To make an accurate assessment regarding the outcome of any plastic surgery procedure we always need to see proper before and after pictures. If you don’t have before, and after pictures and ask your surgeon to forward the pictures they took. without knowing what you look like before we can’t assess your candidacy for the procedure in the first place. For most plastic surgery procedures, there are two variables and will determine the outcome. The first is the patient candidacy, and the second is the choice of providers.It is actually how the procedure is done, but this is pretty consistent from providers who are talented versus those who lack skill and experience. Liposuction should be viewed as a permanent and irreversible procedure. I’m personally not a fan of Renuvion. Purchased the device several years ago and literally saw zero skin tightening in any of my patients. None of my patients appreciated any benefit from using the device. The only outcome from using Renuvion was increased pain during and after the procedure. I’ve since sold the device (at a significant financial loss) because I could not with good conscience recommend it to my patients. The thermal damage caused by this device can have serious implications for poor outcomes like your own. What is supposed to tighten the skin lead to firm scar tissue that potentially makes the results worse. Correcting poor Liposuction results is inherently very difficult. Treatment choices usually come down to revision Liposuction(removing more fat), fat transfer, a.k.a., fat grafting, or in some cases, converting the procedure to a skin tightening operation like a neck lift. recognize that while pulling the skin tight, it probably looks better but a neck lift does not inherently, correct uneven, fat distribution. Restoring the improperly removed fat with fat transfer will be technically difficult with poor fat graft survival. In order for fat grafting to be successful there generally needs to be a sufficient layer of “host tissue” to support the grafted fat. in your case, almost all the fact has been removed. This means that attempts of grafting fat to improve the outcome will lead to grafted fat surviving the least where you needed the most. This is why I say the correcting poorly done. Liposuction is technically very difficult. Usually only modest improvements are possible and this may take several procedures. It is also possible to make things worse in the hands of someone who doesn’t understand the problem or doesn’t have the skill and experience to do this kind of work. Delivering consistent quality, liposuction and fat transfer results is more difficult than most people realize. The number of plastic surgeons who mastered this procedure is pretty small. Most plastic surgeons think they’re better at Liposuction than they actually are. Your outcome is unfortunate but unfortunately, not rare. Find neither I provider to do revision work is more or less the same process I recommend for finding providers to do primary procedures. The biggest difference is when fat transfer is needed. Providers need to be vetted for both fat transfer, and Liposuction skills when corrections will include fat transfer. To find the right provider, I suggest patients start by making a list of providers focusing on providers who seem to have extensive experience with Liposuction or potentially liposuction and fat transfer in your area. Schedule in person consultation with each of those providers.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 have similar characteristics to your own. For Liposuction, this should be the same age, same anatomic area, same amount of subcutaneous fat Same degree of skin laxity, similar age and same gender. Being shown a handful of pre-selected images, representing the best results of a providers career may be insufficient to get a clear understanding of what average results look like in the hands of thus provider, what your results are likely to look like or how many of these procedures that provider has actually done. in my opinion, an experienced provider should have no difficulty showing you the before and after pictures of at least 50 previous patients. Patients should take ownership and an active role during the consultation process. In the end surgeons are responsible for surgical outcomes, and patients are responsible for provider selection. It is your job to vet the provider as if you’re hiring someone to do a job for you, which is exactly what you are doing. Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. Complete all scheduled consultations before considering selecting a provider. The two biggest mistakes I see patients make first scheduling only one consultation and then scheduling surgery. Having only one consultation, more or less eliminates the ability to choose a better provider. People are inherently not good at choosing plastic surgeons.People often use the wrong criteria for provider selection, believing that they can make solid decisions from the comfort of their home using their phones or computers. I’m not sure how you chose your provider, and I am making general statements here. I generally recommend people avoid virtual consultations, whenever possible, and always schedule in person consultations. The second biggest mistake patients make is assuming that being board-certified in plastic surgery with several years of experience, and overall good reviews means that somebody had mastered at most plastic surgery procedures. This is not true. Delivering consistent quality, liposuction results is much more difficult than most people realize. Most plastic surgeons think they’re much much better at Liposuction than they actually are. The number of providers mastered this procedure is fairly small. If there was a third variable, it would probably be to avoid relying on the providers selling you on some technology, as making them a better provider, which is generally never the case. I recognize you’ve already had the procedure. I recommend the same approach for finding providers to do revision work. Generally speaking, the best providers at doing revision work will be the same providers that do the best Primary procedures. The only difference is when fat transfer is needed. You need to vet providers for both Liposuction and fat, transfer skill. You should also not expect providers to have as many before, and after pictures of revision work, since revision work is not nearly as common. Whenever patients present with a complex situation, that has no definitive best option you should expect providers to have a variety of recommendations in regards to “best approach”. This is pretty normal when there is no single good treatment. In a nutshell the things to remember are that poorly done Liposuction is very very difficult to correct and only some improvements may be possible. The potential improvement from poorly done liposuction varies dramatically from one patient to another. Making an assessment for revision work is highly complex and requires an in person consultation. The second thing to remember is that provider selection is the most important variable and patients should focus all of their efforts on finding the best provider before even contemplating having surgery. When it comes to surgery skill it seems to me that there is an inverse correlation between skill and fame. Plastic surgeons who are the best at self promotion are generally not the best surgeons in the operating room. The best plastic surgeons are usually busy taking care of patients, and do not generally engage as much effort in self promotion. The most talented plastic surgeons typically don’t need to advertise. This is one of the reasons selecting providers, based on Google searches and reviews as well as technological means, often leads people to make poor decisions regarding provider choice. The impact of doing surgery on people is an incredible privilege and honor. People are reminded of the outcome every day for the rest of their life. I take the decision of operating on people very seriously. As I mature into the later part of my career, I become more and more selective regarding who I operate on. This is most likely not your providers first Liposuction case. After having invested in expensive technology that cost well over $100,000 they are most likely highly motivated to recoup their investment and will be promoting more Liposuction the best they can. I’m sure your provider had good intentions.Most surgeons do. They also are far down on the long steep learning curve of mastering Liposuction. You would’ve probably appreciated other patients, having written, honest and professional reviews about their own Liposuction experience with this provider. It may have led you to look elsewhere, and consider other options. For this reason, I always encourage people to write professional, honest reviews regarding their experience to help others make better informed decisions. Unfortunately, all too often people are intimidated and Are afraid of publicly displaying their experience especially when they still need follow up from the provider. I do think it’s a good idea to share your experience with others on review platforms. I’m a big fan of a brutal honesty. I think you should sit down and discuss your outcome with your provider in a professional and honest manner. You may want to bring someone with you for support. Plastic surgeons have usually learned to manage patients who are upset with their outcomes and may have an upper hand. It’s important to keep the conversation on the point, staying professional, and not get overly emotional. I think you’re in a good position to negotiate a refund or at least a partial refund for your surgical fee. You may need these funds to eventually get the care you need to restore your outcome. I do not believe your current provider is an appropriate choice for revision surgery. Best, Mats Hagstrom, MD