Lumps & uneven results after LBL & scar revision, thoughts? (Photos)

Question

It's been 8 mos since my 360 lift, w/o muscle revision and 4 mos since my scar revision w/muscle revision. My results look funny, it looks like I have a line down the middle of my stomach to belly button and the right side is larger or more swollen. Belly button down, is lumpy. Between Feb and Apr, I had a seroma in the area to the right of the lump, it was drained 2x. The lump doesn't feel like my past seromas. It's squishy. My left side is good, but the right is not and its tender. Thoughts?

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding the lump on your lower abdomen following your lower body lift. I appreciate you providing your medical history and pictures for assessment.
In this situation, I recommend getting an ultrasound of the affected area. If the ultrasound results are inconclusive, an MRI may be necessary to investigate the mass further. Identifying the nature of the lump is crucial as it could be due to various reasons such as scar tissue, seroma, hematoma, muscle repair, or muscle disruption after the surgery. Each diagnosis requires a different treatment approach.
If the lump is determined to be scar tissue, it might improve with time, or alternative treatments like steroid injections or surgical manual disruption of the scar tissue could be considered. If it's a muscle-related issue, it may require a revision surgery. For a seroma, drainage may be necessary.
Getting this mass thoroughly examined with either an ultrasound or an MRI is essential to arrive at an accurate diagnosis and plan the most appropriate course of action.
I hope this response helps clarify your questions and provides guidance on further steps to take. It will be interesting to learn what is discovered during your medical evaluation.
Good luck!
Sincerely,
Dr. Katzen

Ajaya Kashyap, MD · Answer

Thank you for your query. The lump in the picture can still be a seroma, an organised seroma or some residual fat. The way to find out is an ultra-sound and possibly a needle aspiration. Please discuss this with your Plastic surgeon who can help you with your concerns. All the best!

Carmina Cardenas, MD · Answer

It looks like you developed a bursa after the seroma and the skin didn’t get attached to the muscle fascia. 
The solution of the problem it is relatively easy: removal of the bursa capsule, quilting stitches to reattach the skin towards the fascia to prevent the seroma formation again. Short procedure, outpatient. Not painful. 
Be encouraged. 
Dr. Cárdenas

Daniel Barrett, MD · Answer

Dear gmtnolaz,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Zoran Potparic, MD · Answer

Based on these photos, actually the last one, it would be hard to call your result funny; of course, without preoperative photos to compare, it is always very hard to eveluate result. Asymmetry of the skin and bulge may be result of multiple factors including muscle bulge due to anbominal wall weakness, residual fat pocket or cavity after seroma removal? In person consultation with another plastic surgeon(s) would help to evalute redsidual asymmetry and possibly establish  plan how to treat it. Hope this helps.

Camille Cash, MD · Answer

I encourage you to return to your surgeon to explore the cause of the lump that concerns you.  If it is a seroma it will need to be addressed by your surgeon.  If it is residual fat then some localized liposuction should give you an improved contour.

Lumps & uneven results after LBL & scar revision, thoughts? (Photos)

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