What could be causing my uneven liposuction results and will vaser liposuction be a good choice for a revision? (photos)

Question

1. I had traditional liposuction with J-Plasma about a year ago (I was 183 lbs at the time of surgery, and my height is 5’2”. My current weight is 157 lbs). but I still see uneven areas, lumps, and inflammation. What could be causing this, and is it normal? 2. Would VASER liposuction be a good option for me now, considering I want a smoother result and quicker recovery? 3. Are there risks of complications or further unevenness if I proceed with another round of liposuction now?

Andrew Ray, DO · Answer

Reviewing the images provided, there is definitely options for further liposuction especially of the flanks and abdomen, however in your lower abdomen and around your belly button there appears to be a moderate amount of skin laxity that will not completely smooth out even with Vaser liposuction. This amount of skin would likely require surgery in the form of a tummy tuck or possibly mini tummy tuck.

Arif Eroglu, MD · Answer

HelloIt wouldn’t be correct to comment without seeing your previous condition. Looking at your current situation, it seems that despite Renuvion J Plasma, you still have excess skin, particularly in the lower abdomen. In liposuction, it seems that not as much fat could be removed as desired, and there may be lumps in the lower abdomen due to fibrosis. Likely, the most suitable option for you would have been to remove the excess skin from the lower abdomen after fat removal from the abdomen. I would recommend the same at this point. After the fat is removed with Vaserlipo, I would suggest removing the excess skin from the lower abdomen.

Mats Hagstrom, MD (license on probation) · Answer

There are a few things that should be discussed.
First and foremost in order for us to assess the outcome of any plastic surgery procedure. We 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.
 Liposuction results are based on two variables.
The first issue candidacy for the procedure and the second is the skill of the provider.
Your pictures don’t show obvious uneven outcomes.
They do Show that you have significant skin laxity and skin laxity is the number one reason patients failed to be good candidates for Liposuction.
I’m guessing you have pregnancy related changes which are primarily skin laxity and muscle separation.
You do have excess subcutaneous fat, and some weight loss may help with this. There are other variables that are contributing as well. 
There are four tissue variables that determine what the abdomen looks like.
The choice of treatments should be based on having a clear understanding, which of these tissue layers are causing the problem.
Often it’s a combination.
These four tissue layers are skin laxity, excess subcutaneous fat, muscle separation from previous pregnancies and excess visceral or intra-abdominal fat.
From your pictures, I’m guessing that all four of these tissues are contributing.
You have an abdominal wall that is bulging, which is most likely due to excess visceral, fat and muscle separation. 
Liposuction only reduces subcutaneous fat.
Your subcutaneous fat layer may be thinner than you actually think.
 a full tummy tuck treats, abdominal skin laxity, and muscle separation.
The fourth variable being excess visceral fat can only be reduced with weight loss. If Liposuction didn’t deliver results the first time then it’s unlikely doing more of the same is going to help you.
Secondary Liposuction is technically difficult, has a higher rate of creating contour irregularities and delivers much less than the primary procedure.
The form of Liposuction like adding VASER has little to do with outcomes. 
Likewise, using J plasma really doesn’t deliver any significant skin tightening from my firsthand experience. I purchased the device several years ago, but have since sold it because none of my patients appreciated any significant skin tightening and honestly, I couldn’t see a difference either.
I suggest you have a few in person consultations with plastic surgeons in your community to say what they have to say.
Regardless of what you opt for no procedure is going to be successful without weight loss first. 
Best Mats Hagström MD

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