8 months post Vaser lipo - Should I consider a revision or are there other options that can help target uneven abdomen? (photos)

It's not uncommon to have some contour irregularities after liposuction, with or without vaser. Any reputable surgeon should be able and willing to address this issue. If you were my patient I would likely recommend revision lipo, probably with vaser.

Dear Blondene, I understand your frustration with the lumps, bumps, irregularities, and loose skin post liposuction. Half the work I do is correcting/enhancing cases such as yours. Although it is a risk everyone’s takes when not doing a tummy tuck, there is still room for improvement. Based on your photos, your lower abdomen, anterior waist, anterior flanks, and possibly anterior hips and pubic could benefit from vaser lipo and Renuvion (JPlasma) if you’re interested in that. I could take anywhere from 50-70% of the remaining fat and do body contouring to snatch your waist. I would need to see you in person to fully examine your skin and scar tissue, and discuss the level of skin retraction we could achieve with the use of the Vaser and Renuvion using my advanced techniques. You are currently over 12 months post now, so it’s an appropriate time to consider this revision. Majority of my patients can do this under local anesthesia.
To set up a virtual consultation to discuss this further please call my office at: 925-838-4363. Good luck in your journey! Where ever you go, make sure you select a Board Certified Plastic Surgeon who specializes in Revision Liposuction. Thanks, Vivek Bansal, MD.

I'm sorry to hear that you're disappointed with your Vaser lipo results. If you're still experiencing asymmetry and a pocket of squish on your lower and upper abdomen on the right side, it's important to follow up with your doctor or their assistant to discuss your concerns.
You may want to consider scheduling an in-person consultation with your doctor to evaluate your progress and determine whether the unevenness is due to swelling or if further treatment is necessary. If your doctor is not available or you're uncomfortable with their response, you can seek a second opinion from another board-certified plastic surgeon or dermatologist.
During your consultation, your doctor may recommend additional treatments, such as touch-up liposuction, to address the unevenness. However, it's important to note that revision surgery can be complex and may come with additional risks, so it's important to weigh the pros and cons carefully before proceeding.
In any case, it's crucial to communicate your concerns openly and honestly with your doctor and work together to find a solution that meets your expectations.
Best regards, Dr. Mark Tseng

Photos show common VASER lipo complication of un even fibrosis. Only revision cannulae lipo sculpting can improve. Fee $6,000. Best to virtual consult with...

