Thick, firm, orange peel like skin after lipo 360 - What are my options in terms of revision? (photos)

Dear PeacefulSoul1,
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

Pending a formal evaluation, you may be a good candidate for a Revision Liposuction. You need a formal evaluation by an expert in body shaping and contouring to determine what is best.

The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heats the skin with radiofrequency devices such as Renuvion (J-Plasma), InMode BodyTite, and ThermiRF to heat the undersurface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HI-DEF VASER Liposuction and can only be done by a well-trained body contouring specialist. At the same time, fat should be harvested and purified, with PRP and stem cells added, and then injected into muscles, indentations and cellulite to get body shaping and contouring. For a Brazilian butt lift (BBL), we inject the fat into the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face. Cellulite should also be treated with a combination of QWO or Cellfina, subcision, and/or fillers such as Bellafill, Renuva synthetic fat, or Sculptra. If skin is very loose before surgery, then it will need to be removed: tummy tuck/abdominoplasty for lower abdominal skin; breast lift for excess breast skin; and/or a brachioplasty for loose arm skin. Overall, you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting. See an expert. Best, Dr. Emer.

If you still have fluid (seroma) present, then draining it and injecting a steroid (Kenalog) may help. The peau d'orange (orange peel) is not uncommon on larger patients or those who have lost significant weight or had children post liposuction. It does resolve somewhat over time, but you may be left with some skin wrinkling due to the excess skin. Options are:
1. Do nothing
2. Try non invasive micro-needling and radio frequency treatments (like Morpheus 8)
3. Excision of the skin (tummy tuck, but you do not look like you have that much excess skin).
Best wishes.
Dr. Taranow

Hello,
A board certified/eligible plastic surgeon who specializes in body contouring procedure would need to examine you to determine the best treatment plan for your concerns. If you have not already, bring these concerns up with the surgeon who performed you operation, so they can help you determine what options would be best for you. You can also ask for your operative report as well as treatment notes and bring them with you to another surgeon to get a second opinion. A surgeon would need to do a careful exam and possibly some imaging to see why you are developing a bulge. A bulge should be examined by a board certified/eligible plastic surgeon to confirm that it is only scar tissue. Surgeons often ask for patients to wait 1 year prior to any revisions to confirm that all the inflammation has healed and that the tissues have had a chance to remodel. Skin and scars can improve during that time. If there is skin laxity or problematic scar tissue sometimes liposuction patients benefit from revision of the liposuction with possibly fat grafting or conversion to a tummy tuck.

Only a skin only full TT can improve the abdominal skin effect seen in the 1 posted photo. Seek i person or virtual consultations. Fees from $8,000...

There are contour irregularities and poor skin texture following your liposuction procedure. It is possible to resolve this using high definition vaser liposuction and possibly a skin tuck, depending on the amount of skin redundancy and skin texture quality. The definitive correction for liposuction deformities requires the advanced technology of ultrasound assisted VASER liposuction. As an official trainer of VASER liposuction, I encounter suboptimal liposuction outcome referrals weekly. VASER liposuction has been the only modality that has consistently corrected liposuction caused deformities. VASER liposuction ensures a smooth contour regardless of severity of contour irregularities by virtue of being able to remove any and all remaining fat comprehensively and uniformly. Finally, when skin redundancy irregularities are observed, Renuvion technology can be simultaneously applied to tighten your skin to optimize your overall contour outcome. A Skype or FaceTime consultation with a VASER specialist will help you get an accurate recommendation and pricing.

Respectfully,
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

You’re outcome is a direct reflection of how the procedure was performed. It’s going to be difficult to reverse or correct the outcome went to much fat has been removed. Your best option is to cut out the skin from the lower abdomen by converting this to a full tummy tuck.

There are no other good solutions for getting a normal looking lower abdomen.

Delivering consistent high-quality liposuction and fat transfer results is more difficult than most people believe. I cannot emphasize enough the importance of properly vetting plastic surgeons before having these procedures.

Best,

Mats Hagstrom MD