Lipo and breast aug nightmare. Can I be fixed? (Photo)

Question

Please help. I got breast Aug and lipo at the same time about four years ago. I feel permanently disfigured. I look 10000 times worse than before the surgery and I hate looking at myself. The surgeon claims it is my BODY TYPE that caused me to heal this way. Is that true? I have rippling, lumps and webbing all over my torso and back, and my left breast has a bubble under it. Everything is terrible. Can I be fixed? Should I ask this surgeon to correct it, and is he responsible for this result?

Kevin Dieffenbach, MD · Answer

Aloha Lily,
Sorry to hear about your bad experience and thanks for sharing your photos.
Returning to your original surgeon is generally the best option.
But getting a second opinion from an experienced Surgeon, Certified by The American Board Of Plastic Surgery[ ABPS] and a member of The American Society of Plastic Surgeons (ASPS), can be helpful.
Mahalo and Best Wishes,
Dr Dieffenbach

Gianfranco Frojo, MD · Answer

This is a very complicated problem/issue to fix completely. I would recommend revisionary breast surgery with likely downsizing the implant to a smaller size with support using Galaflex. The liposuction revision would need to be very carefully performed with appropriate technique and with the appropriate device. I would discuss with your surgeon your concerns and that you would like to discuss revisionary surgery.

Gerald Minniti, MD, FACS · Answer

With regards to your breast implants, the pockets are not properly developed and would need to be evaluated to determine the best plan to repair. As for your liposuction result, although there is some irregularities/asymmetries, the biggest defect appears to be a transverse line across the belly just above the level of your belly button. This is almost certainly due to improper/insufficient compression after the surgery; patient care after surgery, like management of garments, pads, and drains, have as big an impact on results as the surgery itself. Once again, an evaluation would determine the nature of the repair, but it would certainly involve revision liposuction. If you want it for free or low cost, then your original surgeon would have to do it. I would strongly consider not doing that as most of this could have been avoided.

Daniel Barrett, MD · Answer

Dear Lily Medina,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

I am sorry you are unhappy with your results. You did not post before photos, and your three photos are somewhat limited. An examination will tell if the bulge under the breast is implant or fat.  Liposuction can remove excess fat. You do appear to have now some loose skin which can be treated with radiofrequency skin tightening like ThermiTight or even with a tummy tuck. Once fat is removed, many will have still excess skin since no skin is removed with liposuction.  Any areas of excess fat can also be treated with liposuction.  Go back to your surgeon and discuss your concerns and options.

