Hip dents after lipo. What can be done to correct this? (Photo)

Question

I’m just over 4 months after lipo and have noticed dents or hollow areas in my hips. Assuming this is pretty permanent after 4 months. What can be done to correct this? I’ve heard of lipo shifting. Is this something that can be performed? I really don’t want more lipo and fat transfer as I fear more dents will be created in new donor areas.

S. Larry Schlesinger, MD, FACS · Answer

I'm sorry you are going through this aesthetic problem.  Contour irregularities may occur as an unanticipated event.  Correction of such irregularities are usually accomplished by fat grafting from other donor areas.A second tool that I have found useful in such situations is the blank cannula.  This looks like a liposuction cannula but has a solid core.  It breaks up the membrane separating the hollow area of missing fat from the surrounding fat containing areas.  This helps give a blood supply to fat grafted cells that have been placed and allows a more even contour to elevations and depressions.  Lipo shifting is a process of pulling fat from an elevated area carrying its own blood supply and migrating it into a depressed area.  I do not recommend this process for you since it will add unnecessary surface scars.  I recommend you return to your primary plastic surgeon and discuss with he or she their plan for correcting this unanticipated sequela.

Rodrigo Rosique, MD, PhD · Answer

Dear, it is very unusual to liposuction this area but it was done on you. This hollow needs to be filled either with a temporary or permanent filler. My choice, would be fat through a careful, crafted liposculpture, but it is a patient decision. Best regards.

George Marosan, MD · Answer

Thank you for your question and photos. Although most surgeons who responded to your post are in agreement about over suctioned areas, you have areas liposuctioned that should've not been suctioned at all! This is an error in judgement and poor understanding of the underlying anatomy. You need an expert to correct this for you with fat grafting and lipocontouring. I reviewed your other posts and photos, and you do not have unlimited fat supplies. You have one good chance to improve this area, which is your lateral buttock and not "hip dips".See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. If you have significant underlying scarring in these areas, you most likely will need more than one procedure. Can't afford to "waste" your fat. Good luck.

Jason Emer, MD · Answer

this needs fat grafting or fillers/sculptra to get improvement.  there is no other options for contour irregularities like this.
You need a formal evaluation by an expert in body shaping and contouring to determine what is best.  Traditional liposuction awake and smart liposuction are old methods and do very poorly for tightening skin or significant skin tightening or contouring.  Small problem areas can be improved slightly by these methods.  The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heat the skin with radio-frequency devices such as J PLASMA/RENUVION, InMode BodyTite, ThermiRF to heat the under surface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HIDEF VASER contouring and can only be done by a well . trained body contouring specialist. At the same time fat should be harvested, PRP and stem cells added and injected into muscles or indentations/cellulite to get body shaping and contouring.  This is known as a Brazilian butt lift when you inject the fat to 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 cellfina, sculptra, 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 such as lower abdominal skin (tummy tuck/abdominoplasty), breast skin (breast lift), arm skin (brachioplasty).  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.  Dr. Emer.

Joseph Mele, MD · Answer

The most common problem after liposuction is a contour irregularity, either a bump or a dent, and the usual solution is liposuction for bumps or fat transfer from another area for dents. It can be a difficult problem and treatment often requires multiple surgeries. I have treated many dents in this area with fat grafting. A few were after liposuction, but the majority were the normal contours that my patients were born with. So while the dent may be new for you, it is not uncommon.Before and after pictures would be helpful in rendering an opinion, but the only opinions that count are those of an experienced surgeon who you see in person. The skin elasticity, and subcutaneous fat that can be pinched in and around the area will guide how best to approach this. Also at four months you are still healing. It could get better, or worse.Lipo shifting is a surgical treatment. It requires release of scarring and an adjacent area of excess fat to "massage" into the indentation. Post operative care is as important as the procedure, so it will be an investment in time. Lipo shifting is not great for moderate to large indentations. I'm not sure you have enough adjacent fat for this type of treatment.You may find people on-line defining lipo shifting as a combination of liposuction and fat transfer. This is technically not lipo shifting, but it is a more flexible option for treating contour irregularities after liposuction. It may be better for you situation, but I cannot know with seeing you.Sorry that you are not happy with the results of your liposuction. At this point, you still have time to heal. Use the time to decide if it is worth taking the risk or additional surgery or if it is better to live with what you have. Unfortunately, the only way to guarantee no surgical risks is to have no surgery. Massage, ultrasound are not likely to help, but these are also less like to harm and may be worth a try while you are deciding what is best for you.

Daniel Barrett, MD · Answer

Dear OutdoorGeek,
it is hard to tell for sure without an examination but you will most likely need fat transfer to improve dents. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD

Kenneth R. Francis, MD, FACS · Answer

Dear OutdoorGeek,Contour deformities such as indentations are one of the risks of liposuction surgery.  Correction of the deformities can sometimes be challenging and often involves further liposuction, fat transfer, and fat shifting (a form of fat transfer).  You may be a candidate for one or all of these procedures.  Your American Board of Plastic Surgery board certified plastic surgeon can evaluate your condition in person and discuss your options.  I tell ALL of my patients to remain patient (no pun intended) with the healing process for AT LEAST 6 months after liposuction.  You would be surprised how things can change even in months 4-6.  Also, be sure to review your before and after photos at that time to have a better understanding of your contour changes.  Good luck!

Mats Hagstrom, MD (license on probation) · Answer

that’s an unfortunate outcome. I’m guessing your procedure was done under general anesthesia with you laying on your back. 
 You probably already know this but your provider didn’t have skill or experience to do good work.

I’m afraid fat transfer is probably the only realistic option. 
 If you get into the hands of someone who knows what you’re doing you should not be at risk for having worse outcomes on other parts of your body from having well done liposuction. 
 This procedure is highly predictable and delivers consistent results in the hands of those who know what they’re doing.  Contour irregularities and poor outcomes should never happen when you’re in the hands of someone who knows what they’re doing.   Undesirable outcomes from liposuction including disfigurement only happens when being treated by those who don’t have the skills or experience. 
 My practice is devoted exclusively to liposuction and fat transfer procedures and has for the last decade. 
 When  doing liposuction on the outer thighs the patient should be on their side with a wedge pillow between your legs to protect the hip dip area especially when being done by those with less experience.
 This becomes much more difficult when using general anesthesia. This is one of several reasons I keep my patients awake using local anesthesia for liposuction procedures. 
 Your situation is complex and you should have in person consultations with multiple experienced board-certified plastic surgeons in your area to get the best opinion. I cannot emphasize enough the importance of finding the best providers who have extensive experience with liposuction. 
 Getting consistent high-quality outcomes from liposuction is far more difficult than both providers and patients believe. 
 I speak from experience when I say this.  I’m not claiming my results are any better than anyone else but I do you know where I used to be 10 years ago and where my results are today 7000 Liposuction procedures later.  
 Please have lots of consultations in person. 
 Ask people to bring out before and after pictures of liposuction.  The person you want to taking care of you should have hundreds and hundreds of liposuction before and after pictures. 
 It may be necessary to travel for your procedure but I am fairly certain you can find quality experienced plastic surgeons in your area. 
 Best,

Mats Hagstrom MD

Sybile Val, MD - Account Suspended · Answer

Since you are already 4 months post op, the only way to correct these dents is with fat grafts. This is an unfortunate situation.  It can be corrected in the hands of an experienced surgeon.

Hip dents after lipo. What can be done to correct this? (Photo)

Answers (9)

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