Dents and unevenness 6 months post-Vaser. What can improve this? (photos)

Question

Hi , I had vaser liposuction 6 months ago, flanks, stomach. Looking for a second opinion. Discussed with my surgeon this result below, I didn't feel like I got a clear expectation of improvement/causes. (Followed aftercare carefully.) I was given home treatment to try like rf machine and microneedling, which I don't feel equipped to carry out. I'm unhappy about the outcome, looking at other suggestions to fix or improve this. 29yrs, dont drink/smoke. 159cm,  52kg. Thanks

Harry T. Haramis, MD, FACS · Answer

Some temporary firm spots, uneven areas common after Vaser ultrasound liposuction. It’s part of the healing process and can take upto 1 year to settle.

Unfortunately, the abdomen shows every spot and is prone to daily movements of torso, clothing digging in when sitting, etc.

Everyone heals differently, continued gentle massage, compression and time will usually improve the area.

If these contour issues persist, rarely some treatment may be indicated. Revision too early can start cycle over again and may be detrimental.

Continued close follow up with your plastic surgeon is recommended during this time.

J. Timothy Katzen, MD, FACS · Answer

Hi Alex9488, 
Thank you for your question regarding dents and unevenness six months post-VASER liposuction and what can improve this. Thank you for your history and your pictures. 
Indentations, waviness, and unevenness of the skin are the most common complications after any type of liposuction, including VASER liposuction. To minimize dents and uneven skin after liposuction, it is very important for you to wear four layers.  Your first layer should be liposuction foam.  Your second layer should be an abdominal board.  Your third layer should be your medical-grade compression garment.  Your fourth layer should be a foam vest created just for VASER liposuction patients made by Medical--Z. You should use the foam, abdominal board, and vest for the first two weeks.   You should wear your compression garment for 6 to 8 weeks after surgery.  At the two-week mark, it is also very important to start lymphatic massage and continue for several weeks.
Before you undergo another liposuction surgery, I would exhaust conservative measures. This should include deep tissue massage, cavitation, magnetic therapy, and micro-current.  If these measures do not resolve your issues and it has been at least eight months after your VASER liposuction, then I would consider revision.  
The indentations and dents that you have are due to scar tissue and loss of fat in these areas. During your VASER liposuction revision, areas of scar tissue must be released.   I would suggest combined VASER liposuction and scar release to the areas of scar tissue. In addition, I would also suggest fat grafting to fill in areas of severe indentation, which may not respond to the scar release.  Please be aware that VASER revision surgery is very difficult to fix. You need to go to a specialist.
Also, you may need several surgical revisions to achieve optimal results.   Good luck.  I hope I have answered your questions about dents and unevenness six months post-VASER liposuction and what can improve this.

Arif Eroglu, MD · Answer

Thank you so much for your question and providing the photos. In the second photo, there is fibrosis due to excessive fat removal (overcorrection) and laxity in the upper abdominal skin and collapses in the skin. To correct the laxity, 3 sessions of Morpheus 8 radiofrequency can be performed on the upper abdomen with 1 month intervals. I recommend manual massage and Morpheus 8 radiofrequency to reduce fibrosis. To correct collapse areas, I recommend either micro fat injections or lanluma or sculptura injections.
Kind Regards

Babak Moeinolmolki, MD, FACS · Answer

The definitive correction for you is the modified abdominal skin resection which will eliminate skin redundancy and allow you to perform VASER liposuction to redistribute the fat you have into a smoother appearance. Please consider a virtual consultation with a high definition body contouring provider.

Anuj Purbey, MBBS · Answer

I'm sorry to hear about your dissatisfaction with the results of your Vaser liposuction. It's understandable and advisable to seek a second opinion to explore alternative solutions. It's crucial to communicate openly with your surgeon about your concerns and expectations. They should provide clear explanations regarding the outcome and potential causes, as well as offer viable options for improvement.
If you feel unequipped to carry out the recommended home treatments like RF machine and microneedling, you should discuss this with your surgeon. They may be able to suggest alternative treatments or provide assistance in finding a suitable solution that aligns with your needs and preferences.
Additionally, consulting with another experienced surgeon for a second opinion can provide valuable insights and potential alternatives for addressing your concerns. Make sure to communicate your specific goals and concerns clearly during the consultation process.
Ultimately, the goal is to find a solution that addresses your aesthetic concerns and restores your confidence.

