Small puffy spot after liposuction. What can this be? (Photo)

Question

I am a 30 year old fit mom of 1 who had abdominal liposuction 6 months ago.. I had a very small seroma that was drained a few times on the right side under my bellybutton. In that same area, it now still appears swollen or puffy. If I feel under the skin, I can feel small little rubbery bumps that move slightly. What can this be?

Andre P. Marshall, MD · Answer

Hi beccam1, 
Liposuction causes many changes to the tissues under the skin. The healing process continues well beyond a year. Seromas are not uncommon after liposuction and are often treated with drainage and compression. If a seroma remains present a capsule can form around it and cause contour irregularities under the skin. Sometimes scar tissue forms after liposuction and this can be treated with aggressive massage therapy. For a proper evaluation and diagnosis I recommend you consult with your previous liposuction surgeon or another board certified plastic surgeon. Best of luck as you continue to heal. 
Dr. Andre P. MarshallDouble Board Certified Plastic SurgeonBeverly Hills, CA 90210

Daniel Barrett, MD · Answer

Dear beccam1,
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

Garrett Jones, DO · Answer

Some general information that might help you understand what could be causing a small puffy spot after liposuction. However, it's essential to consult with a medical professional for a proper evaluation and diagnosis.
1.) Swelling: Swelling is a common side effect of liposuction, and it can persist for several weeks to months after the procedure. This may cause a localized puffy appearance in the treated area. It's a normal part of the healing process, and it should gradually subside over time.
2.) Hematoma: A hematoma is a collection of blood outside of blood vessels and can cause localized swelling. It can occur if there was bleeding during the liposuction procedure or if a blood vessel was damaged. Hematomas may require drainage or medical attention.
3.) Seroma: A seroma is a pocket of clear fluid that can accumulate under the skin. It is also a possible complication of liposuction. Seromas can cause swelling and may need to be drained by a medical professional.
4.) Infection: Infections can cause localized swelling and redness. If you notice signs of infection, such as increased pain, warmth, redness, or discharge from the puffy area, you should contact your surgeon immediately.
5.) Inflammation: Inflammation is a natural part of the body's healing process. It can lead to swelling in the treated area. This type of swelling should gradually improve as your body heals.
6.) Scar Tissue: The formation of scar tissue can sometimes cause a raised or puffy appearance at the incision sites or treated areas. This is a normal part of the healing process and should improve over time.
7.) Allergic Reaction: In some cases, an allergic reaction to medications or materials used during or after the liposuction procedure could lead to localized swelling or skin changes.
It's crucial to contact your surgeon or the healthcare provider who performed the liposuction to discuss your concerns. They can examine the area, provide a proper diagnosis, and recommend any necessary treatments or interventions. In some cases, they may recommend a follow-up procedure to address any complications or aesthetic concerns. Remember that post-operative care and follow-up appointments are essential for a successful liposuction recovery.

Nancy de Kleer, MD, FRCSC (Plast) · Answer

The swollen puffy area, where you feel the mobile rubbery bumps at the location of the previous seroma, is scar tissue that hasn't completely softened yet. 
The best course of action normally is to give it more time.
If you haven't seen your surgeon for a few months it is worthwhile to be seen in person for a physical exam to confirm and to ensure there is nothing more that can be offered to help the area resolve completely. 
All the best to you,
Dr. Nancy de Kleer

Omer Sagir, MD · Answer

hello, it looks like there is oil left, you need to take the oils there again and have a thinner body and have a lymphatic drainage massage.

Connie Hiers, MD, FACS · Answer

You still may have a seroma. Please go visit with your surgeon and discuss your concerns. It may need to be drained or even removed.

Mats Hagstrom, MD (license on probation) · Answer

First and foremost I like to point out that your results look stellar and whoever did your procedure did a very good job.
That said fluid buildup‘s or seromas are fairly uncommon after liposuction. They happen more frequently when certain equipment such as VASER are used.
When detected they need to be treated aggressively and frequently until they low longer form.
This typically means taking a needle and aspirating or sucking out the fluid on a daily basis until the fluid collection no longer forms.
As long as there’s a fluid collection the surfaces cannot be in contact with each other and the fluid pocket will eventually become encapsulated.
Once the square tissue capsule or membrane forms the seroma is chronic and cannot be treated by aspiration(removing the fluid with a needle) this is why it’s important to treat these aggressively as soon as they’re noticed and as inconvenient as it is for both surgeon and patient they should be treated at the most frequent interval possible early until they don’t recur. Progress enclosing the fluid filled space only happens when there’s no fluid in it. An alternative is to put in a drain which continuously collects the fluid. At six months if you have a seroma it is for outside the window of being able to successfully be treated by aspiration.
The presence of a seroma can be confirmed by examination or an ultrasound.
At six months it is highly unlikely it can be removed with anything other than open surgical excision of the scar tissue capsule with the placement of a drain.
Anything less than that will almost 100% lead to recurrence.
Having a aroma by itself is not dangerous and if it doesn’t bother you or cause a contour problem and one option is to simply live with it.
All plastic surgeons should be trained and experienced in managing at aroma since it is fairly basic fundamental surgical knowledge.
Some providers take them more seriously than others.
I suggest you follow up with your provider to see what he or she has to say.
Best,
Mats Hagstrom MD

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