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Scar Asymmetry After Abdominoplasty: The Unexpected Role of Seroma

di Summa, Pietro Giovanni MD, PhD*; Wettstein, Reto MD*†; Erba, Paolo MD*; Raffoul, Wassim MD*; Kalbermatten, Daniel Felix MD, PhD*†

doi: 10.1097/SAP.0b013e3182503ad9
Aesthetic Surgery

Achievement of symmetry remains one of the goals of cosmetic procedures. Interestingly, scar asymmetry after abdominoplasty has been rarely considered a complication. However, this can have a significant impact on patient and surgeon satisfaction. This study identifies silent seromas as a potential cause of scar asymmetry.

Among abdominoplasty procedures in a university hospital institution over a 30 months’ period (October 1, 2007 to April 1, 2010), we retrospectively identified 6 patients who developed abdominal scar asymmetry only 3 months postoperatively and without any early warning complications (hematoma, seroma, or infection). Clinical examination was completed by abdominal diagnostic ultrasonography. Seroma capsulectomy under local anesthesia was performed in all cases.

In all patients clinically presenting late abdominal scar asymmetry, ultrasonography confirmed the presence of an encapsulated chronic seroma. Surgical capsulectomy under local anesthesia resulted in reestablishment of former symmetry and high patient satisfaction. No complications such as wound infection, dehiscence, hematoma, or recurrence of seroma were detected after revision surgery.

In our experience, fibrous capsule due to chronic seromas resulted in abdominal scar deviation and asymmetry. Surgical capsulectomy followed by wearing of compressive garments resulted to be an effective treatment with pleasant aesthetic outcome and no seroma recurrence. Silent seromas should be considered as a possible etiologic factor of scar asymmetries appearing during late follow-up after abdominoplasty.

From the *Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital of Lausanne, CH-1011 Lausanne, Switzerland; and †Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital of Basel, CH-4031 Basel, Switzerland.

Received October 27, 2011, and accepted for publication, after revision, February 13, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Daniel Felix Kalbermatten, MD, MPhil, PhD, FMH (Plast), EBOPRAS, Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University of Basel, CH-4031 Basel, Switzerland. E-mail:

© 2013 by Lippincott Williams & Wilkins