I'm now about 6 weeks post smart lipo on abdomen, flanks and back. The left front side is very noticably bulging out (and has been since the first day after lipo.) At the 3 week checkup, the doc says not to worry it could be "a type of hernia" but wait and see if the swelling goes down. Anyone else had this? How can I not worry? The right side of my abdomen is noticable flatter and straighter i.e. no more spare tire, but the left side still looks like it needs Lipo! (in MHO)
Is It Possible to Have a Hernia from Smart Lipo?
Doctor Answers 4
Several reasons for a bulge after liposuction
There are several explanations for why a bulge on the lower abdomen can appear after liposuction (or SmartLipo):
1. Removal of the fat revealed an underlying hernia that wasn't appreciated when the fat was there
2. Incomplete fat removal on one side
3. The development of a collection of fluid (seroma) or blood (hematoma)
4. Lingering swelling
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I find it unlikely that you have a hernia, as the cannula is too small to make a noticeable hole to cause such a contour deformity as you are describing. There are too many muscle layers to disrupt, and I would have been more concerned with a perforated intestine initially if the cannula punctured through the abdominal wall.
I would wait a few months to see if the swelling will resolve. If you feel a sloshing fluid in the area or a firm mass, then I would suspect a seroma or hematoma, respectively, has developed. You should contact your surgeon if you can feel either of these.
One thing that could have happened, but very, very unlikely is damage to the nerves that supply the muscles to the abdomen. But once again, the surgeon would have had to penetrate in between the correct muscle layers and hit each branch. This type of muscle paralysis is seen with kidney surgeries sometimes as the flank incision can damage the nerves. I have never seen it in liposuction.
Smartlipo liposculpture can cause a perforation of the abdomen
Smartlipo liposculpture can cause a perforation of the abdomen. The risk, however, is the same as with any kind of liposuction. A perforation is a piercing of the abdominal muscles and is a surgical emergency.
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Bulge after liposuction
It would be rare, not impossible, for a hernia to develop after liposuction. Bulges can be related to a seroma which is a collection of clear fluid, a hematoma, swelling or an area that wasn't reduced compared to the rest of the areas and needs more liposuction. If it has been six weeks and is very significant, you may wish to see your surgeon if it becomes painful in the least or seek a second opinion with a board-certified plastic surgeon.