How to treat possible necrosis after liposuction? (Photo)

Question

I had liposuction 30 days ago and have since noticed a hard bulge developing in the center of my abdomen. It is approximately 3 inches in diameter and is much harder than the other abdominal tissue surrounding it. My surgeon, who is out of state, said it is a possible necrosis. What is the best way to treat this? Massage, steroid injections, excision? Is there a surgeon in Las Vegas skilled in treating this form of post op issue? The goal is to completely rid this lump.

Carlos Mata, MD, MBA, FACS · Answer

Hi Alexus,thanks for your question and your photos. It is extremely difficult to tell base on picture only. Being 30 days after surgery likely means it may be a seroma that has a capsule and will need to be drained surgically or if your ribs are low enough, it may be a xiphoid or breast bone. Again it all depends on what the lump is. An ultrasound would help figure out what it is exactly if a physical exam is not enough. If it necrosis, massage would help. Steroid injections may help as well but may cause some underlying fat loss as well and skin color changes. Excision is also an option but time may get rid of it. Most plastic surgeons are capable of taking care of this problem. Good luck.All the best,Carlos Mata MD, MBA, FACS

Jason Emer, MD · Answer

This looks more like a hernia that is now visible after surgery or a seroma/hematoma or scar tissue.  You need a formal evaluation.  Post liposuction hyperbaric oxygen, massage, and radiofrequency treatments may help.  Best, Dr. Emer.

Ajay Mahajan, MD, FRCS (Plast) · Answer

Your surgeon is probably referring to fat necrosis. This can happen if the blood circulation is affected to the fat under your skin during the liposuction procedure. It is unlikely that you will have a collection of fluid (seroma) following a liposuction only procedure. You do have a tummy tuck scar and I am assuming that this was done on another occassion. If it was done at the same time, then seroma is indeed a possibility. It is not uncommon to feel lumps and irregularities 4 weeks after liposuction. You do need to give it time and massage the abdominal wall and see how things settle over the next 3 to 6 months.

Gerald Minniti, MD, FACS · Answer

Hello,It is more likely a small, loculated collection of fluid called a seroma. You should be evaluated by a surgeon locally to evaluate you and possibly drain this.Best of luck!

Nelson Castillo, MD · Answer

Thank you for your question and series of photographs and I am sorry that your results have not been what you anticipated.  It is difficult without an in-person examination to determine what may be taking place.  Most commonly this is a discrete fluid collection termed a seroma, but it would be important to voice your concerns to your surgeon to ensure that other issues are not taking place - swelling, muscle laxity, or residual adipose tissue. Your out of state surgeon may be able to recommend someone in Las Vegas that you can see or you can search for local board certified surgeons in your area using the below link.  Best wishes.

Trevor M. Born, MD · Answer

Dear Alexusgs326Thank you for your question and photos!  You should see your surgeon or another qualified person for assessment.With Warm RegardsTrevor M Born MD

Austin Hayes, MD · Answer

It's best to direct this question to your plastic surgeon. If you can't return to see her/him, then you should find a board-certified plastic surgeon in the Las Vegas area. Hopefully your surgeon has a recommendation for someone to see in your area. A plastic surgeon will be able to examine you and determine whether this is left over swelling, a fluid collection, or necrosis.

Vincent N. Zubowicz, MD · Answer

I doubt you have necrosis. More than likely a seroma is formed. Necrosis means death of the tissue in the only treatment is to have that tissue removed. Small amounts of fat necrosis can be handled by the body.

Michael J. Denk, MD, FACS · Answer

It is not uncommon to have areas of firmness or swelling for 2 - 3 months following liposuction. In my experience, such areas completely resolve without treatment within 6 months of surgery. Examining you in person would be very helpful. Please seek a consultation with a board-certified plastic surgeon so that he or she may provide you with more information and the best options for treatment. Best of luck.

How to treat possible necrosis after liposuction? (Photo)

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