4 months post op lipo of the abdomen and I have these indentations. What can I do to help it go away? Is it permanent? (Photo)

Thank you for your question and photos. It is not uncommon to have areas of irregularities after liposuction. These often improve with time. I would recommend manual massage and the use of a massage device. This helps break up scar tissue, and improves lumps, bumps, and small indentations.

Hello and thank you for your question!

Skin irregularities can happen after liposuction. There are some that get better and some that don't. At 4 months post op, you are in the chronic phase of healing (meaning all of the acute inflammation, swelling, etc has gone down, but there are still slower changes happening as the tissue mature). Sometimes, areas of "induration" or lumps/bumps under the skin can be apparent during this time. These are commonly the "self-defense" mechanism of the fat cells remaining and their response to the inflammatory processes during the post op healing. These areas can commonly get better with time, massage and gentle warm compresses. Sometimes, skin irregularities happen because fat cells too close to the surface of the skin were removed. These sometimes get better on their own with time as tissues fully settle, and this can take 6-9+ months. Typically if sometime has not gotten better after this time frame, this could be permanent.

My best advice is to follow up with your surgeon of record and get their specific recommendations. Thanks again!

Thank you for your question and pictures. Developing irregularities after liposuction can occur in the abdomen or other areas. It sometimes can occur because of liposuction that was very aggressive or superficial. Sometimes these irregularities can occur due to scar formation and can improve with time. I would recommend scar massage to the areas and giving it more time. Make sure you follow up with your surgeon.

Hi, It's still a bit early in your recovery to know if these skin surface irregularities are permanent. There is no treatment laser or lotion that will reliably improve it except waiting. I hope that helps.

Indentations and irregularities following liposuction are generally caused by
1) liposuction performed too superficially and/or
2) indentations caused by folds in compression garments/ clothing during the healing process.
Hoping in your case that it is the latter, I would advise lymphatic massage and ensuring smooth-fitting clothing (avoid tight clothes that crease and constrict, tight waistbands/belts, etc).
If the issues persist beyond 1 year, I would recommend seeing a board-certified plastic surgeon in consultation for possible touch-up, which may be include non-invasive treatments or small procedures.
Best,
Dr. Maryam Zamani

Hello ! I would recommend taking your concerns up with the plastic surgeon that performed the surgery, it could be the type of liposuction that they performed. Depending on which liposuction the surgeon uses can depend on how long the healing process can take.

Following liposuction, especially of the abdomen, it is not uncommon to have mild surface contour irregularities. Although this may be due in part secondary to unequal liposuction, it is more likely secondary to the effects of scar tissue. Scar tissue starts to form several weeks after liposuction and the collagen micro filaments that make up scar tissue underlying the skin wherever liposuction was performed like to clump up. This causes a contraction of the scar tissue which can pull in the overlying skin which causes a depression and shadowing. We are able to manipulate this to some degree with scar massage. Your surgeon will be able to demonstrate techniques and frequency for this. Scar massage tends to be more vigorous and requires more force either by yourself or by a post-liposuction massage therapist. This is different than lymphatic massage which is performed in the immediate weeks after liposuction but before scar tissue starts to form. Often it can take 6 to 9 months to see the results from the time of surgery. Is also possible that although some of these contour irregularities may improve but they may not go away completely.

Unfortunately minor contour irregularities are the most common post-liposuction complication. In general they result from either uneven fat removal during the liposuction process or scarring/fibrosis of the remaining fat during healing. I would recommend aggressive lymphatic massage to help break up any scar tissue and fibrosis that may be forming and contributing to this appearance. Unfortunately, if they do not improve from massage, they likely will be permanent to some degree and may require revision liposuction to help smooth out these areas. I recommend meeting with your plastic surgeon to discuss your concerns and to get their opinion on how to manage this. Best of luck on your healing journey!

Pending a formal evaluation, you may be a good candidate for a Revision Liposuction. You need a formal evaluation by an expert in body shaping and contouring to determine what is best.

The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heats the skin with radiofrequency devices such as Renuvion (J-Plasma), InMode BodyTite, and ThermiRF to heat the undersurface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HI-DEF VASER Liposuction and can only be done by a well-trained body contouring specialist. At the same time, fat should be harvested and purified, with PRP and stem cells added, and then injected into muscles, indentations and cellulite to get body shaping and contouring. For a Brazilian butt lift (BBL), we inject the fat into 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 a combination of QWO or Cellfina, 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: tummy tuck/abdominoplasty for lower abdominal skin; breast lift for excess breast skin; and/or a brachioplasty for loose arm skin. 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. See an expert. Best, Dr. Emer.

Hello, thank you for your question and photos. It is hard to say if these indentations will be permanent or not but to help improve it I would recommend massage. Massage the areas that were treated by liposuction and help smooth out the areas. Also be sure to not wear things that could be to tight and causing indentations to the area while you heal.