Should I go for my second attempt at Vaser lipo with the same surgeon if there was no change the first time? (photos)

Question

I am a 35 year old female. Size 10/12. I had Vaser surgery on my arms, flanks, upper and lower stomach in Nov 2020. 13 months on, there is 0 difference. I followed all the guidelines and ate healthy, followed with MLD massages and deep tissue massage after the 10 sessions of MLD. My question is, should I go back for a second treatment if it didn't work the first time? I am happy to send photos of before and after and have also posted a review with all the details.

Giuseppe Fiore, MD · Answer

Hi ,
Thanks for your question and photos.
I would recommend to make an appointment with the surgeon to perform the procedure and discuss with concerns and possible options including possible second surgery. 
According to the photos, you are good candidate for Vaser liposuction on flanks, lower back upper and lower abdomen ( 360 degree approach). flanks in order to improve your overall silhouette and body contour and give more athletic shape.
Vaser liposuction is a surgical procedure for fat removal and overall improvement of  silhouette and body contour in the right candidates. This means that the fat removed from a specific part of the body will be collected in a canister/container outside of your body. In my clinical practice I am able to show the patient the fat removed.
It is very important also to understand that Vaser liposuction can only remove subcutaneous fat. Visceral fat is located inside the abdominal cavity – it cannot be suctioned out.  
It is possible for fat to return after liposuction if you gain weight after liposuction. In general, the more weight gained after liposuction, the less their results will be.
This is why liposuction is not a weight-loss procedure. 
Weight Loss through diet and exercise can reduce visceral fat safely and effectively.  
Life style program ( e.g. healthy diet and exercise) and bespoke after care/follow-up plan are the very important in this surgical procedure to maintain the results achieved and potentially improve them.
It is important to have a face to face consultation with the surgeon to assess the localisation on the fat, your skin quality ( e.g. elasticity), muscle tone and medical history including previous pregnancies as following childbirth, the muscles of a woman’s stomach can become stretched and separated known as diastasis recti. In this case, liposuction can’t reduce the diastasis of the abdominal muscles and abdominoplasty would be a better indication. 
Hope this helps,
All the best,
Dr Giuseppe Fiore

Mark Edward Hennessy, MD · Answer

The prior to photos would be helpful. I am unable to see any scars on your skin (perhaps located under your clothes). Do you feel any firm areas on your abdomen? What is the opinion of your lymphatic massage specialist? During your follow up visits with your surgeon did (s)he state that you had achieved 100% recovery? Have you lost or gained weight since your procedure? Sorry I have more questions than answers.

Jason Emer, MD · Answer

For best results, I recommend a hi definition procedure like VASER liposuction, which can be performed at the same time as a tummy tuck, depending on skin laxity. I use VASER HI DEF with ThermiRF/J Plasma/Renuvion/InMode BodyTite and fat grafting to get the most fat removal, skin tightening, contour and definition. This combination will give you the most toned result. I recommend getting a formal evaluation with a hi definition physique expert. Best, Dr. Emer

Arian Mowlavi, MD, FACS (license on probation) · Answer

The Gold Standard for superior liposuction results requires use of the advanced technology of high definition VASER liposuction. In order to reach a desirable outcome, the treatment must be performed by a skilled plastic surgeon and other factors that can be discussed via a consult. You will require proper evaluation to ensure that you do not have muscle weakness that is contributing to the prominence of your abdomen.

As an official trainer of VASER liposuction, I perform full body liposuction cases every week. VASER liposuction has been the only modality that has consistently resulted in outstanding liposuction outcomes. VASER liposuction ensures a smooth contour regardless of degree of excess fat by virtue of being able to remove any and all remaining fat comprehensively and uniformly. If skin redundancy is observed, Renuvion technology can be simultaneously applied to tighten your skin to optimize your overall contour outcome. A Skype or FaceTime consultation with a VASER specialist will help you get an accurate recommendation and pricing.

Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

Mats Hagstrom, MD (license on probation) · Answer

Generally speaking if liposuction failed to deliver results from the first procedure doing the same thing twice makes little sense.

There are two major reasons patients fail to get quality results from liposuction. They were either not a good candidate or the procedure was not done correctly.

In your case both may be applicable.

There are four variables to determine what someone’s abdomen looks like. These are skin laxity, subcutaneous fat, muscle separation from previous pregnancies called diastasis recti and lastly excess intra abdominal or visceral fat.

Based on your pictures it looks like you have all four of these variables.

Patients who have moderate obesity need to lose weight in order for liposuction and results to show their best.

It is not uncommon for patients to regain the weight from the fat removed from the procedure.

This means patients should weigh less postoperatively than before the procedure. If not then patients have regained weight which is counter to getting ideal outcomes.

A tummy tuck and weight loss is probably a more appropriate prescription for an ideal outcome.

Based on your previous post I also have some questions about the provider you chose to do the procedure.

I do all my liposuction procedures with patients awake.  The procedure should not be uncomfortable to the point of being painful.

Typically some level of sedation for full body procedures is typically a better approach but each surgeon has their own way of doing things.

Personally I would always choose someone who is board certified in plastic surgery.

For an accurate assessment recommend scheduling in person consultations with other local board-certified plastic surgeons in your community.

Best,

Mats Hagstrom MD

Randy Dean, MD - Account Suspended · Answer

Hi and welcome to our forum!
Has your weight been stable? If there has been weight gain since the procedure, one will expect diminution of the result. How much fat was removed? This can be determined with a phone call to your surgeon's office (or after a release form is signed). 
The answers may provide information as how to proceed.
Best wishes...

Kristine Brecht, MD (license suspended) · Answer

Dear Watford,
Liposuction removes fat cells from under the skin above the muscle.
Doing more liposuction will remove more fat cells, but it will not address loose skin or visceral fat (fat on the organs below the muscles). Consultation with multiple experts would be a good idea, to full understanding what you are needing.
Best. DrBrecht 
Seattle, Wa

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