I have significant abdominal fibrosis (almost 10 years post op from lipo). What are my options to improve appearance?

1. Make sure you’re at your ideal body weight for your height. Weight gain after lipo usually worsens irregularities.
2. Then consider an aggressive treatment plan with endermologie to help break up scar tissue.
3. Revision liposuction may help decrease the fatty areas that are too full compared to other areas that are thinner.
4. An abdominoplasty “tummy tuck” will remove excess skin and the irregularities associated with it. A tummy tuck will also redrape essentially all of the tissue over your abdomen and help smooth things out.

An examination is needed to help guide you. It may be that a tummy tuck will best address your contour concerns. Another option may be fat transfer. I encourage you to begin by visiting with a board certified plastic surgeon near you for an evaluation.

Unfortunately, liposuction results are permanent and irreversible. If done poorly, there are a few treatments available to improve the outcome.
Fibrosis, it’s not a condition that happens to happen to some people. It is the result of overly aggressive liposuction removing too much fat often in combination with leaving and uneven fat distribution in the body‘s response to this is the form scar tissue. Scar tissue itself is not an issue if there is a sufficient layer of subcutaneous fat to hold the scar tissue. One too much fat has been removed. There is no fat to buy for the scar tissue and patients are left with basically skin and scar tissue on muscle.
It’s not possible to remove the scar tissue. Any further surgical intervention will inevitably lead to more scar tissue formation. Restoring the subcutaneous fat layer is often extremely difficult and if it is going to be successful, will require multiple rounds of fat transfer. The reason fat transfer does not work well to restore poorly done previously aggressive, and Liposuction is that the body no longer has a sufficient layer of host tissue to support the grafted fat. Without a layer of tissue to support grafted fat the graphs will not survive, leading to get more scar tissue, fat, necrosis, with small amount of survival of the grafted fat. in some cases, small amounts of fat may survive, and if the procedure is done multiple times, it may be possible to build up the fat layer sufficiently to see some improvements.
Revision work is many times more difficult than doing primary liposuction. Going back in to remove more fat or any attempt at simply breaking up scar tissue generally makes things worse.
Without seeing pictures, we can’t make an assessment, and so these are just general statements that are applicable to those who have had overly aggressive liposuction, which is often described as a condition of having fibrosis.
If you want an assessment, then I suggest including proper before, and after pictures. Unfortunately the number of plastic surgeons who do liposuction well on a consistent basis is relatively small. There’s more variation in Liposuction results based on who you choose as your provider than any other plastic surgery procedure. Doing liposuction well on a consistent basis is more difficult than most people believe. I cannot emphasize enough the importance of it properly, vetting, plastic surgeons, and having multiple in person, consultations before choosing a provider for Liposuction type procedures. the same is true for revision work. Considering that revision of work is more difficult than primary liposuction. The importance of provider selection is even greater. Patient should recognize that only. Modest improvements are generally possible at best. The most important next step is to get an assessment in regards to understanding if any type of revision work is possible, and if so what that procedure would be. Generally correct and poorly done Liposuction comes down to three techniques. Either revision liposuction(removing more fat), fat, transfer a combination of both, or converting the procedure to a skin tightening operation like a full tummy tuck.
I suggest having multiple in person, consultations with local, board-certified plastic surgeons, who seem to have extensive experience in a proven track record with both Liposuction and fat transfer procedures. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures, especially a previous patients who have similar body characteristics to what you do. For primary Liposuction an experienced provider should have no difficulty showing you at least 50 sets I’ll before and after pictures. For revision work, the number of before and after pictures is going to be last since revisions are not as common. When looking at fat transfer results always confirm that the after pictures were taken at least 3 to 6 months from the date of the procedure.
Good luck,
Mats Hagstrom MD