Hello, and thank you for your question regarding a lump 26 days post-thighplasty (thigh reduction) while you were still wearing compression and had drains in place. Thank you for sharing your history and the pictures of your thighplasty. Most experienced, board-certified plastic surgeons would agree that you are describing a seroma. A seroma is a pocket of serous fluid. Serous fluid in your body is a natural superglue that helps tissues glue back together. Unfortunately, too much serous fluid is made for large cavity surgeries like a thighplasty, thigh lift, or a 360 circumferential lower body lift. That is why drains are very important to use during a thighplasty, lower body lift, or tummy tuck. Drains do not eliminate the risk of seromas. However, drains certainly decrease the risk of developing seromas. Nonetheless, it sounds like you have a seroma. You must follow up with your local plastic surgeon. To remove the serous fluid, ideally, a drain should be placed directly into the seroma cavity. If a drain is not present in the seroma cavity, multiple treatment options are available. Typically, the most effective treatment option for seroma is needle aspiration. Needle aspirations are performed approximately every 2 to 3 days for approximately two to three weeks until the seroma disappears. Alternatively, if needle aspirations do not work, injections of a sclerosant can be done to scar the lining of the seroma cavity. The scaring solution causes the seroma cavity to collapse and close. However, most plastic surgeons who treat numerous seromas with sclerosants have found that this technique is not particularly effective. Another seroma treatment option is to make an incision over the seroma cavity and place a ribbon of gauze to allow the seroma to drain. This allows fluid to escape, preventing accumulation, and the serous fluid constantly leaks until the seromas collapse, typically within one to two weeks. The last resort is to go through the prior thighplasty incision and directly excise the seroma along with its scar tissue perimeter. However, resection of seroma is usually reserved for the last stage of treatment. It is unlikely that you will need this more extreme seroma treatment. Therefore, visit your plastic surgeon and continue the present drain. Be prepared for either needle aspiration, incision, or insertion of a static drain to allow the fluid to drain. Good luck. Thank you for your question regarding a lump 26 days after a thighplasty.
