To make an assessment on the outcome of a procedure we need to see proper before and after pictures. If you don’t have before pictures then ask your sergeant to forward the ones they took. To make an accurate assessment will require an examination. The contour of the inner thigh it is tricky. The contour changes from fat removal does not always correlate with what people had anticipated for patients and surgeons. The area typically has a significant amount of skin laxity and gravity together with skin laxity causes they are yet to bulge and this is true even when fat has been removed Revision work is many times more difficult than primary Liposuction. Considering that inner thigh liposuction is technically difficult both in regards to making assessments in regards to what can be achieved and technically doing the procedure. It’s hard enough taking an even smooth fat distribution, reducing it and leaving it even. taking an uneven fat distribution and making it even is very difficult in relationship to primary Liposuction.Considering the revision work is technically far more difficult than doing primary liposuction and add to that and anatomic area that is technically challenging to start with and you have a situation that is not necessarily easy or straightforward to improve upon. I’m sure your outcome can be improved but I will tell you and you should understand that an attempt at improving this can easily make it worse unless you’re in the hands of someone who is truly a master of Liposuction. Fat transfer may or may not be part of the equation. It’s generally easier to avoid fat transfer if they are you can be improved by just doing revision Liposuction. In order for fat graft to be successful there needs to be sufficient host tissue to support the graft. areas that I’ve been previously over treated typically lack sufficient post tissue lowering fat graft survival. The success of grafting fat to correct Liposuction mistakes is very case dependent. The ability to assess who grafting fat will work well on and what the procedure can produce requires real skills and experience. The following is a list of recommendations for people seeking the right provider for Liposuction. The process is more or less the same for revision work with the exception that providers should not be expected to have as many before and after pictures of the revision work as they do for primary Liposuction. In addition, if you need fat transfer and you need to vent providers for both Liposuction and fat transfer skill and experience. The need to be selective is it at most importance for someone needing revision work. Far more so than those seeking primary procedures. Here’s the process I recommend patient take. Start by getting pictures of your body the same way plastic surgeons take before and after pictures. Have someone else take the pictures or use the timer on your camera. pictures should be taken from about six or 8 feet away. Don’t take pictures using a mirror. Pictures should be taken with the camera at the same height of what’s being photographed. For the abdomen the camera should be at the height of the abdomen. for the thighs the camera should be at the height of the thighs. Quality pictures require showing your body. Wear loose revealing undergarments that don’t press into your skin. Take pictures of your front, side and back side standing in a neutral position with your arms down by your side. Print copies of these pictures. Whenever reviewing before and after pictures whether you’re doing it at home or during a consultation always have your own pictures by your side for a comparison. Understanding candidacy is key and understanding with the procedure can or cannot accomplish. When reviewing results look for patients who have similar body characteristics to your own in the before pictures. If they have different characteristics then what you look like and those results don’t apply to you. Make a list of all the local board-certified plastic surgeons in your community. Go to each providers website and document the quantity and quality of Liposuction before and after pictures posted on their website. take a peek at other procedures like tummy tucks etc. for reference. if someone has 25 sets of before and after pictures of the tummy tucks but only has two pictures of Liposuction results and that is probably not The right provider. This will give you a general idea if providers like doing Liposuction, do a lot of liposuction and get enough quality results to post them on their websites. next choose five of those providers and schedule in person consultations. There’s no correct number of consultation someone needs to find the best provider but the more consultations you have the better you’ll get at doing consultations including the ability to properly vet plastic surgeons and the higher your chance of finding the best provider. Considering that a substantial number of plastic surgeons simply aren’t good at Liposuction and the number of providers who are excellent at this procedure is rare you definitely need to have multiple consultations. Personally I do not believe it’s possible to find the right provider using a computer or by having a virtual consultations. Virtual consultations are better than no consultation but in my opinion in person consultations are needed to get a quality assessment and to properly vet the provider. Take careful notes during each consultation. become familiar with what quality