Which procedure would help minimize dimples and cellulite in the legs? Should I consider fat graft w/ vaser lipo? (photos)

Question

I had fat graft done previously and be told I would be a good candidate for vaso lipo..f not sure what the difference is, I'm also looking at a procedure to fix my legs.. dimples and cellulite and overall appearance any suggestion appreciated :)

Jerimiah Mason, MD · Answer

Vaser is a device typically used alongside liposuction that helps melt the fat before it is suctioned out. It can also be helpful in revision liposuction, as it can make it easier to get through the scar tissue from previous lipo. Some experienced surgeons will also use Vaser to perform high definition liposuction, in which muscles can be accentuated (typically abs). 
Fat grafting in certain places is a good option for cellulite. There is no single good option for cellulite, sometimes multiple techniques are needed. Aveli is a new device that can simplify cellulite treatment, but it is pretty new, and would likely work better with simultaneous fat grafting.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding which procedure might help to minimize dimples and cellulite in your legs and if you should consider fat grafting with Vaser liposuction. From your pictures and history, it's clear that cellulite, which results from vertical adhesion bands between the skin and underlying fascia, is the main issue.

These bands can become inflamed, infected, or reactive to trauma, leading to skin contraction and indentation. There can also be an accumulation of fat around these vertical bands. The solution is a surgical procedure that releases these collagen bands. This isn't traditional liposuction but a technique similar to liposuction.

Fat grafting may not help, and it could potentially exacerbate the issue if these bands aren't addressed first. If you don't release these bands, your cellulite will unlikely improve. Therefore, the first step should be to release these cellulite bands and consider fat grafting if necessary.

Thank you for your question about minimizing dimples and cellulite in the legs. I hope this information helps guide your decision-making process.

