Liposuction irregularity help! Fluid filled sack left after seroma & scar tissue removal (Photos)

Question

I had a fat transfer about 3 years ago and after I developed a seroma followed by severe scar tissue. The surgeon went back in and cut out the worst part of the scar tissue and then scraped apart the upper part that was still adhered to the tissue slightly. I now have almost like a fluid filled puff sack left over. It's been over a year since that recession. Is there any hope for me? The surgeon wants me to do cool sculpting to help the bulge. I want to find a new Dr. that can help.

Connie Hiers, MD, FACS · Answer

I would suggest an examination and getting an ultrasound of the area to see if actual fluid is still present. If it is, surgery will be needed to remove the lining of the sac of fluid as well as the fluid.

Mats Hagstrom, MD (license on probation) · Answer

Delivering consistent quality, liposuction, results is more difficult than most people realize. The number of plastic surgeons who mastered this procedure are in a small minority. Being bored, certified in plastic surgery with years of experience in an overall good reputation that does not mean somebody has mastered Liposuction and patient should be highly selective when choosing providers for this permanent irreversible body contouring procedure that can leave people permanently disfigured.
Correct and poorly done Liposuction is difficult and often not possible. Sometimes improvements can be made depending on two primary variables. The first is the patient’s candidacy for the procedure in the first place and the second is how the procedure was performed. Somebody who is not a great candidate, for Liposuction does not have the ability to have a great outcomes no matter who does the procedure. Correcting poorly done liposuction if the primary procedure was done, overly aggressively becomes increasingly more difficult. If most of the fat has been removed, and there’s besically nothing left to work with.
I’ll plastic surgeons should know how to manage a postoperative seroma. They should be drained frequently or a drain should be placed to keep the tissues collapsed continuously. If it’s a Roman is not managed aggressively by treating it with drainage on a regular basis(preferably daily) it will become a chronic encapsulated seroma. Once a capsule has been formed it can no longer be treated by draining it alone, but the capsule needs to be removed. In your case, it is uncertain if you have a secondary seroma or fluid buildup. Contracting poorly done Liposuction is generally done with Revision Liposuction, fat, transfer, and sometimes by converting the procedure to a skin tightening operation like a full tummy tuck if somebody was a candidate for that in the first place.
For example, if the main problem is of the lower abdomen, and someone has enough, skin laxity to allow to excised the problem area converting the procedure to a tummy tuck, and that may be a good solution.
The most difficult cases to treat are ones that were initially treated aggressively, leaving an uneven, fat distribution.
Revision surgery is far more difficult than primary procedures. If your plastic surgeon has already proven that they are not capable of doing quality liposuction, then you should definitely not have that person do more work since revision work is most likely to make things worse rather than better.
to find the right provider, I suggest patients have multiple in person consultations. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar body characteristics to your own. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Being shown a handful of pre-selected images, representing the best results of a providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider or how many procedures they have performed. It is also important to see results of patients who are of equal candidacy for the procedure. 
Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures shown.
There’s no correct number of consultations needed to find the right provider. Sometimes patients are lucky and find the right provider during the first consultation. Considering how much variation there is in the consequence of not picking it sufficiently talk to provider I suggest patients consider having at least five consultations before scheduling surgery. This may seem excessive, but if you consider the consequence of a poorly made decision regarding provider selection it seems more than reasonable to me.
People are unfortunately of the assumption that Liposuction is a simplistic procedure. Removing fat with a Cannula isn’t rocket science, but mastering body contouring and anticipating the procedure should be done is highly complex and requires a total lifetime commitment.
In your case, I wonder if you really were a good candidate for Liposuction. We generally always need to see a complete set a before and after pictures to make quality assessment. If you don’t have before and after pictures and ask your surgeon to forward the pictures they took. I do think there’s room for improvement especially treating the transitional area between treated and untreated areas. 
Start scheduling consultations with other plastic surgeons, who have a solid track record for doing lots of Liposuction and see where it takes you.
Best,
Mats Hagstrom, MD

Liposuction irregularity help! Fluid filled sack left after seroma & scar tissue removal (Photos)

Answers (2)

Recommended reading

Everything you need to know about Liposuction Revision

Our mission is to create a world where every investment in modern beauty is Worth It.

Liposuction irregularity help! Fluid filled sack left after seroma & scar tissue removal (Photos)

Answers (2)

Browse related questions

Recommended reading

Everything you need to know about Liposuction Revision

Our mission is to create a world where every investment in modern beauty is Worth It.