Can fat & skin be removed without implants/fat injections? (Photo)

Question

I have recently lost weight & have noticed the loss of shape in my bum. Could you please recommend procedures to help w/the sagging skin/dimpling in my bum, upper thighs, & legs? I know it's difficult to remove cellulite, but is it possible to smooth out? I don't mind the top of my bottom; is it possible to just remove the extra fat on the bottom w/o implants? P.S. I have also attached a pictures of my stomach, as I wish to combine surgeries. Previous c-sect/hysterectomy Thank you

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding if fat and skin can be removed without implants/fat injections. Thank you for your history and your pictures. These can excise the excess skin and fat from your lower buttock. There are two approaches an incision can be made underneath the buttocks or inside the thigh. Or an incision can be made across the top of the buttock. When an incision is created underneath the buttock, the targeted area is the lower buttock, a crescent skin area, and fat is directly removed from the lower buttock. When an incision is made on top of the buttock, the buttock is lifted, and the wrinkles are eliminated. These can be combined with abdominal procedures, but I am not sure which abdominal procedure you are seeking. Please clarify. If you do not want buttock augmentation, you do not need buttock implants or injections. Buttock implants or fat injections are for patients who want their buttocks to be more significant. Thank you for your question regarding if fat and skin can be removed without implants/fat injections.

Michele A. Shermak, MD · Answer

Hello!
Gold standard answer is a lower backlift/buttock lift continuous with your abdominoplasty, which most definitely could be a "mini" with no belly button scar. The backlift will pull the skin up and over your existing buttock tissue so will reshape the buttocks in a great way. The incision above the buttocks may be in a gull wing shape or straight across the upper buttocks, depending on your surgeon.
Best of luck to  you!

Zoran Potparic, MD · Answer

Most likely that possible approach to a buttocks problem would be fat grafting and use of skin tightening devices based on radiofrequency or J plasma. That also includes treatment of abdomen. Hope it helps.

John Paul Tutela, MD · Answer

Thanks much for reaching out. It was significant amount of excess skin and not enough fat rest of your body qualify for fat transfer.  An implant would help fill out the skin laxity it is probably your best option. Also cutting the skin out directly in the banana role has many problems, including opening up and very poor scarring. However, that will also take out the skin in that area, but it may come with too much risk.

Leland Webb, MD · Answer

One of the ways to combat the sagging skin that can occur with weight loss is to add volume back in the form of Fat grafting . The hardest part here is the small amount of fat remaining. Furthermore, I do agree with you that implants in this area are fraught with difficulty. Nevertheless, if you discuss your goals with a board-certified plastic surgeon, they may find that they can harvest some fat for Fat grafting to provide you with some additional volume in this area. There are other options to include a lift in this area, however, this is a more comprehensive surgery with scarring. Have that conversation with a board-certified plastic surgeon and I think you can find a good option. We are happy to help in any way we can.

Connie Hiers, MD, FACS · Answer

For your buttocks, I recommend nonsurgical EMSculpt to help build and tone your muscle and help fill out your buttock.  Your breasts would do well with a lift and augmentation if you want something fuller.

Camille Cash, MD · Answer

There are options to address the various areas that you mentioned.  You can consider Aveli which is a treatment designed especially for cellullite.  You can also consider liposuction with J Plasma for skin tightening.  See a board certified plastic surgeon near you to learn more.

Kevin Tehrani, MD, FACS · Answer

Thank you for your question and posting appropriate pictures. You are a good candidate for skinny BBL procedures where liposuction using WAL or body jet is used to maximize graft take in addition to Acell. Fat from your the bottom of your bum, inner,  outer thighs, and possibly other areas like arms or front of your thighs can be used. Best to have a virtual consultation to discuss options.

Darryl J. Blinski, MD · Answer

Nice posted photos. Seems you need sub skin aggressive lipo of posterior buttock/thighs with specialized taping, Aveli cellulite releases, fat grafting yo buttock and areas of cellulite with skin only TT and muscle repair. Fee $15,000
Best to virtual consult with ….

Mats Hagstrom, MD (license on probation) · Answer

To answer your question properly requires a 45 minute in person consultation at minimum.
Generally speaking, you should never have a fat removed from your buttocks.
There are a few good treatments for flabby thighs.
You’re a good candidate to have a tummy tuck in a breast lift with implants, if desired.
I suggest scheduling multiple in person, consultations with local board-certified plastic surgeons in your community. If you’re interested, offer assessment and learning about various procedures, and what each procedure I can and cannot accomplish.
There is significant variation in skillet experience a lot of plastic surgeons. Being bored, certified in plastic surgery with years of experience, and having a solid reputation does not necessarily mean somebody has mastered anyone in particular procedure.
For that reason I recommend patients have multiple consultations to help find the best provider and get the most accurate understanding of the role of the candidacy procedures possible.
Bring pictures of your body, preferably in a printed format to use as a reference during each consultation. During each visit, ask providers to open up their portfolio and show you their entire collection of before, and after pictures of previous patient who had similar body characteristics to Llorona. This is why bringing pictures of your auto body is useful during consultations. There’s no point in seeing outcomes of patients who are perfect candidate. It is also likewise not helpful to see preselected images, representing the very best results for providers career. The goal is to find out what the average results look like especially on patients who have your candidacy for the procedure of choice.
For reference an experienced surgeon that should have no difficulty showing you at least 50 sets of before and after pictures of commonly performed procedures and cosmetic surgery. Highly experienced charges should have hundreds or possibly thousands of before and after pictures of the most common procedures.
Before committing to having surgery, make sure you’ve had enough consultations to be able to clearly differentiate who is the best provider in your community for whatever procedure you’re interested in. This means first and foremost understanding your own candidacy for the procedure as well as having a clear understanding of what a quality results look like. Providers are going to prefer to stick to showing you their best results. One, but it may be nice to look at. It is critical that patients get enough exposure to before, and after pictures to get a clear understanding of what the typical results look like, especially based on your own candidacy. 
There is no correct number of consultations required to find the best surgeon. The more consultations you have the more likely you are to find the ideal provider. I do not recommend patients and rely on virtual consultations if possible, and I definitely recommend against traveling long distances for elective surgical procedures, unless absolutely necessary.
Certain conditions like flabby, thighs and cellulite, are inherently limited to what can be achieved. 
Sometimes it’s better to except your body the way it is then undergoing surgery that costs thousands of dollars with the risk of having things turn out worse. 
When in doubt slow down and schedule for a consultation. 
Be especially selective for liposuction and fat transfer procedures. These operations have the greatest variation in outcomes based on provider selection than other plastic surgery procedures.
Best,
Mats Hagstrom, MD

Can fat & skin be removed without implants/fat injections? (Photo)

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