Delivering consistent quality liposuction results is more difficult than most people believe it.
A substantial number of board-certified plastic surgeons with overall good reputations do not have the skill and experience to deliver quality results.
Liposuction results have more variance based on who does the procedure than any other plastic surgery operation
Liposuction results should be considered permanent and more or less irreversible.
When someone is unhappy with their liposuction results we need to first make an assessment in regards to candidacy in the first place. To make an assessment on the outcome of an operation we always need to see proper before and after pictures.
Without knowing what you looked like before the procedure we can’t assess what your surgeon did.
If you don’t have proper before and after pictures and ask your surgeon to forward the ones they took.
They are part of your medical record and will be forwarded to you if you request them.
Whenever seeking a second opinion always show proper before and after pictures
It’s also a good idea to have a copy of your operative report in case another surgeon wants to know what happened during the first procedure.To correct poorly done liposuction results generally comes down to revision liposuction, fat transfer or a combination of both.
Occasionally the best way to improve the outcome is to convert the procedure to a skin tightening operation like a full tummy tuck.
The hardest cases to improve on come from patients who were treated very aggressively and left with an uneven fat distribution.
You appear to have moderate skin laxity and this lesson your potential as a candidate to some degree to start with.
It’s important to differentiate if skin laxity and how the skin drapes the body is contributing to contour.
You can do that yourself by putting the skin under attention and seeing if that improves the results. One fat is removed on individuals with skin laxity the tissue that supporting the skin and contour is sometimes made worse.
People with skin laxity issues are never going to have the same type of results that people with tight skin have the potential for when it comes to Liposuction.
Your results are a bit uneven and a transition zone from treated to untreated wasn’t done ideally either.
The importance of choosing a sufficiently experienced and talented provider for this procedure cannot be overstated. I recognize that at this point that decision has already been made so no point in going over the past. The process of finding a provider to do revision work is however quite similar to the process of finding a provider to do primary liposuction.
To find the right provider start by making a list of local plastic surgeons who seem to have exceptional quantity and quality before and after pictures of Liposuction on their websites.
Schedule exclusively in person consultations avoiding virtual consultations or traveling long distances for elective surgical procedures whenever possible.
During each in person consultation ask each provider to open up their portfolio and show you their entire collection of before and after pictures.
Being shown a handful of preselected sample pictures which most likely represent the best results of the providers career is totally insufficient to get a clear understanding of what average results look like or how many of these procedures a surgeon has actually performed.
For reference and experience plastic surgeon should have no difficulty showing you at least 50 sets of before and after pictures of commonly perform procedures like abdominal liposuction.Highly experienced surgeons will have hundreds or even thousands of before and after pictures for each commonly performed procedure.
Ask specifically for them to show you only pictures of previous patients who had similar body characteristics to your own. This means the same level of skin laxity, the same overall size, the same thickness of subcutaneous fat, pregnancy related changes if applicable etc. etc.
There’s no point at looking at results from individuals who had a different type of candidacy for this procedure.
Ask providers to show you examples of excellent outcomes, average outcomes and outcomes that did not turn out as well as they had hoped for.
Ask specifically what each surgeons revision rate is for this operation and what the revision policy is.
Become familiarized with quality before and after pictures and create a rating or a grading system for what you believe is quality work.
When reviewing before and after pictures look exclusively for previous patients who had similar body characteristics to your owner.
Candidacy plays a major factor in what’s possible with this operation.
Some people are simply not candidates for Liposuction while summer or exceptional candidates. Most people are in fact average candidates which means they were going to get average type results even if done by a sufficiently talented provider
Bring pictures of your own torso taking the same way plastic surgeons take before and after pictures and use that as a reference when comparing results.
Take notes during each consultation about the quantity and quality of before and after pictures and all other aspects of the consultation such as physical exam, review before and after pictures, review of medical history, risks and benefits, alternative procedures, preparation for surgery, recovery etc. etc.
There’s no set number of consultations patients need to find the right provider but considering how much variance there is and liposuction results I suggest a minimum of five consultations but be prepared to schedule many more unless you feel very comfortable you found the right provider.
Once the procedure has been performed the potential of a quality outcome is almost completely lost.
The ability to salvage or improve and Liposuction results varies depending on how much fat was removed during the first procedure and how uneven the results are.
Like I mentioned earlier it’s also important to get a clear understanding of each persons candidacy for quality results in the first place.
Revision liposuction is many times more difficult than primary liposuction.
It’s hard enough to take an even thick fat distribution and create an even thin the fat distribution.
Taking an uneven fat distribution and making it even is very very difficult.
If someone can’t keep the fat level even then it’s unlikely they’ll be able to create an even fat distribution starting with an uneven one.
The best of getting a quality result is in the first operation.
Things go downhill and become more difficult from their on.
The advantage of having your provider do revision work is that it may be cost effective.
Your surgeon has already demonstrated that they don’t have the skills to consistently deliver quality results.
That said your results are probably fairly average considering how few plastic surgeons have actually mastered this operation.
Giving excuses like swelling and time are just a failure of acknowledging the truth.
Ethical talented and Experienced providers will own the results and well honestly acknowledge when things didn’t turn out the way they should.
They will be the first to explain the quality(or not) of the outcome, the reason why and what can be done to improve them.
This type of behavior is unfortunately not the norm in the community.
Instead some providers will start by blaming the patient.
If someone wasn’t a good candidate for Liposuction and they should’ve been told that during the consultation.
To get an accurate assessment and to find a sufficiently skilled surgeon to do quality revision work you’ll need to start the process again this time thoroughly vetting providers when it comes to skill and experience.
You can also follow up with your provider but you already know firsthand what that person‘s skill is like.
Some revisions are easier than others but someone who can’t do primary liposuction well is generally not going to make great improvements with the revision and can easily make things worse.
The more fat that’s removed the more complex and difficult things yet when it comes to correct in the outcome.
Skill and experience on behalf of the plastic surgeon it’s not only relevant to the technical ability to do Liposuction well.
It also includes the ability to make accurate assessments and be able to accurately predict exactly what each persons outcome will look like.
Sufficiently skilled and experienced providers should be able to make an accurate assessment and show you applicable before and after pictures of previous patients with the same or very similar characteristics giving you a very good idea of what your results will look like.
Some of your issues may be related to your candidacy for the procedure. You didn’t include the information but I’m going to guess that you have previous pregnancies and in some ways the reason you thought Liposuction was to correct pregnancy related changes.
I could be wrong so forgive me if that’s not the case.
It’s an assumption but it’s a common scenario.
Pregnancies do not change fat distribution and pregnancy related changes are generally not treated the best by Liposuction.
Pregnancy related changes are generally treated by having a full tummy tuck.
Patients need to recognize that when they opt for a treatment that doesn’t treat the primary problem results are going to be limited.
Pregnancy related changes are related to skin laxity and muscle separation not fat distribution.
At this point I suggest following up with your provider and consider having second opinion in person consultations by other providers in your community if you feel like your provider is not the right person to do your revision.
Liposuction revisions should not be done within the first six months.
Liposuction results are final and do not change after three months. Waiting six months it’s appropriate to allow internal scar tissue to mature before doing a second procedure.
Best,
Mats Hagstrom

Hi and welcome to our forum!
From your photos, I note patchy areas of relatively minimal soft tissue fullness about the abdomen associated with a degree of lax abdominal skin.
As you are only 8 months out from liposuction, one cannot yet differentiate between residual swelling and residual fat (or loose skin). It takes 12-18 months for swelling to subside and for healing to be complete.
The "hardness" you are experiencing is most likely residual swelling that has not yet abated.
The final result is not yet clear....Allow the swelling and hypervascularity of healing to subside. If the irregularity does not diminish, consider secondary surgery if still concerned.
Best wishes...