I Think my Doctor Missed a Spot

Question

7 Days have passed since I got Tumescent Lipo on my upper and lower abdomen and I am starting to fear that the doc missed an entire area. He mentioned before the surgery that it's dangerous to go too high up because of your heart and lungs but it seems to me as if he totally just missed the entire upper area. My stomach is swollen and extremely sensitive but the area I think he missed feels like normal, like nothing ever touched it. When I pinch it I can feel the fat there still, thoughts?

Vivek Bansal, MD · Answer

Only your surgeon knows what he/she did or did not do. If you paid for the upper abdomen, and they did not do it, then you should address this with them. Also, see a Board Certified Plastic Surgeon and listen to their input. Thank you for your question and good luck with everything.

Vincent N. Zubowicz, MD · Answer

Tumescent fluid is introduced into the fat antecedent to liposuction. Most plastic surgeons use the technique with all kinds of lipo (conventional, ultrasonic, laser assisted). If your surgeon missed a spot with whatever technique of lipo used, he should touch up that area. It's too early to tell and it is not dangerous to suction high on the abdominal wall or the chest.

Ron Shelton, MD · Answer

Liposuction of the lower chest area, above the lowest ribs is usually not done. When lying on the table it is possible that some of the upper part of the upper abdominal fat is so close to the ribs that doctors might approach that area cautiously. Better to be safe. Allow for a few months of healing and reduction of swelling. See your surgeon in follow-up examination to discuss a plan for observation and then additional liposuction if necessary several months after the procedure.

Peter E. Johnson, MD · Answer

After liposuction not all areas will be sore and bruised, and the result should be judged on the contour, not only on the ability to pinch remaining fat in any particular area. Wait a full six months and if the contour is good enjoy your result. If a spot has indeed been overlooked you should see your surgeon about a touch-up if needed.
	Best of luck,
	peterejohnsonmd

Juan A. Brou, MD · Answer

7 days after liposuction is no time to see the final results.  I tell my patients that there will be swelling for several months and the swelling gets worse after 2 weeks until after a month.  Only then the results will start looking more like the final product but never before at least 3 months.  Now, judging by your photos, you look like someone who has lost a lot of weight and your problem is not so much fat but a large amount of loose skin.  Generally when the problem is redundant skin the only solution is to remove it with excissional surgery such as a tummy tuck or a body lift.  Patients who had massive weight loss appear to have fat within the loose skin but when liposuction is attempted no fat can be extracted because there is no fat left.  I've been there many times.  Extracting fat from massive weight loss patients is nearly impossible and very frustrating.  I have the feeling your doctor was not aware of this and thought you were a piece of cake, "no sweat! I can get that fat out in no time".

	I treat a lot of patients who have lost 40, 80 plus Lbs. after gastric bypass or just by dieting and excercising.  Excissional surgery is always indicated (tummy tuck, body lift, arm lifts, etc.) I still use liposuction for contouring but the residual fatty tissue is so fibrous that the fat cannot be removed easily or at all with lipo.

	I hope this answers your question

Francisco Canales, MD · Answer

I think you should be frank with your doctor and ask specifically where he suctioned and where he did not. I make the marks with the patient standing and awake so we review exactly where we will be going. The area you are pinching in the photo is the upper abdomen and we usually don't have concerns about internal organs like the heart or lungs when doing liposuction of the upper abdomen. (that is, in the usual situation with no previous scars, etc.)

I Think my Doctor Missed a Spot

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