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Plastic Surgery/tummy tuck scar tissue

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Question
I had a Tummy Tuck with lipo a yr ago April 1st.  I had a seroma that had to be drained several times after.  I now have a large (grapefruit) pooch just about my scar that is very hard which i am assuming is scar tissue.  I have been back in several times to have this looked at and once my doctor removed more fat through the same scar and that did not work, actually made it worse and the last time he did lipo which seemed to help for about 2 days and then the pooch came right back.  It has been 2 weeks since the lipo which was done in office and I understand there may still be some swelling from that but I dont understand why it was pretty flat for 2 days and then went right back to the grapefruit size bulge again.  The skin is very tight and I have some pain in lower back and hip, not sure if this could be the cause.  I would like to have the scar tissue removed if at all possible.  Can you please adivise?

Answer
Debbie

Of course it is difficult to specifically answer your question without an examination, but  your problem sounds like what is called a "pseudocyst."  Sometimes, when a patient develops a seroma, a membrane forms around it causing a cyst like structure to develop.  It can have an appearance exactly like you describe.  If that is the case, that surgical excision is required.

The diagnosis can usually be made with ultrasound, but sometimes a CT scan is required.  I would suggest the ultrasound as an initial step since it is a lot less expensive than a CT scan.

Hope this is of help

Sincerely

Howard Tobin MD FACS

Plastic Surgery

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Howard Tobin MD FACS

Expertise

I can answer questions related to Cosmetic Surgery. I cannot answer questions related to reconstruction, burn treatment, cleft palate surgery or traumatic surgery. My practice is, and has been for 36 years, limited to Cosmetic Surgery. For further information, go to www.newlook.org

Experience

As mentioned above, I have exclusively practiced cosmetic surgery for over 36 years. My practice encompases all aspects of cosmetic surgery

Organizations
American Academy of Cosmetic Surgery (past president) American Society of Liposuction Surgery (past president) Cosmetic Surgical Society of Texas (past president) Fellow American College of Surgeons Texas Medical Association see cv on website www.newlook.org for further details

Publications
Seventy three published articles. see cv on website www.newlook.org for further details

Education/Credentials
Graduate of Princeton University and Baylor College of Medicine Internship - University of Virginia Residency - Baylor Medical College Affiliated Residencies Fellowship - University of Cincinnati see cv on website www.newlook.org for further details

Awards and Honors
American Medical Association - Physician's Recognition Award; 1969- present American Academy of Otolaryngology - Head and Neck Surgery Honor Award, October, 1983 American Board of Cosmetic Surgery - Certificate of Appreciation - 1987 American Academy of Cosmetic Surgery - Best presentation at 1987 annual meeting: "Revision Mammaplasty with Replicon Prosthesis" Accreditation Association for Ambulatory Healthcare Certificate of Appreciation 1989-90 American Academy of Facial Plastic & Reconstructive Surgery Honor Award for distinguished service, 1989 American Academy of Facial Plastic & Reconstructive Surgery Appreciation Award for authorship of monograph on outpatient surgery , 1993 Certificate of Excellence in Continuing Medical Education in Cosmetic Surgery, 1993 - American Academy of Cosmetic Surgery. International Academy of Aesthetic Surgery & Aesthetic Medicine - Honor Award, 1994 American Academy of Cosmetic Surgery - Recognition plaque following term of Presidency - 1995 Accreditation Association for Ambulatory Healthcare Special Citation of Appreciation for Service; November 1996 International Academy of Aesthetic Surgery & Aesthetic Medicine - Appointed honorary North American President, 1995 1997 American Academy of Cosmetic Surgery: Award for excellence in cosmetic surgery; Jan 2003 Cosmetic Surgical Society of Texas Appreciation Award for Leadership; 2004 Honorary Member Mexican Academy of Cosmetic Surgery 2007

Past/Present Clients
A past sponsor of the Miss Texas USA pageant, he has also served as a judge for this and other pageants. His patients include many pageant contestants and winners up to the Miss Universe title

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