Liposuction revision & fat grafting? (Photo)

Question

A year ago I had botched vaser lipo of stomach, flanks, lower back, inner and outer thighs and inner knees. My stomach was under corrected and uneven, I have lumpy and uneven inner thighs and a bulge in the right outer, hip dips, and a dropped right buttock. Can revision and fat grafting fix this? What options are there to fix my dropped butt cheek?

J. Timothy Katzen, MD, FACS · Answer

Hi peakgrl,

Thank you for your question about VASER liposuction revision and fat grafting, and for providing your history and pictures. Yes, a revision of liposuction can definitely be achieved. Concurrently, fat grafting can be performed to correct areas of indentation. The success of fat grafting will depend on several key factors: the amount of healthy fat harvested, how the fat is handled post-aspiration, and the method used for injecting the fat during the surgery. Post-surgery, the survival of the fat graft will be influenced by your overall health, avoiding pressure on the grafted areas, and the quality of the skin envelope above the transferred fat.

To address your concern regarding the “dropped butt cheek,” I recommend autologous fat transfer, a procedure some plastic surgeons refer to as a Brazilian Butt Lift. This method involves transferring fat to the buttock, which not only fills in the indented areas but also provides a lifting effect to the buttock. This lifting effect is the reason behind the name 'Brazilian Butt Lift' - the transferred fat effectively elevates and enhances the buttock's shape and contour.

Good luck. I hope I have provided a clear answer to your question regarding liposuction revision and fat grafting.

Sincerely, Dr. Katzen

Camille Cash, MD · Answer

I'm sorry you have had issues with your liposuction results.  A revision will be helpful, but tricky.  You will most likely need further liposuction to help with contour irregularities as well as fat grafting to fill in some of the areas that were over suctioned.  I encourage you to visit a few board certified plastic surgeons near you for consultations to listen to varying opinions.

Mats Hagstrom, MD (license on probation) · Answer

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

Liposuction revision & fat grafting? (Photo)

Answers (3)

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