What can I do to remove the dent in my abdomen and is it fibrosis? Had 2 previous lipo 360 procedures done (photos)

Your pictures are not particularly good quality pictures. To make an assessment on the outcome of a procedure we always need to see proper before and after pictures. If you don’t have your proper before and after pictures and ask your surgeon to forward the ones they took. i’m assuming you’ve already followed up with your provider and discussed your concerns with him or her. if not then that’s the first place to start. if you cannot get access to your before pictures and at least get better pictures by taking a new set. Try having someone else take the pictures in the room with good lighting from 8 feet away. The camera should be at the same level as what’s being photographed. For the Abdomen the camera should be at the abdominal level. We need pictures showing your front, side and backside. Crop the pictures to include your body from your neck to your knees.
Based on the pictures you included you were not a particularly good candidate for Liposuction. do you have domino wall bulges most likely due to muscle separation from previous pregnancies and you have skin laxity.
The full tummy tuck would’ve been a better procedure and is probably the best way to improve your outcome at this point.
Delivering consistent quality liposuction results is more difficult than most people believe in. The number of plastic surgeons were truly excellent and Liposuction is relatively few and patient should be very selective when it comes to choosing a provider.
Repeat Liposuction makes the situation more difficult and more difficult.
If the second procedure was unable to give you significant improvement in doing a third or a fourth procedure especially doing more liposuction is unlikely to improve your outcome.
It’s hard enough to take an even smooth fat distribution and reduce it and keep it even.
Starting with an uneven fat distribution trying to reduce it to make it even is almost impossible.
Treatments for poorly done liposuction generally comes down to revision liposuction(that’s what you had), grafting fat and sometimes converting the procedure to a skin tightening operation like a full tummy tuck.
Your situation is complex and making an accurate assessment will for sure require an examination and in person consultation.
Debility to improve on your outcome is going to be really limited.
You weren’t necessarily a great candidate for Liposuction in the first place so improving a poorly done procedure on someone who wasn’t a good candidate and has already had a secondary procedure put you in an unfavorable position regarding anybody getting excited about giving you a quality outcome.
Because Liposuction did not treat skin laxity or muscle separation and a tummy tuck will you can get the full benefit of a tummy tuck though your fat layer may still be slightly uneven.
In my opinion converting this to a full tummy tech is your best option even though it will not necessarily correct the uneven fat distribution created by the two previous procedures.
Patients should be very selective when it comes to choosing Liposuction providers. Doing this procedure well on a consistent basis is more difficult than most people believe. Most plastic surgeons think they’re much better at Liposuction and they actually are.
The number of plastic surgeons who can deliver consistent quality results that are predictable and reproducible is a relatively rare.
For those interested in having liposuction I recommend patient start by having at least five in person consultations. Bring pictures of your own body with you and use for reference during the consultation.
During each consultation ask each provider to open up their portfolio and show you their entire collection of before and after pictures.
As providers to only show you pictures of previous patients who have the same body characteristics or candidacy for the procedures that you do. there’s no point of seeing impressive pictures of patients who are perfect candidates if you are not a perfect candidate.
As providers to show you examples of excellent results, average results and results that did not turn out as well as they had hoped for.
Providers may be reluctant to do this and it will instead prefer to show you preselected images representing the best results of their career.
But this may be more impressive it does not serve your needs which is to find out what average results look like and especially what results look like based on your individual candidacy for the procedure.
Patients were not good candidates for liposuction should be told is this during the consultation case.
I’ve already mentioned it to Liposuction well it’s more difficult than most people believe. This includes the ability to make an accurate assessment and accurately predict exactly what each person‘s results will look like.
You were most likely shown some before and after pictures before you had your procedure. your results probably do not look like the pictures you were showing.
This is the problem.
By asking providers to open up their entire portfolio and show you the diversity of pictures including enough pictures to get a good representation of average results you will have a much more accurate idea if the provider you’re consulting with is the right provider for you.
For reference and experience provider should have no difficulty showing you at least 50 that’s a before and after pictures of commonly performed procedures like abdominal liposuction. Personally I prefer to treat the entire torso when doing abdominal liposuction. By treating the entire torso patients are left with a natural thin fat distribution without transition zones between treated and untreated areas. A full torso includes upper abdomen, lower abdomen, love handles(all the way down to the top of the hip dip), waist, full back and under arms all the way to the side of the breast.
Fibrosis is not some thing that some people get and some people don’t get. It is what happens when you remove almost all the fat in the body response by making scarred tissue. scarred tissue formation is normal after liposuction and is not particularly noticeable when a sufficient amount of fat is left behind.
If almost all the fat is removed then there’s no fat to absorb the scar tissue and the tissues become firm and hard because there’s only scar issue and no fat to absorb it.It’s not some thing some people get and some people don’t get. Everybody will get that condition if they have aggressive uneven liposuction that is poorly done.
Fibrosis is the endpoint of a badly done highly aggressive liposuction.
At this point you have a few options.
If you up to go straight for a tummy tuck then you simply need to consult with plastic surgeons very good at that procedure and vet plastic surgeons for a tummy tuck just like you should have it for liposuction.
To judge providers for tummy tucks results look for plastic surgeons who consistently get natural looking belly buttons with a very low sets car that follows anatomic contours naturally and evenly on both sides. The Taurus I should look balanced appropriate and attractive from all angles including from behind.
Go through the same process of asking providers to open up their portfolio and show you their entire collection of before and after pictures. Ask them to only show you pictures that have similar characteristics to your body. in your case there’s one unique difference in that you’ve had two sessions of liposuction first and providers may not have that many pictures of patients who had liposuction first.
Liposuction does create some scar tissue throughout the skin and fat layer and this can compromise a tummy tuck to some degree. This is minimized by waiting at least six months from the last liposuction procedure.
For tummy tucks plastic surgeons once a patient experience should’ve hundreds or even thousands of before and after pictures and shit again I have no difficulty showing you at least 50 sets a before and after pictures during a consultation.
If you opt for not having a tummy tuck and want to go for another revision procedure then you need to set your expectations on the low side and recognize how difficult it’s going to be to improve your abdomen.
Considering you’ve had two rounds of liposuction removing more fat is probably not the answer. Grafting fat becomes very challenging because the areas that need volume the most are now depleted of host tissue to support the graft.
This means that grafting fat in the areas that were over treated will not survive well and to get good results will most likely require multiple sessions of fat transfer.
Each individual subdivided problematic area needs to be addressed individually.
Procedures to try to correct poorly done Liposuction especially after a second round of Liposuction are extremely difficult and only minor games can be had and is often requires multiple surgeries.
It also has to be done by a sufficiently skilled provider for your results can easily be made worse.
If somebody tells you this is easy to fix or that some special device can break up your scar tissue and that should probably be a big red flag and you should probably run.
The importance of properly vetting plastic surgeons and having sufficient numbers of consultations so you can choose the best provider is imperative when it comes to Liposuction. It is far more important when doing the revision work since the revision of work is technically more difficult than primary Liposuction.
Converting this to a full tummy tuck is in my opinion your best option but even that will come with limitations.
The full tummy tuck is a big operation. It requires two full weeks of dedicated aftercare.
The choice to have a full tummy tuck should not be taken lightly. People need to be emotionally, physically, financially and socially stable before having that procedure.
Best,
Mats Hagstrom, MD