10 months post-op - What can be done to smooth out all the lumps? (Photo)

Question

I am 10 month post laser lipo. What can be done to smooth out all the lumps?

Daniel Barrett, MD · Answer

Dear Taw021,
I would have to examine you but it appears that this is a contour irregularity after liposuction. This happens often when areas the undergo liposuction are not feathered appropriately.
The good news is that it can be fixed and I have done so with good results before. While there is always a chance for contour irregularities with liposuction, someone who takes their time and uses the appropriate sized cannulas should give you a superb result.I have all my patients wear compression garments and I use multiple sized cannulas to feather out the result.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Dean P. Kane, MD, FACS · Answer

Dear Taw021, 
Thanks for sharing your photo. You appear to have received a very good lipocontouring reduction with some mild residual irregularity. The fat cells are enclosed in smaller and medium and larger fibrous compartments. With the use of tumescent fluid infiltration, the ability to visualize all these compartments becomes compromised. I have also found while laser liposuction is more efficient, concern regarding burn injury to skin or nerves may make the user less vigorous. Superficial fat liporeduction is also associated with residual irregularity as well. Having said this, your overall contour is very good! 
To improve residual thin liposuction irregularities, consider a practitioner with experience using the flat applicator of CoolSculpting. While less efficient than the curved applicators, it will more evenly cool and reduce the more superficial and residual fat bundles.. 
I hope this helps.

Mats Hagstrom, MD (license on probation) · Answer

Liposuction is a permanent and irreversible procedure.
Delivering consistent quality liposuction results is more difficult than most people believe and this includes plastic surgeons.
Poor results are very difficult to improve upon especially if the treatment was aggressive.
There is really no one single treatment to even out the results other than attempted revision liposuction or fat transfer.
Neither one of these options are going to give great improvements. Whether it’s worth having revision surgery depends on how much the condition bothers you, what you’re willing to go through and your ability to find a surgeon with enough skills and experience to not make things worse but actually improve the outcome.
Doing quality liposuction alone is difficult enough. Consider that revision work is technically much more difficult than primary Liposuction the importance of finding the most talented provider speaks for itself.
Anyone who claims results can be improved easily or that some technology or energy-based device such as VASER will make things better should be avoided.
Best,
Mats Hagstrom MD

Kristine Brecht, MD (license suspended) · Answer

Dear Taw,
Thank you for sharing your story.
It appears your surgeon over liposuctioned in some areas and not enough in others.
This is tricky to correct because you risk making things worse in a post overliposuctioned area.
Vaser ultrasound liposculpting taking care to address smoothing and not debulking may give improvement. This should be done by an experienced liposculpting surgeon.
Best. DrBrecht 
Seattle, Wa

Randy Dean, MD - Account Suspended · Answer

Hi and welcome to our forum!
Irregularities at the skin surface after liposuction may be caused by localized areas of residual inflammation (which may last for 12-18 months), residual fat, lax skin, or overly aggressive liposuction.
Various modalities of treatment are available to treat lumpiness, including massage therapy, radiofrequency and ultrasound therapy, and laser skin tightening. Injectable Kybella (deoxycholic acid) is moderately effective as well. 
Discuss this issue with your plastic surgeon.
Best wishes...

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