10 months post op. Is this a burn or hyperpigmentation after lipo? (photos)

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.
Best,
Dr. Karamanoukian
Realself100 Surgeon

you will need in office series of vbeam treatment and RF treatments at home you will need a combination of peels that we can send to you at home. this may never be able to be cleared but can be improved. Best, Dr. Emer.

Both signs are known complications of liposuction. Fluid collection, seroma, is relatively frequent and, if small, it will be absorbed by your body in time. However, if large fluid collection is left untreated, it may create cavity filled with fluid, like a cyst; this will not resolve without evacuation of fluid by means of aspiration. If fluid is still present 10 months after surgery, it needs to be evaluated with ultrasound and should be evacuated. Bruising may also be present early after liposuction but goes away within few weeks. However, in some cases, when serious venous congestion develops in the skin vascular system, it may evolve into full thickness skin loss. Hope this helps. Good luck.

Dear ali2424,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I suspect your discoloration is from a burn from the laser or radiofrequency used and not actual liposuction. I would suggest using products to help treat this discoloration and keeping it completely out of the sun.

Dear Ali,
Collection of fluid (seroma) and pigmentation issues are not uncommon post liposuction. The fluid usually reabsorbs without treatment unless too large. In this case, needle aspiration early in the postoperative course inhibits the formation of a permanent collection. If you still have fluid present, ultrasound may be used for guided aspiration of the fluid. The pigmentation may be treated with topical agents: Hydroquinone, Vit C creams and even laser in some cases.
Best wishes.
Dr. T

Fluid collections after surgery called a seroma should be drained with a needle or catheter until they do not recur. This should be done frequently early after surgery.

If the fluid collection becomes chronic then it becomes lined with scar tissue called a capsule or encapsulation. Once in capsulated simply draining the fluid will not be sufficient to make it go away.

The only way to get rid of and encapsulated fluid collection is the surgically remove the capsule and at that point Place a drain.

I’m not sure if you have a seroma or not. It can sometimes be diagnosed by an examination or a more definitive diagnosis is to do an ultrasound. If you do have a chronic seroma then I don’t think draining it at this point will be curative.

It will most likely simply come back because it’s been encapsulated at this point.

You may not have a seroma at all but if you do that’s the deal.

The discoloration looks to me like you have a partial thickness dermal injury. Did the provider use a laser (Smart Lipo ) or ultrasound called VASER? The discoloration may continue to slowly improve for the next 12 months. it would be helpful to have a close-up picture of the discoloration.

There are different underlying ideologies of what can cause skin discoloration.

It can be hyper pigmentation which can be melanin-based. It can be vascular with information of visible capillaries. It can also be caused by tissue staining from iron pigments from leftover blood in tissues called hemosiderin deposits.

continue following up with your provider.

Best,

Mats Hagstrom MD