liposuction results look like on people who have bodies similar to your own. Create a rating system for Liposuction results. Recognize that most pictures available on the Internet either represent some of the best results because that’s what the providers usually put out on their website or disastrous results from patients who are seeking help. most average liposuction results don’t end up as pictures on the Internet. During each consultation ask each provider to open up their portfolio and show you their entire collection of before and after pictures. Bring printed copies of your own pictures of yourself. Ask providers to show you examples of excellent outcomes, average outcomes and outcomes that didn’t turn out as well as they had hoped. Ask providers to only show you pictures of previous patients who had similar body characteristics to your own. Again, there’s no point at seeing quality results and somebody who had a different candidacy for the procedure than you do. Providers may be apprehensive to do this and will generally prefer to show you preselected images representing the best results of their career. Why this baby more impressive to look at it does not represent average results and it is in your interest to find out what the average results look like and to get a clear understanding of how many of these procedures each provider has actually performed. For reference an experienced plastic surgeon and should have no difficulty showing you at least 50 set of before and after pictures of commonly performed procedures like liposuction. highly experienced surgeons will in fact have hundreds or even thousands of before and after pictures of commonly performed procedures. Obviously there are those who are earlier in their career. Personally I recommend staying with skilled and experienced providers. When reviewing before and after pictures look very closely at all areas treated with Liposuction. Make sure there are no skin contour irregularities in any of the treated areas. ask the provider to point out exactly what areas were treated with Liposuction and what areas were not treated. then look carefully at transition zones between treated and untreated areas.In regards to Liposuction of the abdomen I view the torso as a single anatomic unit and generally prefer to treat the entire torso as a single unit. By treating the entire torso as a single anatomic unit patients are left without transition zones between treated and untreated areas. The concept of treating the torso as a single unit without transition zones is less important and low BMI patients. and chubby people with over an inch of subcutaneous fat the impact of liposuction is dramatic enough that it’s not possible to have a natural transition zone between treated and untreated areas even if the procedure is done well. most people simply get a better result if the entire torso is treated uniformly. A full torso includes upper abdomen, lower abdomen, love handles (all the way down to the top of the hip dip), waist, fall back, under arm (arm pit )all the way to the side of the breast. You should also take careful notes about the overall thoroughness of the consultation including all aspects of a complete consultation like review of medical history, physical examination, assessment, recommendation of procedures, alternative procedures, risks and benefits, complications including what complications a surgeon is had and how they are managed, preparation for surgery, instructions for recovery, revision rates and revision policy etc. Take careful notes about both the quantity and quality of before and after pictures any of the provider showed sufficient number of pictures of previous patient that look very similar to what you look like. Most people don’t have a lot of experience consulting with plastic surgeons. On the other hand plastic surgeons typically have lots of experience giving consultations. Recognize that you are the one paying for the procedure and you are hiring someone to do a service for you. You have all the right in the world to ask for documentation including seeing a variety of results including results that were less than what the provider read hoped for. If providers fail to cooperate then simply make a note of that and continue to the next provider. I think you’ll find that the most talented and experience providers will be the most open minded in regards to showing you a variety of results and being truthful about what the procedure can and cannot accomplish in their hands. Assessing patience for Liposuction candidacy is not easy or straightforward. Even mild skin laxity can contribute significantly to contour and some areas simply don’t respond to Liposuction because of how the skin drapes especially in certain anatomic positions. Lower extremity liposuction is technically difficult and often does not deliver the results patients had hoped for. True saddlebags can respond well but other areas like the upper inner thigh Typically does not give the results patience and hope for and it’s prone to having contour irregularities if the procedure is not done with technical expertise. If you have any doubts then simply slow down and schedule more consultations. Nobody has to have liposuction. Based on your description of yourself a question if the procedure is indicated in the first place. Recognize that if provider selection is not done well the procedure can leave you permanently disfigured. Good luck, Mats Hagstrom MD