4 days post op, why is my skin bright red after liposuction? It is hot to the touch and very sore. (photos)

Question

About 4 days after surgery I broke out in hives on my back. They eventually went away but ever since my back has gotten more and more red. It is very uncomfortable and itchy. I had Liposuction on my abdomen and flanks, however, The redness is only on my back. My surgeon said it could be an infection, or a reaction to my compression garments (I have 2 different kinds). How long will this last? It’s torture. I’ve tried Benadryl and cortisone cream. It has been 3 full days of this

Kenneth Hughes, MD · Answer

Itching is fairly common after surgery.  If there is any sign of rash or allergic reaction, that would be something different.  My patients choose to wear a soft cotton t-shirt under the garment to lessen the itching.  Follow up with your PS to determine if any of your medications could be the culprit.  Keep a positive attitude, and eat/drink enough complete protein to facility wound recovery.
Kenneth Hughes, MD, Board Certified Plastic Surgeon
Los Angeles, CA

Robert M. Tornambe, MD · Answer

seb860.  So sorry to hear you are having this issue, and obviously, in-depth evaluation and examination is needed. However, it appears from your photos that you are experiencing a rash or allergic reaction, probably from the garment. Your plastic surgeon should treat this issue immediately. In the meantime, either stop wearing the garment or wear a T-shirt and then place the garment over the T-shirt. Please see your surgeon right away.

Daniel Schmid, MD · Answer

This appears to be an allergic reaction given the distribution on your skin but an infection cant be ruled out.  If you develop fevers or chills you should be seen immediately by an ER or your surgeon.  Most likely you need a course of oral steroid to get the reaction under control.  Usually within a few days after starting an oral course of steroids it will subside and you will feel better.

Deborah Ekstrom, MD · Answer

You have a specific pattern on your skin which suggests that it is either one of your garments that you are wearing you are allergic to, or an antiseptic used on your skin caused a rash.  If you suspect the garment, wear something thin and conforming under the garment.  If the rash is driving you crazy and it is not responding to anti-histamines you may be able to have your doctor prescribe you some steroids such as prednisone.  These take about 48 hours to kick in and in some patients they can make you feel "wired" or euphoric or cause trouble sleeping.  Hope you feel better soon!

James M. Sheridan, MD · Answer

Dear seb860,Thank yo for your question.  I agree with Dr Tornambe's response.  The redness could represent either an allergic response or an infection.  It is mandatory tht you see your surgeon ASAP.  But you could remove the foam and garment for now.  good luckJames Sheridan, MD

Melih Erogul, MD (retired) · Answer

Hi and welcome to our forum!
The appearance, location and pattern of the itchy redness suggests an allergic reaction to your dressing / garment. The area is quite well circumscribed. 
The wearing of a compression garment is occasionally associated with development of an allergy, necessitating the use of a thin garment beneath it to which you are not sensitive. Continue the use of the benadryl and cortisone cream.
Signs of infection would include pain, swelling, fever, or drainage. 
This should resolve.
Best wishes

4 days post op, why is my skin bright red after liposuction? It is hot to the touch and very sore. (photos)

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