Hi cb79, Thank you for your question regarding a lump present 6 years after your panniculectomy and what can could it be. I am glad you healed well and that are you are happy after your panniculectomy. In regards to the lump that you developed 6 years after panniculectomy, this should be work-up with an ultrasound. If your post-op panniculectomy ultrasound does not yield a conclusive diagnosis, you may need a CT scan or even an MRI. In regards to what this lump may be, it could be several things. The differential diagnosis includes a hernia, seroma, hematoma, and scar tissue or fibrosis. Your postoperative panniculectomy lump may be a hernia. A hernia is a hole in one cavity leading to the egress of another cavity’s contents. Hernias can contain a variety of tissues. In the abdominal area, usually, an abdominal hernia is a hole in the anterior abdominal wall which communicates with the peritoneal cavity. This hole can be caused by trauma or congenital defects. The trauma can include heavy lifting and surgical incisions. A hernia can contain fat, or even intestine, which spills from the peritoneal cavity. Your postoperative panniculectomy lump may be a seroma. A seroma is a cavity or ball of serous fluid. Serous fluid is your body’s natural superglue, which helps to glue surfaces together. Sometimes the body makes too much serous fluid and a serous cavity develops. This is much like an egg of serous fluid. Your postoperative panniculectomy lump may be a hematoma. A hematoma is a collection of blood. Much like a seroma, this collection of blood becomes encased in scar tissue. Usually, overtime, the blood in the hematoma is absorbed and a ball or collection of scar tissue is left. Your postoperative panniculectomy lump may be a ball of scar. Another term for scar tissue is fibrosis. Either way, it is a collection of scar. Some of these conditions will require surgery; others conditions may not. If your hernia is of a certain size, it should be surgically repaired. If the seroma is bothersome or contains fluid, I would suggest surgical resection. If the hematoma is large and contains fluid, I would suggest surgical removal to minimize the chance of infection. If the area just demonstrates scar tissue, this may or may not need to be removed. Please consult with your plastic surgeon regarding the ultrasound results. I hope my answers addressed your question of what a lump after a panniculectomy could be. I specialize in reconstructive plastic surgery after weight loss. If you have any more questions regarding the panniculectomy, extended lower body lift, lower body lift, 360 circumferential lower body lift, belt lipectomy, belt abdominoplasty, or belt dermolipectomy, please contact my office. Since the panniculectomy or lower body lift is a big procedure, please seek an experienced, board certified plastic surgeon with significant experience performing the panniculectomy or lower body lift. Do your research. Make sure they have performed at least 100 panniculectomies or circumferential lower body lift surgeries and have the before and after pictures to prove it. Carefully examine their before and after pictures and check their reviews on RealSelf. If you cannot find an experienced, panniculectomy or lower body lift surgeon in your neighborhood, consider traveling out of state if you must. Sincerely, Dr. Katzen. (“Verified” Plastic Surgeon, President of the American Society of Bariatric Surgeons, certified by the American Board of Plastic Surgery, Fellow of the International Society of Aesthetic Plastic Surgery, American College of Surgery, and International College of Surgery and member of the American Society of Plastic Surgery, American Academy of Cosmetic Surgery, RealSelf Hall of Fame, and RealSelf Doctor Advisory Board for Medical Review and Consumer Panel.)
