Botched thigh liposuction (3 years po) - what do you recommend?

Question

I have lipo 3 years ago on my outer and inner thighs. My outer thighs have clear deformities and the inner thighs were left with strange waviness. I have been recommended to go for vaser to try and melt the fat + bodytite/morpheus. Have you seen cases like this before? Can this be fixed?

J. Timothy Katzen, MD, FACS · Answer

Hi illustrativeb,

Thank you for your question regarding the possibility of fixing your botched liposuction, and for providing your history and pictures. Since you are only three months post-surgery, I recommend waiting another three months before making any decisions. If your condition does not improve after this period, revision liposuction should be considered.

For revision liposuction, using a VASER along with a specialized cannula can be effective in breaking up any scar tissue or fibrosis. Most plastic surgeons would advise against doing a revision only three months post-surgery. It is generally recommended to wait a full six months or longer before considering any revision.

It's important to note that the issues you're experiencing, such as seromas, skin rippling, and asymmetries, are known potential complications of liposuction and can occur with any patient and surgeon. These complications are not necessarily reflective of your surgeon's skills. Seromas, in particular, are a recognized complication associated with liposuction.

Therefore, rather than attributing these issues solely to your surgeon's performance, I suggest continuing to work with your chosen plastic surgeon to achieve the results you desire, even if it means undergoing another surgical revision. Good luck and I hope this provides clarity on whether your “botched” lipo can be addressed effectively with further intervention.

Sincerely, Dr. Katzen

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

David Hansen, MD · Answer

Liposuction under local with the micro canulas really can fix most irregularities nicely and easily since the patient can be stood up to fine tune the results right then and there.  Also Morpheus and bodytiteRF will  help tighten up the skin nicely.

Camille Cash, MD · Answer

BodyTite and Morpheus8 treatments may give you improved contours.  BodyTite is minimally invasive and uses RF energy to melt underlying fat and tighten skin.  Morpheus8 can then be used to improve overall skin tone and texture.  I've included a video I hope you find helpful.

Kenneth R. Francis, MD, FACS · Answer

Dear plau,
It is unfortunate that you have experienced the MOST common risk of liposuction surgery, contour deformities.  Newer technologies such as ultrasonic and laser liposuction have decreased those risks, but still they remain a possibility.  For this reason choosing the right candidate for liposuction is essential for the surgeon and choosing an American Board of Plastic Surgery board certified plastic surgeon is essential for the patient.  Laser, or ultrasonic liposuction may help to improve your current deformities and the addition of radiofrequency skin tightening may add to the improvement depending on your skin quality.  Good luck!

Mats Hagstrom, MD (license on probation) · Answer

To make an accurate assessment regarding the outcome of a plastic surgery procedure we always need to see a complete set of proper before and after pictures. If you don’t have before and after pictures and ask your surgeon to forward the pictures they took. Delivering consistent quality, liposuction, results is more difficult than most people realize. The number of plastic surgeons who truly mastered this procedure or in a small minority. On top of this lower extremity liposuction is technically more difficult, and the number of patients who are truly excellent candidate for this procedure is not that high. 
Liposuction results should be seen as permanent and irreversible. Correct and poorly done. Liposuction is extremely difficult and sometimes not possible. Revision work is many times more difficult than primary Liposuction, and should not be attempted by anyone who does not have an absolutely rocksolid proven track record with both Primary and Liposuction of this area and with doing Revision Work. 
Your results very easily made much worse with any attempt at revision.
Improving poorly done. Liposuction is generally done with Revision, Liposuction, fat, transfer, or a combination of both.
Sometimes improvements can be had by converting the procedure to a skin tightening operation like converting poorly done liposuction of the lower abdomen to a tummy tuck.
I would be extremely cautious about letting someone try to improve this with only doing more Liposuction.
Anyone who tells you this is easy to fix or that some technology is what is required to improve the outcome it’s probably more likely to make things worse.
If you have any doubts about the skill of the provider, offering the revision that I suggest it’s safer to wait.
Corrective poorly done Liposuction is one of the most difficult things to do in plastic surgery. This should only be attempted by those who is truly mastered this procedure.
Being board-certified in plastic surgery, with years of experience, and an overall good reputation, does not mean that somebody has mastered anyone single procedure, especially not Liposuction, and especially, especially not Liposuction Revision Work. 
The learning curve for mastering this type of work is long and steep. 
The following are some general guidelines for finding the right provider. These should be true whether you’re looking for someone to do Primary Liposuction or Revision work. . With Revision Work, you need to vet providers for not only liposuction skill but also for fat transfer skills.
Some improvements may be possible. Significant improvement may require multiple procedures. Any attempt at making this better can easily make things worse.
Here are some recommendations to find the best provider.
To find the best provider, I suggest patient schedule multiple in person consultations with experienced plastic surgeons in their community. 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 body or facial characteristics to your own. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. An experienced provider should in fact have hundreds or preferably thousands of before and after pictures to choose from for commonly performed procedures. 
Being shown a handful of preselected images, representing the best results of a provider’s career is insufficient to get a clear understanding of what average results will look like in the hands of each provider.
There is no correct number of consultations needed to find the best provider. The more consultations you scheduled the more likely you are to find the best provider for your needs. 
Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. It’s not a bad idea to bring pictures of your own body/face to use as reference when reviewing before and after pictures. 
The biggest mistake patients make is scheduling only one consultation without properly vetting or comparing providers before scheduling surgery.
Best,
Mats Hagstrom, MD

Botched thigh liposuction (3 years po) - what do you recommend?

Answers (6)

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