Mats Hagstrom, MD (license on probation) · Answer

Delivering consistent quality, Liposuction is more difficult than most people realize. Number of plastic surgeons who truly mastered this procedure are in the minority. Liposuction is a permanent and more or less irreversible procedure. Once it’s been performed incorrectly, it’s very difficult to improve on the outcome.
Liposuction skills vary dramatically among different plastic surgeons. Being bored, certified in plastic surgery with years of experience and an overall good reputation does not mean somebody has mastered anyone single procedure. For these reasons, I suggest patience to be extremely selective when choosing providers for body contouring Procedures. Improving Liposuction outcomes is going to be limited. Revision work usually comes down to more Liposuction, fat transfer, or a combination of both. The ability to improve the outcome is inherently limited. Revision work is far more difficult than primary Liposuction to the importance of choosing a sufficiently talented provider goes without saying. I suggest patients start the process by having multiple in person, consultations with local board-certified plastic surgeons, who seem to be good at Liposuction. If you’re considering fat transfer as a method of correct in the outcome than the provider needs to be vetted for both Liposuction and fat transfer skills. 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. Being shown a handful of preselected images, representing the best results of a providers career is completely insufficient to confirm a provider has the skill and experience necessary to deliver consistent quality results.
Competence in body, contouring, not only includes the technical ability to do Liposuction well, but also the ability to make accurate assessments and deliver predictable outcomes, consistent with before, and after pictures of previous patients with similar body characteristics. There should be no guessing game with what Liposuction results look like if providers are vetted properly.
There’s typically always room for some improvement, but restoring your body to what it looks like pre-procedure is probably not a reality.
There are no nonsurgical options to correct poorly done Liposuction.
Results are direct reflection of the patient’s candidacy, combined with the skill or lack there of of the surgeon. 
I suggest you take your time and beginning the arduous task of finding the most talented provider for your needs in your community.
Best,
Mats Hagstrom, MD

William A. Ross, MD - Account Suspended · Answer

Thanks for your question. I am sorry you’re having this experience. Contour irregularities that persist six months after liposuction can have several causes. It's important to note that liposuction is generally a very safe and effective procedure. It can, however, carry potential risks and complications. Some factors that can contribute to contour irregularities after liposuction include: Inadequate fat removal: If not enough fat was removed during the initial procedure, it can result in remaining pockets of fat that cause contour irregularities. This affords the simplest opportunity for correction. Uneven fat removal: If the fat removal was uneven or asymmetrical, it can lead to contour irregularities in the treated area. This is most commonly the case. Poor skin elasticity: Patients with poor skin elasticity may experience contour irregularities after liposuction due to inadequate skin retraction. Certain inherited diseases can lead to loose skin, such as the cutis laxa-related syndromes, Ehlers-Danlos syndrome, and Pseuedoxanthoma elastica. Fluid accumulation or seromas: Seromas are collections of fluid that can develop after surgery and can form because of inadequate drainage or accumulation of fluid after swelling.If these are aesthetically significant during the early phases of healing, they may constitute persistent deformities. To correct contour deformities after liposuction, several options may be considered. These can include: Revision liposuction: A secondary liposuction procedure can be performed to address remaining pockets of fat and improve contour. This is a commonly employed option and can be successful when executed well. Fat grafting: This involves transferring fat from one area of the body to another, which can be utilized to improve contour irregularities. Unwanted fat in one area can be used to smooth out another area. It is extracted, processed, washed and transferred where needed. Skin tightening procedures: For patients with poor skin elasticity, additional procedures such as skin tightening or excision may be necessary to improve the overall contour.It is not uncommon to employ a combination or all of these techniques to address a complex contour deformity.In conclusion, contour irregularities six months after liposuction can have various causes, including inadequate fat removal, uneven fat removal, poor skin elasticity, or fluid accumulation. Treatment options may include revision liposuction, fat grafting, or skin tightening procedures. A thorough evaluation by a board-certified plastic surgeon is essential to determine the best approach for addressing and correcting contour deformities. I hope this helps.

Dents and unevenness 6 months post-Vaser. What can improve this? (photos)

Answers (7)

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