4-5 months post-op. Is this fibrosis, and if so, can I do anything to remove it? (Photo)

Question

Hello, I have lipo about 4-5 months ago but I'm so so with my results and unsure if this is fibrosis or just swelling from the drain. Would you recommend I undergo vaser/laser lipo for the fat pockets that remained to achieve a flat smooth look or should I just start to consider a tummy tuck ( I've never been pregnant )

Gerald Minniti, MD, FACS · Answer

Hello,
If you had a drain, you may have had a collection of fluid after removal which would contribute to this contour irregularity. At 4 months, I would wait a bit longer, and perhaps get aggressive lymphatic massage from a specialist, or Endermologie treatments. If there is no improvement over two months, then you can consider revision surgery. I caution  you regarding Vaser or any other modality that adds heat (laser, radiofrequency, ultrasound). It throws into the equation an unknown variable, and offers no benefit over the current proven technology of SAFE lipo (Simeon Wall, Jr., MD). This is not a machine, but a series of techniques that were specifically devised to treat secondary liposuction defects. Surgeons who've been paying attention for the last decade are likely now experienced with the technique. Best of luck!

Francis Johns, MD · Answer

Thank you for your question.It appears you have some unevenness of the liposuction contours. It is hard to tell if it is residual fat or fibrosis. I would recommend being evaluated in person to discuss all of your options.

Jason Emer, MD · Answer

This can be improved with a liposuction revision. For best results, I recommend a hi definition procedure like VASER liposuction. I use VASER HI DEF with ThermRF and fat grafting to get the most fat removal, skin tightening, contour and definition. This combination will give you the smoothest result. I recommend getting a formal evaluation with a hi definition physique expert. Best, Dr. Emer

Daniel Barrett, MD · Answer

Dear lm_Gabby,I would have to examine you but it appears that this is a contour irregularity after liposuction.  This happens often when areas the undergo liposuction are not feathered appropriately.
The good news is that it can be fixed and I have done so with good results before. The revision can often be done under local as well.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Usha Rajagopal, MD · Answer

I notice some irregularity in your abdominal area. It also appears that your upper abdominal area was not treated with the liposuction. I would wait a few more months until it is settled. I would encourage getting some massage for that area to break down the unevenness. Otherwise you can get some procedures done like the mini abdominalplasty to smooth out the skin contour. But before you proceed with the mini abdominalplasty I would wait several months, maybe up to a year.

Tim Sayed, MD, MBA, FACS · Answer

Your uneven results may be related to one or more of the following:1. Over-aggressive liposuction with some pockets left over and other areas oversuctioned, leading to irregularity2. Loose skin that was present BEFORE surgery that is more noticeable after surgery, which requires skin removal via tummy tuck or mini-tummy-tuck3. Seroma (fluid) pockets that formed and firmed up as the skin was retracting, leading to scattered bulges.Lymphatic massage could be partially helpful in achieving a smoother result but the best outcome is likely to be achieved with conversion to a tummy tuck or mini with skin removal in order to redrape the skin envelope better. Physical exam in the office is required to best assess this and provide proper counsel. Thanks.

Mats Hagstrom, MD (license on probation) · Answer

Poorly done liposuction can be difficult and sometimes not possible to correct.
This is especially true if someone has been over treated.
Treatment options generally come down to revision liposuction in an attempt to make the surface more even, fat transfer to fill-in the over treated areas or a combination of both.
At times skin resection procedures such as an abdominoplasty can help.
Personally I don't believe the concept of"Breaking up scar tissue you with technologies such as VASER"do any good since it will simply cause more scar tissue to form.
It appears you only had your lower abdomen treated which is somewhat unusual.
To get an even natural outcome from liposuction adjacent areas should be treated as well.
Considering your results you may want to seek a second opinion other than the provider who did your first procedure.
At this point you can consider your results final unless you undergo some type of secondary procedure.
Best,
Mats Hagstrom M.D.

William H. Jervis, MD, FACS (in memoriam) · Answer

liposuction always leaves some scar tissue under the skin as anyone knows who does a revision liposuction because of the resistance encountered.  I have done both vaser and laser assisted liposuction and both are helpful in redos in that the energy both cuts through the tissues with less resistance keeping you in the right plane and both tighten the skin.  the problem may not be fibrosis but could be too much tissue removed leaving a groove above the pubis.  if the latter is the case autologous fat injection may be an alternative.  one could try to reduce and tighten the horozontal ridge with laser or vaser assisted lipo, and at a later time after resolution fill up the groove with autologous fat to gain further improvement.  interesting that you had a drain with your lipo. drains don't usually work well with lipo.

4-5 months post-op. Is this fibrosis, and if so, can I do anything to remove it? (Photo)

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