How can my lump be fixed? (Photo)

Question

I had a fall down some stairs 21 years ago and injured my bum at a time when I didn't know how to look after the injury and had no one to help or advise. I was left with a 4inch lump on the upper side of my bum, which has never gone down . 1 perso suggested they might be able to remove it / remodel my bum, but my conultation woudln't be for another 9 months before they can tell me whether or not they can do something about it.

Finny George, MD · Answer

Hi, thank you for sharing your question. This irregularity can be fixed with liposuction or fat grafting depending on your desired goals.

Zoran Potparic, MD · Answer

It seems that your "deformity" may be corrected with injection of fat grafts. Only on the basis of in person exam, an experienced, board certified plastic surgeon, may give you a more detailed answer. It is possible that UK still has a ban on liposuction/fat transfer and, in that case, you may need to look somewhere else. Good luck.

Daniel Barrett, MD · Answer

Dear Philosophical100149,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Reza Alamouti, MD, FRCS · Answer

HelloThank you for the question. You need to have an imaging (either MRI or US) to check for the consistency, depth and type of lump. Treatment can then be adjusted accordingly.

Connie Hiers, MD, FACS · Answer

You appear to have lost a small area of fat, and a fat transfer could fill this area back in nicely. this could be done under local anesthesia as well.

Jeremy S. Hurren, BSc, MBBS, FRCS (Plast) · Answer

To make a diagnosis and recommend treatment it would be necessary to examine you in person. However, with a direct injury to the buttock it is quite common to develop a fat fracture. This is where the fat layer between the skin and the muscle is split. As this heals it may leave a depression at the site of the 'fracture' and one or both sides of the split may form a lump.Secondly, The term Morel-Lavallee Lesion is sometimes used to describe an injury to the fat where there is separation of the tissues which then fills with fluid called a seroma or blood called a haematoma. These seromas and or haematoma may resolve but can also be long lasting resulting in a lump. As a seroma or haematoma resolves contraction of the cavity in which it had accumulated may cause deformity such as a lump.Finally, injury to the fat can cause an area of fat to die in what is called fat necrosis. This will feel like a hard lump under the skin. It may be painful or tender. These can resolve with time or may persist. They are not harmful but may be uncomfortable or sometimes cause a visible lump.A traumatic injury may have elements of all 3. These 'lumps' can usually be improved by either flattening the prominence using liposuction or filling in depression using fat grafting. Frequently, a little liposuction under local anaesthetic to smooth out the prominence can give a useful improvement without resorting to fat grafting. A large tender lump of fat necrosis that was causing problems would probably need to be removed surgically but this is unusual.This information is offered as a general guide for your information as it may be applicable to you. However, if you would like medical advice I recommend you consult a suitably trained and experience plastic surgeon who is familiar with traumatic fat injury and the use of liposuction.Best wishes.

Douglas McGeorge, FRCS(Plast) · Answer

It looks as though you have sustained a fat fracture.
Seek an opinion form a member of the British Association of Aesthetic Plastic Surgeons.  They should be able to counsel you for treatment.

Douglas Taranow, DO, FACOS · Answer

Better photos with both buttocks would aid in accurate answers.  There are several options. If the lump is firm, you may try steroid injections to see if it softens and goes down.  The chance of it being a fluid collection is rare this far post trauma, but not impossible (diagnosed with either a sonogram or a needle aspirate).  The mass might be liposuctioned out or excused (requiring a moderate length incision.  
Most trauma injuries to the buttocks I deal with are dents due to loss of fat.

Arian Mowlavi, MD, FACS (license on probation) · Answer

Your photos shows that it can be fixed easily with either lipo or excision or a combination of the two

Mats Hagstrom, MD (license on probation) · Answer

Your picture is insufficient to make an assessment.
Unless there’s only one plastic surgeon in your community I suggest finding a few other plastic surgeons to consult with who may be available within the next nine months.
I would definitely recommend not having a virtual consultation but be seen in person.
If there’s scar tissue contracting and pulling on the skin then that makes correcting this difficult. Different doctors may have different approaches. From what you describe this might be challenging to correct especially with a single procedure.
Good luck,
Mats Hagstrom MD

How can my lump be fixed? (Photo)

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