Can Lipo be done on the same area multiple times if many years have past between?

Question

I have had lipo on my calves 3x (different) over the past 15 years. My results have been very conservative each time. I questioned why this is and was recently told that I have lipedema on my calves. I am not overweight or unhealthy I just have 16 inch calves and I am only 5ft so this looks odd. I can still pinch at least a 1/2 of dense fat on my calves. Is liposuction an option again?

Thomas Wright, MD · Answer

The calves and ankles are under the greatest fluid pressure in your body.  The calves and ankle liposuction even one time is a bit more risky for complication than say the abdomen or flanks.  With each surgery, there is some scarring and the chance of incomplete healing. Additional surgeries can be done, but the risk is slightly higher each additional time. You should only consider this surgery with a surgeon who is very experienced with calf and ankle liposuction and experienced with lipedema.  Wishing you the best of health.

Alex Campbell, MD · Answer

Thanks for your question. Yes you can get liposuction done in the same areas that you treated previously as long as there is fat available. You definitely have to choose your surgeon correctly and make sure that he/she has the training and experience to meet your goals with absolute safety.  A key quality indicator is Board Certification by the American Board of Plastic Surgery.  Don’t settle for less than a Board Certified Plastic Surgeon with specialized expertise in this procedure.

Geuris Cruz Quiroz, MD · Answer

Thank you so much for sharing with us your question. 
A Liposuction surgery can be performed in the same area multiple times but only if the area has enough fat tissue. 
If your case and your records of past liposuction, a physical evaluation needs to be done in other to have the best recommendation to help you to get the results what are you looking for. 
Please contact a Board Certified Plastic Surgeon whom had performed this type of surgery numerous times.
Best of luck,
Dr. Quiroz!

Jason Emer, MD · Answer

you may need more liposuction and specifically with energy based devices and proper Lipedema liposuction.  you need an evaluation as sometimes this is skin that needs to be tightened along with the fat removal.  If there is fat there, liposuction can be performed.
You need a formal evaluation by an expert in body shaping and contouring to determine what is best.  Traditional liposuction awake and smart liposuction are old methods and do very poorly for tightening skin or significant skin tightening or contouring.  Small problem areas can be improved slightly by these methods.  The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heat the skin with radio-frequency devices such as J PLASMA/RENUVION, InMode BodyTite, ThermiRF to heat the under surface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HIDEF VASER contouring and can only be done by a well . trained body contouring specialist. At the same time fat should be harvested, PRP and stem cells added and injected into muscles or indentations/cellulite to get body shaping and contouring.  This is known as a Brazilian butt lift when you inject the fat to 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 cellfina, sculptra, 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 such as lower abdominal skin (tummy tuck/abdominoplasty), breast skin (breast lift), arm skin (brachioplasty).  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.  Dr. Emer.

Daniel Barrett, MD · Answer

Dear Leanne789,
as long as that area has enough fat tissue, liposuction revision might be an option. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Kenneth Hughes, MD · Answer

Provided that the area has an adequate fat content, then the same area can be liposuctioned again. A liposuction performed in the same area may be less likely to respond due to nature of scar deposition.  Another option might be computer controlled BodyTite.  A physical exam by a board certified plastic surgeon will be necessary to determine which procedure will be the best option.  
Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon
Los Angeles, CA

Boris Volshteyn, MD, MS · Answer

Yes, liposuction can be performed many years later. It can be done for various reasons, including change in hormones, change in shape, change in the amount of fatty tissue, etc. However, any secondary procedure in the same area is usually more challenging because the surgeon Hass to go through previously formed scar tissue.

Tania Medina de Garcia, MD · Answer

Hello dear!
Thanks for the question and provided information as well.
Yes, liposuction can be performed twice in the same area.
In general, you need to be physically healthy and at a stable weight, have realistic expectations, be a non-smoker and your BMI needs to be 30 or less.
I recommend you to make an appointment with a board certified plastic surgeon to talk about your goals and anything you need to know.
Good luck :)

Connie Hiers, MD, FACS · Answer

Liposuction of the lower leg can be tricky and can take quite some time for the swelling to subside. Since you have had that area treated 3 times with liposuction, I would recommend no more surgery in that area. You don't want to damage your venous or lymphatic system further. You might want to consider some skin tightening with radiofrequency.

Mats Hagstrom, MD (license on probation) · Answer

The correct way to assess if someone is accounted for secondary or tertiary liposuction it's by examining them and preferably review previous operative reports.  There are a lot of people who have sufficient amounts of fat left after a single liposuction procedure and could benefit for a second go round.  That said, people of had repeat liposuction almost always have an issue with skin laxity and much less fat than people believe.   One away to differentiate between skin laxative and subcutaneous fat is simply pull the skin up tight over the area you're concerned about and see if you get the contour you like.  If this is the case and the contour is correct when the skin is put under tension and you have at least a significant skin component to the problem of why you're not looking as good as you want. Multiple liposuction procedures also lead to the development of excess scar tissue . The best way and only accurate way is that an in person consultation with a local board-certified plastic surgeon who specializes or has a lot of experience with liposuction. Calves and ankles are probably the two technically most difficult areas to treat with liposuction.  Best, Mats Hagstrom MD

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