Mats Hagstrom, MD (license on probation) · Answer

To make an assessment on the outcome of a plastic surgery operation we need to see proper before and after pictures. if you don’t have your before and after pictures and ask your surgeon to forward the ones they took. if you had liposuction on anything other than just the front of your abdomen you need to include pictures of those areas as well. typically for abdominal liposuction we look at frontal pictures, side pictures and pictures from behind.Knowing what you looked like before the operation tells us what type of candidate you were to have Liposuction. there are two variables to determine with Liposuction results look like the first is the patient’s candidacy for the procedure and the second is the skill and experience of your surgeon.Delivering consistent quality Liposuction results is not as easy as most people think and this definitely includes plastic surgeons.A substantial number of board-certified plastic surgeons with overall good reputations are not particularly good at Liposuction. Some plastic surgeons don’t like doing the procedure and think it’s simple and basic and requires no skill. With that mindset this is what their results look like.The truth is being able to make accurate assessments with accurate predictions and deliver consistent quality results with this procedure requires a lifetime dedication to mastering this operation.The number of plastic surgeons who can consistently deliver quality results and know exactly who is going to get what outcomes is actually quite rare and patients interested in the procedure should be very careful and provider selection.I recommend patients choose providers only after proper vetting and having multiple in person consultations at which time you need to confirm with the skill and experience of each provider is.Do that by having each provider open their portfolio and show you their entire collection of before and after pictures.Providers may be apprehensive to do that and instead will want to show you at their preselected best of their career examples.This is however insufficient to get a clear understanding of what average results look like in the hands of each provider.For that reason you should ask providers to show as many pictures as they possibly can especially of patients who have similar body characteristics to your own.Before having consultations you should have a clear understanding of what quality a liposuction results look like and have a grading or writing system set up based on looking at lots of pictures of other people who had similar body characteristics to your own.Ideal candidates for liposuction can be described by the triad “young tight and pudgy”. The opposite is also true that older individuals or individuals who have skin laxity such as women with significant pregnancy related changes or history of weight loss typically don’t get good liposuction results.In your case your outcome is a direct reflection of how the procedure was done. If you were not a good candidate for liposuction your surgeon should’ve told you so during the consultation.Your surgeon is responsible for the outcome of the procedure and you are responsible for choosing that surgeon.Considering that provision Liposuction is many times more difficult then primary Liposuction your surgeon is not the right person to try to do any restorative work at this point.Liposuction is a permanent and more or less irreversible operation.There are definitely areas that can be improved upon on your body but once someone has had bad liposuction they’re never going to be restored back to pre-liposuction condition.Liposuction is very much one of those do it ones do it right type of things. you would think that’s the case for most plastic surgery procedures but things like breast implants can be removed in a way that Liposuction cannot be reversed.Treatment options for poorly done liposuction include revision liposuction, fat transfer, a combination and sometimes converting the procedure to a skin tightening operation like a tummy tuck. your abdomen has horizontal lines of your regularity which makes me think your surgeon may have attempted doing high definition or etching type Liposuction.If you’re going to get second opinion consultations then you should come prepared bringing with you proper before and after pictures and a copy of your operative report. Those are all available from your surgeons office upon request as they are part of your medical record.The process of finding a plastic surgeon for revision work is pretty much the same as primary Liposuction with one major difference. For primary Liposuction and experience provider should have no difficulty showing you at least 50 sets of before and after pictures. highly experienced surgeons full of hundreds or even thousands before and after pictures of commonly performed procedures.This is not going to be the case for revision work. Also secondary liposuction or revision work is going to be much more variable and it’s unlikely you’ll be able to find someone who has an impressive collection of before and after pictures of revision work on patients who look just like you.Instead you’re most likely have to base your decision on the surgeons ability to perform quality primary liposuction. revision work and primary Liposuction are related but we’re also based on slightly different skills. this is especially true if fat transfer is involved.During each consultation ask providers to show you examples of excellent outcomes, average outcomes and outcomes that didn’t turn out as well as they had hoped for. Ask each surgeon what the revision rate is and what the revision policy is.It is your surgeons responsibility to correct the outcome but if the provider doesn’t have the skills for the primary procedure tonight question if they are up for the task of doing the revision work.It’s also been four years and most plastic surgeons expect patients to bring up discontent about outcomes within the first year.You could potentially save some money if your surgeon is willing to do the original work but you already know what their skill level is.Almost all plastic surgeons do a liposuction on a fairly regular basis in conjunction with other procedures. It is still remarkable how much variation there is in liposuction results among plastic surgeons who have proper training with an overall good reputation.The truth is a substantial number of plastic surgeons don’t like doing Liposuction and see it as a simplistic procedure.If you want to move forward and get a proper second opinion consultation and those need to be done as in person consultations.Like I mentioned earlier you need to bring them before and after pictures in order for the surgeon to make a quality assessment.What you look like before explains a lot in regards to your outcome. Look for plastic surgeons who have disproportionately high numbers of Liposuction results on their websites and then start the process of vetting plastic surgeons.You’ll need to push providers to open up their portfolios and show you more than just their “show and tell” photo albums. Pay attention to how thorough each surgeon is during all aspects of the consultation. Talented providers tend to be detail oriented inside and outside the operating room.There’s no correct number of consultations patients need to find the right provider. I suggest for primary liposuction most patient start with at least five consultations and continue having more if they have any questions or concerns.Considering the revision work is more complicated and more difficult it may take substantially more consultations to find the right provider.The process is time consuming but patience learn how to become better advocates for themselves and learn to vent plastic surgeons better by practicing having lots of consultations.Most people are not skilled or experienced at how to consult with a plastic surgeon.Until you feel very comfortable you found a surgeon who can definitely improve your outcome you should probably slow down and just continue scheduling consultations.It may be worthwhile to recognize that taken care of other providers unhappy patients is not perhaps the favorite part of plastic surgeons work. patients who’ve been disfigured or had bad outcomes from other providers tend to consume a substantial amount of time and often don’t become paying customers.For that reason some providers may be apprehensive to want to take on your case. Best,Mats Hagstrom MD

Lipo and breast aug nightmare. Can I be fixed? (Photo)

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