I’m going to try to explain my best guess and why your outcome looks the way it does based on somewhat limited information. To makeI’m going to try to explain my best guess and why you’re outcome looks the way it does based on somewhat limited information. To make a quality assessment really requires an in person consultation with an examination. When it comes to Liposuction candidacy and understanding Liposuction results it’s really important to have a clear understanding of both skin laxity, and the amount of subcutaneous fat. Any degree of skin laxity typically from weight loss, related loss of elasticity, or in women previous pregnancies will reduce the potential outcome from Liposuction even when it’s done well. to understand the impact of potential skin laxity pulling skin so it’s under tension by pulling up the skin above your areas of concern. With the skin under tension, you can see the contour of your abdomen based purely on fat distribution. Another words by pulling the skin tight, you remove any skin laxity contribution to the outcome. Having had a mini tummy tuck, gave you some skin tightening of your lower abdomen, but the procedure did not give any of the skin tightening Advantage Around your bellybutton or of the upper abdomen. It looks to me like the outcome is a combination of skin laxity with uneven fat removal. Delivering consistent quality Liposuction is more difficult than most people realize. The number of plastic surgeons who approach mystery of Liposuction is in reality quite small. An average plastic surgeon who may not have excelled at Liposuction doing the procedure on a patient who has a history of weight loss with skin laxity is a set up for dissatisfaction. Perhaps your surgeon could’ve done a better job on a patient who is more of an ideal candidate with thick layers of subcutaneous, fat and tight skin which tends to be What makes someone a perfect candidates for Liposuction. Correcting poorly done Liposuction is much more difficult than doing primary Liposuction well. Any attempt at improving the outcome can make things worse. Liposuction revision can potentially improve the outcome based on a few variables. The first variable is the patient’s candidacy for Liposuction in the first place. The second variable is the amount of subcutaneous fat left to work with. The most difficult revision cases are either of patients who were not good candidates for Liposuction in the first place or patients who have an uneven fat distribution with previous aggressive Liposuction. When there’s a little fat left to work with, and the fat layer is uneven. It becomes very difficult to make significant improvements. Insufficient Liposuction around the belly button is something we see pretty often when the procedure was done by inexperienced providers. Again, any degree of skin laxity will contribute to an undesirable outcome because skin laxity can look like excess subcutaneous, fat and adds to contour. It would be very important to know your age and any history of significant weight fluctuations. Even a 40 pound weight fluctuation can have significant impact on someone’s candidacy for liposuction. Age also impacts the potential results greatly. The patients who are the best candidates for Liposuction are usually in their 20s or early 30s. As people get into their 40s, they typically have too much loss of skin elasticity to have the ability to get Liposuction results. Finding someone to do revision work for you is going to be challenging. Typically, the best plastic surgeons are doing revision work are the same surgeons who do the best primary Liposuction. To find the right provider for Liposuction, including work or more or less any plastic surgery I recommend the following. First make a list of local providers who seem to excel in the procedure you’re interested in. If there are board-certified plastic surgery to focus exclusively on the procedure, you’re interested in then put those providers on top of the list. Once you narrow down the list, five or more providers start scheduling in person consultations. Compared to the consultation by bringing you a complete set of before and after pictures or pictures of your body. If you don’t have a complete set of proper before and after pictures and ask your surgeon to forward the pictures they took. Always bring pictures of yourself to use as reference. Don’t rely on memory to remember what your body looks like during the consultation, especially when reviewing before and after pictures. Take notes during the consultation how thorough the provider seems to be especially any hard evidence that they have extensive experience and have approach mastery of the procedure. In the end, the best way to do this is to ask the provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar body characteristics to your own. This may require some work. I’ll behalf of the provider. Many plastic surgeons will have show and tell photo albums with the very best results of their career. This is not what you’re looking for. What you’re looking for is the results of previous patients who had similar body characteristics to your own period This means the patient had similar amounts of subcutaneous, fat, gender, approximately the same age and the same degree of skin laxity for the same areas you’re interested in treating. It may be difficult for providers to show you an extensive collection of similar revision work. it is important that you providers to show as many examples of revision work as possible. You need to push the pro provider to show you as many pictures as possible. In the hands of the right provider you’ll be given access to see more before and after pictures, then you have time to look at during the consultation. Highly experienced plastic surgeons should have access to hundreds or prefers thousands of before and after pictures. Ask the provider what their own revision rate is for Liposuction work. In a perfect world, plastic surgeons should have a certain revision rates. All of us have cases that can be improved with a touchup procedure. You can ask providers to show you examples of their own revision work or revision procedures on patients from other providers. Take notes during each consultation, especially regarding the quality and quantity of the before, and after pictures. A good consultation should also include an examination. In my opinion, it’s really important for the provider to differentiate skin laxity by putting the skin under tension which typically helps determine if the subcutaneous fat layer is uneven and if so, in what areas. There’s no correct number of consultations needed to find the right provider. The more plastic surgeons you meet with the more likely you are to find the better provider for your needs. The biggest mistake I see patients make is having only one consultation and then scheduling surgery. Scheduling only one consultation, more or less eliminates the ability to choose a better provider. The second biggest mistake I see patients make is assuming that being board-certified in plastic surgery With a few years of experience and a handful of positive reviews means somebody has mastered most plastic surgical procedures. As I mentioned earlier mastering, Liposuction is really difficult and typically it’s only achieved by those specialize in liposuction over a lifetime. Too many patients as well as plastic surgeons, see Liposuction as a simplistic procedure, which it is not. As I mentioned earlier, revision work is difficult, and typically only subtle improvements are possible. The chance of having a high-quality outcome goes down significantly when their secondary variables like skin laxity. Skin laxity is the number one reason why patient failed to be ideal candidates for Liposuction. It’s really important for plastic surgeons to understand any history of weight fluctuations and take this into context with the patient’s age. A good consultation should definitely inquire about a history of weight loss. There’s definitely room for improvement, but The final outcome is probably not going to be what you had hoped for. This is in part because revision work is so much more difficult than primary. Liposuction and I question if you were an ideal candidate for Liposuction in the first place because of your skin laxity. I don’t know what your history is, but based on having had a mini tummy tuck, I’m going to guess that skin laxity was always part of the issue. The amount of work to find the right provider is pretty significant. Considering the impact is going to be with you for the rest of your life I think spending 10 or more hours interviewing with plastic surgeons seems like a very reasonable commitment. I’m sometimes amazed at how many people Forgo the importance of consultation, especially with multiple providers. Above all always avoid virtual consultations and whenever possible choose providers who are local. Best, Mats Hagstrom MD