I am rarely if ever discuss changes in body size, inches or pounds.All too often in patients do not see changes in actual body size from either liposuction nor from an abdominoplasty.it's very common for patients to have a persistent fullness in the love handles after a full abdominoplasty.There are two reasons for this and it varies somewhat from patient to patient.If there is skin laxity that continuous not only from the front but around to the sides and the back then this extra loose skin needs to be removed all the way to the back to get a flat contour all the way around.I sometimes referred to this as an extended abdominoplasty or a three-quarter wraparound abdominoplasty.Sometimes removing the loose skin around the hips can be difficult without turning the patient either on their side or laying the patient with your backside up during the surgery.Unless an extended abdominoplasty including turning the patient has planned on it before the procedure some plastic surgeons will not take the skin all the way around to the back.The remaining loose skin that can be left behind can look like extra fat and is usually referred to as dog ears.sometimes fullness in this area can be left behind be insufficient amounts of fat or removed during the bow suction.This area is difficult to properly liposuction with patients under General Anastasia.again without turning the patient on their side or having the patient lay facedown it's difficult to reach these areas to treat them correctly.What you describe is one of the most common complaints after a full abdominoplasty.Basically the front of the abdomen looks great but you follow the contour of the body to the sides and the back all of a sudden it doesn't look so great.It's as if only the front was treated.That is in fact exactly what happens all too many times. When making a proper assessment before surgery the surgeon should have a game plan for how to treat the whole torso as a single unit.One that requires turning the patient on their side during surgery and that should be incorporated into the procedure.The good news is removing either dog ears or doing Limited liposuction on the love handles can easily be done in an office setting without the need for General Anastasia.Your concern is not uncommon after the procedure you had done.Often the smal revision is needed to get the final results.it's important to differentiate if the love handles now represent skin laxity, unremoved fat or possibly a combination of both.Continue follow up with your plastic surgeon and ask him or her to address your concerns. Revisions after cosmetic surgery are fairly common.In my opinion about 10% of patients should probably have some form of revision after major cosmetic surgery.This is not to say that plastic surgeons don't do a great job but with a major job. Some small areas of fine-tuning are often needed.If a contractor builds a house here will most often need to be some adjustments along the way.Plastic surgeons who have a very low revision rates may not be self-critical of their results or are not willing to do their best to get the best outcomes.there are of course plastic surgeons who are extremely talented or become experts a simple procedure who have very low revision rights and deliver exceptional outcomes on a regular basis.just like there are some who may not be as talented and have an unnecessarily high revision right because your work is subpar.Unfortunately there are a few plastic surgeon who are very resistant to do revisions when they are truly indicated and can make the difference of a great final outcome.most plastic surgeons do not charge for revision work but may charge for deficit lady fee if needed.ideally it's plastic surgeons policy on revisions when needed should be discussed before surgery.Please follow up with your plastic surgeon and ask him or her to address your concerns, make an accurate assessment and come up with a treatment plan if indicated.Best,Mats Hagstrom M.D.
