Lumps/uneven skin after arm lipo. What can I do to treat this? (Photo)

Question

Hi, I had arm lipo in Sept 2021. As of today, Aug 2023, my arms have a lot of dimples and uneven appearance to them. Why did they heal in this manner and what can I do?

Camille Cash, MD · Answer

Contour irregularities are a risk of liposuction but can often be avoided.  A revision is needed for improvement of your results.  I encourage you to visit with an experienced board certified plastic surgeon.  Review credentials and look at before/after photos.  Schedule a consultation with those who meet your criteria.

Mats Hagstrom, MD (license on probation) · Answer

Delivering consistent quality, liposuction, results is more difficult than most people realize. The number of plastic surgeons have truly mastered. Liposuction are in a small minority. Most plastic surgeons think they’re better at Liposuction than they actually are. There is substantial variation in Liposuction scala among plastic surgeons. Being bored, certified in plastic surgery with years of experience in their overall good reputation does not mean somebody has mastered anyone single procedure, especially operations like Liposuction.
Considering how much variation in there is a liposuction skills, I recommend patient be highly selective when it comes to choosing providers. I suggest patients do this by having multiple in person consultations. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients went similar body characteristics to your owner. An experience plastic surgeon should have no difficulty showing you with the before and after pictures of at least 50 previous patients. Upper extremity Liposuction is more technically challenging and difficult compared doing abdominal work. Your results are a direct reflection of your candidacy for the procedure combined with the skill of your provider. To make an accurate assessment on the outcome of a procedure we always need to see proper before and after pictures. If you don’t have before, and after pictures, then ask your surgeon to forward the pictures they took. the result is a direct reflection of how the procedure was performed. The only two variables that matter when it comes to Liposuction results are the patient candidacy for the procedure in the first place and the skill of the provider. Nothing else really matters. 
Improving poorly done liposuction results can sometimes be done with revision work. Revisions can be done with further liposuction, fat, transfer, and occasionally by converting the procedure to a skin tightening operation.
Generally, speaking revision work is far more difficult and complex than primary Liposuction. Patient should be even more selective when it comes to choosing providers for revision work. The plastic surgeon is in capable of delivering quality outcomes during the primary procedure, and they are less likely to give substantial improvements attempting revision work.
Considering how much variation there is in Liposuction scale among plastic surgeons, I suggest patients be highly selective and schedule multiple consultations before choosing a permanent irreversible body contouring procedure. There’s no correct number of consultations needed to find the right provider. The more consultations you have it the more likely you are to find the best provider for your needs. For Liposuction I suggest patient start the process by having at least five consultations before choosing a provider. I recognize this is a time and labor-intensive process, but considering the potential impact and the fact that patient can easily be disfigured if the procedure is not done well I believe having multiple consultations is worth it.
If you’re interested in trying to improve on the outcome, then I suggest consulting with multiple plastic surgeons, who seem to have a lot of experience doing arm and Liposuction in your community. Highly selective when consulting providers, insisting on seeing clear evidence of quality work. Take careful notes during each consultation, especially regarding the quality and quantity of before and after pictures showing. Providers showing you a handful of preselected images, representing the best results of your career or not giving you sufficient information to get a clear understanding of what average results look like in the hands of each provider or how many procedures they’ve actually performed. mastering, Liposuction is a lifelong dedication to excellence, and is finally only accomplished by a handful of committed providers. 
In your case, I think your outcome has good potential for improvement with revision surgery, but getting a quality outcome will require in finding as efficiently talented provider. You can see some of my before, and after pictures of our Liposuction results posted under my profile on this website. My approach to arm liposuction is the treat the arms circumferentially from the top of the shoulder blending into the forearm.
Best,
Mats Hagstrom, MD

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