Dear Questionqueen76, Thank you for reaching out with your query regarding scar tissue following liposuction and the implications for subsequent treatments. To address your concerns: Scar Tissue After Liposuction: Following liposuction, scar tissue, or fibrosis, can develop in the treated areas as part of the body's natural healing process. Even after 20 years since your previous liposuction, some scar tissue is likely still present in the treated areas, with its extent and density varying from person to person. Second Liposuction and Scar Tissue: When contemplating a second liposuction, the existence of scar tissue from the prior procedure may present some challenges but isn't an insurmountable obstacle. Scar tissue can make the area more resilient to the cannula, potentially leading to less uniform outcomes. Nevertheless, experienced plastic surgeons have specific techniques and strategies for navigating scarred regions to attain satisfactory results. VASER Hi-Def Liposuction and Scar Tissue: VASER Hi-Def Liposuction is an advanced form of ultrasound-assisted liposuction that can be especially beneficial for areas with pre-existing scar tissue. The ultrasound energy helps to liquefy fat cells and, crucially, can aid in breaking up and softening scar tissue. This technology can make the extraction of fat more precise, while also addressing fibrous areas, ultimately improving the smoothness and evenness of results. Not a Revision but a New Treatment: As you mentioned, your second liposuction would address newly accumulated fat rather than rectifying any complications from the initial procedure. However, the prior surgical history remains essential when mapping out a new procedure. Consultation: It's of utmost importance to seek out a board-certified plastic surgeon experienced in secondary or revision liposuction procedures. They can assess your skin's elasticity, gauge the scar tissue's presence and extent, and guide you through the best-suited approach for your unique situation. This consultation also offers you an opportunity to establish realistic expectations and grasp the potential challenges and outcomes. Final Thoughts: Although scar tissue from your previous liposuction might still exist, it does not necessarily deter you from having a successful subsequent operation. Employing methods like VASER Hi-Def Liposuction can offer a strategic advantage in achieving desired outcomes, even when contending with the challenges posed by scar tissue. Please be sure to consult with a board-certified plastic surgeon. I wish you the best of luck. Sincerely, Dr. Katzen