Sincerely,
Dr. Katzen

Mats Hagstrom, MD (license on probation) · Answer

First of all to get a quality response do you need to give more specific detailed information.
What area did you have fat transfer? Did that turn out well? Are you interested in more fat transfer?
What part of your body do you want Liposuction?
When it comes to Liposuction don’t worry about the brand of equipment or what form of Liposuction.
There is in reality very little difference in the final outcome or patient perceived experience between different types of Liposuction.
All of them use the same thin stainless steel cannula connected to a source of vacuum.
Whether the fat is pre-treated with an ultrasound probe as in VASER or pre-treated using a laser fiber as in smart Lipo really doesn’t make much difference compared to the two variables that are the determining factors for high-quality liposuction results.
The two variables that matter are the candidacy of the patient combine with the skill and experience of the surgeon.
I don’t think you’re a good candidate for liposuction of your lower extremity.
Liposuction will not help cellulite and can definitely make it worse.
Likewise, fat transfer is not a good treatment for cellulite and again can also make it worse.
Cellulite treatments need to be based on subsicion. Cellulite is caused by connective tissue anchoring the skin to the underlying facia layer pulling down the skin as the surrounding subcutaneous fat layer expanse thicker than the length of the connective tissue strand.
It’s like tufted furniture that has buttons creating a pattern in the furniture.
Cellulite treatment needs to be based on cutting the connective tissue strands that are pulling in on the skin.
There are a few devices that are aimed specifically at this type of treatment one of them is Celfina. There are others.
Cellulite is notoriously resistant to treatment and difficult to get high-quality results when attempting.
The condition is misunderstood by people who lack sufficient medical training.
Cellulite does not respond to augmenting the volume. The contour irregularity is not based on volume and volume based treatment do not correct the problem.
Lower extremity liposuction is technically difficult and unless somebody really needs contour a change or substantial reduction of their thigh size they are far better off skipping lower extremity liposuction.
Perhaps you meant liposuction of your abdomen. Your post doesn’t make it clear.
Regardless delivering consistent quality liposuction results is more difficult than most people believe.
Going to well-trained board-certified plastic surgeon with overall good reputation is insufficient to confirm someone has mastered this procedure.
There are a number of well qualified overall talented plastic surgeons with years of training who cannot produce consistent quality liposuction results and whose results are far lower than those who have mastered this procedure.
In other words Liposuction regardless of qualifications has more variation in outcomes purely based on skill and experience.
Who are you choose to do the operation is critically important to minimize having undesirable outcomes that are permanent.
Define providers for any treatment but especially procedures like liposuction and fat transfer suggest patients be extremely selective and properly wet plastic surgeons 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.
Providers may be apprehensive to do that and I will instead I want to show you what their preselected pictures which may represent only the best results of their career.
This is insufficient to get a clear understanding of what average results look like or how many of these procedures any one provider has actually performed.
As providers to specifically show you as many pictures as possible of previous patients will have very similar body characteristics to your own.
Ask them to show your results that are excellent, results that are average and results that didn’t turn out as well as they had hoped for.
For reference and experience provider should have no difficulty showing you at least 50 sets of before and after pictures of commonly performed procedures like liposuction.
Look very carefully at all after pictures reviewing with the provider all areas that were treated making sure there are no skin contour irregularities anywhere.
When considering fat transfer make sure you bet the provider for both Liposuction and fat transfer results.
Said transfer results should not be judged within the first three months since early results look very different than final results.
When in doubt slow down and schedule more consultations.
Anybody who claims they can improve cellulite using liposuction or fat transfer should probably be avoided. small amounts of fat can be grafted in conjunction with Subsicion in the treatment of cellulite but subsicion must be included in order to get improvements.
Even then results may not be permanent and patients should only expect partial improvements.
I cannot emphasize enough the importance of finding the most talented and experienced providers. This requires having multiple in person consultations.
It also requires patience standing up for their rights and recognizing they have a right to see a variety of outcomes and should take responsibility for properly vetting each plastic surgeon confirming what their typical results look like I haven’t seen enough results to be clear that they have the skill and experience to deliver quality results on a consistent basis.
If you’re not sure and slow down and schedule more consultations.
Avoid virtual consultations whenever possible and stay away from traveling long distances for elective surgical procedures.
You may or you may not be a good candidate for procedures but I suggest you clarify exactly what treatment you want to wear and show sufficient quality pictures for us to make a better assessment.
To take pictures of your body for plastic surgery procedures look at how plastic surgeons take pictures and follow their example.
Don’t take pictures of yourself using a mirror.
Instead you use the timer on your camera or have someone else take the picture for you.
You should be in a standing neutral position picture should be taken from the front, side and back side. Four assessments of the torso the body should be included from your shoulders to your knees.
Pictures should be taken from about 8 feet away and then cropped.
Liposuction results are permanent and more or less irreversible.
Poorly done liposuction can leave people disfigured and correcting bad outcomes is almost impossible.
Best,
Mats Hagstrom MD

Randy Dean, MD - Account Suspended · Answer

Hi and welcome to our forum!
From your photos, I note that you appear to be of normal stature. There is mild skin wrinkling of the posterior thighs. There are no visible fatty deposits of the thighs. The problem appears to be loose skin rather than excessive fat.
When a balloon is filled with air, the "skin" (rubber) of the balloon becomes smooth and tight. When partially deflated, the overlying skin becomes loose. To eliminate the resulting wrinkling, one can either fill the balloon further or somehow shrink the "skin"envelope". 
As skin ages, a considerable number of dermal elastic fibers progressively stretch and ultimately rupture, causing the skin to become inelastic and loose. 
If moderate or severe, one can fill the lax skin of the thighs with fat harvested from elsewhere. Conversely, one can tighten the thighs by removing the involved overlying skin (a lift). A third non-surgical option is specifically designed for patients with mild skin wrinkling. Energy based devices utilize radiofrequency, ultrasound or laser energy to tighten loose skin and are often employed. 
Visit a board certified plastic surgeon for evaluation and discussion.
Best wishes...

Which procedure would help minimize dimples and cellulite in the legs? Should I consider fat graft w/ vaser lipo? (photos)

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