Can Liposuction Fix My Thigh Dent From A Hematoma?
Q: Dr. Eppley, I am interested in liposuction of one thigh. I had an injury that created a large hematoma on my upper thigh and I would like it removed. (It is stable). The hematoma occurred when I fell off of one of my horses and he jumped on my leg a few times (also happened to the other leg, but not as extensively). It tore my quad and created the “dent” that you can see as shadowing in the picture. The hematoma is behind that. It has settled into the size that it is now. My grandfather (retired surgeon), stated that he was most familiar with cases where they would evacuate the hematoma after it was non-expanding. He may have outdated information, as he is 84! If you have any other ideas for treatment, I would be very interested. I also attached a picture a few days after the injury occurred.
A: Liposuction may or may not be what you are looking for. Large expanding hematomas may need to be surgically drained if they create a large pocket, but that is not what you had. You had generalized bruising through the thigh musculature which must be allowed to resolve on its own…which yours now has. Liposuction is never a treatment for a hematoma regardless of the type.
The dent that is now in your leg is the result of the initial hematoma due to subcutaneous fat atrophy. Between the initial trauma to the tissues and the breakdown products of blood, some fat loss has occurred and this is why you have the dent. (tissue loss) This is extremely common occurrence from large hematomas.
Fat management is the key to improvement in your thigh contour but there are two different approaches depending upon what you want to achieve. If you want the surrounding contour to be even at the level of the dent, then the surrounding thigh areas need to have liposuction down to it. If you want the dent to be built out back to the level of the rest of the thigh (as it was before) then fat injection grafting is needed.
Dr. Barry Eppley