Is this fibrosis? I'm 6 months out from BBL (Photo)

Question

Is this fibrosis or poor liposuction? my abdomen is very soft and i'm 6 months out from BBL

Semih Yildiz, MD, FEBOPRAS · Answer

The photo shows mild abdominal contour irregularity and shadowing, but it cannot confirm fibrosis by itself. Since your abdomen feels very soft, dense fibrosis is less likely, but an in-person exam is needed to feel for firm bands, tethering, swelling, or uneven fat removal.

At 6 months after BBL/liposuction, some swelling and tissue remodeling can still improve, but the result is becoming more stable. If the problem is scar tissue, treatment may involve massage, ultrasound or radiofrequency treatments, or selected injections; if it is uneven liposuction, correction usually means waiting until healing is mature and then considering conservative revision. Your original surgeon or a board-certified plastic surgeon should examine you before starting treatment, because fibrosis and contour irregularity are managed differently.

Gianfranco Frojo, MD · Answer

This is a contour irregularity secondary to likely excessively superficial liposuction in the area. I would recommend seeing a board-certified or board-eligible plastic surgeon with aesthetic surgery training and experience to tackle this type of problem in a safe and efficient manner. Best of luck!

Emmanuel Mallol Cotes, MD · Answer

Thank you for your questions. Based on the picture it looks like fibriosis. I would suggest to be treated by board certified plastic surgeon with experience in this procedure, to get the best desired results.

Respectfully,
Dr. Emmanuel Mallol Cotes.-

Respectfully,
Dr. Emmanuel Mallol Cotes.-

Alan Gonzalez, MD, FACS · Answer

Hello @Kelly Pittsburg, thank you for your question. It depends on several factor to determined the diagnostic, including whether there was a previous liposuction. Often when a sweep is done with laser or other technology and there are previous surgeries, as there is less fat, the depressions are more noticeable. For more information and recommendations, it is best to consult one or more board-certified plastic surgeons. Best wishes! Alan Gonzalez MD, FACS.

Andre P. Marshall, MD · Answer

Hi Kelly, 
It's hard to make a proper assessment without an actual consult/exam and only one picture. However, from the one picture you are showing it does appear that you have abdominal contour irregularities after liposuction. The best treatment for these is prevention, however sometimes (but not always) this condition can be improved with a revision. Superficial and aggressive liposuction is often the reason for these contour irregularities, but also lack of appropriate postop lymphatic massages also contributes. 
Dr. Andre P. MarshallDouble Board Certified Plastic SurgeonBeverly Hills, CA 90210

Daniel Barrett, MD · Answer

Dear Kelly Pittsburg,
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

Very limited viewed posted photo. I think might be combination of fibrosis with irregular liposuction. Only virtual consult with... can allow a determination of exactly the issues. But the 2 ways to improve is re lipo doing superficial lipo releases or injection of nan/micro fat grafts vs Radeisse/Sculptra injections. Fees range from $5,000-$12,000.

Cagil Meric Erenoglu, MD · Answer

Hi, Kelly Pittsburg! Thank you for your question and photo.
Liposuction heals with swellings and use of pressure garments and massaging with herbal oils help amazingly on the recovery period. This helps the residual fat tissue to get equally distributed on the surface. So I recommend you to da massage for at least 3 months.

Douglas Taranow, DO, FACOS · Answer

It appears that you have contour irregularities due to your abdominal liposuction.  Most commonly due to over liposuction and a combination of thin skin (which does not conceal the dents). Very difficult to treat.  Many times feathering (breaking up the remaining fat using a cannula without the suction on) may help this.  Weight gain certainly makes it more visible.

Mats Hagstrom, MD (license on probation) · Answer

Delivering consistent high-quality liposuction and fat transfer results is more difficult than most people believe in this is true for both patients and plastic surgeons. Most plastic surgeons think they are better at liposuction than they actually are. Liposuction and fat transfer has more variance or difference in outcome purely based on who does the procedure than any other surgical procedure I’ve ever seen. Being board-certified in plastic surgery with an overall good reputation is not sufficient to guarantee that somebody has mastered body contouring with liposuction and fat transfer. Personally I view the torso as a single anatomic unit and either treated the entire torso or don’t do Liposuction. There are of course exceptions but for the most part I believe in treating the entire torso. A full torso includes upper abdomen, lower abdomen, love handles all the way down to the hip dips, waist, the entire back and under arm area all the way to the side of the breast. this leaves people with a natural thin fat distribution without transition zones between treated and entrteded areas. I’ve viewed the BBL as an enhancement to body contouring creating an ideal feminine S-curve that goes from the armpit to the knee. I did not emphasize a large buttocks with liposuction of the outer thigh creating a big round butt on the small leg which I sometimes called the “lollipop look”. Instead I emphasize long smooth harmonious curves creating a slightly hyper feminized balanced figure. To find the most talented and experienced provider in your community I suggest having multiple in person consultations. I do not recommend patients travel for elective surgical procedures and I recommend patients whenever possible avoid virtual consultations. During in person consultations ask each provider to show their entire collection of before and after pictures of BBL results. Always confirm that after pictures were taken at least three months from the time of surgery. anybody who shows early postoperative pictures such as pictures with patients still showing surgical drawings on them, being in the operating room or any evidence of recently having had surgery should be immediately discounted as showing “.fake news”. Early fat transfer results can look very impressive but do not at all represent final results. Ask the provider to show you examples of excellent outcomes, average outcomes and less than outcomes. Specifically ask each provider to show as many pictures as possible‘s of patients who have similar body characteristics to your own. An experienced provider should have no difficulty showing you a minimum of 50+ sets of before and after pictures. Simply seeing a handful of pre-selected sample pictures which in reality most likely represent the best results of that providers career is insufficient to get a clear understanding of what average results look like for that provider. Highly experienced providers will have hundreds or even thousands of before and after pictures and should be willing to give you access during the consultation to see as many pictures as possible. If somebody claims to of done a lot of surgery but doesn’t have a lot of before and after pictures then you should ask yourself why? Do not commit to surgery or pay a down payment during the time of consultation until you’ve finished all your consultations and have given yourself plenty of time to think about your decision. The results from these procedures are permanent and irreversible. When in doubt slow down and schedule more consultations. Finally I recommend patients read all reviews on all various physician review websites avoiding providers for any significant number of justified negative reviews. The absence of justified negative reviews is more important and more telling and having an abundance of positive reviews. Plastic surgeons with the biggest social media profiles are not necessarily any more talented than those who have no websites at all. Famous or likable does not equal talented. 
Doing Revision Work is many times more difficult than primary Liposuction so the importance of finding the right provider is even greater.
Find the right plastic surgeon and everything falls into place. 
Good luck, Mats Hagstrom MD

Is this fibrosis? I'm 6 months out from BBL (Photo)

Answers (10)

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