thanks y'all!

I remember you getting the plastics recently but I don't recall how long ago the drain was removed.  I haven't had a seroma or a hematoma but I do know they should be taken care of promptly.

When is your next follow up appointment?  If it's Monday or Tuesday, you should be fine.  If it's any later than that, you should call your plastic surgeon and get in sooner.

Best wishes.

Hi, I am responding to your e mail regarding seromas. I was diagnosed with two of them about three weeks ago. I had my surgery(panniculectomy) on November 30 of last last year. I had two drains, one of them for 6 weeks and one of them for 8 weeks. I started to hear gurgling in my belly and was also able to hear fluid sloshing around as I pressed on my belly. I also felt  a bit hot under the areas were the seromas are located. I felt like the skin that had adhered to my abdominal wall after the surgery was coming apart. It isn't intense pain but is uncomfortable. This feeling was similar to the feeling I had in my incsicion area a week or two after my surgery. I finally decided to visit the surgeon and after examination she did not feel I had seromas but prescribed an ultrasound to rule this out. I had the ultrasound the next day and the seromas were diagnosed. They are pockets of fluid that form withing layers of skin and are full of fluid(serum or lymphatic fluid) which is not able to be absorbed by the tissue. If the seroma is not attended to the pockets that hold the fluid can develop a membrane making it nearly impossible for the fluid to absorb or can alos get infected. The surgeon told me to start wearing my binder again to see if  with the aid of the pressure the binder creates the fluid will absorb onto the tissue and let the layers of skin grow back together. If this doesn't work there were two options, to drain it with the use of a needle or to insert new drains. My surgeon has a radiologist do either of these procedures with the use of ultrasound so they can determine exactly were the fluid is and were to insert the needle.She felt that this was the best approach so she didn't have to pock around with the needle trying to find the seroma.  How deep the needle will go depends on the location of the seroma as it relates to the surface of your skin. My seromas were about 2 to 3 cm from the surface. I viewed the ultrasound as it was taking place and they found both of them in seconds. This is the best and safest way to diagnose them. The ultrasound is not painful. As far as the hard lump, I have the same issue and I asked the ultrasound technician and she stated that this was very common and that  the lump was probably scaring or hardened fat. She stated that depending on what it was it could dissolve over time.

If any of the above symptoms take place contact your surgeon and make sure they do an ultrasound, I feel that if the ultrasound would not have been done I would not have been diagnosed with seromas. She also told me to limit my abdominal activity since this will prevent my tissue from growing back together.

I hope this helps and good luck to you. I have a follow up ultrasound next week.
 

Hi!
Sounds like a seroma from your description of it.  Have you called your surgeon?  If not you should do so as soon as you can so you can get an appointment to get it drained.  You don't want to risk an infection or worse skin dying off.  Sorry, don't mean to worry you just want you to take care of it quickly.

Let us know how you make out.
TTFN

 Tonight I noticed a tiny new stretch mark in the swollen area.  My surgeon is out Monday, so I am going to try and go in Tuesday and let her take a look.  From what you guys say I suppose I may be getting aspirated then.  I hope it doesn't hurt!