What can I do to correct lumps in my liposuction areas? 2 years post op (photos)

Question

I had lipo 2 years ago. I am athletic. The front part of my belly does not look good. I have lumps and little balls. The contorn is good, is just how my stomach looks. What can I do? What would be my solution to improve it and get a stomach flat? I am fit so I did not gain any weight after. I am 27 years old

Jeffrey Lisiecki, MD · Answer

It depends what the cause of the lumps was and what they feel like now on examination. Most often, this is something that can be smoothed out by ultrasound-assisted liposuction to break up any irregularities.

Daniel Barrett, MD · Answer

Dear Dazzling837946,
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

Mats Hagstrom, MD (license on probation) · Answer

Improving and poorly done Liposuction is very difficult.
Liposuction is a permanent and irreversible procedure. When done aggressively and uneven Lee it’s very difficult to improve on the outcome.
Treatment options generally come down to revision liposuction, fat grafting or a combination of both. for some individuals converting the procedure to a skin tightening operation like a tummy tuck may be an option especially those who have significant skin laxity.
Starting with an even better distribution, doing a liposuction and leaving an even fat distribution is hard enough. taking an uneven fat distribution and making it even is many many times more difficult.
When doing a liposuction the fat is injected with tumescent solution which eliminate the contour irregularities you currently see. Areas that are high or need more fat removed needs to be marked off as needing Liposuction and the areas were too much far was removed are marked as requiring fat grafting. 
Each individual small problem area is treated individually with the help of a baking minor improvements.
Getting an overall better outcome becomes more difficult if the primary procedure was done in an aggressive manner. 
There is generally room for minor improvements but restoring your abdomen to pre-liposuction or converting this to an excellent outcome is probably not reality.
Revision work is many times more difficult than primary Liposuction so the importance of finding a provider with enough skill and talent to not make things worse is by far the most important variable.
Things can definitely be made worse by having secondary liposuction especially if your first procedure was done aggressively.
Delivering consistent liposuction results is more difficult than most people believe.
The number of plastic surgeons how have truly mastered this procedure and can deliver flawless results on a regular basis is relatively few.
Patients should be highly selective when choosing providers for Liposuction.
Being board-certified and plastic surgery with an overall good reputation and years of experience is not sufficient to confirm someone has mastered Liposuction.
Finding the right surgeon for revision work is more or less the same process as finding one for the primary procedure with a few exceptions. 
To find a sufficiently skilled provider I recommend patients have multiple in person consultations with local board-certified plastic surgeons in their community who seem to have a knack for doing it Liposuction well.
Bring pictures of your own body to use for a reference.
During each consultation ask each provider to open up their entire portfolio and show you all of their before and after pictures for liposuction results of the abdomen.
Being shown a handful of preselected images most likely representing the best results of the providers career is insufficient to get a clear understanding of what average results will look like or how many of these procedures they have actually performed.
As providers to only show you pictures of patients who have similar body characteristics to your own. Use your own pictures as a reference as to not be shown pictures of patients who had a different body type or amount of body fat. There are many variables that have to be considered when deciding someone’s candidacy for this procedure. Skin laxity and pregnancy related issues and major deterrence for inhibiting quality results.
Ask providers to show you examples of excellent outcomes, average outcomes and outcomes that did not turn out as well as they had hoped.
For reference unexperienced surgeon should have done difficulty showing you at least 50 set a before and after pictures. highly experienced surgeons should have hundreds or even thousands of before and after pictures of commonly performed procedures like liposuction of the torso. 
The exception is for revision of work when you should not expect providers to have nearly as many before and after pictures because revision work is less common.
If providers are reluctant to show you the quantity have before and after pictures and ask them how many procedures they’ve done and ask to see more pictures.
If someone has done 100 Liposuction cases then they should surely have at least 40 sets of before and after pictures. (not all patients follow up after surgery).
Look very carefully at all liposuction results to make sure there are no skin contour irregularities in any of the areas treated. Ask the provider to point out exactly what areas were treated and what areas were not treated and look very carefully a transition sentence between treated and untreated areas. 
Personally I view the torso as a single anatomic unit and try to treat the entire torso if I’m going to treat it at all. A full torso includes upper abdomen, lower abdomen, love handles, waist, full back and under arms all the way to the side of the breast. They treating the entire torso as a single anatomic unit patients are not left with transition zones between treated and on treated areas.
Fat transfer (fat grafting )is often not particularly successful in the areas that have been over treated. The reason for this is the areas that are devoid of far are left with very little to no host tissue to support the graft causing increase graft failures. 
In some cases grafting fat can restore some volume in areas that I’ve been over treated previously. Sometimes using fat grafting requires doing a few sessions to build up tissue sufficiently to get a significant improvement.
This is why cases that have been aggressively over treated during the primary procedure are more difficult to improve upon.
I suggest each patient start by having a minimum of five in person consultations and consider having many more and less they feel very confident they found as efficiently skills and experience provider.
As I mentioned earlier doing liposuction well on a consistent basis is more difficult than most people believe in the number of plastic surgeons to truly excel and do quality work is relatively few.
In reality a significant number of Wellington ended properly trained board-certified plastic surgeons of you Liposuction is it simple minded procedure with a low learning curve.
In reality Liposuction it’s a highly complex procedure that has a very steep and long learning curve and mastering this procedure to the point of getting consistent quality results with the ability to make accurate predictable assessments on a regular basis is far more difficult than most people think.
Liposuction results are permanent and irreversible. For this reason that patients should be extremely selective and picky about who they choose to do the procedure.
Sufficiently skilled an experience provider should have what seems like an endless supply of before and after pictures and be upfront and honest about what can and cannot be accomplished.
It is very difficult to improve the outcome once the procedure has been performed.
Liposuction is very much one of those do it ones do it right type of procedures.
If you didn’t get it done right the first time it’s difficult to improve upon the outcome.
The importance of provider selection becomes even greater for revision work so if you are serious about getting work done do you need to start interviewing a lot of plastic surgeons.
You may be able to get some headway by selecting plastic surgeons who have exceptional numbers of quality before and after pictures on their website compared to other types of procedures. Alternatively we can look for plastic surgeons who specialize exclusively in liposuction or possibly consider a specialty clinic that offers just liposuction.
Large corporate outfits specializing exclusively in liposuction have certain advantages but also disadvantages.
Insist on having consultations directly only with the surgeon who will be doing your procedure and make sure you are seeing only before and after pictures from the actual surgeon who’s going to be doing your procedure. In large multi provider groups this becomes a bit of a challenge since the company may put out company before and after pictures rather than selective photos for each provider.
Most patients know when they were in the hands of an expert provider. They have a sense of confidence in their before and after pictures usually speak for themselves.
Finally I recommend reading all the reviews and various physician review websites avoiding providers for any significant number of justified negative reviews.
The absence of justified negative reviews is more important and more telling them having an abundance of positive reviews.
Find the right plastic surgeon and everything falls into place.
Recognize that revision liposuction especially if the first treatment was aggressive is inherently limited.
Best,
Mats Hagstrom MD

What can I do to correct lumps in my liposuction areas? 2 years post op (photos)

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