What can I do to soften fibrosis after liposuction. Should I worry about my results? (Photos)

Question

I had power assisted lipo of the abdomen and flanks 25 days ago. This is how my abdomen looks right now. It’s hard in some areas and soft in others. Some areas look uneven. I had closed incisions. I’m depressed, I was 130lbs, 5’5, no children, 24 yo before surgery and expected a better result since I wasn’t too fat to begin with. Now I feel deformed. Will the bumps and harness improve or what can I do to make it better? Should I consider a revision?

Kenneth Hughes, MD · Answer

Two weeks following liposuction, lumps are common.  Even after 6 weeks, lumps are common.  Massage may help, but time will be the best treatment.  The swelling may persist for 6 months and sometimes up to a year, so you do have to be patient to appreciate the results. You should trust your plastic surgeon to recommend the best postoperative instructions for you to obtain optimal results. It is of paramount importance that the patient follow postoperative instructions to the letter and that the compression garment is worn as instructed. When the proper postoperative regimen is followed, the risk for contour irregularity is exceedingly small.

Robert M. Tornambe, MD · Answer

oneperspective  I appreciate your concern, however it is still extremely early in your postoperative recovery journey  and I do not see any reason for concern at this stage. You are experiencing early scar formation under the skin combined with residual swelling. Both of these conditions will improve with time. I recommend gentle self massage with moisturizer within the areas of concern. It can take as long as six months for complete recovery. Try to stay patient and positive and follow up with your plastic surgeon. Good luck!

Lawrence Iteld, MD · Answer

Following liposuction it is normal to have bruising and swelling. While patients should notice a significant size reduction and improved contour immediately after surgery, it takes time for the body to completely recover and for the tissues to smooth out. I advise patients to expect some residual swelling for 3-6 months after surgery. Massage of the treated areas helps keep the tissues pliable and for them to settle smoothly.Please stay in close contact with your surgeon during the first 6 months of recovery.

Tania Medina de Garcia, MD · Answer

Hello dear!!
Thanks for the question and provided information as well.
You are still early on the healing process, it can take up to six months to see your final results, so please be patient. At the stage you are in, inflammation and irregularities are normal.
I suggest my patients to try the lymphatic massages and to use a full body compression garment, 24/7 for the first 3 months, and after that, for 12 hours a day for 3 more months, to get the best results.
It is important for the compression garment to be very tight, for it to help with the swelling, after surgery. Please, follow up close with your plastic surgeon.
Good luck :)

David Finkle, MD · Answer

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Liposuction is the suction removal of subcutaneous fat. Subcutaneous fat is located just below the surface of the skin and above the muscles and bones. It doesn't remove all of the fat, but it does remove the majority of the fat. The perfect candidate is at or near their ideal body weight and has localized areas of fat that are out of proportion to the rest of the body.  It is not a weight reduction technique. It can be used on any area of the body, but it relies on the skin redraping after the fat is removed. So, if you have loose skin, you may end up with wrinkles or folds after the surgery. Some areas respond better to liposuction than others, the lateral thighs always look nice, the inner thighs and arms, not so much. The tummy depends on how loose the skin was to begin with. It does not remove or improve stretch marks. There are many different terms used for liposuction:
Tumescent liposuctionPower liposuctionLaser liposuctionVaser liposuctionSmart liposuctionUltrasonic liposuctionAnd many, many more. All these techniques vary a little, but the bottom line is that the fat is removed by high powered suction. A small tube or cannula with multiple holes at the end is hooked to a suction device. The cannula is moved rapidly back and forth to remove the fat through very small incisions in the skin. All blood vessels, nerves, muscle, bone and skin is left alone, just the fat is removed. Large amounts of fluid are placed in the subcutaneous fat before the suction begins to reduce bleeding and to numb the skin, this fluid is referred to as tumescent fluid and consists of a balanced salt solution mixed with adrenalin and a local anesthetic. There are 3 choices of anesthesia:
Local anesthesia (the patient is awake)Local with sedation (the patient is given a mild sedation)General anesthetic (the patient is asleep)The choice is based upon an agreement between the patient and the surgeon. Make sure you consult with a Board Certified Plastic Surgeon who operates in a nationally accredited surgery center and offers board certified anesthesia. If the price you are quoted seems abnormally low, please do your research and find out why, you do not want to be surprised the day of your surgery! Liposuction can be combined with many other procedures; tummy tuck, breast reduction, thigh lift, arm lift, neck lift and is an essential part of a Brazilian Butt lift (this is where the fat comes from!)
All of my patients are treated post operatively with a compression garment that is worn for 2 weeks and 5 Endermologie sessions that start 3-4 weeks after the procedure. Endermologie is a non surgical massage technique that helps to smooth out the results of the surgery to help prevent wrinkling and rippling of the skin. Liposuction is not a very painful procedure and recovery is usually quick. 
Most people are back to work in 3-5 days and back to vigorous exercise in 2 weeks. Of course, if more areas are treated, there will be more pain post operatively and a longer recovery. I was back to work 3 days after my abdominal liposuction and no one knew any better! 
The cost varies not only from city to city, but from patient to patient. The more areas that are treated, the higher the cost. In the midwest, typical liposuction prices varies from $3,000-6,000 total.
Good Luck!

Karol A. Gutowski, MD, FACS · Answer

It takes 3 to 6 months for things to soften up. In the meantime, massage, steroid injections, and other treatments may help. Follow up with your surgeon.

Christopher L. Hess, MD · Answer

So it doesn't sound like your surgeon really prepared you for what to expect.  You're VERY early in the post operative period.  You are experiencing a normal post operative course.  During liposuction the cannulas are run through the fat hundreds of times.  This removes the fat but also creates scar tissue.  This scar tissue builds up after the surgery and peaks around six weeks after surgery.  What you see and feel is the scar tissue with softer area in between.  This scar tissue will soften over the next six to eight months.  It can take up to a year to finally mature.  So relax and massage this firm tissue as much as possible.  It will improve.

Mats Hagstrom, MD (license on probation) · Answer

Final results of liposuction can be assessed early to some degree. Someone who is highly irregular at 25 days is probably not going to have a perfectly smooth final results.  As substantial amount of you are lumping us, uneven Ness and firmness will dissipate with time.  In my practice I tell my patients they can start looking in the mirror around six weeks to intensive paid what the results will look like but need to wait three months for final results.  Patients who are happy at six weeks will love the results at three months.  Patients who are highly dissatisfied at six weeks ( I try to keep these to an absolute minimum ) Will generally not be satisfied at three months.  Based on your pictures you are very swollen. Do you still have bruising and areas of firmness. This will go away with time.  Your results may not be perfect but you are a long ways from your final results and you should anticipate substantial improvements with time.  Be patient and follow up with your provider. Best, Mats Hagstrom M.D.

What can I do to soften fibrosis after liposuction. Should I worry about my results? (Photos)

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