Vaser liposuction - seroma recurring 1 year post-op - advice?

Question

38 y/o 67kgs, Vaser lipo 13 months ago, extracted +/- 2.4 liters fat. Since day 1 til today I still develop seroma. Post op was done accordingly and attended all 30+ massages/therapies and still stubborn as day 1 Last week ultrasound report again shows more than 25cc and being 5.5 cms wide I indeed can tell when touched is +/- that wide, hardened when touched and not that watery as in the early days. Tends to come a blackish color the last 5 months or so, need a final solution its been a YEAR!

Navjot Singh, MD, FACG · Answer

A seroma that cannot be drained by conventional means may be drained by a interventional radiologist as an outpatient procedure that needs to be ordered by your provider.It is quick and simple. Due to the duration of length of the seroma you may also consider a ct scan of the abdomen to ensure it is something unrelated.
Good Luck

Arian Mowlavi, MD, FACS (license on probation) · Answer

IF you are on a blood thinner, you may want to stop it for a while since it sounds like you may have a small leak in the area which can cause the dark color you are describing. Sometimes, you may need a revision of the region if you develop some scar tissue.
The definitive correction for liposuction deformities requires the advanced technology of ultrasound assisted VASER liposuction. As an official trainer of VASER liposuction, I encounter suboptimal liposuction outcome referrals weekly. VASER liposuction has been the only modality that has consistently corrected liposuction caused deformities. VASER liposuction ensures a smooth contour regardless of severity of contour irregularities by virtue of being able to remove any and all remaining fat comprehensively and uniformly. Finally, when skin redundancy irregularities are observed, Renuvion technology can be simultaneously applied to tighten your skin to optimize your overall contour outcome. A Skype or FaceTime consultation with a VASER specialist will help you get an accurate recommendation and pricing.

Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Mats Hagstrom, MD (license on probation) · Answer

When I postoperative fluid collection forms it needs to be drained on a daily basis until it no longer forms.

If the tissue surfaces cannot be in contact with each other because of the fluid a capsule or scar tissue membrane will eventually form. Once this happens the patient has a chronic encapsulated seroma.  Once the capsule has formed the seroma is no longer treatable by aspiration alone.

A chronic encapsulated seroma is treated by direct open excision of the capsule with the placement of a surgical drain.

Your choice is to live with the seroma or have it properly surgically excised.

All plastic surgeons should be versed in how to manage fluid collections.

Some do it better than others.

The key is aggressive early intervention by draining it on a daily basis or as close to that as possible.

Personally I do not recommend postoperative massage after liposuction for any of my patients and I have yet to have a patient develop a seroma after having done over 7000 Liposuction procedures.

I also do not use VASER which has a known higher seroma formation rate.

Best,

Mats Hagstrom MD

Randy Dean, MD - Account Suspended · Answer

Hi and welcome to our forum!
I'm sorry to hear of your difficulties following your Vaser liposuction. A seroma is a collection of tissue fluid accumulating at the operative site. It is caused by injury to the soft tissues. When blood vessels and lymphatics get damaged through the normal course of the operative procedure, the body mounts an inflammatory response, resulting in the production of clear fluid. Normally, the body absorbs this fluid, but, if excessive, it will accumulate and create a seroma.
Small seromas will naturally resorb, but larger seromas require drainage. Serial needle aspirations may be required. If repeated aspirations fail to control the seroma, a drain is placed and is usually left in place until the drainage subsides. If the seroma persists for more than several months, sclerosing solutions (we employ doxycycline) can be introduced through the drain to create scar which will retard fluid accumulation. In unusual instances, surgical excision of the tissue making up the walls of the seroma is required. Closing the resulting defect with a quilt like technique appears to be of benefit.
Continue followup with your plastic surgeon.
Best wishes...

Vaser liposuction - seroma recurring 1 year post-op - advice?

Answers (4)

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