Can you receive addition lumps with an abdominal lipo revision and fat transfer? (Photo)

Question

My doctor wants to do additional lipo and add fat to some of my lumps and bumps on my stomach. I feel like most of my inconsistencies can be fixed with the right amount of a reverse tuck. I already had one but it feels like not enough skin was taken out. Should I be cutting my losses, only do a reverse tuck, only do fat grafting? Thoughts and suggestions would be appreciated.

Robert M. Lowen, MD · Answer

This is a tough situation. Although pulling up the abdominal skin improves the appearance, the irregularities may recur when the skin stretches after a reverse abdominoplasty, and it will stretch or relax since there is not as firm an anchoring point compared to a regular tummy tuck.
   You also do not appear to have a lot of fat for fat grafting, and it usually takes more than one session to get a good improvement as not all the fat will live.  The areas to be grafted are also probably scarred just from previous lipo which makes it harder to graft.
   Again, an in person evaluation of your donor sites would be needed. I have no experience with a reverse abdominoplasty because I don't like the scars, but if you have already had one, the scars are already there and no additional scarring would be incurred by trying to take up some of the upper abdominal slack.  These would be very individualized decisions between you and your plastic surgeon along with any second opinions you may choose to get.

Daniel Barrett, MD · Answer

Dear thechester,
while there is always a chance for contour irregularities with liposuction, someone who takes their time and uses the appropriate sized cannulas should give you a superb result.I have all my patients wear compression garments and I use multiple sized cannulas to feather out the result.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Mats Hagstrom, MD (license on probation) · Answer

Delivering consistent quality liposuction results is more difficult than most people believe and this includes plastic surgeons. Correcting bad outcomes is many times more difficult than doing primary liposuction.
This is especially true if the patient has been overtreated or the problem is too much fat has been removed.
Treatment options typically come down to revision liposuction, fat transfer or occasionally cutting out the area by converting the procedure to a skin tightening procedure like a full tummy tuck.
None of the options are great and the best way to treat these problems need to be discussed in detail during in person consultations. each specific area of contour irregularity is treated individually by either Liposuction or grafting fat.
The problem with fat grafting is that areas that need volume are now depleted of host tissue to support the graft and this means that grafted fat often doesn’t survive.
Since the problem is often too much fat was removed doing more Liposuction is in someways an insult to injury or simply making the problem worse. sometimes revision Liposuction despite not being ideal the only option patients have.
I continue to emphasize the importance of carefully choosing only the most experienced and talented providers for any body contouring work requiring liposuction and fat transfer.
Provider selection becomes even more important when it comes to revision work.
To choose an ideal provider I suggest patients start off by having multiple in person consultations with local board-certified plastic surgeons who seem to do a lot of liposuction and have a reputation for the procedure. In this case it should also include fat transfer.
During the consultation ask each provider to show their entire collection of before and after pictures for the procedure or area you’re interested in. Simply seeing preselected sample pictures which most likely represent the best result of the providers career is insufficient to get a clear understanding of what the average results look like in the hands of each provider. this is why patients need to push providers to open up their portfolio and start showing a lot of pictures. ask the provider to show as many pictures as possible of patients with similar body characteristics to your own. Likewise as the provider to show samples of excellent outcome, average outcomes and less than outcomes.
We all have a variety of outcomes and experienced surgeons will have hundreds or even thousands of before and after pictures. A provider should be able to show you a minimum of 50 sets of before and after pictures to feel confident that the provider is experienced.
I also recommend reading all reviews on various physician review websites avoiding any providers with any significant number of justified negative reviews. The absence of justified negative reviews is more important and more telling than having an abundance of positive reviews.
Continue having consultations until you feel you found the most talented and experienced provider. This is true for both primary and secondary procedures.
Obviously your provider is responsible for the outcome of the procedure likewise you are responsible for choosing that provider. ultimately your provider is responsible for correcting the defect but you should also consider the limitations considering that revision work is more difficult than primary Liposuction.
Because revision work is so much more technically difficult than primary liposuction providers in capable of delivering quality results can easily make things worse with attempted revisions.
Your problem is not abdominal skin laxity but an uneven fat distribution created by poorly done Liposuction.
Successful procedures have to treat the primary problem in order to give consistent quality results.
Any type of tummy tuck, secondary tummy tuck or reverse tummy tuck is only aimed at treating skin laxity and will have no impact on fat distribution.
Best,
Mats Hagstrom MD

Can you receive addition lumps with an abdominal lipo revision and fat transfer? (Photo)

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Can you receive addition lumps with an abdominal lipo revision and fat transfer? (Photo)

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Everything you need to know about Liposuction Revision

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