Help! I have a lumpy stomach and fibrosis after BBL/lipo. What do I do? (Photo)

Thank you for your question and posting appropriate pictures. You seem like a good candidate for revision liposuction using VASER and skin tightening with Renuvion or J Plasma. Best to have a virtual consultation to review options as well as expected outcome.

Dear cholly92,
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. 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

On a daily basis I answer peoples questions on this form about Liposuction and fat transfer for the most part. To date I have answered over 14,000 questions.
I also specialize exclusively in doing only liposuction and fat transfer procedures and have been specializing exclusively for the last 10 out of 22 years of practice.
Delivering consistent quality liposuction results is more difficult than most people believe and that includes plastic surgeons.
Liposuction is a permanent and more or less irreversible procedure.
Liposuction causes a moderate Netwerk of scar tissue to form throughout the subcutaneous fat layer. this by itself doesn’t cause a problem because it’s usually nicely blended with the remaining subcutaneous fat and that’s the scar tissue matures the texture of the fat begins to feel normal. if almost all the fat is removed then even more scar tissue forms but worse is there’s no fat to support the scar tissue and this is what we typically referred to as fibrosis after liposuction.
Any procedure that removes fat in this area or adds scar tissue will make it worse. Using high energy devices like VASER will simply make even more scar tissue. There’s no such thing as breaking up scar tissue in regards to improving the outcome. further surgery will create more scar tissue.
Poorly done Liposuction can be divided into two categories. Simply uneven results or uneven results with excessive fat removal.
It is the latter of the two that is the most difficult to try to improve upon. If most of the fat has been removed then there’s a little left to work with.
The treatment options typically come down to revision Liposuction(partially explained above), Fat grafting, a combination of the two or converting the procedure to a skin tightening procedure like a full tummy tuck.
When deciding on what procedure to have patients and surgeons should have a clear understanding of what the primary problem or ideology is.
In other words we need to make a diagnosis before recommending a treatment. In your case the diagnosis is an uneven fat distribution with previously excessive fat removal. It appears you have mild skin laxity but it isn’t bad.
It is not possible to return your body to pre-liposuction and while some improvements can probably be had you should recognize that while delivering consistent quality liposuction results is difficult more difficult than people believe revision work is many times more difficult than primary Liposuction. getting consistent quality results when it comes to revision work requires being in the hands of the most talented and experienced provider in your community. Mastering these procedures takes not only years of practice and doing thousands of cases but doing so with the intent of mastering the procedure with a commitment to constantly improve your outcomes. there are plenty of plastic surgeons Who have been doing the same mediocre Liposuction without changing their techniques for a whole career.
Finding ones that are committed to mastering the procedure always thinking about how it can be improved upon is another story.
The problem with revision Liposuction is that too much fat was removed in the first place so removing more can simply make the problem worse and will create more scar tissue. The problem with grafting fat is that the areas that need volume of the most have the least amount of host tissue to support grafted fat creating a poor environment for fat graft survival.
Converting the procedure to a full tummy tuck doesn’t change that you have an uneven fat distribution. even if your abdomen looks much better when you pull on your skin pulling on your skin is not the same effect that you get from having a tummy tuck. A tummy tuck without addressing the uneven fat distribution will leave you with a big scar, potentially I’m natural looking bellybutton a long recovery and still have an uneven fat distribution. Converting the procedure to a full tummy tuck is the best option for individuals who are good candidates for a tummy tuck in the first place and especially those whose liposuction problems are mostly in the lower abdomen which is partially the case for you.
One thing to consider is that having had previous liposuction creates a diffuse Netwerk of scar tissue throughout your fat layer and scar tissue has far less pliability and this can limit how much skin can be successfully removed with a tummy tuck.
Usually plastic surgeons try to remove the skin from just above the belly button down to the low pubic area but removing this much skin may be a challenge if the skin doesn’t have the elasticity because of scar tissue.
These are difficult cases and simply making decision of which route to go is difficult enough. they are also very difficult technically and the most important variable is always choosing the right provider. that was the most important variable for your first procedure and it wasn’t done correctly. It is an even more important variable now.
To find the best provider I suggest patients start the process of having lots of in person consultations with local board-certified plastic surgeons.
I don’t believe patients can find the right provider without meeting them in person and having proper full in person consultations.
Avoid virtual consultations whenever possible.
For primary procedures during the consultation ask each provider to show their entire collection before and after pictures for the procedure you’re interested in. Simply being shown a few sample pictures which most likely represent the best results of the providers career is insufficient to get a clear understanding of an average results look like in the hands of each provider. For a common procedure like the BBL an experienced provider should have no difficulty showing you a minimum of 50 sets of before and after pictures. You may want to ask the provider to show as many pictures as possible of patients with similar body characteristics to your own. You may also want to ask providers to show pictures of patients who had excellent outcomes, average outcomes and less than outcomes. We all have those.
When it comes to revision work you’re not gonna find somebody who has collections of hundreds or even thousands of before and after pictures like some might for primary procedures. plastic surgeons I’ll have revision work they’ve done on their own patients and unhappy patients from each plastic surgeons office will make the rounds and go to their colleagues offices asking for second opinions so we all see each other‘s work when the patients are not pleased with the outcome.
Still, the percentage of revision work is relatively small compared to primary liposuction or fat transfer.
If you’re opting straight for just getting a tummy tuck then the specific question or types of pictures you’ll want to see our patients who’ve had tummy tux after previous abdominal liposuction.
It may take some time and it may be challenging for surgeons to go through their entire portfolio to find those specific pictures but in your case they are needed.
To judge plastic surgeons for a full tummy tuck I recommend looking primarily it who gets the most natural looking belly buttons with a low set scar that follows in a time we contour is naturally. The Torso should look good from all angles including from behind. Creating a natural looking bellybutton is one of the technically most difficult parts of a full tummy tuck and surgeons that can consistently get good looking belly buttons ,which is really the appearance of the central abdomen , consistently tend to be good at all other aspect of the procedure.
What are you up for a Liposuction revision procedure with or without fed transfer or converting this to a tummy tuck do you need to be in the hands of someone who is truly talented and has an extensive amount of experience.
Recognize the inherent limitations for how hard it is to improve upon your outcome.
Finally I recommend reading all reviews on various physician review websites avoiding 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.
I’m sorry this happened to you. It is unfortunately all too common. The number of plastic surgeons who can consistently deliver quality results without any contour irregularities is actually quite small.
Liposuction is very deceptive. It looks so simple yet it turns out to be one of the most difficult procedures to master in regards to delivering consistent quality results every time.
Best,
Mats Hagstrom MD