6 months post-op and have a Gum-ball sized, hard, painful, bump. Do I need a revision? (photos)

Question

I’m SIX MONTHS POST OP and I have this Gum-ball sized, hard, painful, bump above my bellybutton. The pain is extremely sharp bursts which make its hard for me to lift my arms, sleep on my side, wear non-elastic wait pants, it is disruptive to my life. It’s not fluid, already had an ultrasound. PS used a mini jackhammer thing on it two weeks ago to, even gave me an injection in the lump to stop the pain. Neither worked. I’m worried I’ll need a revision…. Anyone ever seen anything like this?

Vasileios Vasilakis, MD, FACS · Answer

Thank you for the question. It is difficulty to determine what your best options are without a physical examination. My recommendation is to visit with several plastic surgeons before you make your final decision. I wish you the best of luck. Vasileios Vasilakis, MD. Double board-certified, fellowship-trained plastic surgeon, Houston. TX.

Zoran Potparic, MD · Answer

In same patient painful, red and hard lump may be result of aseptic fat necrosis. Usually this can be seen on ultrasound imaging and confirmed with clinical evaluation. It would be in your best interest to discuss this issue with your surgeon. Good luck.

William T. Stoeckel, MD · Answer

It is really hard to tell what is going on with just the photos. It could be that you just have some scar tissue or a seroma pocket or a cyst from seroma fluid.  If you did, those things may improve with time, massage, steroid injections, etc. But it could be residual weakness of the abdomen fascia or loss of integrity of the fascia plication if it was completed with the abdominoplasty. It is unlikely to be a hernia, but it could be. Really hard to tell without an in person exam or imaging.

Daniel Barrett, MD · Answer

Dear Rebekah46281,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

From your description it sounds like you have a good relationship with your surgeon who is trying to work to address your concerns.  I encourage you to continue with this process.  Your surgeon is most familiar with the details of your surgery and how you've been progressing through recovery.

Douglas Taranow, DO, FACOS · Answer

A physical exam would answer many questions.  If the sonogram was negative for fluid, the ball does not come and go throughout a month, then I agree with the use of a steroid injection ( sometimes it may take several injections of varying concentrations). 
One issue I see is the convex curvature (outward curve) of your belly in this area.  This could be many things, mostly benign (not of any concern) or possibly something from the procedure.

6 months post-op and have a Gum-ball sized, hard, painful, bump. Do I need a revision? (photos)

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