Did my Ps Hit my Lymph Node?

Question

My left leg is still sensitive and swollen from medial thigh lift with lipo on both legs. The right side is doing well and doesn't bother me. Swelling is completely gone on that side and scar is healing,closing and flattening. However, when I stand up the left side (scar) is protruding. When lying down and massaging I can feel what feels like round knots under the scar and the left thigh is bigger than the right which is kind of sensitive to touch and when I lay on my left side(leg) it hurts. A

Richard J. Bruneteau, MD · Answer

Persistent unilateral lower extremity swelling is unusual following combined liposuction and thigh lift procedures and should be investigated vigorously whenever it occurs. Although it's not unusual for patients to have swelling following this type of surgery, it's unusual for it to be unilateral. The bumps located beneath your incision are probably an unrelated phenomena. This often occurs following thigh lift surgery as the buried absorbable sutures start to dissolve and create inflammatory nodules.Unilateral lower extremity swelling following thigh lift surgery can be related to the formation of blood clots in the lower extremities. These deep venous thrombosis have the potential to break free and go to the lungs where they can cause life threatening situations.Another possibility is the development of lower extremity lymphedema. This diagnosis can result in chronic disability and the need for lymphatic massage. This condition may be related to disruption of the normal lymphatic channels during surgery.When unilateral lower extremity swelling occurs, it should be aggressively investigated. The treatment will depend upon the causative factors. It's, therefore, important to consult your plastic surgeon as soon as possible. Your surgeon should be able to evaluate your situation and formulate an appropriate treatment plan.

J. Timothy Katzen, MD, FACS · Answer

Hello and thank you for your question regarding inflammation seven months after surgery.

Based on the information you provided, it is challenging to determine precisely what is happening without a physical examination and pictures. Since there is no infection, the most likely cause of your blisters and thick discharge could be the rejection of remaining internal sutures. It is not uncommon for sutures to remain even seven months post-operation after an arm lift.

For treatment, I recommend hyperbaric oxygen therapy daily for 10 days. This can accelerate wound healing. Additionally, the application of normal saline wet-to-dry dressings twice a day can help clean the wounds and manage the discharge.

It is essential to follow up with your plastic surgeon or seek a second opinion to ensure proper evaluation and treatment. Good luck, and I hope this helps address your concerns.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

Stephen Salerno, MBBS, FRACS · Answer

Hello and thanks for the question and photos.Thigh lifts are always associated with some swelling post operative and it is not uncommon for it to last some time as well.  The lymph nodes may be affected in this are and the lymphatic system may be caught up in scar.  This will probably resolve with time.  The knots you can feel when you massage are most like just some scar tissue which will resolve with time and the sensitivity you are experiencing is related to the surgery as some superficial nerve may have been stretched, pulled or cut which can give the type of discomfort and sensitivity you are experiencing.  Again this may settle however it will take some time.  I would recommend that you contact your surgeon and ask them to examine you thighs to ensure that all is OK and you do not require any further investigaton.RegardsStephen Salerno

Did my Ps Hit my Lymph Node?

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Answers (3)

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