Are Blood Clots and Seroma Common Liposuction Complications?

Hi Keely

Although seromas are reportedly a common complication after liposuction, this is a rare and benign finding in my personal practice. I suspect the incidence of seroma is technique driven. On the other hand, blood clots, i.e. deep venous thrombosis is a very uncommon complication but the seriousness is such that it should never be ignored. Your surgeon will take special precautions during surgery to reduce this risk of this dreaded complication and post-operatively your contribution will be to get out of bed and begin ambulation as soon as possible.

Good luck and best wishes to you in Las Vegas.

Blood clots are rare and seromas are a bit more common.  Staying active after surgery is the most important thing a patient can do to prevent blood clots.  

The only patients I would be concerned about would be someone with a history of DVT. In 30 years of doing liposuction, I have never had a patient with either. You can be up and moving about the next day with only soreness.

DVT with PE (clots) is one of the most dreaded complications following liposuction. Fortunately, it is relatively rare. Unfortunately the incidence is not known due to difficulty calculating the number of procedures performed. We have had studies that show a wide variation in the incidence of DVT with PE following liposuction AND abdominoplasty that ranges from 1 in 3,500 to 1 in 40,000. The incidence with liposuction alone certainly should be less than that. In any unique situation, the physician must assess the risk factors that are specific to that patient.
The risk of seroma may be related to the technique and it is generally believed that the incidence is higher following the use of ultrasonic assisted lipoplasty. I am not sure of the incidence following laser assisted lipoplasty.

Any surgical procedure that enters the subcutaneous cavity has a risk of bleeding which can occur after surgery as a delay especially if the patient takes medication that causes bleeding. There are even herbs such as Ginko, Ginger Fish Oil and Garlic that if taken as supplements might induce more bleeding.Clotting can occur if someone is not in good medical shape, too sedentary, or if garments or clothing are too tight and digs into the skin.

Seromas are fluid collections of the liquid component of blood without the red blood cells. Although clots and seromas are infrequent they are a risk with any physician, despite excellent technique,

Blood clots after liposuction are extremely rare.  Seromas are extremely rare in traditional liposuction but more common with other forms of liposuction that use a heating or ultrasonic component.

Fortunately, both blood clots and seromas are uncommon complications after liposuction. During surgery, your surgeon may use pneumatic sequential hose to pump the blood in and out of your legs. Post op, you should move around frequently, and when relaxing, frequently flex your leg muscles. It is the natural movement of your muscles that works best to maintain blood flow and reduce the risk of blood clots.

Seromas are very uncommon in my practice and I have not had a patient have  "blood clots" after liposuction surgery. I agree with the other surgeons that early ambulation and hydration after liposuction is a must in preventing deep vein thrombosis.

This is an excellent question -- you ask about one of the rarest complications of liposuction (blood clots) and one of the more common ones (seroma), according to the literature. What does that mean? I think it varies from individual to individual, but I have personally never seen a seroma in my liposuction practice in Santa Barbara. I usually encourage my patients to wear a conforming compression garment for 3-4 weeks following the liposuction surgery, and i do not perform large volume liposuction of over 5 liters in my office.

This leads to discussion of the other, more dreaded complication -- blood clots and pulmonary em bolus (PE) where the blood clot travels to the lung. I have never seen this complication from surgery in my center either, and this is a rare event following safe amounts of liposuction alone. It is more commonly seen with large volumes of liposuction and combining liposuction with other procedures, particularly abdominoplasty.

I would not fear the complications that you ask about if you are seeking liposuction. I would recommend, however, that you see a real plastic surgeon who is certified by the American Board Of Plastic Surgery, and who you feel will do a safe, conservative operation. Don't be fooled by the multitudes of non-plastic surgeons who do liposuction in their office -- you want to be in a safe environment with a well trained professional, and your risks of problems should be quite low.

I have personally never seen a seroma after traditional tumescent liposuction. I believe that ultrasonic and laser types can lead to seromas however. I have also never had a DVT after liposuction. It is critical to ambulate after the surgery, pump your legs and use the muscles to keep good flow in the veins. The last thing to do is to stay in bed!