Developed an Infected Pimple Right Above my Butt Crack Post-Op BBL, Why Would This Be? On Antibiotics.

Question

I had a brazilian butt lift about two months ago and I started to get a pimple right above my butt crack and it got bigger until it bursted. I have a lot of fluid coming out and i have pain and sometimes fever. My surgeon keeps giving me antibiotics but it doesn't seem to get better. What could be the problem? What should I do?

Wilberto Cortes, MD · Answer

Infection risk after cosmetic surgery is very low. I have done many fat transfers to the buttock without any infection. I always stress that fat needs to be handled with care and in a very sterile fashion. Fat behaves as graft (no blood supply) in the first couple of weeks, which decreases its ability to fight infection, if such an event occurs. If fat is not placed in small amounts and with multiple passes in the buttock, then, it can die and form a nidus for infection. It appears that you must have a small abscess that spontaneously drains. This is a normal body response to an infection. Typically, the draining of an infection is the management of any infection that turns into an abscess. You should continue on antibiotics that have good coverage for MRSA and good fat penetration like clindamycin. I have noticed that clyndamycin has better penetration in areas that have had liposuction as compared to bactrim. Make sure that you follow with your surgeon an infection in areas that have had liposuction and/or fat grafting since fat can take a long time to resolve due to a diminished blood supply. Also, the infection can kill the fat quickly and compromise your results.

Vivek Bansal, MD · Answer

It sounds like a localized infection that the right antibiotic should take care of.  Have they cultured the drainage yet? Thank you for your question and good luck.

Samir Shureih, MD · Answer

You have to work on the assumption that you have an infection involving the buttock fat transfer.

	MRI will help, then a more aggressive treatment to open the abscess open and drain every area of collection of fluid, , IV antibiotics.

Wendell Perry, MD · Answer

Infection which is rare after liposuction alone can happen after fat injection. When you do a fat injection a certain percentage of the fat cells will die. And this dead fat is a good source for infection. Continue with your antibiotics is important, monitoring fever with the thermometer can be your gauge to tell you if the infection is improving are getting worse.

	If you continue to have fever you must follow up with your doctor right away. If this fever does not stop or gets worse while on antibiotics you may want to discuss with your doctor the possibility of infection that is not covered by typical antibiotics like a microbacterium or a  fungus.

Developed an Infected Pimple Right Above my Butt Crack Post-Op BBL, Why Would This Be? On Antibiotics.

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