26 days post thighplasty, still wearing compression, drains in, noticed lump (Photo)

Question

After putting some pressure On It noticed my compression at drain site was wet took compression off to look at lump it was smaller so I put firmer pressure on it with a towel and felt it pop the drain bulb instantly filled up this has happened a few times since putting pressure on it more fluid releases. If I leave it alone will it eventually absorb or be pulled out by the drain? The pocket as I call it seems to keep filling Some times when I put pressure I get some bloody looking fluid too.

Yannis Alexandrides, MD, FACS · Answer

This is a collection of fluid which can be recurrent for many weeks. One solution is to have a drain for continuous drainage.

J. Timothy Katzen, MD, FACS · Answer

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.   
I hope that I have answered your questions regarding the thigh reduction.  If you have any more questions regarding thigh lift, thigh reduction, vertical thigh lift, medial thigh lift, spiral thigh lift, crescent thigh lift, or thigh lipo, please get in touch with a thigh lift expert.  Please consult an experienced, board-certified plastic surgeon with a proven track record of performing thigh lifts.    Do your research.  Make sure your chosen plastic surgeon has performed at least 150 thigh lifts.  Make sure they have the before-and-after pictures to prove it. Please carefully look over their before-and-after pictures and check their reviews on RealSelf.   Consider traveling if you cannot find a thigh lift or reduction specialist in your area.   Good luck!    Sincerely, Dr. Katzen, MD, MBA (Plastic Cosmetic and Reconstructive Surgeon, President of the American Society of Bariatric Plastic Surgeons, Certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, International College of Surgery, and American Board of Metabolic and Bariatric Surgery,  and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery and RealSelf Hall of Fame.)

Mehmet Surmeli, MD, FEBOPRAS · Answer

Hi, 
26-days post-op is a very long time. In my practice (as well as in the practice of almost any surgeon) leaving drains for more than 12-14 days is not considered to be safe. Even if the drains become full, we generally discard the negative pressure after 3-5 days and let the drains only do suction to the excessive fluid, not with suction pressure. In every case (even if the drains are full) we remove the drains at most on7-10th day and leave the patient with moderate compression garment. Keeping the drains for so long time increases the occurance of pseudo-cyst and continuous discharge as well as increasing the risk of drain-site infections.
The comments above may not applicable to you and these are only the general principles that we follow. You should consult your PS for the medical advices.
Best wishes,

Nick Masri, MD, FACS · Answer

Congratulations on your thigh lift, nicolboiseau!
Your drains may be clogged, which is why popping that small lump may have triggered more drainage. Don’t worry because there’s no harm done.  
However, 26 days is quite a long time to still have drains. I suggest that you go for a follow-up consult with your reputable and board-certified plastic surgeon so that you can have your drains monitored.
Good luck!

Peter Fisher, MD (retired) · Answer

Hello and thank you for your question. Pressure is the correct thing to do. The drain was probably a little clogged, but the pop that you heard or felt was the unblocking. It’s lucky your drain is still in. The fluid is either seromatous or lymph fluid. Make sure to obviously follow up routinely with your surgeon.Peter Fisher M.D

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