Female, 51yo, 5'5", 165lbs - can this flank/side/underarm lipo be fixed?

Question

Female, 51yo, 5'5", 165lbs, active, runner. I had a lumpectomy years ago, finally decided to have my breasts match, the Dr also did lipo, the results are tragic. It is so uneven, one side worse then the other, and it goes toward my back, and under arm.

Daniel Barrett, MD · Answer

Dear k9fancy,
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

George Marosan, MD · Answer

Thank you for your question and photos. Unfortunately, you fell victim to poor liposuction techniques. Many plastic surgeons and others like cosmetic surgeons believe that liposuction is easy and they do not spend the time to learn the right techniques. You have extremely uneven liposuction, grooving and excess fat, and you also have some skin looseness (best evaluated during a physical examination). Body sculpting is technical and artistic fat removal and/or fat grafting. You underwent poorly done fat reduction with no respect of the underlying muscle and bony anatomy. 
See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

Darryl J. Blinski, MD · Answer

Even with OK posted photos best to virtual or in person consult with... I recommend lipo/fat grating or injections of combination of Radeisse/Sculptra in sessions or both. Fees range from $6,000-$20,000.

Kevin Tehrani, MD, FACS · Answer

Thank you for your question and posting appropriate pictures. You seem to be a very good calendar for revision live percuction which can occasionally be done under local anesthesia. You would also need skin tyning in this area either with Bodytite or Renuvion. It is best to have an initial virtual consultation to discuss options of course.

Mats Hagstrom, MD (license on probation) · Answer

Most women who have a lump ectomy also have radiation. Previous radiation therapy is a contraindication to doing liposuction so be glad you did not have healing problems on that side. other uncle logical issues that would be important to know is if you had a full node dissection. The area of concern is typically mostly related to skin laxity in regards to contour.
In order to assess the outcome of an operation we need to see before and after pictures.
If you don’t have before and after pictures then ask your surgeon to forward the ones they took.
Delivering consistent quality liposuction results is more difficult than most people think and this includes plastic surgeons who typically think they’re far better at Liposuction than they actually are.
Simply sucking out fat with a Cannula is in itself quite simplistic and this often puts providers into a false believe that this is an easy procedure to do well. 
It is not.
To master body contouring with Liposuction requires doing thousands of cases with a commitment to mastering the procedure. most plastic surgeons never get to that stage in their career despite doing Liposuction thousands of times. There are a variety of reasons why surgeons fail to improve upon their Liposuction results but one of them is that the feedback loop of seeing the final results comes too far after having done the procedure. we typically look at final results around 3 to 6 months. There’s no way surgeons can recommend what their technique was, how aggressive they were, how they blended into other areas what equipment was used etc. six months ago. to get feedback that can be applied immediately to another procedure to improve your technique requires doing liposuction on a regular basis and being committed to improving and that means not being content with less than perfect results.
Liposuction is permanent and more or less irreversible. For that reason I encourage all patients considering Liposuction to be very careful and choosing their provider. Find the most talented and experienced providers. Being board-certified and plastic surgery with an overall good reputation is not sufficient to confirm someone is good at Liposuction.
Define the right provider I suggest patients schedule multiple in person consultations. Avoid virtual consultations whenever possible. During in person consultations ask each provider to show their entire collection of before and after pictures of the procedure you’re interested in it. For common areas which this is not and experienced plastic surgeon should have no difficulty showing you a minimum of 50 sets a before and after pictures. Look carefully at all the areas treated to make sure there are no skin irregularities and ask the surgeon to point out areas that were treated and areas that were not treated so you can look carefully at transition zones between treated and on treated areas.
Symmetry surgery after breast cancer treatment is covered by medical insurance and is never considered a cosmetic procedure. Hopefully you didn’t pay for the surgery because it’s a covered medical benefit.
Perhaps it was breast surgery other than the liposuction at the same time? it’s pretty common to do some liposuction at the edge of the scar when doing certain breast procedures.
In the end your surgeon is responsible for the outcome and you are responsible for choosing that surgeon.
Improving on poorly done Liposuction is usually done with revision Liposuction(treating areas with more liposuction to make things even), fat transfer(tends to not work well after liposuction), A combination of both and occasionally converting the procedure to a skin tightening operation by cutting out the poorly treated area. this last option would work for someone who had poorly done liposuction on their lower abdomen and has skin laxity and would be a good candidate for a tummy tuck anyway.
Improving on the outcome is going to be challenging and you need to ask yourself how much you’re willing to go through and what you’re trying to achieve.
For example, you could liposuction the rest of your torso to the same fat thickness so that everything is uniform. unless you’re interested in having liposuction of your torso that may be not your first option. blending the area better with Revision Liposuction isn’t really going to fix the area next to the breast it just makes the transition from treated to untreated area a little more gradual.
Revision Work is many times more difficult than primary Liposuction and doing revision work for poorly done Liposuction typically should be done by providers who are not only good at Liposuction but also fat transfer.
I’ve already mentioned that Liposuction is more difficult than most people think and considering that Revision Work is many times more difficult the need to find the most talented an experience provider goes without speaking.
There are no shortcuts to finding the most talented provider. It requires having numerous in person consultations.
Best,
Mats Hagstrom MD

Female, 51yo, 5'5", 165lbs - can this flank/side/underarm lipo be fixed?

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