Bulkier Thighs After Smart Lipo and Traditional Liposuction

Question

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!

Ricardo L. Rodriguez, MD · Answer

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.

Vincent N. Zubowicz, MD · Answer

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.

Bulkier Thighs After Smart Lipo and Traditional Liposuction

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Bulkier Thighs After Smart Lipo and Traditional Liposuction

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