Kenneth Brito, MD

The most objective way is to get an ultrasound to see if it is fluid (seroma) or fat. Fluid has a different sonographic appearance and can even be aspirated by needle by the radiographer if appropriate (ie depends on the size and amount of seroma).

Foam vests are great in maintaining the shape and decreases the risk of seroma or fluid accumulation after liposuction. Will it ruin the result if you don’t wear it for a few hours at work? It depends. If the amount of liposuction is large or if the fluid accumulates rapidly, then I suggest wearing it 24/7.

It depends on the doctor’s clinical judgement whether blood test is required. However, most day surgeries/ operating theatres will require blood test screening before any surgical procedure. This is to prevent any untoward incidences (both surgical and anaesthetic). It decreases the risks of unexpected risks and also provides a good baseline in case patient becomes unwell for any reason.

I normally request for pre-op blood tests for all my surgical patients.

Fluid can accumulate and continue to be produced even weeks after liposuction procedure. Several factors need to be taken into account - ie lymphatic drainage, compliance to wearing garment.

Fluid tends to draw into area by gravity. It depends on how much fluid is expected. Generally, if it is expected to be less than 30ml, we can leave it because body can reabsorb it. However, if the fluid is expected to be greater than 30ml, then it is better to aspirate it out.

One way to get an accurate estimate is to do ultrasound and if necessary, aspiration can be performed under ultrasound guidance. However, most of the time, proper clinical examination is suffice and aspiration can be done in the clinic.

One of the risks of performing aspiration of fluid is infection. However, if the procedure is done under sterile environment, the risk is very low.

Risk of not doing it depends on the amount of fluid estimated. If a significant amount of fluid is left without aspirating and if the body is unable to reabsorb it, it can potentially form a capsule and seroma (fluid) could reaccumulate constantly until seroma capsule is removed. This is a very rare scenario and very unlikely to happen post liposuction.

It is not advisable to use thermal energy device near metal plates as it can conduct heat. Unless the surgeon is confident that he will not go near the area where the plates are, I suggest using traditional liposuction technique to be safe.