8 years post op - What can I do to fix fibrosis from BBL? (photo)

Question

I had bbl done 8 years ago . I had a baby and the no todos looks way worse than before . Help what Can I do

Alan Gonzalez, MD, FACS · Answer

Hello @Madeindr31 thank you for your question and showing your picture. Is important that you choose a board certified specialist that can help minimize the fibrosis. The surgical procedure of liposuction, may or may not be associated with technology. Many times the characteristics of these lumps under the skin or retractions are secondary to a conventional fat extraction technique. We handle fat from the use of laser technology, which is light, or vaser, which is internal ultrasound associated with microair (PAL- Power ssisted liposuction) the first two devices allow us to vase or Laser produce lipolysis (is to pass the fat of a solid state to a liquid state so that there are no irregularities under the skin) and the microaire or the PAL allows us to make the extraction of the melted liquid without so much trauma.It is important to be able to evaluate the case a little more to determine if only with a new lipolysis from the combination of technology can be improved. If it is only a lipolysis of the body contour, we will be able to improve the appearance by 50% towards 70% of the result you currently have; because fibrosis behaves as a scar inside the tissue and it is very difficult to be able to remove it completely. Best wishes!

Zoran Potparic, MD · Answer

Unfortunately, you developed atypical scarring and fibrosis as a result of liposuction. One of the ways to improve this condition would be liposuction without aspiration and fat removal. This procedure would brake most of the lumps and leave released fat to float and distribute like a fat grafts. For this you need to find really experienced board certified plastic surgeon with excellent reputation in secondary liposuction. Good luck.

Jason Emer, MD · Answer

this is just bad work and the only thing to fix this is fat grafting and/or renuva injections. you need to soften the area with RF treatments and shock therapy.  Best, Dr. Emer.

Daniel Barrett, MD · Answer

Dear Madeindr31,
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 present a very very difficult fibrosis/skeltinization abdominal issue. I have used S.A.F.E. lipo techniques with a drain and specialized taping along with 30 days of lymphatic massages. I have seen so nice results but never a guarantee can be given,. Fee $12,000.

Douglas Taranow, DO, FACOS · Answer

Thanks for the question and photo.  
It is a difficult issue to remedy.   Nothing works great, but certain things may improve it. 
Morpheus is a radio frequency with microneedling technology that helps melt some fat and tighten shin.  
Revision liposuction using only feathering (no suction applied so just undermining) May also be of use. 
Fat transfer to any deeper dents works, but you appear to have more shallow denting. 
Best wishes. 
Dr. Taranow

Mats Hagstrom, MD (license on probation) · Answer

The term fibrosis is sometimes used as a term of something that just happens to some people.

Usually the conditions with his term is used are in reality and normal outcome of poorly performed Liposuction.

It is often the combination of overly aggressive Liposuction done in an irregular manner using poor technique.  Typically almost all the Fed has been removed and the body creates scar tissue in its place.  The scar tissue acts like internal glue holding the small amounts of the irregularly left  fat anchored in place.

Liposuction is permanent and in many ways irreversible.

The combination of removing too much fat and doing so in an irregular fashion is the most difficult and complex to treat or improve upon.

Treatment options for poor Liposuction results typically come down to revision Liposuction, fat transfer and sometimes converting the procedure to a skin tightening operation like a full tummy tuck in cases where patients have skin laxity.

In cases like your own none of these options are particularly good.

Since that primary or inherent problem is that too much fat was removed and the fat layer is now uneven nonsurgical options aren’t going to improve upon that.

The only way to change the current fat distribution is through surgical means.

Further Liposuction is in many ways insult to injury since the problem came from too much fat haven’t been removed in the first procedure.

Fat transfer works poorly because the areas that desperately need fed to be replaced are now completely void of any healthy post tissue to support and keep grafted tissue alive.

Since there are no better alternatives providers are left with Revision and Liposuction and fat transfer as they on the options.

Typically each individual area of uneven contour is marked off basically separating high points and low points.

The high points are treated with Revision and Liposuction and Bello points are treated by adding fat.

Only a small amount of the grafted fat will survive and in order to make progress patients should expect to have multiple rounds of this type of treatment.

There is no one single fix or procedure for these outcomes.

The outcomes I’m not random or some unusual circumstance but instead or a direct reflection of the lack of skill and experience from the surgeon who did the primary procedure.

I cannot emphasize enough the importance of patient vetting surgeons properly before undergoing Liposuction and fat transfer procedures.

I encourage patients to do this by always scheduling multiple in person consultations at which time patients should ask providers to show their entire collection of before and after pictures.

Do not move forward until you find a provider who can show you a minimum of 30 competent long-term before and after pictures.

A highly experienced provider will have hundreds or possibly thousands and this is really what you’re looking for.

Likewise I also recommend patient read all reviews on various physician review websites and avoid providers with any significant number of justified negative reviews.

The absence of justified negative reviews is more telling and more important than an abundance of positive reviews.

Revision work as many times more difficult than primary Liposuction so it goes without speaking that if anyone is going to do revision work they need to be careful he screamed and you need to confirm that they are truly one of the best in the field.

While finding appropriately talented provider takes work and effort this is the first step in the process.

Start scheduling lots of consultations and push each provider to show their entire collection before and after work in your case specifically of revision procedures.

Because liposuction and fat transfer results take three months to show her final results it’s important that providers only show long-term results as final outcomes.

Recognize the inherent limitations with revision work and move forward only when you feel comfortable and that you found the right provider to do this type of work for you.

Avoid any providers who feel that this can easily be approved upon especially those put out that energy devices such as VASER can magically do things like “break up the scar tissue”.  Recognize that more surgery will always create more scar tissue.

Ultimately each provider is responsible for the outcome of procedures they perform and likewise patients are responsible for choosing their provider.

What board certification in plastic surgery is a fundamental foundation in becoming a talented qualified provider it is not sufficient by itself to guarantee someone has the skill and experience to deliver consistent high-quality results.

Delivering consistent high-quality results with Liposuction and fat transfer is far more difficult than most patients and to some degree providers believe.

It’s important that you initially followed up with your provider so that he or she could know  what the results looked like. Your provider needed to stop doing liposuction or significantly changed their technique in order to avoid disfiguring more people at that time. Hopefully by this time they have improved their technique.

I wish I could be more optimistic about treatment options of restoring your body to one that looks normal.

Some improvements can almost always be had but getting there sometimes requires a few rounds of surgery and the total amount of improvement is still limited.

Best,

Mats Hagstrom MD

8 years post op - What can I do to fix fibrosis from BBL? (photo)

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