There is bruising on my butt 10 months after surgery. Can it be related to fat necrosis? What could be causing this? (photos)

If the bruising is hemosiderin deposits, they can persist for more than a year and some can be permanent.  Recommend that you return for a post-op visit with the plastic surgeon who performed your BBL ten months ago to determine best treatment plan for you.Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA 

Unfortunately, at 10 months post op the darker pigment you see is not bruising. Bruising is blood under the skin. What you are seeing is PIH or post inflammatory hyperpigmentation. This can occur from the inflammation from the surgery (trauma or injecting the fat). It can occur if there was fat necrosis. It can occur with infection or allergic reaction. Anything that is associated with inflammation. A common example is when you get a bug bite and it leaves some pigment behind. Direct sunlight will make this darker. There are topical creams and lasers than can lighten this pigment. PIH is more common if you can tan easily. It can occur in areas of liposuction too, so with the BBL we commonly see it along the waistline. It tends to lighten over time too. 

 This far out the pigmentation changes are not to bruising.This is most likely hemosiderin deposits which can be the remnant of previous bruising. The iron in red blood cells can stain tissues if the iron is changed to hemosiderin.  Bruising typically resolves within the first 2 to 5 weeks.  If you had extensive bruising in this area within the first month of surgery than this most likely is hemosiderin.  Removing hemosiderin deposits can be challenging. I'm not a laser expert but there may be lasers that can help with this.  Hemosiderin deposits are very slow to improve and sometimes can't be semi permanent or permanent.  Best, Mats Hagstrom MD