Introduction: Seroma is a common complication following panniculectomy surgery for massive weight loss (MWL). We investigated risk factors for seroma in this population and describe treatment strategies. Methods: From March 1997 to December 2005, 222 patients underwent contouring surgery for MWL. Factors assessed included age, gender, medical conditions, tobacco use, BMI,and weight of skin excised. Results: There were 187 women and 35 men, with a mean age of 42 years. Weight loss was achieved by open (n=168) or lap (33) gastric bypass surgery, or diet(20). Average BMI at contouring was 33, ranging from 20-69. Areas addressed alone or in combination included the abdomen (n=205), thigh (71), arm (69), back (59), and chest (57). Average weight of skin excised was 9.6 lbs, ranging up to 49 lbs. Seroma occurred in 32 patients, placing risk at 14%. Seroma occurred in 15 abdominal panniculectomy patients, in 14 circumferential patients, and in 3 thighlifts. On multivariate statistical analysis, the major risk factor for seroma was weight of skin excised at surgery, with risk increasing 10% for each additional pound of skin excised. Conclusion: The most important risk factor for seroma is weight of skin excised at surgery. Treatment strategies we will discuss include aspiration, drainage, sclerosis, and surgery.
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