What is a Seroma?
After surgery, tissue and fluid may build up heavily under the skin at the site of the incision, forming a seroma (x). They are most common after breast cancer treatment procedures. Most of the time seromas are harmless and physicians leave them to heal on their own naturally. However, they can cause a lot of pain and extend the patient’s stay in the hospital post surgery. In one research study, 35 percent of patients developed a seroma after surgery for breast cancer and 20 percent developed a postoperative seroma six months later (x).
Characteristics of a Seroma
Usually, a seroma is a swollen lump that looks like an enlarged cyst. It is sore and tender to the touch and clear discharge oozes out of the surgical incision. The incision site may also develop a hard knot as the growth forms (x). Sometimes a seroma may look identical to other conditions, such as a hematoma, lymphocele or abscess (x).
Though it is generally harmless, the area may develop into an abscess if it gets infected. Signs of infection include redness, swelling, pus or watery blood, severe pain or warmth, fever, increased heart rate or a lump near the incision (x).
Causes of a Seroma
Seromas are most common after breast cancer surgery. However, medical researchers are not exactly sure why they develop (x). There are a few risk factors that may increase the risk of a seroma after surgery, including age, body mass index (BMI) or breast size. The patient may also be at a higher risk if they have cancerous nodes in the armpit or if they have had a previous biopsy (x). Aside from breast cancer treatment, they can also develop after other procedures such as:
- Breast implants or reduction
- Cosmetic or reconstructive surgery
Seromas usually develop a week to ten days after surgery when the doctor removes the drainage tubes from the incision site. The growth develops from damage to tissue and blood vessels. The surgery leaves dead space that forms lumps filled with fluid under the skin. The body then releases an inflammatory response, which causes pain and swelling and the fluid builds up to form a seroma (x, x).
Treating a Seroma
Most of the time, the body reabsorbs seromas within about a month, but it may take up to a year. In more severe cases, the growth may develop into a capsule and require surgical removal to drain the fluid in it. Patients should see a doctor if the symptoms worsen or if they notice any of the following signs (x):
- Tenderness, discharge and pain
- Increased swelling
- Redness and warmth at the incision site
- Increase of fluid
If the seroma does not improve, the patient may undergo a process called fine-needle aspiration. The process draws the fluid from the seroma and also monitors how much fluid is inside. If the patient continues to develop seromas, a doctor may insert a drainage tube. However, draining may cause it to drain slower and it may even increase the risk of infection (x).
If the seroma does get infected, a doctor may prescribe antibiotics to remove bacteria. The patient may also need sclerosis, a procedure that closes the growth. If other treatment options fail, the patient may need surgery to remove it (x).
Managing a Seroma
Usually seroma heal on their own. However, patients should take steps to make sure the area heals properly and try to avoid infection.
Applying a heating pad or hot compress may help the seroma heal faster. It may help the fluid drain and possibly ease the discomfort. Apply it for about fifteen minutes every few hours. Be careful not to apply too much heat or use it for too long because it can cause additional fluid buildup (x).
Keep the Area Clean
To avoid infection, it is important to keep the affected area as clean as possible. This will keep harmful pathogens and bacteria away and allow the seroma to heal properly on its own. Also, make sure that heating pads or compress are completely clean. Avoid touching the area with the hands and make sure the hands are clean if it is necessary to touch it (x).
Keep the Area Elevated
A doctor can instruct patients on different positions that may help the growth drain properly. If a doctor advises it, keep the area elevated and follow their instructions. After surgery, patients should limit physical activity to allow the body to heal. Refrain from any kind of heavy activity that can cause stress to the affected area (x).
Preventing a Seroma
After surgery, patients may wear compression garments to keep the area clean, reduce fluid and keep the incision from stretching. Physicians recommend that patients wear the compression garment for at least two weeks and gently massage the area to move the fluid, keeping it from building up under the skin. This will not heal the seroma, but it may reduce the risk of it developing in the first place (x).
Keep the Drainage Tubes Clean
Seromas develop on the body after drainage tubes are removed. It’s important to make sure the tubes stay clean and follow all of the doctor’s instructions about managing the drainage tubes and preventing infection (x).
Supplements for Surgery Recovery
Supplements may help patients have a healthy recovery after surgery and prevent complications. But they are not a treatment for any medical condition or symptoms. Instead, they aim to promote general health. Always consult a doctor before taking any supplement.
Centuries ago, people used arnica as an herbal remedy for different conditions, including bruising, wounds and inflammation. One of its oldest uses is for care after surgery because it reduces swelling and helps the body heal after operations. Arnica is also available as a dietary supplement. Add one or two teaspoons of arnica extract powder to 50 ml of warm water. Then use it as a topical and soak a clean linen cloth in the solution and apply it to the skin. Consult a doctor before taking this supplement.
Grape seed can help reduce inflammation in the body and improve blood circulation. Studies state that it acts as a natural antioxidant agent to reduce inflammation in the body and protect the blood vessels. This is important because surgery can damage the blood vessels and this may cause a seroma to develop. The recommended dosage for grape seed extract is 50 to 200 mg (1/64 tsp to 1/16 tsp) daily or every other day after confirming with a doctor.
Fish oil is a powerful antioxidant that can promote healthy skin. It helps protect the skin from UV rays, protects collagen and helps heal wounds. This may include wounds and incisions from surgical procedures. It can also help protect the body from blood clots that can develop in the vein and cause damage if they travel to other parts of the body. As a dietary supplement, take one or two fish oil softgels at 1,000 mg two or three times per day, after consulting a doctor.
Coenzyme Q10 (COQ10) is an antioxidant that helps protect the body from damage and several medical practices use it to treat heart conditions. It is present in meats, fruit, vegetables, oils, nuts and seeds. It can help support the immune system and promote healthy skin. The recommended dosage for COQ10 powder as a dietary supplement is 50 to 200 mg (1/32 tsp to 1/8 tsp) if a doctor approves the dosage.
The Bottom Line
Seroma is a lump under the skin that can develop after surgery, most commonly after procedures to treat breast cancer. It develops from fluid buildup under the skin after the procedure removes body tissue and leaves dead space. Surgery can damage blood vessels, which causes inflammation.
The growth is red and tender or sore to the touch and it also oozes a clear fluid. It usually goes away on its own when the body reabsorbs it, but it is possible for a seroma to get infected if bacteria gets inside the incision. Antibiotics can treat the infection and if the seroma does not disappear, it may need to be drained or surgically removed in more severe cases. However, patients can also use natural home remedies to manage the symptom, such as warm compresses and elevating the area to help the fluid drain. Supplements may also help patients recover after surgery and prevent complications or infections.