Can a fat graft be done to help blend the appearance of my lower stomach? (photos)

Dear ILoveLife8,
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

To give you a recommendation we need to make a quality assessment.
For people who had previous procedures we always need to start by seeing proper before and after pictures from all angles of your torso.
If you don’t have your before and after pictures and ask your surgeon to forward the ones they took.
We need to see your torso from your shoulders to your knees. You can crop your head. Photos should be taken wearing undergarments standing in a neutral position with your arms down showing your front side and back side
Fat transfer for your abdomen is not a good option in your case.
Most likely completing the liposuction and making your fat distribution consistent with your lower abdomen throughout your torso would be a far better alternative.
Personally I view the torso as a single anatomic unit and generally try to treat the entire torso if I’m going to do liposuction on any part of it.
By treating the entire torso as a single unit people are left with a natural for an even fat distribution.
Grafting fat to the lower abdomen will be very challenging because that area is now devoid of any sufficient amount of host tissue to support the graft.
Grafting tissue requires having healthy tissue to support the grafted fat or the fat will not survive.
To get anything representing a quality assessment you’ll need to show better pictures or better yet schedule in person consultations.
A reverse tummy tuck is not a common procedure and there’s a good reason why people don’t do the operation very often.
The many drawbacks of the reverse tummy tuck compared to the limited improvement simply makes it and not very good operation.
It looks like your belly button is now positioned in a quite high location on your abdomen.
Delivering consistent quality liposuction results is more difficult than most people believe. The number of plastic surgeons have truly mastered this procedure and can leave consistent quality results as well as make accurate assessments with accurate predictions is relatively low.
A sufficiently skilled provider should be able to make a good assessment then show you an ample number of before and after pictures of previous patients with similar body characteristics to your own to show you accurately what your results will look like.
They should be very little guessing game when it comes to making an assessment and delivering consistent quality results.
In reality most plastic surgeons cannot do this.
All plastic surgeons can do liposuction and most claim to be fairly good at it.
From what I see the majority of plastic surgeons are not particularly good at liposuction and unfortunately the procedure is viewed as simplistic with a little learning curve.
In reality delivering consistent quality results with the ability to accurately assess and predict to the point of having mastered the procedure is rare enough that patients need to put in a solid effort to search out if you individuals will have the skills necessary.
Liposuction is a permanent and irreversible procedure.
When done poorly correcting the results is usually not possible. Revision attempt with further Liposuction or fat transfer can make subtle changes but anybody considering Liposuction should accept that the procedure and it’s results are going to be permanent.
The importance of properly vetting providers cannot be overstated.
Simply choosing a board-certified plastic surgeon with years of experience who has good intentions and overall good reviews is not sufficient to confirm but that individual has mastered liposuction.
Define providers for liposuction I recommend patients have multiple in person consultations.
I recommend people avoid virtual consultations whenever possible and especially avoid traveling long distances for elective surgical procedures unless absolutely necessary.
For each consultation bring in pictures of yourself. For those who have had previous procedures like yourself bring in all of before and after pictures and a copy of your operative report. These are available from your current providers office if you request them. take notes during consultations and be familiar with what quality Liposuction results look like by reviewing lots of pictures in advance. When reviewing before and after pictures look very carefully at your own pictures and add the before pictures to make sure you select only individuals who have similar body characteristics to your own. in your current situation it’s going to be challenging to find people who have the same fat distribution because what you underwent it’s a bit uncommon.
Have a reading or grading system when looking at before and after pictures so you can make good notes and be able to compare to other providers.
Ask each provider to open up their portfolio and show you their entire collection a before and after pictures for abdominal liposuction.
Being shown a handful of preselected images most likely representing the best results of the providers career is insufficient to get a clear understanding of what average results look like or how many of these procedures any one surgeon has actually done.
Ask providers to only show you before and after pictures of previous patients who have similar body characteristics to your own.
This means approximately similar age, similar pregnancy history, similar amount of body fat, skin laxity etc. etc.
Ask providers to show you examples of excellent outcomes, average outcomes and outcomes that did not turn out as well as they had hoped. Specifically ask each surgeon what the revision rate is and what the revision policy is.
For a reference an experienced surgeon that should have no difficulty showing you at least 50 set a before and after pictures of commonly performed procedures like abdominal liposuction.
Highly experienced surgeons will have hundreds or even thousands of before and after pictures of the procedures that are done on a regular basis.
Look very carefully at all results including all areas treated to make sure there are no skin contour irregularities in any treated area. review the pictures with the providers asking them to point out what areas were treated and what areas were not treated and look carefully at transition zones between treated and untreated areas. Quality Liposuction should not leave any visible transition zones. this is Wyatt my preference is to treat the entire torso as a single anatomic unit leaving people without transition zones. For people who have more than an inch of subcutaneous fat good liposuction results should reduce this to about a quarter inch. The difference between 1/4 inch and one full inch of subcutaneous fat cannot be hidden even if well blended from one part of the torso to another. it’s simply cannot leave and natural fat distribution unless the entire torso is treated and left with a consistent thickness of subcutaneous fat
In your case it’s far easier to just finish the job then it is to restore the fat of your lower abdomen.
The more someone needs fat transfer the less likely it will be successful. The last post tissue available to support the graft the less fat that will survive. you should also consider the grafting fat is inherently imprecise, unpredictable and can be unforgiving. The outcome is not only dependent on how the fattest grafted but also the amount of host tissue and finally fat survival which is influenced by a number of variables.
Even if fat is grafted evenly it may not survive in an even manner leaving you with an uneven fat distribution.
Your situation is complex because of your previous procedure. To get a quality assessment you really need to rely on in person consultations.
Pictures are really not sufficient and it’s important to put this all in context of what you’re trying to achieve and what you’re willing to go through.
I recommend patience start they having a minimum of five in person consultations and considering scheduling many more if needed.
Delivering consistent quality liposuction results is far more difficult than most people believe in the number of plastic surgeons who do this well is small.
Much smaller than what most people believe and this includes the great majority of plastic surgeons.
Most plastic surgeons think they’re far better at Liposuction than they actually are.
When in doubt slow down and schedule more consultations.
The more complex situation is the more you need to take your time and think things through thoroughly.
In the end there are generally only two variables that determine what a cosmetic surgery outcome will look like. those are patient candidacy and surgeon skill.
It looks to me like your provider attempted to do etching or high definition liposuction.
Personally I do not recommend that technique but I am I believe in the minority in regards to that view.
I am also one of the only plastic surgeons in the United States whose practice is devoted exclusively to doing only Liposuction.
To me it looks like you’re a really good candidate for Liposuction and most likely just finishing the job and making your fat distribution consistent should get you to a pretty good place but since we don’t have pictures we can’t really make a good assessment.
I would be very careful moving forward with an attempt of grafting your lower abdomen. The chance of that that looking good and having a natural appearance is going to be challenging and may very well take multiple procedures.
If you do opt for fat transfer as a way to correct us then you’ll need to vet providers for both Liposuction and fat transfer results.
The process is similar to vetting plastic surgeons for liposuction with one major exception. Fat transfer results changed dramatically over time. any result that’s less than 3 to 6 months does not represent final results in any way.
Early fat transfer results can look very impressive but they are not the final results.
When reviewing fat transfer results always confirm the exact timeframe from the date of the procedure and the results you’re looking at. results should never be judged within the first three months and preferably not within the first six months.
Good luck,
Mats Hagstrom MD