Hematoma with fat necrosis after fall. Is it best to cut out mass to get contour back or fat graft and lipo mass?

Dear Buttinjury,
it is hard to tell for sure without an examination. Generally speaking, your hematoma should be removed and once you heal you can get fat transfer in order to improve the shape of your buttocks. If you are considering a surgery, I would suggest you to 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

There’s no straightforward answer to your question. Most surgeons would probably not intervene on the hematoma. If they are large, liquefied and easy to drain then getting that blood out can be helpful. There isn’t much to do about fat necrosis. The timeline is very important. You should give all the tissues sufficient time to heal and allow scar tissue to mature. This means at least six months for probably 9 to 12 months from the date of injury would be better. Cutting out the mass may or may not be justified. Without pictures we can’t really make an assessment. Unless the mass is bothersome it may be better to leave it in place. If it’s close to the skin surface and causing a problem that it may be justified in cutting it out. Fat transfer may be an option but liposuction may be limited in removing scar tissue left from hematoma or necrotic fat with scar tissue.

Best,

Mats Hagstrom MD