Lipedema liposuction, Is this fibrosis? What are my treatment options? Hard areas, bumps, dents, and dips. (photos)

Lipigirl thank you for sharing your photos. I am sorry to hear about your complications during recovery. You likely have some increased fibrosis but I dont see any evidence for lymphatic injury. You have several options. You could give your healing more time and then have revision surgery. You could have revision surgery now. I recommend waiting at least six months to let your skin and lymphatic heal before revision surgery. Or you could not have any further surgery. Please remember that there is no cure to lipedema and it requires lifelong management. Following a low refined carb antinflammatory diet and the use of medical grade compression and staying active are all part of the long term management of lipedema.

Delivering consistent quality liposuction results is more difficult than most people believe and this includes most plastic surgeons.
On top of that lower extremities tend to not give results that are as impressive as other anatomic areas.
Finding plastic surgeons who have mastered liposuction often takes interviewing multiple providers before finding someone who is really talented.
I typically encourage patients to insist on seeing enough before and after pictures during consultations that they feel well reassured that the provider can deliver consistent results. Being shown a few selected cases which most likely represent the best results of a providers career is insufficient to confirm that that provider is competent at doing Liposuction.
An experience provider should be able to show you at least 50 sets of before and after pictures of commonly performed procedures. lower extremity liposuction is a moderately common procedure so perhaps it’s a reasonable to expect someone to have at least 20 sets of before and after pictures for that procedure.
It should be enough that patients can see consistent results on a regular basis and feel they have a good understanding of what the outcome will be.
Experienced surgeons will also understand how complex doing these cases are and should let you know that the outcomes may not look attractive and recovery can be difficult.
It’s very difficult to get nice attractive thighs from debulking procedures removing as much fat as you have done. Most people with your condition already have skin laxity and cellulite issues which are only made worse by fat removal.
Liposuction is a permanent and more or less irreversible procedure.
Treatment options for poor outcomes include revision liposuction (trying to improve the outcome by removing more fat), fat transfer or sometimes converting the procedure to a skin tightening operation like a thigh lift or tummy tuck for a Abdomen.
Revision surgery is far more difficult than primary liposuction so if you’re going to have another procedure you need to make very sure that Dr. has the skills to be able to do the primary procedure well in the first place. Even then you should keep your expectations low and only expect moderate improvements or subtle changes. these are difficult procedures and they require direct and honest conversations during in person consultations.
Plastic surgeons can be a notorious bunch for not owning up to results that are less than what both patient and doctor I had hoped for.
Patients are often told to simply wait and things will improve even though the surgeon knows well that the results are not good hoping the patient will simply not return.
Forthright honesty is a virtue in the situation is.
Good luck,
Mats Hagstrom MD