I'm 6 days post-op w/vaser lipo on my stomach & pubic area. Is this a seroma or hematoma or normal? (photos)

Question

I'm 6 days post-op w/vaser lipo on my stomach & pubic. I've had this since the beginning. Is this a seroma or hematoma or normal? It's hard and I try to massage it. In doing so today, I starting leaking fluid a little again. Normal and I just need to wait it out?

Jed H. Horowitz, MD, FACS · Answer

Bruising and #swelling are normal and usually increase slightly after the removal of any tape or foam. The bruising will decrease over 3-4 weeks, but may last as long as 6 weeks. The majority of the swelling will be gone within the first 3-4 weeks. However, it may take 6-9 weeks to disappear completely. 
Swelling after #Vaser liposelection is not uncommon. Gentle #walking may increase circulation and help to alleviate swelling. But you must not strain or push yourself. Also, if you were provided a post-procedure #garment, be sure you are wearing it until prescribed otherwise by your doctor. The purpose of the post-procedure #garment is to provide some gentle #support and to reduce swelling. If it feels too tight or causes pain, take it off. Many patients wear the #elastic garment for several weeks after procedures, as directed by their doctor; some choose to wear it longer for several months for comfort.The #compression garment helps reduce the swelling, and the longer it is worn, the more quickly you will #heal. It can also assist in the retraction of the skin. If you have any concerns about #healing, its best to ask questions of your surgeon or their nursing staff.
The final results of the procedure are typically most noticeable 2-4 months following the #Vaser. As swelling gradually diminishes, the contours of the treated area(s) will continue to improve up to one year post procedure. If you have concerns about your healing, or pain that you question to be unusual, it is important to call your plastic surgeon to discuss these further asked to be examined. It's best, in this situation, to be seen and #evaluated by your doctor or their staff to confirm as to whether you have a serious issue that requires further medical attention. The sooner, the better. If at any time you have any concern at all about your #healing process, do not hesitate to contact your surgeon. The sooner, the better.

Jason Emer, MD · Answer

All my vaser patients get immediate lymphatic massaging and use foam vests under their full body compression.  This looks like bruising not a hematoma but I suggest formal consultation with your provider.  All vasers also start venus legacy in my practice to tighten skin after the procedure.  Best, Dr. Emer.

Julio Clavijo-Alvarez, MD, MPH, FACS · Answer

Congratulations on your procedure and thanks
for sharing your question. I can appreciate your concern.
Your pictures are showing significant bruising and swelling
after your surgery. This unfortunately is expected with older techniques such
as VASER or ultrasound based technology.The Swelling is the result of the high temperatures that the device
generates.
Lymphatic massage, and garments are your best allies.

Finally, make sure that your doctor is
aware of your process. He should be able to guide you best in your care.

Wishing you the best in your journey

Edwin Ishoo, MD · Answer

Its not possible to provide you with a definitive diagnosis based on the picture. I would suggest having an examination by your surgeon who can determine on physical exam if there is a fluid collection requiring drainage or its just ecchymosis or bruise which does not require intervention.

Mats Hagstrom, MD (license on probation) · Answer

Based on the picture you appear to be quite bruised.   Bruising is The manifestation of blood being broken down by the body.  The hemoglobin which is contained in red blood cells breaks down into various pigmented molecules. Any blood left in tissues during or after surgery need to be processed by the body.When there is little or no blood then patients see minimal bruising.  with liposuction there is always some bleeding. Liposuction is a "closed procedure "meaning the surgeon cannot stop small blood vessels from bleeding directly through the tiny incisions made to remove the fat.  Bleeding is kept to a minimum during liposuction by using a drug called epinephrine which is mixed with lidocaine and Celine.This mixture is called tumescent solution .When tumescent solution is properly placed in the right amounts and sufficient time has been given before   the surgery starts bleeding is kept to a minimum.  I find patients who undergo liposuction without General Anastasia tend to over all have less bruising.  When performing liposuction on awake patients the proper placement of tumescent solution is mandatory or the patient will not tolerate the procedure. The process is also slower giving medications more time to take effect.  when you sing general anesthesia less emphasis is sometimes placed on the Kamas and part of the procedure. These are general statements and represent my opinion.Others may vary. It's not possible to tell if you have a set Romo or hematoma based on your picture. When we talk about hematomas after surgery there are usually referred to as a youth large single collection of blood.This is quite different than diffuse blood throughout tissues that often happens during liposuction. When a single large blood collection or hematoma is detected it is sometimes removed.  It is not technically possible to remove diffuse collection some blood throughout tissues after liposuction.  With time your body will process the breakdown of hemoglobin.The initial firmness and inflammation will settle down and tissues become soft.  As this process continues to tissues also shrink in size giving the final results many months after the procedure.  Patients who develop seromas after liposuction should have them drained frequently until resolved. VASER has a proven higher rate of developing serums they are still fairly uncommon after liposuction.   I suggest you contact your plastic surgeon and let him or her evaluate  you and address your concerns. Best,Mats Hagstrom M.D.

Vincent D. Lepore, MD (retired) · Answer

Although, it would require a physical exam to determine if you had a seroma or hematoma,  the bruising you have is fairly typical of a liposuction in this area and doesn't necessarily mean anything is wrong.  Check back with your surgeon, but the bruising should resolve over the next week or two.  Best wishes, Dr. Lepore.

I'm 6 days post-op w/vaser lipo on my stomach & pubic area. Is this a seroma or hematoma or normal? (photos)

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