Do I really need to be drained via syringe? (Photo)

Question

I had Vaser liposuction of the upper and lower abdomen, inner thighs and flanks 7 days ago. At my 4th lymphatic massage yesterday at the clinic I was told that I may need my back to be drained via syringe depending how it looks when I go back tomorrow! For sure I am still swollen - also in my lower belly and thighs, but she only mentioned my back regarding draining. I’ve had drains in which were removed yesterday. Does this really seem necessary? And why? Are there any risks to not doing it?

Kelvin Eusebio, MD · Answer

Dear amandaLam,Thank you for sharing your picture with your question. If you feel still have liquid moving inside after the massages you probably need it out. Syringe is a very useful method to drain it if the liquid does not come out, it sounds more pain than what it actually is. Best wishes.

Babak Moeinolmolki, MD, FACS · Answer

Hello,
Thank you for your question. I understand your apprehension.
Seromas (fluid collections) after vaser liposuction are an unfortunate minor complication that demand early attention. Without prompt drainage, the fluid pocket may form a permanent capsule that can be challenging to treat. Thus it is best to address any fluid collections early.
Best wishes,
Dr. Moein

Kenneth Brito, MD · Answer

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.

Guang (Sam) Qin, MBBS, MS · Answer

Thank you for your question. Very occasionally fluid collects in pockets following liposuction. In my experience aspirating the fluid via syringe is suitable method of drainage and is surprisingly comfortable for the patient. Please visit your surgeon for assessment for possible drainage.

Raja Mohan, MD · Answer

It is very difficult to tell from a photo if you need drainage. At first glance, it does not seem that way and you have an expected amount of swelling. I recommend you follow up with your surgeon to see if there is a fluid collection requiring drainage. He can perform a physical exam to double check. For small amounts of drainage that is needed, surgeons use a syringe and a needle to drain the fluid percutaneously. Another important thing is to wear a compression garment. Hope this helps.

Randy Dean, MD - Account Suspended · Answer

Hi and welcome to our forum!
In our practice, we do not routinely place drains after liposuction. We allow the fluid to leak out of the incisions over the first 24-48 hours. Perhaps there was a bleeding problem, or the area of treatment was extensive, requiring suction assistance for tissue adherence. Apparently your massage therapist recognized a fluid collection yesterday.  A fluid collection may represent blood or tissue serum. Either entity represents a dead space, which may be prone to infection, or may expand. If small, it may resorb, but if of sufficient size, it will persist, becoming encapsulated, making it far more difficult to remove, and may lead to permanent local deformity. If appropriately drained at intervals, most collections of fluid will resolve uneventfully.
I recommend you follow your surgeon's advice. 
Best wishes...

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