Options for Correcting Lumpy Liposuction Results?

Question

I had tumescent liposuction of my saddlebag area in September of 2008. I just had my 6 month recall and discussed a touch up with my PS. I am 5'6", 128 lbs, and a size 4. I was the same size and weight prior to surgery. Although my saddlebags were removed, the results are a bit lumpy. One lump is about the size of a half-dollar, others are a bit smaller, maybe quarter-sized. They don't protrude much, just look bad in certain lighting and from certain angles. Since I was slim before surgery, there is not much fat left in the area. My left thigh still has some dull aching pain on occasion since the surgery.  My PS recommended using a rasp-type cannula that he described as looking like a cheese grater to go back in and smooth the lumps. He said he would use two of the adits perpendiular to each other to cross tunnel back through. He did, however, mention that a complication of this that has been reported (though he has not seen) is damage to the skin vascularity.  I am wondering what other plastic surgeons think of the safety and effectiveness of this. Should I just leave things alone and live with the lumps? I am worried that there's not much fat left to keep the cannula away from the skin, and also about the effectiveness of tunneling back through an area that probably has a lot of scar tissue from prior lipo.  Has anyone seen other methods or options for dealing with lipotrops/liponots after surgery? Could the Accent work? Any advice to help me in making this decision would be appreciated.

Otto Joseph Placik, MD · Answer

I am very impressed with your understanding of the subject. You have a much better understanding of the risks than most. You are correct in being concerned. You are approximately 7 months out and it is possible you will see some improvements but not likely complete resolution.
It comes down to how much it really bothers you and if you can live with it. No one will be able to tell you for certain that it will get better or worse. It sounds as if your surgeon has been straightforward in discussing these options.
In my limited experience, I know one aesthetician who uses the Accent on patients and has been unable to achieve significant improvement in "mild" irregularities caused by abdominal liposuction by another physician.
On a few instances I have proceded with small cannula liposuction over previously treated liposuction areas with subtle improvements. I have ccasionally employed fat grafting in areas where the fat seems excessively thin or the skin is adherent to the underlying tissues. I have achieved modest improvements. It would be unrealistic to expect a completely smooth result and I advise patients that I realistically hope to achieve a 30% improvement. Anything more than that is a gift. Of course this comes with the risk of vascular compromise and that is possible but fortunately rare.
I hope this helps.

Raffy Karamanoukian, MD, FACS · Answer

It sounds like you would benefit from a Hidef liposuction revision that includes laser skin tightening, Exilis multiplane tissue tightening, lipocavitation, lipo fibrous release, liposculpture, and fat grafting. Best, Dr. KaramanoukianLos Angeles

Steven Wallach, MD · Answer

If you have lumps that are more than a few months old after liposuction, it may represent areas that were not treated as evenly as other areas. It could also represent fat necrosis, or even small areas of fluid collections. I could not say for sure without an exam.

Hisham Seify, MD, PhD, FACS · Answer

Hello,Your PS did give you an honest technical description of what needs to be done. Any procedure we do has risks involved and alternatives that could be done.In this case the very small lumps (quarter size) could either be ignored, liposuctioned with a very fine cannula, or excised. Since the latter will leave a scar, the first option might not be your best option. It seems that a small revision under local could do it.

Brooke R. Seckel, MD, FACS (retired) · Answer

I understand your concerns regarding re do liposuction and the potential for contour deformities following liposuction close to the skin.
The technique your surgeon describes is an accepted technique which can give good results in experienced hands.
I have had good results using a new laser liposuction technique called SlimLipo to correct lumps and contour deformities after liposuction.
I have been very impressed with the results of laser liposuction to remove lumps and smooth and tighten the skin.
See before and after pictures of SlimLipo.

Options for Correcting Lumpy Liposuction Results?

Answers (5)