I have pitting on my saddlebag area due to lipo that I got 11 years ago. My plastic surgeon says that to fix it he would "untether" the skin from the muscle by running a thin rod under the skin, and then pouring in my own fat to smooth out the area. I've heard that untethered skin can hang loose and get saggy and I don't want that! Could I just get fat injections to fill in the pitting without untethering the skin?
Untether Skin from Muscle to Fix Bumps/pitting Caused by Lipo?
Doctor Answers 9
Dimpling and skin
If you have some areas of dimpling and depression, fat injecting alone may help. Sometimes the skin needs to be released.
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How to treat dimpling of saddlebag from previous liposuction
In my experience this is loose skin and best treated by a thigh lift. However, most pateints are reluctant to undego this extensive of a procedure. Fat injecting alone could make the dimpling more prominent.
Fat Injections for Liposuction Irregularities
You can try to have just the fat injections but sometimes you also need to untether the skin if it is really stuck down.
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Post liposuction irregularities
There are many things to consider when evaluating a patient who is unhappy with their prior surgery. An assessment of the following is critical: 1. how much fat will be required to fix the deformity; 2. Is the overlying skin mobile or fixed to the deeper tissues ( if the latter some "release" will be required; 3. Quality of the overlying skin - if it is poor, you may require some type of excisional surgery to accomplish your goal.
How to Correct Skin Pitting Caused by Liposuction
I agree with Dr. Wilke. If the skin is stuck to the muscle, it has to be released and then the area filled with fat. Remember, without the fat the skin may be loose and wrinkly, but with the fat filling the area, the chance will be minimized (think of an under filled balloon which is being filled).
Repair of irregularities from liposuction
Fat injections are helpful in the correction of irregularities from liposuction. If there is scar contracture causing a tethering effect on the skin, then release of this tethering is needed in addition to lipotransfer. The type of localized release of the skin needed for this is not likely to result in worsening of skin looseness or sag.
Fat injections for depressions after liposuction and subcision
Although fat injections are very good for depressions in the subcutaneous compartment after surgical or traumatic events, some depressions are anchored by your collagen bands and the fat won't displace the epidermis and dermis high enough. In fact, if this situation exists, the fat could extend outwardly beyond the depression which can raise the normal skin and make the depression look deeper! Your plastic surgeon has examined you and has a better idea if fat injections without the untethering (subcision) could help or if the subcision is necessary.
Depressions in the skin after liposuction fixed with fat injection
The transfer of fat from one area to areas of depression work well for divits after liposuction. Any bumps would require some additional liposuction to get them to smooth out.