Which liposuction method is best for revision lipo?

Hello!
Liposuction with added energy is best for revisions. This includes Power Assisted Lipo (PAL) and Ultrasound Assisted Lipo (UAL). These technologies work differently but both provide optimized scar tissue navigation and contour.
Be sure to consult with a board certified plastic surgeon. You can find one at plasticsurgery.org.
Best of luck to you!

Although Vaser can be used for revision liposuction, most of my colleagues still use the tenants of SAFElipo (an acronym: Separation/Aspiration/Fat Equalization, SAFE) to manage irregularities and create a smoother result. Specifically speaking, an expanded basket canula is used in the Separation phase to break up the scar tissue, usually after Vaser energy is applied. Also, fat grafts may be necessary to address excessive resections; these grafts are introduced into the region and then 'pushed around' to distribute them (Fat Equalization). It is my opinion that Vaser does very little to help, which is seconded by many that achieve a great result without Vaser. Keep in mind one important thing: there is no modality that achieves true skin tightening.

Dear Sacramento4651,it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you 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

Most revision liposuction is to remove excess fat. The Vaser portion is to tighten skin. If you only have excess fat and your skin is still fairly tight, then liposuction is all you need. An examination can tell what would be best for you.

It is more the experience in doing lipo revisions than the lipo technology used. Though, personally, I prefer traditional canulae small caliber over Vaser heat energy generating lipo. The Vaser has high rates of fibrosis and internal burns.

