What's the rate of seromas & persistent fibrosis after a tumescent liposuction?

Question

I heard that seromas are fairly common complications with tumescent liposuction, and I'd like to know how common they are in percentages. And also I'd like to know what's the rate/how common is permanent fibrosis/scar tissue after a tumescent liposuction in a very thin/skinny patient (I know that with massages, they can improve/go away, but I'd like to know if it's common that they stay and don't go away

Kimberly Butterwick, MD · Answer

When liposuction is performed by a board-certified doctor with extensive experience and training in the procedure, the risk of seromas and persistent fibrosis is very small. The technique I use, tumescent liposuction, reduces that risk even further by placing tumescent fluid in the area that reduces bleeding during and after treatment. It also allows for tiny cannulas, so there is minimal trauma. In my office, we take every precaution to minimize the potential for seromas and scar tissue, with very good results. Make sure you select a qualified physician for your procedure and your risk should also be extremely low.

N. Bill Aydin, MD · Answer

Seromas after liposuction occur in 10% of the population and is usually based on the patients anatomy. Seromas usually appear about a week or two after the procedure. The best way to get rid of a seroma and prevent fibrosis is finding it early on during the recovery period. Once the seroma has been diagnosed, it would then be aspirated. Serial aspirations may be needed depending on each patients case. After a couple aspirations, the pocket will eventually collapse. Sometimes, collagen starts form overtime and give a firm appearance. We usually wait until all the swelling settles and reassess if diluted Kenalog injections (steroid) are needed to help break down those fibers.

Kenneth Hughes, MD · Answer

No drainage after liposuction is unusual, but the amount of drainage can vary quite a bit depending upon the number of areas liposuctioned, the volume infiltrated, the amount of lipoaspirate, and the use of sutures for closure of liposuction ports.  The fluid, if not present as a collection, should be absorbed.  They are usually reabsorbed into the body within a month, although this can take up to a year. If the seromas are causing a deformity, I prefer to drain them immediately.  Recommend that you follow your PS's protocol and have him/her continue to drain if necessary.If you had a hematoma due to medication, the filling of that space with fluid (seroma) is the logical physiological response.  I will say that the more that is liposuctioned the more likely the occurrence of fluid collection.  In addition, early activity and lack of compression probably contribute as well.  Fluid collection is reported in the literature as one of the most common occurrences following liposuction.

Harry T. Haramis, MD, FACS · Answer

In my experience, seroma (fluid collection) and permanent fibrosis (thick scar tissue) are rare (

Connie Hiers, MD, FACS · Answer

Using tumescent fluid, which most surgeons do, does not cause seromas, but adds local anesthesia and decreases the risk of bleeding. Liposcution may cause some seromas in the early healing process, but most are quickly resolved without draining. All surgery will cause some scarring. But, if liposuction is not done too superficially or too aggressively, the fibrosis will be none to minimal.

Mats Hagstrom, MD (license on probation) · Answer

All forms of liposuction it included the addition of tumescent solution when done correctly Making all forms of liposuction tumescent liposuctio.Using tumescent  solution Has no impact on fluid buildup or seroma formation.The only variable that has a proven increased rate of seroma formation it is the use of VASER or ultrasound assisted liposuction.Overall the chance of developing a seroma is pretty low. Out of 7000 liposuction procedures to my knowledge I’ve never had a patient get a seroma. 100% of patients will develop scar tissue after liposuction.The term fibrosis is often inappropriately used to describe the condition of being a grossly over treated with an irregular contour done and by poor technique in which the patient is left with virtually no fat and only scar tissue.There is no postoperative treatment that can change this like a massage. In fact there’s no proven benefits of massage after liposuction for any reason.Most providers who push lymphatic massage after liposuction have a secondary gain by selling this treatment in house.The best way to avoid fibrosis is avoiding being botched by selecting talented surgeons. The most common scenario I see is where the word fibrosis is brought up as patients having been over treated. I find this is commonly associated with inappropriate use of ultrasound assisted liposuction called VASER.  this is not a bad device but it is a device that when used inappropriately by inexperienced surgeons can grotesquely disfigure people by having settings too high or using too much energy.To minimize the chance Of complications eliminating ending up with fibrosis and not having a botched outcome that is irreparable I suggest finding the most talented plastic surgeon that you have access to.This is the single only variable you should be concerned about and the only variable that matters.Find the right  plastic surgeon and everything falls into place.Choose the wrong plastic surgeon and you will have complications and bad outcomes.Equipment used, name of technique or postoperative treatments such as massage or anything else are irrelevant in relationship to the skill of the provider.There’s really nothing else to it. An attempt of trying to learn the  other variables is pointless because most people turn to sources with biased information.I suggest having numerous in person consultations with local experienced board-certified plastic surgeons who have enthusiasm, experience and skill with liposuction. Best, Mats Hagstrom MD

What's the rate of seromas & persistent fibrosis after a tumescent liposuction?

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