Crease after botched lipo - how can this be fixed? (Photos)

Question

I surgeon that I previously trusted performed a botched lipo procedure under the gluteal fold and across my outer thigh. He ended up creating a a sagging, crooked, deformed looking crease, and a sagging cheek, and a groove on the outside of my outer thigh. (Note: I had not asked for this, we hadn't discussed it, I hadn't consented to it, and he was board certified, so I don't know what in the world he was thinking). I'm desperately trying to find a procedure that will fix this, but so far not having much luck.

Ryan A. Stanton, MD · Answer

Allow me to answer your question as best i can based upon your photos. However, please keep in mind that an in-person, or at least a virtual, consultation with physical exam is first necessary before any legitimate evaluation or final surgical recommendations can be made.

Buttock “sagging”, a “crease”, and/or loose skin is usually a combination of loss of volume or deflation (after weight loss, liposuction, or post-BBL) and/or the effect of aging and gravity. So,  I personally first treat patients like you by restoring volume to the buttock with a buttock implant. This will create a more desirable smooth and rounded perky buttock profile. If not adding volume with an implant, the buttock will most certainly always appear more flat if just a buttock lift from above is performed. On the other hand, an “autologous buttock lift” usually provides very little volume and projection, and almost nothing to the lower 2/3rds of the buttock.

A lower buttock tuck is usually then performed at six months following implants. Coincidentally, a lower buttock tuck also doubles as a thigh lift, removing loose wrinkled skin from this area as well. In this sequence, the implants have fully settled into final position so that any remaining loose skin can be most accurately identified and removed with the lower buttock tuck.

Any “non-surgical” treatment or device as well as exercise, unfortunately, will have little to no effect on this problem area. Furthermore, fat transfer and “fillers” perform very poorly in this area and usually result in just a waste of hard earned money.

Please note, because an extremely few number of board certified plastic surgeons specialize in buttock implants or lower buttock tucks, you may have to travel away from your local area to seek consultation with this particular type of surgeon.  Getting it done right the first time around is not only the best chance for success, but also will save you from a lot of headaches and money in the future. Glad to help.

Gary M. Horndeski, MD · Answer

As others have stated, this is a very difficult thing to correct. One thing to consider is, take your hands and pull upward and if this improves the appearance then it is possible that a thigh lift could help the appearance. This is probably the most easiest and most reliable thing that would be effective. At the same time, a liposuction cannula can be used to pass through the scar area to break it up, not to provide suction, just break up the scar from the previous liposuction.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

George Marosan, MD · Answer

Thank you for your question and photos. This is the result of a poor liposuction technique not recognizing or respecting the normal anatomy. This is difficult to correct and will require more than one procedure. If you were my patient, I would do the GoldIncision procedure first to release the scars and use biostimulators. This is my approach to cellulite treatment of the buttocks and thighs, including this deep scar. This is done awake under local anesthesia only. Once healed, you would need fat grafting to the buttocks to reshape them into a more feminine silhouette. Fat grafting this area without the cellulite and scar release will not be successful and can aggravate your deformity. Good luck.

Mats Hagstrom, MD (license on probation) · Answer

To make it quality assessment regarding the outcome of any plastic surgery procedure we generally need to see a complete set of proper before and after pictures.
If you don’t have before, and after pictures, then contact your surgeon and ask them to forward all the pictures they took.
 To correct the indentation created is going to be difficult.
Restoring the volume with that transfer may be insufficient because of contractile scar tissue.
It may be possible to improve it to some degree but complete resolution would most likely require a combination of procedures and may also require some follow up touchup procedures.
 To get a good assessment, you’ll need an in person consultation.
Because this is not an easy situation to correct expect many different providers to have different opinions.
I don’t think you’re gonna get quality information by posting on the Internet.
Instead, you should rely on in person consultations, and it may require meeting quite a few plastic surgeons before Finding the right provider to be working with.
Ask plastic surgeons to show you lots of before, and after pictures of previous patients who had similar conditions for whatever treatment the provider recommends. 
I’m sorry you find yourself in this situation.
It is unfortunate.
Best,
Mats Hagstrom MD

Crease after botched lipo - how can this be fixed? (Photos)

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