Should I Have to Pay for my Lipo Revision?

Question

I had lipo done to my abs, flanks, inner and outer thighs 9 months ago. I knew I would need some revision, doctor agrees; but wants to charge me $1300 for an in office touch up. Should I have to pay for more than the tray fee? Areas are obvious that revision is needed due to not enough removed.

Stanley Okoro, MD · Answer

This is a very difficult subject as the patient does not really want additional surgery or pay additional money. Many patients spend thousands for the original procedure. However, it is very important to understand that Plastic surgery is not an exact science. Its not always possible to remove all the excess fat in a single procedure. Sometimes, there are excess bleeding or the fat does not come out. Some patients need staged liposuction. This is not revision liposuction. However, every great plastic surgeon at some point must revise his or her work. As Plastic surgeons, we do our very best to obtain the best results for our patients. In our office, revision is not very common, but it does happen.  We do have our own revision policy which is discussed with every patient prior to surgery.  If there is a need for revision (not weight gain or non-compliant) within the first year, we do NOT charge our patients a surgeons fee. However,  the OR (hospital or facility) and the Anesthesiologist fee are the responsibility of the patient.  We do not have control of these costs. The best way to minimize revision liposuction is to do your homework and select a real Plastic Surgeon to do the work initially. Some revision work can be more expensive than the original procedure. The best way to deal with revision is to discuss your dissatisfaction with your Plastic Surgeon.

Raffy Karamanoukian, MD, FACS · Answer

You have to find the right balance for fees between you and your surgeon. I would recommend liposuction, lipocavitation, skin tightening, and the Brazilian Cellulite Treatment. Best, Dr. KaramanoukianRealself100 Surgeon

Ron Shelton, MD · Answer

Liposuction is not an ideal method for weight reduction. If there was too much fat to remove safely at one sitting from several body sites, then the surgey could be staged with one or two areas being done at one time. There is a limit to how much anesthesia can be used and how many ccs of fat can safely be removed. The total work expected to be done might not have been enough but that doesn't mean that you shouldn't expect to pay for more work, when the work done has been good. There are expenses to performing the procedure and there should be a fair remuneration to the surgeon for doing more work.

Jeffrey J. Roth, MD, FACS · Answer

Different offices do things differently. Often, if there is a need to back to the operating room, there will be a charge for the OR and the Anesthesiologist. These are costs that the surgeon usually has no control over. The surgeon may charge a fee. This fee is usually reduced. With liposuction, patient compliance with wearing the compression garment makes a big difference. Also those patients who have a proper diet and exercise program also usually do better than those who don't.

Eric Swanson, MD · Answer

Often the surgeon performs touchups without a professional fee, but you still pay such expenses as the facility fee and anesthesia. Your surgeon has offered to perform a touchup in the office. Here is the problem - you are likely to be dissatisfied. You would be better treated under general anesthesia in a surgery center. The office is for small touchups. You basically desire a redo. This is best done asleep because the surgeon can remove more fat this way. So your options are either to talk to your surgeon about redoing the surgery under general anesthesia (presuming it was done this way the first time) or going to another surgeon who will be more aggressive. Keep in mind, I am not viewing your original photos and your surgeon may well have been aggressive the first time and you simply need another liposuction procedure, but it should be like the first and under general anesthesia to allow maximum results. Many plastic surgeons, including myself reoperate on about 20% of our liposuction patients. It is common.

David Stoker, MD · Answer

It is best for a patient and surgeon to discuss revision policy before doing surgery. Although hopefully uncommon, all surgeons must do revisions in some cases. Each office will have their own revision policy, and usually this will be in writing. It is most common for the surgeon to do revisions at a much lower cost to patients, where the patient may be responsible for operating room and anesthesia costs, if necessary.

Erez Sternberg, MD · Answer

In your case there does not seem to be any error or problem with the surgery itself, infact, your results are quite satisfactory. What you need is additional liposuction to those areas to remove more fatty tissue. Likely, the surgeon was not able to perform more liposuction during your procedure due to the amount of fluid or blood loss that is associated with such high volume liposuction. Therefore, your best options now would be to continue dieting and exercise to further improve your results or sign up for more liposuction. If you choose the latter, it would be up to your plastic surgeon to decide whether or not to charge a professional fee. There is no way to avoid the surgical anesthesia and facility charges. To get the best result possible with additional liposuction, you should not opt for the cheap way out, instead, pay for the surgery and anesthesia so that your plastic surgeon can do the best job possible. Good luck.

Rafael C. Cabrera, MD · Answer

revisions are handled based on office policy which you should have been made aware of preop and is in writing on your contract (usually). If it's not in writing, then everything is negotiable. based on your photos, a substantial amount was removed. I personally think you are a poor candidate for lipo because you're shape is nice. the problem is the fat is evenly distributed, looks good but really not a localized lipodystrophy case. sorry but exercise and diet control are your best revision option.

Ayman Hakki, MD · Answer

in 87 i used to do revisions for free, since then i have charged patients.

	i find that paying increases the odds of satisfaction. it's a real dilema!

	the key is this; did the surgeon tell you he charged for revisons, i do.

Richard P. Rand, MD, FACS (retired) · Answer

As has been said, there is a wide varaibility of fees involved in revisionary plastic surgery. Your doctor seems to have treated you well. Be aware that overdone liposuction causes uncorrectable problesm so don't fault your doctor for not going too far. In fact, as others have commented, based on your photos, you would be far better served at this point by diet and exercise than by more liposuction.

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