Giant lipoma removed - upper buttock, lower back. Developed a hematoma seroma and scarring - how can I help the pain? (Photos)

Thank you for sharing your story — what you’ve been through sounds incredibly difficult, and it’s understandable that your body is still reacting after such an extensive and complicated recovery. Large, deep lipomas — especially those over 10 cm — can leave behind significant space under the skin, and complications like hematomas, seromas, and dense scar tissue can unfortunately lead to prolonged pain and mobility issues.

Here’s how I think about your situation and the options that may help:

1. Understanding What’s Causing the Pain

The pain you’re describing can come from several sources, often overlapping:

Internal scar tissue (adhesions) binding down nerves or limiting mobility

Residual fluid pockets or chronic seroma cavities

Nerve irritation or neuroma formation from the original surgery or the drain

Muscular imbalance from months of moving, sitting, and sleeping differently

Chronic inflammation around the surgical tract

Identifying which of these is the main driver is key to choosing the right treatment.

2. Imaging Is Important

A high-resolution MRI with contrast can help determine:

Whether there is residual fluid

The extent of internal scar tissue

Whether nerves or fascia are involved

If there is any asymmetry or structural change from the original procedure

This can often guide treatment without the need for exploratory surgery.

3. Non-Surgical Options That May Help
• Targeted Physical Therapy (Different From the Deep Massage You Had)

Some PT approaches can actually worsen scar discomfort. Instead, look for a therapist who specializes in:

Post-surgical fascial work

Nerve mobilization

Myofascial release

Gentle mobility restoration rather than aggressive deep pressure

The goal is to slowly restore movement and decrease nerve tension.

• Pain Management Interventions

Pain management specialists can offer options such as:

Nerve blocks

Trigger point injections

Scar or fascial plane injections with anesthetic or steroid

Radiofrequency ablation for chronic nerve pain

These don’t fix the underlying scar tissue but can dramatically reduce symptoms.

• Scar Tissue Treatments

Some patients benefit from:

Ultrasound-guided scar release or hydrodissection

Laser therapy for scar remodeling

Manual therapy techniques specifically designed for adhesions

These treatments aim to restore glide between tissues that have become stuck.

4. When Surgery Becomes Necessary

Exploratory surgery can be intimidating, and surgeons are understandably cautious.
However, in cases where:

There is a persistent seroma cavity

Dense scar tissue is tethering nerves or muscle

There is a fibrous mass causing mechanical pain

Surgical scar revision or removal of the seroma capsule can sometimes bring relief.

It’s not the first option — but it can be appropriate if imaging shows a correctable problem.

5. Supportive Measures at Home

These don’t replace medical treatment but can help:

Warm compresses to relax tissue

Gentle stretching

Lymphatic drainage techniques

Avoiding deep pressure on the area

Maintaining mobility as tolerated to prevent further stiffness

A Few Final Thoughts

What you’re experiencing is real, and it’s not “just scar tissue” — your body has gone through a major event in a sensitive area. Recovery from complicated seromas and adhesions can take time, but many patients do improve with the right combination of imaging, conservative care, and targeted interventions.

I hope this gives you a clearer path forward and some reassurance that what you are feeling has an explanation — and that there are options to help you feel better.