Delivering consistent quality, Liposuction result is far more difficult than most people realize. The number of plastic surgeon soup truly mastered this procedure are in a small minority. There are at substantial number of well intended well trained board-certified plastic surgeons, who simply aren’t that good at this procedure. Liposuction results should be considered permanent and more or less irreversible. Correcting poor outcomes is inherently difficult, and sometimes not possible. Plastic surgeon who lack the skills of doing primary liposuction well can easily make things worse with attempt at revision work. Revision word is many times more difficult, and complex than primary Liposuction. Attempt at improving poor Liposuction result is usually done with revision Liposuction fat transfer or a combination of both. Occasionally improvement can be made by converting the procedure to a skin tightening operation such as a tummy tuck if the problems are the lower abdomen. Fat transfer is inherently difficult because over treated areas now lack sufficient host tissue to support grafted fat. Grated fat survival becomes tenuous and unpredictable. The potential for long-term quality outcomes and poorly done liposuction depends on the number of variables. One of the most important variables is the patient’s candidacy for liposuction in the first place. Not everybody taking Liposuction is a good candidate for this procedure. Perhaps the second most important variable is how aggressive the primary procedure was done. Some improvements can always be obtained, but the amount of improvement becomes a point of diminishing return, and making significant headway, especially if fat transfer is required, typically requires multiple treatment. Simply finding a provider who has sufficient skill to do this type of work correctly, is a major feet in itself. The best surgeons for doing the revision work I’m generally going to be the same surgeon to do the best primary procedures. The exception is when fat transfer is indicated in which case the provider needs to be vetted for both Liposuction and fat transfer results. Recognize that early fat transfer results can look very impressive, but do not in any way represent final or long-term results. This makes reviewing fat transfer before, and after pictures difficult without having certainty of the timeframe of when after pictures were taken. When will reviewing fat transfer results always confirm the timeframe of when after pictures were taken in relationship to the date of the procedure. After pictures are not representative until at least three to six months from the date of surgery. Be leery of anyone who thinks this is easy to correct or that some new technology can fix your outcome. The following are some general guidelines to find the right provider for Liposuction, or other cosmetic surgical procedures potentially also including Revision Work. To find the best provider, I suggest patient schedule multiple in person consultations with experienced plastic surgeons in their community. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures of previous patients who have similar body characteristics to your own. An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. An experienced provider should in fact have hundreds or preferably thousands of before and after pictures to choose from for commonly performed procedures. Being shown a handful of preselected images, representing the best results of a provider’s career is insufficient to get a clear understanding of what average results look like or what your results are likely to be in the hands of each provider. There is no correct number of consultations needed to find the best provider. The more consultations you scheduled the more likely you are to find the best provider for your needs. Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. It’s not a bad idea to bring pictures of your own body to use as reference when reviewing before and after pictures. The biggest mistake patients make is scheduling only one consultation without properly vetting or comparing providers before scheduling surgery. For procedures that have substantial provider variation like Liposuction, patients should consider having at least five consultation before choosing a provider. When in doubt slow down and schedule more consultations?Best, Mats Hagstrom, MD