Delivering consistent quality, liposuction, results is more difficult than most people realize. Liposuction has more variation and outcomes, depending on who you choose as your provider and any other plastic surgery operation. Liposuction results should be viewed as permanent and irreversible. The importance of properly vetting plastic surgeons and confirming providers have sufficient skills and experience is best done before scheduling surgery. I generally recommend people do that I having multiple in person consultations with local board-certified plastic surgeons. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar body characteristics to your own. And experience plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Revising Liposuction Resort is difficult, and the ability to make improvements is inherently limited but depends on the patient’s initial candidacy for Liposuction in the first place, and how the first procedure was performed. If the first procedure was done in an overly aggressive manner leaving uneven contours, then correcting the outcome becomes more difficult. Likewise, if somebody was not an ideal candidate for Liposuction, in the first place, then the quality of the outcome is going to be inherently limited. Revision Work is many times more difficult than primary Liposuction. All the techniques you mentioned it may be viable options. If you’re provider didn’t have the skills to do liposuction well as a primary procedure, then they are not the right person to attempt revision work. Remember that revision work as many times more difficult than primary Liposuction. Patients to keep their expectations on the low side when it comes to Revision Work. The potential for improvement may be limited, and whether it’s even worth attempting to improve, the outcome, depends on a multitude of variables, but they basically come down to your candidacy for revision, combined with your ability to find a sufficiently talented provider. As efficiently experienced and talented provider should be able to have a clear understanding of how difficult revision work is and give you a realistic expectations to the degree of improvement that’s possible. Fat transfer becomes challenging because the areas needing fat to be replaced or lacking sufficient host tissue to support fat graft. This makes survival rates of grafted fat small and often multiple rounds of fat transfer may be needed. Some improvements are almost always possible, but whether this justifies the expense and going through surgery is another story. Revision work, and very easily make things worse than they already are, especially if you do not put in sufficient effort to find an exceptional provider. The process of finding providers for Revision Work is more or less the same as finding a provider for primary procedures. Generally speaking the best doctors and doing revision work are generally the same doctors that do the best primary liposuction. The one exception to this is a fat transfer is required, in which case you need to vent plastic surgeons not only regarding Liposuction skills, but also fat transfer skills. When reviewing fat, transfer results always confirm the exact timeframe I went after pictures were taken in comparison to the date of the procedure. Early fat transfer results can look very impressive, but do not in any way represent final results. After pictures should not be taken within the first six months after fat transfer in order to be representative of final results. A tummy tuck by itself will not create an even fat distribution. It may be an option if you were a candidate for a tummy tuck in the first place. Bing board-certified and plastic surgery with years of experience and overall good reputation does not mean that somebody is master Liposuction or is even good at it. The number of plastic surgeons who have truly mastered Liposuction is in a small minority. Most plastic surgeons think they’re better and Liposuction than they actually are. As mentioned previously doing this procedure well on a consistent basis, including the ability to accurately predict outcomes, and displaying what results will actually look like based on showing before, and after pictures of previous patients, is more difficult than most people realize, and this includes a substantial number of plastic surgeons. Your best chance of having an improved outcome is going to be based on your ability to find the right provider. I do not recommend patients have virtual consultations if possible. Generally recommending in person, consultations as being better in regards to getting an accurate assessment, and the ability to properly vet providers. I generally also do not recommend people travel long distances for elective surgical procedures, unless they’re willing to travel for consultations and follow up. Best, Mats Hagstrom, MD