Is fat that feels thick (not soft or pliable) difficult to lipo? (photos)

Question

I am 18 months post op ftom a tummy tuck. The fat in my upper abdomen was not liposuctioned at the time of my tummy tuck. The fat that I now have in this area feels thick / tough to the point of not being able to pinch it it or tug on in it unless I am in a seated position where it then becomes easier to grasp or pull on. I am wondering will it be difficult to lipo in that area being that it doesn't feel soft when standing upright. Thanks.

Edwin C. Pound, III, MD · Answer

Some fat is more fibrous which makes it feel thicker.  The fat in the upper abdomen might be an example of this.  I don't like to do liposuction in conjunction with a tummy tuck either, however, I have no problem going after that fat later if necessary.  Using the laser (SlimLipo or SmartLipo) may also make removing this fat easier.  I would suggest that you make an appointment with a board-certified plastic surgeon who can examine you and review your options with you.

Vincent N. Zubowicz, MD · Answer

Fat that feels firmer generally has more connective tissue and is a bit more difficult to remove. In your particular case some of the upper abdominal prominence may be due to intraperitoneal fat which can only be lost by weight loss or by the specifics of your skeletal anatomy. The

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs and congratulations on your tummy tuck results! The tissue of your upper abdomen likely feels thick/tough as a result of your tummy tuck having tightened your underlying muscles and overlying skin.  This does not preclude you from having liposuction performed and does not make it a more difficult procedure.  Hope this helps.

Joel M. Stewart, Jr., MD · Answer

From the photos you supplied, it looks like you could benefit from some contouring liposuction to further improve your figure.
You are far enough outside the healing process of the tummy tuck that this would be considered safe to perform. Contouring of the upper mid abdomen and flanks and also possibly the upper hips.
Best of luck.

Lisa M. DiFrancesco, MD · Answer

Thank you for your question. The thick or tough fat most likely is a combination of fat and scar tissue from your prior abdominoplasty which is normal. You are correct, it will make liposuction more difficult but more importantly post op care will be key to preventing that scar tissue from returning. I would recommend using smartlipo or power assisted liposuction for your procedure and post op care which includes ultrasound and lymphatic drainage to achieve your best results. This will help to break up scar tissue during the procedure and help to prevent it from returning post op.

Jean Paul Giudicelli Saba, MD · Answer

Hi, thanks for sharing your concern and photos with us!
First I want to congratulate you for making this important decision. Deciding to get an aesthetic procedure to change your body and get a new life style is a big step!
  
Looking at your photos I might say that you´ll be a great candidate to get an entire abdomen, this is because you have located fat that can be done with lipo.
  
Before all this, of course, you need to get a complete medical evaluation and laboratory exams to check everything is fine. For us your safety, always, is going to be first.
  
Have a great day! 
  
Dr. JPG

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