Infection or fat necrosis? (Photo)

Question

Hello, I am 13 days post op from my BBL. My 1.5 yo climbed on my butt a few days ago and I now have these lumps. They are not hard (pliable) and they are not tender. But they do appear to be draining clear fluid? Is this an infection or fat necrosis? I have a call to my doctor and am waiting for a response. I am worried that it might be either!

Matthew J. Nykiel, MD · Answer

Hello and Great Question.  I appreciate the time you are spending researching this procedure.  My name is Dr. Matthew J. Nykiel.  I am a Board Certified Plastic Surgeon, a Fellowship Trained Cosmetic Surgeon, and a Butt Augmentation Specialist.

You need to go and see you Dr.  He/she is your best source of information and evaluation.  I recommend seeing a Board Certified Plastic Surgeon.Best of Luck!  Please reach out if you have any further questions or concerns.

Matthew J. Nykiel, MD#TopREALSELFDoctor#CoreREALSELFDoctorButt Augmentation SpecialistLiposuction SpecialistBoard Certified Plastic Surgeon

Karol A. Gutowski, MD, FACS · Answer

An in person evaluation by your doctor is the only way to determine this, but it may be just some liquefied fat.

Robert J. Paresi Jr., MD, MPH · Answer

Thanks for the question.  At 13 days after a BBL it is not uncommon to have some residual fluid at the recipient site.  There does appear to be some mild redness around the area so prophylactic antibiotics may not be a bad idea.  Followup with your surgeon to determine the best course of action.

Mats Hagstrom, MD (license on probation) · Answer

I don't think anyone can give you an accurate assessment.

This early after surgery there's a lot of inflammatory process is going on.

Generally the first symptoms of infections are increasing pain.

This and redness are the first things patients usually notice.

At 13 days the transferred fat cells or probably has the most sensitive stage in regards to long-term survival. This is the time when the fat has become dependent on a reestablished new blood supply called neovascularization.

Any grafted fat that does not develop a blood supply or the blood supply is destroyed early in the healing process will become necrotic fat.

The term fat necrosis is not something that happens instantaneously though there is no real set definition other than tissue that is dead is considered the chronic.

In other words the fat that has been removed with Lipo suction is technically dead as soon as it's removed from the body.

The fact that establishes a new blood supply after being grafted survives.

The fat that does not develop a new blood supply remains dead and it will eventually be absorbed and leave scar tissue.

This is a little bit like death and resurrection.

It's possible that physical trauma can have caused some compromise and long-term fat survival but most likely it's just inflammation and swelling and your results will be fine with time.

I would follow up with your plastic surgeon and have him or her take a look at you.

Best,

Mats Hagstrom M.D.

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