Roger Smith, MD, FACS

Hi Celebrated337449,

The differential for causes of this drainage from the umbilicus is fairly large. Causes include chronic suture abscess, mesh infection, draining urachal cyst, or even an endometrial implant (related to endometriosis). The dark color you mention as well as changes in your symptoms in relation to your menstrual cycle elevate my concern for a possible endometrial implant. That is unusual, but I have seen it multiple times in my practice. Have you a history of endometriosis or a laparoscopic hysterectomy?

My recommendation would be to have a CT scan of your abdomen with IV contrast to carefully evaluate the area. Surgical exploration is likely going to be required. The extent of that exploration would be determined based on CT findings. This could mean just evaluation of the skin and subcutaneous tissues or a more involved surgical procedure.

I wish you the best of luck.

-Dr. Smith

Hi Teagz1988,

Based on the photos that you provided and without knowing your specific cosmetic goals, you appear to be a good candidate for liposuction with fat transfer. Certainly, during your consultation, your surgeon will examine you and determine if you have significant rectus diastasis (separation of the abdominal muscles) that might change the recommended surgical approach to help you achieve the look you desire. I think you will have a great result.

Best of luck!

-Dr. Smith

Hello Considerate630036,

In the subcutaneous space between the fascia covering the muscle and the Scarpa's fascia on the skin, where most liposuction is performed, there are no 'main arteries.' Certainly there are arteries and veins in this space, but they are relatively small and will not cause massive hemorrhage if injured during surgery. Liposuction cannulas are blunt tipped and all larger that the blood vessels that are in the subcutaneous tissue, making it more likely that the cannula will allow the artery to 'roll around' the side of the cannula during the procedure rather than poking right through it.

Certainly, bleeding can occur during liposuction or any other surgical procedure, however, it is not likely to be severe. If a blood vessel that we described above were to be injured during the procedure, you would notice bruising of the skin (which is likely to happen after liposuction anyway) or a collection of blood under the skin called a hematoma. The smaller blood vessels in the areas where we perform liposuction will stop bleeding on their own or with just mild pressure such as you get with your post-operative compression garments.

I would recommend consulting with a qualified surgeon who can further address your specific concerns regarding bleeding.

Best of luck!
-Dr. Smith

Hi Justme1024,

Thank you for your question. I'd like to start my answer by sharing what my partner tells her patients. "Perfect symmetry does not exist in nature." Although it is certainly not easy nor definite to make this claim with certainty based on review of a photograph alone, but you may have slight scoliosis causing your left hip to be just a bit higher than your right. This could account for some of the differences that you have noticed in your body contour. You DO have an 'hour glass' figure, so what I assume that you are meaning in your question is that you are looking for a ways to achieve is a more 'toned' and smooth look. That can be accomplished with liposuction to accentuate your natural curvature and help to smooth some of the mild irregularities that you mention. I would recommend a consultation to address the specific areas of concern with your shape with a qualified surgeon.

Best,
Dr. Smith

Hi Dazzling4662,

Based on the photo that you provided, I do think that this area in your upper back/lower neck may represent a condition commonly referred to as a 'buffalo hump.' Other items on the differential diagnosis include a large lipoma (fatty tumor with a capsule around it) or early kyphosis (rounding of the spine - doubtful given your young age). I would recommend that you show the area to a qualified surgeon so that they may confirm with an exam what this area represents or order an ultrasound to assess for a well-defined capsule that may represent a mass rather than fatty tissue accumulation. Treatment options range from liposuction to the area to surgical excision. Each method has its pros and cons, and the surgeon you meet with will be able to specifically discuss which approach makes the most sense for you.

Sincerely,
Dr. Smith