Will lipo be enough for bulge in my upper left abdominal? (Photos)

Question

So about 4 years ago I had a Fleur De Lis tummy tuck and my Dr did some lipo in my stomach. I am here because more recently I am noticing a bit of a bulge in my upper left abdominal section of my stomach. A new Dr told me via video consult that I could need a whole new tummy tuck. I really do not want to do another tummy tuck when it seems like this one problem area is like a small pocket of fat. My question is, wouldn't liposuction to the area be enough? thank you in advance !

Jason Emer, MD · Answer

Laser liposuction is good for problem areas of fat, but lacks body shaping. The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heats the skin with radiofrequency devices such as Renuvion (J-Plasma), InMode BodyTite, and ThermiRF to heat the undersurface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HI-DEF VASER Liposuction and can only be done by a well-trained body contouring specialist. At the same time, fat should be harvested and purified, with PRP and stem cells added, and then injected into muscles, indentations and cellulite to get body shaping and contouring. 
Overall, you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting. See an expert. Best, Dr. Emer.

Emmanuel Mallol Cotes, MD · Answer

Thank you for your question, I recommend you waist and back Liposuction, getting better curves especially in the waist, improving your body contour.

Kind regards

Daniel Barrett, MD · Answer

Dear Hereforit,
it is hard to tell for sure without an examination. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Nancy de Kleer, MD, FRCSC (Plast) · Answer

Liposuction is often a great treatment for a bulge, however if there is laxity in the skin or fascia liposuction won't be enough to treat the bulge.
On the photo it appears that when you lean forward the bulge is worse,  which implies there may be some skin that could be removed to provide you with a better result than liposuction alone. 
An in person physical exam is needed before you make a decision about how to proceed.   This will allow full assessment of the fat that may be present, skin laxity that may be present as well as integrity of the abdominal wall.
All the best to you.

Douglas Taranow, DO, FACOS · Answer

From your photos, it appears that liposuction may work for the upper left abdominal bulge.  A physical exam would answer this question.
Best wishes.
Dr. Taranow

Mats Hagstrom, MD (license on probation) · Answer

If they bulging of your abdomen it’s not related to fat distribution the Liposuction is not going to correct it.

Considering your history it is much more likely to be skin laxity and how your skin drips on your upper abdomen.

Skin laxity requires skin surgery and most likely the surgeon you consulted with is correct that this would entail redoing your tummy tuck.

There are four variables that contribute to the shape and contour of someone’s abdomen. These are skin laxity, subcutaneous fat, the muscle wall itself often changed by previous pregnancies and lastly intra-abdominal fat A.k.a. visceral fat.

One easy way to differentiate between skin laxity and subcutaneous fat is this simply pull up on the skin above the area of concern. If it flattens out nicely by pulling on it then it represents skin.

If the contour is not changed by putting the skin under tension then it’s not related to skin laxity.

Best,

Mats Hagstrom MD

Jose A. Munoz, MD - Account Suspended · Answer

Hi and welcome to our forum!From your photographs, there is a noticeable bulge present...is it fat?...Is it an abdominal wall weakness? An in-person examination is required.If it is fat, a liposuction will remove the repository. If there is abdominal wall weakness, repair of the musculo/fascial defect is required.Best wishes...

Robert T. Buchanan, MD (retired) · Answer

If this is, indeed, nothing but localized fat, then all you will need is liposuction. However, This could be a weakness in the abdominal fascia, which would require an open surgery to correct. You need to an experienced plastic surgeon in person for an exam to determine what this is and what you need.

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