How to address my plastic surgeon about my results.

Question

I am 4 months post vaser of upper/lower abs. I have a protrusion of fat around my belly button, seroma on my pelvis, and loose belly skin. The doc acts happy with his work, telling me to wait to see final results. I'm skeptical that my results will improve, and worried about the seroma becoming permanent. He is treating my concerns as overly critical, but I am totally embarrassed by my tummy. I feel I didnt need a tuck before, I need one now. What rights u have when it comes to expected results?

Jed H. Horowitz, MD, FACS · Answer

Hi, as you heal, the suctioned area may feel “lumpy” and irregular. This decreases with time, and massaging those areas will hasten their softening. Improvement of results will continue for 4–6 months as swelling and irregularities resolve. These contours can even improve throughout the year after surgery. On the other hand, seroma usually is spontaneously absorbed by the body but It is still best to have it drained to prevent any complications that would interfere with your results.Please remember that #Vaser liposuction results are generally permanent. However, please take note that if the patient gains a large amount of weight in the future, the area of liposuction will also gain fat but to a lesser degree. With massive weight gain, #rippling may occur. If you did not gain any weight, you may already have loose, sagging, or inelastic #skin before the procedure that are problems which would tend towards poor results in liposuction. In fact, these problems may be worsened and may be best addressed by other procedures such as a leg or body lift (e.g. tummy tuck) in conjunction with liposuction. Excess skin would usually shrink back over the area of the body, but please take note that liposuction is used to reduce volume not tighten skin. There are non surgical devices such as #ThermiSmooth radiofrequency and #VelaShape3 (visit web reference below) to help tighten skin after liposuction for patients who will benefit from this additional care. 
Please be patient and continue aftercare as prescribed (such as wearing garments or lymphatic massage) for best results. Do not hesitate to contact your surgeon regarding this concern. Best of luck!
#RealSelf100

Millicent Odunze Geers, MD, MPH · Answer

Liposuction doesn't create loose skin. If the skin has already lost its elasticity, then the skin is compromised. However, liposuction can exacerbate the look of skin that is already loose because the skin is no longer filled out with fat. This can result in a crepey look. Think of a balloon that has been inflated for weeks and then deflates. It never gets its smooth appearance back and has stretch marks. Hopefully your surgeon discussed this possible outcome with you.The seroma should be drained as it can cause permanent outpouching by pushing out on the skin, even after it resolves. In terms of your rights, no results are guaranteed when it comes to plastic surgery. Do not be afraid to bring up your specific concerns to your surgeon. Go over them one by one and ask him for a solution to each one. Ask him when he expects it to improve and what the plan is if it doesn't improve by that time. If a revision is necessary, there will likely be some charge, but every surgeon varies on their revision policy. I encourage you the be frank with your concerns. 6 months is a reasonable amount of time for a final result and to start creating a revision plan if necessary. Revision may not occur until 9-12 months out to allow for scar tissue to really settle down. In the meanwhile, Velashape or other treatments combining infrared, heat, and massage may help improve any bumpy contour. Hang in there. It may be a slow process, but it can get better. Best of luck to you.

David Matlock, MD, MBA, FACOG · Answer

Hello, Thank you for your time. It is difficult to diagnose your current situation without photos. We tell our patients that maximum results are usually seen in 6 weeks. However, some patients can take up to 3-6 months to see final results. Every patient heals differently. Remember, liposuction does not treat loose skin. Every office has a different policy on results. I would suggest comparing your before and after photos and reviewing your consent forms. We wish you the best in your medical future.

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How to address my plastic surgeon about my results.

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