Is this botched liposuction? Hard lump on right side and uneven results. (photos)

Question

I had a tummy tuck with liposuction of the flanks. My flanks are still there unfortunately but what bothers me most is there’s a lump on my right side that has not gone away despite massages and compression. It is a hard lump. It is noticeable through my clothing. Is this a botched liposuction? My results look so uneven. The whole right side looks like less was removed than the left.

Zoran Potparic, MD · Answer

In the case of liposuction and tummy tuck, one of the complications is fat necrosis, dead fat tissue as a result of a poor blood supply. Any kind of local surgery will decrease blood supply to the area of surgery, and fat tissue, being poorly vascularized, is the first to undergo necrosis, death. Dead tissue is replaced with hard scar. This is most likely what happened in your case. Evaluation with your surgeon and discussion about treatment is what is suggested. Your result is far from botched!

Justin Yovino, MD, FACS · Answer

It's hard to say what the issue is exactly. Typically, it's best to review these findings with your surgeon since he/she should have the best answer on what is causing the findings. I recommend a thorough review of your before and after photos in all positions to see if there was some element of asymmetry before the procedure. There is usually some asymmetry that is present before surgery and that can be hard to completely address if it's due to underlying structures such bone and muscle. With that said, it can also be differences in soft tissue such as fat. If excess fat is the case, then liposuction is usually the answer. If the area is hard, it could be related to healing from the previous surgery and may take more time to heal and may benefit from dedicated massage techniques to soften it. If there is uncertainty on what it is, then a diagnostic ultrasound can be performed to help define the anatomy. I have met a lot of tummy tuck / lipo patients with a satisfied tummy tuck result but dissatisfaction with their lipo results around the waist. In these cases, I have found that the liposuction of the waist, hips, flanks, and back was somewhat limited when compared to the efforts of the tummy tuck. In this situation, dedicated liposuction of these areas has helped.

Daniel Barrett, MD · Answer

Dear Genuine957207,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Darryl J. Blinski, MD · Answer

You have now posted same issue twice. Why have you not seen a second pinion in person (If in Miami??)?? I recommend in office ultrasound of the "lump" on right side to see if fat or something else, fee $500. Yes, only way to "fix your TT is compete scare revision of lateral incisions with possible re liposuction including lump if it is fat. Fee $5,000. If lump a cyst or fluid sac then fee charges increase since only excision of area indicated. Best to virtual consult with...

Mats Hagstrom, MD (license on probation) · Answer

To do Liposuction well for love handles and waist patients need to be turned on their side or face down. Plastic surgeons typically don’t do this when doing liposuction in conjunction with a tummy tuck.
Doing liposuction to shape the waist with patients laying on their back is simply difficult.
The human torso is typically highly asymmetric as a baseline. If you look carefully at your before pictures you can probably see that one side is different than the other to start with.
Whether the surgery should have been done differently or some thing you need to discuss with your provider. Sometimes revisions are indicated and can be used to improve outcomes.
Some firmness or lumpiness is common after these operations but typically resolve within the first couple of months. it’s important to make sure that that area fullness is not a fluid collection called a seroma. that is a fairly common complication after a tummy tuck and usually forms on the lower abdomen.
Follow up with your provider or if you want a proper second opinion schedule second opinion consultations as in person consultations with other local board-certified plastic surgeons.
A tummy tuck it’s a pretty major procedure and it definitely takes time to get used to having your body be so different.
Time helps quite a bit in terms of getting used to how things are as well as improving results with fading of scars etc.
To make an assessment on the outcome of an operation patients need to show proper before and after pictures. If you don’t have your before and after pictures then you should ask your surgeon to forward the ones they took.
With proper before and after pictures other surgeons can assist in assessing the outcome more accurately.
If you seek a second opinion consultation you should bring before and after pictures as well as a copy of your operative report. These are part of your medical record that you can request from your doctors office.Overall based on the pictures you’ve posted I would say your results look like a fairly average or typical tummy tuck results. I certainly would not call it botched. i’ve seen better and I’ve seen worse.
In the end your surgeon is responsible for the outcome of the procedure and you are responsible for choosing that surgeon.
Best,
Mats Hagstrom MD

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