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Plastic Surgery/seroma after abdominal therapy

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QUESTION: I had surgery on the 10th of November to remove a gastric stimulator. About a week out I developed a seroma that kept getting bigger by the day and very painful. I called my general surgeon and he had me go in to have the seroma needle aspirated to drain. Well about 2 days later it was back. It started getting painful again and he suctioned out 6 syringes of old blood(dark red). He said that the next time they would have to place a drain in. Well right after I started walking it came back, and is about the same size, and even more painful than before so it looks like a drain will be put in. Can you please answer a few questions for me. Is this done in the office, will I have anastegia, is it painful for this procedure. Here is the tricky part I have no adrenal glands so everthing needs to be done with caution.Thank You Elaine

ANSWER: from Dr. Alan Engler

Hi Elaine,

It is, of course, nearly impossible to give specific advice via this forum - but, that being said, I would agree that if the fluid continues to reaccumulate (or become more apparent) then you have to consider more than just aspirating.  In general, this procedure can be done under ultrasound guidance to make sure they're in the right spot.  Your adrenal situation certainly has to be taken into consideration; you may need some steroids around the time of the procedure but should, either way, clear this with your internist.

So, in short - it's not unreasonably to try one or even two more attempts at aspiration but unless there is clear improvement I would be more likely to recommend the insertion of one, or even two, drains, if indicated.

I hope that this helps and good luck,

Dr. E
www.bodysculpture.com

---------- FOLLOW-UP ----------

QUESTION: Is this done under anasegia, and is this procedure painful. Otherwise thank you

Answer
Usually some local anesthesia.  Sedation is not normally an option and it is, in general, a little uncomfortable but not too painful.  You can ask your doctor to prescribe a pain pill to take 45 or so before the procedure starts to help take the edge off.  If you're anxious about it, some Valium (probably instead of the pain pill) maybe even more effective in smoothing out the procedure.

Good luck,
Dr. E

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Alan M. Engler, MD, FACS

Expertise

Dr. Engler has answered over 6400 questions on social media sites, including over 3500 on AllExperts alone. His expertise includes breast surgery (breast enlargement with implants, breast reduction, breast lifts), liposuction, eyelid surgery, tummy tucks, facelifts, lipomas, skin cancers, cysts, etc. Dr. Engler has been listed as one New York`s Top Doctors, and as "One of the World's Most Famous Aesthetic Surgeons" (Aesthetic Surgery, TASCHEN Books, Angelika Taschen, Editor). He is the author of 4 books, including "BodySculpture" (a best-selling plastic surgery book on breast surgery, liposuction and tummy tucks), "EyeScapes" (Plastic Surgery of the Eyelids), "Restylane," and "The Slim Book of Liposuction." Dr. Engler has two US Patents for surgical instruments that he's designed, and has appeared on numerous television shows, including The Tyra Banks Show, The Ricki Lake Show (four times), the Dr. Keith Ablow Show and Jerseylicious. Videos of his appearances are available on YouTube (search for "DR. ENGLER"), and his discussion of breast implants, also on YouTube is "How to Choose a Breast Implant." His website is www.bodysculpture.com. Follow Dr. Engler: @AlanEnglerMD

Experience

Dr. Alan Engler is a board-certified plastic surgeon in New York and the author of BodySculpture - Plastic Surgery of the Body for Men and Women (ISBN 0966382749) one of the top-selling plastic surgery books on amazon.com, barnesandnoble.com, as well as EyeScapes - Plastic Surgery of the Eyelids.

Education/Credentials
Dr. Engler graduated from Yale University (BA, Russian Studies) and the Columbia University College of Physicians and Surgeons (MD). He did his residency training in General Surgery and, after that, Plastic Surgery, at the Montefiore Medical Center in New York. He is on the faculty of the Albert Einstein College of Medicine in New York in the Departments of both Surgery (Plastic Surgery) and Medicine (Dermatology), and is a Special Lecturer in the Department of Dermatology at Columbia University in New York. He has admitting privileges at Beth Israel Medical Center and Montefiore Medical Center, both in New York.

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