WAVE - San Francisco

Thank you for your question. Your PS has given you the option of liposuction with or without tightening of the abdominal wall to improve your appearance. This is not unreasonable, and the answer depends upon the source of you dissatisfaction. If you don’t like the roundness of your lower abdomen, you will have to get that tightened again with additional sutures, as your PS has suggested. Personally, I think you have had a fair degree of improvement in your diastasis. You still have some laxity, but many people feel that a bit of roundness is more feminine, whereas a flat abdomen can appear somewhat masculine. It is a personal preference. You also appear to have a tiny bit of fullness above your incision line. This can be improved with liposuction alone.

Thank you for your question. It is possible to undergo multiple rounds of liposuction, although it may become more difficult with each successive procedure due to subcutaneous scarring. There is also the fact that with each liposuction procedure, there is less fat to remove as fat does not generally regrow. In your case, relatively little fat was removed for your facial fat grafting. I do a lot of it in my practice and it does not take more than a few milliliters. I you have enough fat for a BBL or breast augmentation, there should be little difficulty harvesting it despite the fact that you have had previous fat grafting procedures.

Thank you for your question. The best way to avoid dents is to not get them in the first place, but it happens occasionally, even in the best of hands. A big part of the problem is that liposuction is typically done in a supine position, and what appeared to be smooth with the patient lying down can occasionally not be so smooth when standing. Using smaller cannulas, and repositioning the patient is helpful in avoiding this. That is why I sometimes prefer doing liposuction under sedation, so that the patient can help the surgeon visualize the treatment area from different positions. Experience of the surgeon also helps, I believe, as an experienced surgeon knows to randomize his or her liposuction strokes so as to not remain in the same area too long and reinforce a contour irregularity. That being said, your dents can be improved through a combination of liposuctioning the areas around the defects and fat grafting the dents themselves. Alternatively, an abdominoplasty can even out the irregularities (and in fact, remove these areas) as most of them are below the belly button. This is, of course, a much bigger procedure.

Thank you for your question. It is uncommon to request liposuction in the lower neck, but is within the realm of possibility. Great care must be taken in this area as it is near the thoracic inlet. Major blood vessels, the lungs, the esophagus, and trachea are nearby, so complete familiarity with the anatomy in the area is essential. You should seek consultation with an experienced surgeon who is completely comfortable with the special anatomy of the region.

Thank you for your question. Liposuction is excellent for improving those areas of stubborn fat that don’t seem to go away with diet and exercise. It is not for removing fat from an arbitrary 360 degree zone around the torso or around a limb. You can dictate what areas you want treated, and it is up to the surgeon to try and blend it in to the surrounding areas. To be honest, there really isn’t much fat under the skin of the mid-back/bra roll area in most people. The skin there is simply very thick, making it appear that there is a lot of excess fat there. The areas you highlighted are very amenable to “spot” treatment and can greatly enhance the contour of the entire region.