6 months post liposuction. Should I still have bruises and hyperpigmentation? What can I do to minimize appearance? (photos)

Skin discoloration six months after liposuction is most likely either a result of iron pigmentation of the tissues due to excessive bleeding during surgery called hemosiderin deposits or skin hyperpigmentation as a reaction to mild skin trauma.
The best way to understand the ideology is to know your post surgical history.
Excessive bleeding during liposuction sometimes happens when the procedure is done using general anesthesia and the surgeon fails to inject sufficient amounts of tumescence solution or wait to allow the medication in the solution at sufficient time to be in full affect.
Tumescent solution is injected into the fat whether the procedure is done with or without general anesthesia. The solution contains lidocaine and epinephrine.
Lidocaine is used to reduce pain during an after surgery and epinephrine causes blood vessel constriction shutting down blood flow to the fat during surgery.
When done as an awake procedure injection of tumescent solution in a thorough and methodical manner is absolutely necessary or the patient will have intolerable pain during the procedure.
During general anesthesia the patient is unaware of pain and surgeons often focus less time and effort on the injection of tumescent solution.
Thoroughly injecting the entire torso on an awake liposuction procedure can last from 30 to 40 minutes. this step under general anesthesia is often done in just a few minutes.
The drug epinephrine takes 15 to 20 minutes to be in full affect causing complete vasoconstriction.
If liposuction is done with insufficient injection of Tamasin solution or without proper waiting patients often have significant bleeding during the procedure.
Ideally fat removed during the procedure should be bright yellow in color with no blood in the container.
If bleeding happens the body responds by creating significant bruising that is the direct relationship to the number of red blood cells left in the tissues from blood loss during surgery.
A relatively bloodless liposuction procedure should cause only mild bruising lasting 10 to 14 days.
Moderate bruising can last longer.
Amount of bruising during the first few weeks after surgery it’s a direct reflection of how much bleeding happened during the liposuction procedure.
Excessive amounts of blood in the tissues causes the release of iron from the hemoglobin in red blood cells which becomes an iron pigment called hemosiderin which stains the tissues like an internal tattoo.
Some individuals particularly individuals with a higher melanin content or darker skin can be prone to hyper pigmentation from mild to moderate dermal injury. People prone to hyper pigmentation and scars will typically have the incisions turned dark for several months after the procedure and are typically accustomed to having all healing followed by skin color changes with temporary darkness. liposuction can cause mild dermal injury stimulating skin hyper pigmentation.
If the procedure was done with very little blood loss with very little bruising afterwards and the pigment or color changes developing or worsening at six weeks or longer after surgery and skin hyperpigmentation is the more likely ideology or cause.
Hyper pigmentation typically settles down and improves starting at 3 to 4 months after surgery while hemosiderin staining can be semi permanent and take much longer to improve.
Understanding the inherent ideology of the discoloration indicates what potential treatments or prognosis the patient should have or expect.
You could consider a dermatology consultation and if unable to differentiate a skin biopsy could confirm the ideology or diagnoses.
Best,
Mats Hagstrom MD

Hi and welcome to our forum!Pigmentary changes after liposuction are frequent. However, they are also usually transitory, lasting up to a year or so after liposuction. Some folks advocate Arnica, which appears to reduce bruising and swelling when applied topically or taken as a homeopathic treatment in pill form. Rarely, if bruising was initially significant, blood pigment (hemosiderin) may be permanently deposited into the skin. Continue follow up care with your plastic surgeon.Best wishes...