Can I get rid of my saddlebags? (photos)

Question

I am 19 and had lipo surgery (inner & outer thigh) just over a year ago to get rid of my saddlebags, but I still am left with a good amount of fat in the area (attached before & after). I do not want to go back to this surgeon as I am not happy with this result. What can be done at this point to make my lower half (particularly outer hips) slimmer?

Daniel Barrett, MD · Answer

Dear 1980usamac,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from a liposuction. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jason Emer, MD · Answer

it looks as if you may have lipedema, I suggest you see an expert this will need full 360 lipo of the thighs, heating of the full leg and outerthigh with renvion and body tite, and fat grafting to the buttock outer buttock to give a nice curve/shape.  you need liposculpture and long term lipedema workup with our hormonal physican (see link).  Best, Dr. Emer.
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You need a formal evaluation by an expert in body shaping and contouring to determine what is best.  Traditional liposuction awake and smart liposuction are old methods and do very poorly for tightening skin or significant skin tightening or contouring.  Small problem areas can be improved slightly by these methods.  The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heat the skin with radio-frequency devices such as J PLASMA/RENUVION, InMode BodyTite, ThermiRF to heat the under surface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HIDEF VASER contouring and can only be done by a well . trained body contouring specialist. At the same time fat should be harvested, PRP and stem cells added and injected into muscles or indentations/cellulite to get body shaping and contouring.  This is known as a Brazilian butt lift when you inject the fat to the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face.  Cellulite should also be treated with cellfina, sculptra, subcision and/or fillers such as bellafill, renuva synthetic fat, or sculptra.  If skin is very loose before surgery then it will need to be removed such as lower abdominal skin (tummy tuck/abdominoplasty), breast skin (breast lift), arm skin (brachioplasty).  Overall you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting.

David Hansen, MD · Answer

You would do very well to get the thighs liposuctioned again and add the benefit of skin tightening with Bodytite at the same time.  You would look so much better with a real through liposuction.

Misbah Khan MD, FAAD, FACMS · Answer

a 2nd surgery in such a sensitive area has to be done very carefully as its very easy to remove too much as opposed to removing JUST enough fat. sometimes I do surgery in this area with the patient standing upright so that i can get the shape that they desire. the anatomy is very different in this area when the patient is laying down. I specialize in Revision surgeries. most common complaint patients have for defects or problems in this area are due to either too much fat removed or it wasn't removed in a  smooth fashion.

Arian Mowlavi, MD, FACS (license on probation) · Answer

If you are still unsatisfied with your results this can likely be addressed using high definition VASER liposuction.  The Gold Standard for superior liposuction results requires use of the advanced technology of ultrasound assisted VASER liposuction. As an official trainer of VASER liposuction, I perform full body liposuction cases every week. VASER liposuction has been the only modality that has consistently resulted in outstanding liposuction outcomes. VASER liposuction ensures a smooth contour regardless of degree of excess fat by virtue of being able to remove any and all remaining fat comprehensively and uniformly. If skin redundancy is observed, Renuvion technology can be simultaneously applied to tighten your skin to optimize your overall contour outcome. A Skype or FaceTime consultation with a VASER specialist will help you get an accurate recommendation and pricing.
Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

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