Justin Yovino, MD, FACS

If filling the deficit has not worked for you, then consider removing some fat from below and above the dent. That would be liposuction of the inferior outer buttock / superior lateral thigh junction as well as the superior buttocks.

I think the best approach for your breasts is to remove excess skin from the lower poles. That will relatively lower your nipples while maintaining the current appropriate sternal notch of nipple distance. Adding volume with your own fat to the upper poles will also help. This is can all be performed in the office without general anesthesia.

From the looks of your photos, I think the donor sites can be inner, outer, and anterior thighs as well as inner knees. That would likely generate 200-250 cc for each breast. Total of 400-500 cc for both breasts. This is a guess based on your appearance. A virtual or in person consult will better determine the estimated donor amount available and if you are a good candidate in general. Yes, 2-4 weeks of compression is reasonable.

I don’t recommend more lipo for those areas. Lipo (with or without energy) will almost certainly make it worse. I agree with the treatment as if it’s cellulite. Aveli is an option to release the tethered areas. Combining Aveli with fat transfer may be even better.

You’re a great candidate for breast fat transfer if you have enough donor fat. A consultation will help determine that.

It appears that additional strategic lipo is a good approach for you. Fat transfer to depressions and irregularities may also be favorable. It’s always best to be at your ideal weight so being 15 lbs overweight is a limiting factor to some extent. The “bruising” you describe appears to be shadowing. Local anesthesia works great for these cases but the doctor must be very experienced.

From the looks of your photos, I think you’re a great candidate for lipo 360. Pick the correct surgeon and there’s a real good chance you’ll love the results.

No photos, no surgery. We require all surgical sites to be photographed before surgery. It’s crucial to the post op evaluation and discussion. Storage is part of the chart.

One combo option for you may be a breast lift combined with fat transfer to the top and cleavage. This will depend on your volume goals and donor fat availability. An advantage of this approach is the avoidance of an implant. A disadvantage is the more subtle volume enhancement with fat transfer.

I find it best to use your own fat for improving post liposuction irregularities. You likely have donor fat available from your arms. A consultation will help determine your options.