A seroma is a sterile collection of fluid under the skin, usually at the site of a surgical incision. Fluid builds up under the skin where the tissue was removed. It may form soon after your surgery. Or it may form up to about 1 to 2 weeks after surgery. It may look like a swollen lump and feel tender or sore. Seromas tend to appear 7 to 10 days after surgery after drainage tubes have been removed. Areas involved in the surgery may develop spots that are swollen and feel like a liquid under the skin. Surgery causes damage to the blood and lymph vessels and surrounding tissue. An inflammatory response occurs, and the severed vessels and tissues will produce clear fluid in response. This is why there is pain and swelling after surgery. In some cases, the fluid forms a pocket, which leads to the formation of a seroma. Seromas form lumps under the skin. They are filled with a yellowish-to-white fluid called serous fluid. This is the same fluid commonly seen in blisters and fresh cuts. 

Management of seromas in Gynecomastia

  1. Seromas occur almost universally in gynecomastia due to liposuction and dead space created from gland excision
  2. 90% seromas don’t persist and settle following pressure and massages in 3 months
  3. If seromas persist at 3 months, we give triamcinolone injection 10-20 mg inside the seromas. 2-3 sessions at gaps of 3 weeks
  4. If the seromas have reduced and patient does not have any pain or visible swelling, we don’t do any further treatment
  5. If the seromas dont reduce or small part is still left with pain or visible swelling, we consider a revision procedure, that is done in local anesthesia. 50-100 ml saline and local anesthesia is infiltrated into the seroma, and seroma is broken down with a special micro fork canula, and removed. This is a scarless way of removing a seroma
  6. In less than 1 percent of cases, we need to do open surgery to remove the seroma. It is hard like a gland and complete removal is done.