Bulkier Thighs After Smart Lipo and Traditional Liposuction

I had secondary liposuction on my thighs 13 months ago. I was thrilled with the first procedure on my thighs 4 years prior. Overly perfectionistic, I returned to my surgeon for refining of front and back thighs. The surgeon used combination Smart Lipo / regular Lipo to remove 250 ccs. Recovery difficult but religiously massaged (power electric massager). I wore garment two months. My thighs are now bigger (I’ve measured) and horrible, different in shape! Yet still have my veiny arms and extreme dieting to no avail. Not fattier nor more muscular per se, just inexplicably bulkier w/ numbness. Still swell frequently! Could this be excessive fibrosis? Anything to do? I’m devastated!

Doctor Answers 2

Bigger thighs after lipo

There are 2 possible reasons for this.

1. Fat storage distribution

Your body has areas where it likes to store fat. On some people the areas are very unevenly distributed; i.e., a woman with a big abdomen and big breasts but almost no hips and stick legs, or the converse, a woman with tiny chest and abdomen but very wide hips and big legs. The cells in those areas will take up fat easily, but metabolize it very slowly.

Even after lipo, the remaining "fat storage" cells in the area will continue to accumulate fat, until such a time most of them have been suctioned away, then secondary areas of fat storage will start taking up fat.

2. Scarring and fibrosis

This is also likely. The fact that you still swell frequently means you have scar tissue interfering with lymphatics. The trouble with Laser and ultrasound lipo is that the extra heat energy used to melt fat also causes some damage to the tissues left behind. The body has to heal this slowly.

The public is not aware of this, but when laser and ultrasound lipo "melt" fat, they also melt the fat in the cells that protect nerve fibers (Schwann cells). This can cause pain.


Baltimore Plastic Surgeon
4.4 out of 5 stars 89 reviews

Leave thighs alone and let swelling subside after Liposuction procedures

Use of laser or ultrasonic energy creates thermal damage and longer healing. The vigorous mechanical massage is traumatic and I would advise you stop doing that. Compressive garments will help the long term result but will not alter the length of the healing processs. You must be patient and not seek unnecessary of even harmful treatment because you are a "perfectionist". There is no way the surgeon could increase the volume of your thigh by suction, so the only explanation is swelling.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.