Lipo 360/arms/thighs/J Plasma. What should I get done? Should I get a BBL? Or is this foundation just bad already? (Photo)

Question

Looking to get lipo 360/arm/inner thighs. Had a BBL a few years ago & dr did a bad job overall. Now I am left with this! Wish I did more research. I love my body but it could use improvements. I'm also usually more fit but this pandemic messed me up. Anyways, I'm thinking of getting a round 2 BBL but more so for the shape and not the size. Will that be possible? Am I a good candidate for lipo 360, arms, thighs? What would you recommend for me to get done? Attached wish pics as well-Is it doable?

Emmanuel Mallol Cotes, MD · Answer

Thanks for the question.

In this regard, I recommend you waist and back Liposculpture, getting better curves especially in the waist, improving your body contour.

Kind regards

Daniel Barrett, MD · Answer

Dear superdupercool,
based on your photos, you look like a good candidate for a BBL. Liposuction of your abdomen, back and flanks should give you more curves and hourglass shape and fat transfer to buttocks should give you more projection. I would suggest you to consult a board-certified plastic surgeon because 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

Jason Emer, MD · Answer

if you have loose skin you may need it removed but revision liposuction with internal heating will help.

my whole practice is doing lipoabdominoplasty, or at least liposuction with internal heating (which is not the gold standard for skin tightening with body contouring).

the smaller you are before liposuction the more contouring you can get from the procedure. most of my liposuction patients get pre and post surgical optimization with hormonal therapy (see link to help boost their weight loss before surgery and help them heal after).

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.

Johnson C. Lee, MD · Answer

You can get a revision BBL with 360 lipo including your arms and thighs as well as J plasma. It is best to have an in-office evaluation to determine how much fat you still have. Some of the bulk that you still have may be residual scar tissue from your initial surgery so it does not necessarily mean you have a lot of fat to use. You can still improve your shape though with a second round. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon

Johnson C. Lee, MD
Board-Certified Plastic Surgeon

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and photos and I would go on some complimentary consultations with experts and compare recommendations after a full examination and discussion of desired results. That said you can certainly benefit from liposuction to the desired area but your ultimate result may be different from your ideal result

Dr Corbin

Dr Corbin

Mats Hagstrom, MD (license on probation) · Answer

You can certainly have A secondary BBL’s. You didn’t describe what you don’t like about your bottom. Fat transfer is primarily going to add volume and it’s less effective in changing shape than people think. Your wish pictures are not realistic.

Secondary procedures are far more difficult than primary procedures especially if the first procedure was done in an irregular uneven uneven fashion.

I suggest you follow up with your provider or have a few new in person consultations.

From first-hand experience I found J plasma added nothing other than pain to my patients recovery and I have since sold that worthless equipment.

Best,

Mats Hagstrom MD

Robert A. Hardesty, MD, FACS - Account Suspended · Answer

Dear Ms. Superdupercool,

Thank you for your story, photos and questions. Unfortunately with out a exam of your tissues I can can only make general comments. I hope find the following helpful.

It appears you have asymmetry of buttock size and shape. 
To obtain a more sharply buttock You will require both liposculpture and precise lipoinjection. Yes you will benefit from liposuction of arms and thighs.

Secondary/revisional surgery is always more difficult and less predictable because of previous surgery and scar tissue.

The amount of fat that takes depends: 1) the gentle technique of harvest providing the least amount of damage/trauma to the fat cells 2) how the fat is injected 3) the receipent area (good blood supply, lack of previous scars, etc.) 4) postoperative care 5) genetics of the individual

The process for performing a fat injections the same regardless of the patients weight or fat location: 1) harvest the fat  2) purify the fat 3) sculpting the buttock:    a) with precise liposculpting     b) with precise fat injection

The final shape of the area of fat injection  depends on: 1) your underlying boney pelvic frame  2) the shape of your muscular anatomy 3) the elasticity (stretchability) of the skin  4) the patients desired shape (where fat is injected)

The bottom line:  1) fat survival as a graft is multifactoral but usually varies between 70-80%. 2) the fat that doesn't survive is broken down, dissolves and is excreted by our body 3) the amount injected fat depends on how much fat there is available to harvgest. 4) the individuals genetic anatomy and elastic properties of the skin will dictate  and limit attaining certain desired shapes 5) Just importantly the liposuction should be done to "sculpt" other parts of the body to attain a body that is in proportion and attractive. Thus a small amount of fat can go along way or in contrast a large amount may not give you the desird appearance.
I suggest you collect multiple model photos of your desired abdominal shape and schedule several appointments with experienced Plastic Surgeons who are Certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).
 
My best wishes,

R. A. Hardesty, MD, FACS Diplomate and Certified by the Am. Bd. of Plastic Surgery Awardee: RealSelf Top 100 wwwimagineplasticsurgery.com 4646 Brockton Ave Riverside, Ca 92506 
(951) 686-7600

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