What To Do About Fat Necrosis Post Abdominoplasty?

My first question is what makes you think you have liquefied fat present? If you have a fluid collection after a tummy tuck it is most commonly a seroma, which is not the same thing as liquefied fat. Seromas can be drained with simple needle aspiration. Fat is thicker than seroma fluid and not simply withdrawn through a small needle. Firmness just along the incision itself is usually the scar undergoing a normal healing process. You are correct that an abdominoplasty should result in a flatter belly, so if you have a fluid collection or swelling out of the ordinary, your surgeon will want to know about it. I recommend following up with your surgeon to see what is going on.

RE; " The ‘liquefied fat’ that I have in my belly sounds like fat necrosis. I read that necrosis to the fat cells cause fat to be liquefied before hardening. My question – wouldn’t it be better to remove the fat now before it hardens? Abdominoplasty should result in a flatter belly. I am afraid that allowing the fat to stay and harden will permanently stretch my skin and would leave me with a bigger lower belly than before surgery. I am 3 wks post full TT, normal wt, nonsmoker"

You fail to mention HOW do you know you have fat necrosis instead of just swelling or fluid. It is a natural human tendency to explain everything around us with the level of knowledge that we have. As medical students learning Pathology and disease processes, we often began dreading that every lump and swelling on our bodies was a foreboding disease processes. Frequently, that was far from true. Because of subjectivity, doctors are often advised NOT to diagnose and treat themselves and their families.

I suspect (and may be wrong) that you fall into the same class. As much as you know and think you know about Tummy Tuck surgery, you do not know enough to diagnose much treat yourself.  Talk to your surgeon and he will advise you on what it is you are feeling as well as what the best way of handling it may be. And in the meantime, try and stop worrying about. A large part of healing is beyond our control and a positive mental attitude is VERY beneficial.

Dr. Peter A Aldea

 

Dear Kyllie,

Fat necrosis does not generally become evident within weeks of surgery. Your swelling is more likely general postoperative edema, fluid collection and/or scar tissue. I would suggest that you see your plastic surgeon for follow and discuss your questions as well as getting his input after examining you. Your body will need time to heal and recover. This is a process that takes time and generally you will see improvement over 2-3 months. It is important that your surgeon make sure you don't have any process, like a fluid collection, that should be addressed. Otherwise time and patience, and you will have a result you are pleased with.

Sincerely,

Behzad Parva, MD, FACS

Kyllie, if you are just 3 weeks post abdominoplasty the fluid you are noting is probably a seroma (fluid collection) and is not necessarily associated with fat necrosis.  If the seroma is relatively small it can be treated conservatively by limiting you fluid and salt intake and wearing a post surgical compression garment.  Your surgeon may also want to consider giving you an diuretic medicine to help you loss the excess fluid.  If it is a larger collection of fluid, your surgeon may want to remove it by needle aspiration.  Rest assured that this type of seroma formation after a tummy tuck is relatively common and does resolve with time and usually does not result in fat necrosis.