Despite claims made by people promoting their practices there is actually very little difference among different brands of Liposuction Equipment.
All of them rely on more or less the same thin stainless steel cannula connected to a source of vacuum. that part is true for all forms of liposuction.
Their major differences evolved around a secondary pre-or post treatment using either an ultrasound probe, a laser probe or with power assisted Liposuction the cannula actually vibrating.
The question really is does the ultrasound probe treatment make a difference in liposuction outcomes.
VASER is traditional liposuction with a secondary ad on treatment with this proprietary ultrasound probe.
The use of ultrasound before liposuction can help providers remove more fat in the last time.
That is the biggest advantage.
It doesn’t allow more fat to be removed and it doesn’t make results better or worse. It simply speeds up the process which some surgeons find very appealing.
The added energy from the ultrasound probe increases potential complication rates and the device in the hands of providers lacking skill and experience can lead to worse deformation‘s than if the treatment was done without the ultrasound.Ultrasound assistance also increases complication rates.
Whether results are improved or not is purely subjective and no one has ever proven that either ultrasound or laser makes results better.
Since there is in the end very little difference between the different modalities of liposuction I recommend patients not focus on choosing equipment but instead focus all of their energy exclusively on finding the right provider.
Delivering consistent quality liposuction results is in the end based on only two variables. The first is patient candidacy and the second is the skill and experience of the provider.
There isn’t much patience can do regarding their own candidacy for the procedure. Those who are overweight can attempt to lose weight but otherwise candidacy is a bit predetermined.
Liposuction as a procedure has more variation in outcomes purely based on who does the operation than any other plastic surgery procedure I’ve ever seen.
It is a remarkable variation and the truth is that there are a substantial number of board-certified plastic surgeons with overall good reputations who are not particularly good at Liposuction.
Secondary liposuction or revision work is generally more difficult and complicated than primary liposuction. Secondary procedures typically deliver very little improvement compared to a primary procedure.
Revision work needs to be further broken down into what the problem actually represents. revision work can be done because insufficient amounts of fat were removed. More commonly the problem is that the fat was removed lacking skill leaving the patient with an uneven fat distribution. Starting with an uneven fat distribution and making it even is very very difficult. it’s hard enough to start with a normal fat distribution do Liposuction and create an even fat distribution.
Starting with an uneven fat distribution and creating an even one is almost impossible.
The more aggressive the first procedure was the worse the chance of improvement with secondary liposuction.
For cases where the primary procedure was excessively aggressive fat transfer can sometimes improve the outcome and sometimes converting the procedure to a skin tightening operation is appropriate as well. This could be the case for someone with a dominant skin laxity who had a bad liposuction result on their lower abdomen. In such cases converting the procedure to a full tummy tuck may be the best option.
Without seeing pictures we can’t make an assessment. It doesn’t matter what equipment the provider is using. What matters is finding the right provider.
I mentioned earlier that there are substantial numbers of well-trained providers who lacks efficient skills to deliver consistent quality Liposuction results.
I mentioned earlier that there are substantial numbers of well-trained providers who lacks efficient skills to deliver consistent quality Liposuction results.
Liposuction is kind of a unique procedure and that the fundamental concept of inserting a cannula and removing fat is so simple that the procedure is often seen as something that doesn’t even require learning.
The truth is that deliver in consistent quality liposuction results is one of the most difficult procedures a plastic surgeon can perform.
Simply removing fat and simplistic but making the patient look better predictively and consistently is another story.
To be able to deliver consistent quality liposuction results requires a complete dedication to mastering this procedure and doing thousands of cases.
The learning curve is far steeper and far higher than most providers ever realize.
I have a unique perspective on Liposuction because I chose to specialize exclusively in this procedure halfway through my career.
I spent the first 10 years as a board-certified plastic surgeon doing general plastic surgery.
That included some form of liposuction on a at least weekly basis if not almost daily.
12 years ago I decided to stop performing all other plastic surgery procedures and focus instead exclusively undoing only liposuction and fat transfer.
The day I removed all other procedures from my website the telephone stopped ringing for anything except liposuction and fat transfer.
I have since performed over 8000 liposuction and fat transfer procedures. that is more Liposuction than most providers will ever do in a lifetime.
When you do some thing consistently on a regular basis with the intention of getting better you start seeing patterns that were not obvious earlier.
These are the nuances that allow some to excel and master certain procedures.
Because Liposuction is a permanent and irreversible operation and can potentially leave people disfigured it is incredibly important that patients take the decision-making very seriously.
The consequence of not properly choosing a provider for liposuction can be disastrous.
I recommend patients start by first getting a good idea regarding their own candidacy for the procedure.
Doing this requires having in person consultations.
Patients should learn about alternative procedures then begin the process of finding the right provider.
I recommend patients avoid virtual consultations whenever possible and especially avoid traveling long distances for elective surgical procedures if at all possible.
During each consultation ask each provider to open up their portfolio and show you their entire collection of before and after pictures.
Providers may be apprehensive to do this and may prefer to stick to their preselected show and tell albums representing the best results of their career.
This however is insufficient for the patient to get a clear understanding of what average results look like or how many of these cases a provider has actually performed.
Patients need to understand that they are the ones hiring the surgeon and they have a full right to get verification and documentation of previous work and what that provider can and cannot accomplish.
This includes viewing as many pictures as necessary to get a clear idea of what average results look like in the hands of each provider.For reference I typically quote that an experienced plastic surgeon should have no difficulty producing at least 50 sets of before and after pictures of commonly performed procedures. in reality most plastic surgeons will have hundreds or even thousands of before and after pictures of commonly performed procedures like liposuction.
There are cases where patients do not consent for their pictures to be shown and there are patients who don’t follow up for aftercare.
That’s still typically represents a fairly small percentage of all patients.
I’m going in for a consultation patients should come prepared bringing with them printed copies of pictures of their own body especially the areas interested in being treated. Picture should be taken the same way plastic surgeons take before and after pictures. Use pictures of your own body as a reference when reviewing before and after pictures.
There’s no point at looking at good or bad results of individuals who had totally different body characteristics than your own.
It may be difficult for those not in the profession to make early assessments in regards to similarities or candidacy for the procedure.
Look for similarities in variables like age, BMI, amount of skin laxity, potential body changes from previous pregnancies, thickness of subcutaneous fat layers and overall body frame type.
Likewise during the consultation ask each provider to show as many pictures as possible of previous patients who had similar body characteristics to your own.
There’s no point in seeing pictures of patients who had completely different sets of candidacy for a different potential outcome.
Ask the provider to show you examples of excellent outcomes, average outcomes and outcomes that didn’t turn out as well as they had hoped. You should also talk to the surgeon about what the revision rate is and what the revision policy is.
All plastic surgeons have a certain revision rate and those who claim they don’t do revisions or not delivering the best results possible.
High revision rates typically indicate someone is not sufficiently skilled at the procedure. views may differ but in my opinion a healthy revision rate should be around 5%.
Most plastic surgeons will not charge for revision surgery but may ask patients to cover facility fees if applicable.
When results are unsatisfactory and this is a direct reflection of surgeons lacking skill and experience it is probably in the patience best interest to seek a second opinion before moving forward with revision surgery from the original surgeon.
For a second opinion consultations I recommend patients come well prepared bringing with them all sets up before and after pictures and a copy of your previous operative report. These are all available from the first surgeons office. They are part of your medical record that you have a right to.
Finally I recommend patients not schedule surgery on the day of consultation. Always give yourself time to think about your options and major decisions that will have an impact for the rest of your life.
Make sure you finished all schedule consultations before choosing a provider. If during the process you have doubts or don’t feel comfortable simply slow down and schedule more consultations.
It is time consuming and there are no shortcuts.
The consequence of not following an appropriate protocol for choosing the right plastic surgeon has such consequences that my recommendation for this approach is justified.
Finally I recommend patients read all reviews on various physician review websites avoiding providers for any significant number of justified negative reviews.
The absence of justified negative reviews is more important and more telling than having an abundance of positive reviews.
There are numerous other variables to take into consideration. The form of anesthesia is an important one both in regards to safety, comfort and potential quality of outcome.
It’s also important to have a clear understanding of exactly what’s included with the procedure and what areas are not included. Any area that’s included with the procedure needs to be reviewed by looking at before and after pictures so you know exactly what to expect and every treated part of your body.
In the end most patients know when they’re in the hands of a skills and experience provider. There’s a vibe in a sense of confidence about people who know what they’re doing.
There are also those with great financial motivation looking to schedule surgeries who may not have skill and experience but have excellent personalities and bedside manner.
In the end both are important but there is no substitute for skill and experience when it comes to plastic surgery consistent quality results.
Best,
Mats Hagstrom MD

Hi. Almost all the revision liposuctions I have done have had a lot of scarring/fibrosis. I have used PAL, Traditional liposuction and VASER. The only one that helped me get the most fat out and achieve a smooth contour was VASER. In fact part of the reason why I bought the machine was because I was getting so many revision liposuction patients referred to me. Feel free to reach out to my office if you want to see some examples or discuss this further. My office manger Nicole has dealt with many revision liposuction patients and she can give you firsthand account of what works and what doesn't.

Hello, when a revision liposuction is performed, several situations must be considered to choose the best procedure; example residual fibrosis, asymmetries, et al.For this reason, the best alternative is laser liposuction to carry out this revision, since the advantages are many, including eliminating fibrosis and increasing collagen fibers and improving the previous result.