Scars and evaluation of my results after Vaser lipo? (Photo)

Question

I had Vaser on my back, flanks and stomach 6 months ago. The results look fine but I see areas of fat that could’ve been removed and some dark scarring where the incisions and draining tubes were left for a few days after the op. The scars at the front are especially long and look bigger than the usual scarring I see on lipo patients. My doctor said these will fade in time but will they and are they a normal size and shape? How can I lighten them? How can I also remove the remaining fat? Thanks

Raffy Karamanoukian, MD, FACS · Answer

Plastic surgery scars require attention after surgery so that they remain cosmetically-appealing and barely noticeable. In our office, we use a protocol for scars that minimizes their activity in the 6-8 weeks after surgery. If you have late plastic surgery scars, you may also require laser and RF therapy to help reduce the longterm effects of the scarring. Keloids, hypertrophic scars, widened scars, red scars, and hyperpigmented scars all require scar modulation with topical creams followed by lasers and RF therapy. Topical skincare should be directed to a specific need, whether for pigmentation or hypertrophy and our office can guide you through the process to obtain the correct Plato’s Scar cream or Melarase cream for hypertrophy and discoloration. In terms of lasers, we would employ the vbeam laser for redness, Venus Viva RF, PRP microneedling, chemical peels, and Morpheus 8, fractional erbium, or fractional co2. All of these have their individual benefits. Most of all, we recommend you visit a solid plastic surgeon who understands surgical scar revision, laser therapy, and RF therapy for scars. 
 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Anuj Purbey, MBBS · Answer

Thank you for reaching out and sharing your concerns about your Vaser liposuction results and scarring. I understand that your journey to achieving your desired outcome may involve addressing specific areas and ensuring optimal healing.
Regarding the areas where you feel there might be remaining fat, it's not uncommon to have some unevenness or residual fat after liposuction. However, it's essential to give your body time to heal completely, as the final results may continue to improve over several months.
As for the dark scarring around incisions and draining tubes, it's not uncommon for scars to appear more prominent initially. Your doctor's reassurance that they will fade over time is generally accurate. To aid in scar lightening and reduce their appearance, consider the following tips:
Scar Massage: Gently massaging the scar tissue can improve blood circulation and promote healing.Topical Treatments: Applying silicone-based or vitamin E creams can be beneficial for scar management. Consult with your doctor before using any specific products.Sun Protection: Protecting the scars from sunlight can prevent them from darkening further. Use sunscreen or cover the area when exposed to the sun.If you remain concerned about the results or have questions about the scars, it's crucial to follow up with your treating physician. They can assess your progress, provide additional guidance, and address any specific issues you're experiencing.
Remember, patience is key in the post-operative phase, and gradual improvements are expected. If you have any immediate concerns, do not hesitate to schedule a follow-up appointment with your doctor for a more personalized evaluation.
Wishing you a smooth recovery and the best possible outcome.

Mats Hagstrom, MD (license on probation) · Answer

Skin incisions continue to mature and change for up to 1 1/2 years. At six months unless something is abnormal the best course of action is to give yourself time to heal. Attempt at improving hyper pigmentation early with treatments like lasers can make things worse. If the scars are bothers some at 18 months then consider treatment options.
VASER requires making larger incisions than other forms of liposuction.
At six months it’s still early and your scars will most likely fade on their own given enough time.
In regards to your results you did not mention what area you’re concerned about. I’m guessing it’s your love handles.
That area often and does not deliver results patients had hoped for and it’s not unusual for male patients to feel their area was under treated.
That area is prone to showing fullness from even mild skin laxicity in men who have been overweight we’ve had even slight weight fluctuations. The best way to differentiate if they are ya has subtitaneous fat or if skin laxcity is contributing to the contour is to have someone take a picture, use the timer on your camera or try while looking in the mirror while pulling up on the skin above the area of concern. my best guess is you’ll find that the contour improve significantly when you put the skin under tension and with the skin under tension if you feel the fat thickness with your finger you’ll recognize that it is equal and thin consistent with all the areas treated. There are some things I may have done slightly differently. I personally recommend treating the entire tour so when doing abdominal liposuction. This means I include the entire back and under are Maria all the way up into the armpit and typically also treated the chest.
In order to get good results that mimic looking lean the entire torso needs to be treated so there are no transition zones between treated and entréed areas.
Another area where the mail torso differs a bit is in how we treat the waist. on the Mail tour so the goal should not be to bring in the waist as much as possible because it feminizes the torso. There is a small bulge on your lower abdomen. This most likely represents a skin bulge but again put the skin under tension to Assess whether it’s due to skin laxicity or related to subtitanious fat distribution.
Your results look fairly typical. Delivering consistent high-quality Liposuction results is far more difficult than most people believe. I think your results are probably very typical I would most plastic surgeons will Deliver. The only thing I may have done differently was to include the chest, under arm area and full back. i’m guessing your surgeon was aggressive in their attempt to bring in the love handles. That area is notorious for not responding as much as patients had hoped for male clients. it is particularly difficult for patients with the history of weight fluctuations or those who are a little older.
Love handles are much easier to treat on women and I believe the reason for this is that women have a wide pelvis with a smaller chest cage while men tend to have a small pelvis with a wide chest cage. this difference in anatomy changes how they are your response to this procedure. this is only my opinion from personal observation having performed over 8000 Liposuction cases in my career.
Continue following up with your provider. If you want a proper second opinion consultation then those should be scheduled as in person consultations. For in person second opinion consultations it’s a deal if patients bring proper before and after pictures showing all angles as well as a copy of your operative report. Those are all part of your medical records and will be forwarded to you if you request your surgeons office to do so.
A revision of the previously treated areas may not give much improvement if the problem comes from how the skin is dripping your body. It’s very important to differentiate the difference between mild skin laxity and subcutaneous fat to not erroneously have a second procedure that doesn’t give much improvement.
I’m fairly particular about how I do body contouring and can be a bit opinionated. some of my opinions come from the fact that I’ve specialized exclusively in doing only liposuction and fat transfer for the last decade. I gave up doing general plastic surgery 10 years ago to specialize exclusively and only liposuction and fat transfer procedures of the body.Overall I think your surgeon did a nice job for you. 
Best,
Mats Hagstrom MD

Randy Dean, MD - Account Suspended · Answer

Hi and welcome to our forum!
From your photos, I note a degree of residual fullness of the abdomen and flanks. Significant improvement in contour is noted. You demonstrate red healing surgical scars which do not appear to be mature.
It appears that significant improvement has been achieved.  However, you may wish to consider a secondary liposuction to further define these areas. 15% of cosmetic procedures can be improved with a "touch up". 
The surgical scars will take at least 12-18 months to mature and fade. Avoid sun exposure to the scars while they are healing.
Best wishes...

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