To make an accurate assessment we need accurate quality pictures.The last two pictures are good, but you also need to include your full torso and at least part of your lower extremities. We need those type of pictures showing your front side and backside wearing high waisted pants is not helpful. It’s very important to know if women have had previous pregnancies, because that changes the abdomen in ways that are not related to fat distribution.In the end, there are four variables that determine what the abdomen looks like. Depending on which of those four variables is causing the contour problem tells which is the best treatment option.The four variables that determine what the abdomen looks like are abdominal skin laxity typically due to previous pregnancies or weight loss, excess subcutaneous fat, muscle separation from previous pregnancies, or excess visceral or intra-abdominal fat.You can assess your own subcutaneous fat layer by gently pressing one finger against your skin until you feel the underlying muscle wall. This takes very little pressure and you can practice doing it over your rib cage first to get an idea of how thick the fat layer is then do the same on different parts of your abdomen. You can expect 75% of that subcutaneous fat to be removed with well done Liposuction. In other words, if you’re subcutaneous fat layer is 1 inch then you can expect that area to be reduced by 3/4 of an inch.. It doesn’t look like you have a significant skin Laxcity, but for individuals to do I suggest pulling on the skin until it’s tight and see if that changes the body contour. If it does, then that tells you the extent of which skin Laxcity contributes to body contour.In reality, there is not all that much difference between different forms of Liposuction. The differences are mostly emphasized as marketing efforts by those who recently bought new equipment. All forms of Liposuction still rely on a small stainless steel tube connected to some sort of vacuum. This is not changed in the last 40 years.Weather pre-treatment with an ultrasound probe a.k.a. VASER for a laser, fiber a.k.a. smart Lipo makes a significant difference. It’s fairly relevant to the skill and experience of the provider. I recommend patients avoid choosing providers based on what equipment they use, and focus exclusively on finding the most talented an experienced provider regardless of what equipment they used. As a general rule, plastic surgeons have the tools they need to do their job. Whether they are talented or not is fairly irrelevant of equipment used. It’s not much different than the idea of choosing plumbers or electricians or mechanics based on what brand tools they use.Delivering consistent quality, Liposuction results is more difficult than most people believe. Being bored, certified in plastic surgery with an overall good reputation and years of practice does not have any relationship to somebody have a Master Liposuction. There’s a substantial number of plastic surgeons, who simply are not good at this procedure, don’t like doing Liposuction, and will never master it.Considering the poorly done, Liposuction can leave people disfigured, and once the procedure is performed it’s virtually impossible to improve bad outcomes. Patient should be extremely cautious when choosing providers, and be far more selective than they think necessary.I recommend patients start the process by having at least five in person, consultations for the local, board-certified plastic surgeons, who seem to do a lot of Liposuction. Providers should see enthusiastic about the procedure, and show clear evidence of having done the thousands of cases.There is market variation in skill and experience among different plastic surgeons for this operation. I asked providers to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who have the same body characteristics to your own. Look specifically for previous patients, who have the same degree of skin, laxity, the same amount of subcutaneous, fat, muscle, separation, or visceral fat, though it may be a little confusing at first to learn for differentiates Between these variables. Even plastic surgeons make poor assessments from time to time. The hallmark of a quality plastic surgeon is the ability to make an accurate assessment and deliver not only quality results, but predictable quality results as indicated by showing previous patients results who had similar candidacies for the procedure.For reference an experienced plastic surgeon that should have no difficulty showing you the before and after pictures of at least 50 previous patients. Liposuction is one of the most common cosmetic surgical operations and a sufficiently experienced surgeon should’ve done the procedure hundreds if not thousands of times.Being shown pre-selected images, representing the best results of a provider’s career is totally insufficient to get a clear understanding of what average results look like in the hands of each provider or how many procedures they’ve actually performed. You’re in the hands of the right provider when they show you what looks like an endless collection of quality before and after pictures that goes on and on like reading a telephone book.Look very carefully at all after pictures to make sure there are no skin contour irregularities in any of the treated areas. As the surgeons to point out exactly what areas were treated, and what areas were not treated and look very carefully at transition zones between treated an untreated areas. Personally, I view the Torso as a single anatomic unit and prefer to treat the entire tour so if I’m going to do Liposuction. By treating the entire Torso patients left for the natural thin fat, distribution without transition zones between treated in on treated areas. The full torso includes upper abdomen, lower, abdomen, love handles, waste, full back, and under arm or armpits all the way to the side of the breast.A substantial number of plastic surgeons failed to include treating the entire back and under arms area and this can leave women with an abnormal fat distribution making the back look wedge like and different than the narrowed waist.There’s no correct number of consultations needed to find the right provider. A lot has to do with luck and if you happen to find the right provider early in the search. I suggest patient start by having at least five in person consultations before even considering scheduling surgery. The process is time consuming, but if you consider the impact, and that you’ll be reminded every day for the rest of your life, the process is worthy of putting in a significant amount of effort. I personally recommend patients avoid virtual consultations, whenever possible, or at least schedule an in person consultation before having the procedure. I also recommend patient avoid traveling long distances for elective surgical procedures, unless absolutely necessary. Unless someone lives in a rural area, there’s usually local talent within driving distance.Do not discount providers who don’t have great Internet exposure. Tne ability to get on social media, or have strong advertising presence has little to do with skill and experience in surgery. To me, you look like an excellent candidate for Liposuction. I sometimes describe ideal Liposuction candidates as individuals who are “young tight, and pudgy”. The opposite is also true. Older individuals who have lost skin elasticities, individuals with skin, Laxcity and those who do not have thick layers of subcutaneous fat do not have the same candidacy potential as those who are ideal candidates. The majority of patients getting Liposuction, or in fact, average candidates. Excellent results can only be obtained by being an excellent candidate, and being in the hands of an excellent surgeon. If somebody is an average candidate for liposuction the best they can hope for are average results regardless of how talented the provider is. Patients who are poor candidates for Liposuction cannot have excellent Liposuction resultsIndividuals who are excellent candidate can however be left disfigured if they do not choose providers correctly. Considering there is little you can do to change your candidacy for Liposuction. I suggest putting all your efforts on choosing the right provider.The more consultations, you schedule, the more likely you are to find the best provider in your community. Most people do not have a lot of experience consulting with plastic surgeons. Plastic surgeons in the other hand have years of experience giving consultations. I encourage patient to take an active role in the consultation process. Recognizing that you are hiring someone to perform a service for you. You need to insist on seeing qualifying information that confirms skill and experience of the provider you’re about to hire.Do not ever assume that someone is talented at Liposuction, because of anything other than showing you consistent quantity and quality of before and after pictures.Reviews can be helpful. I recommend patient focus mostly on avoiding providers who have a substantial number of justified negative reviews. The presence of ample positive reviews may seem reassuring but it’s not nearly as important as avoiding providers with multiple justified negative reviews.In my opinion, the number of plastic surgeons who have truly mastered Liposuction is an a small minority and need to be found.When, in doubt, slow down and schedule more consultations.Best,Mats Hagstrom, MD
