How to Remove Hardened Scar Tissue 3 Years After Power-Assisted Liposuction?

Question

I had liposuction 3 years ago. The doc used PAL, results were pretty poor. Overuse of garment caused scar tissue and underlying fat caused more uneveness. I followed this up with slimlipo,unevenes has reduced but scar tissue is still there. Can this scar tissue be decimated using PAL? broken up and removed. Some of it seems like fat got hardened, around existing tissue. The tissue is numb and feels like leg gone to sleep. How can this scar tissue be removed?

Brent Moelleken, MD · Answer

The single greatest cause for severe scarring after liposuction is aggressive liposuction.  This causes a skin-on-muscle deformity and prevents mobility of the tissues.  This can definitely to be avoided by not performing the procedure too aggressively.  It is sometimes possible to release scar tissue but this of course does not correct the underlying irregularities in fat thickness.

	Excessively superficial liposuction, or burns with the laser technique also cause irregularities.  In both cases, these irregularities are very difficult to treat.

	In such cases, revisional microliposuction can help, but lifts are often necessary, with direct removal of scar tissue.  However, further removal of fat often just compounds the problem.

	Experience is a must in revisional cases.

Richard H. Fryer, MD · Answer

Fibrosis after liposuction is difficult to treat.  Fibrosis is usually hardened areas of tissue which can be caused by fat necrosis, over-resection of tissue, excess tissue trauma, or unrecognized seromas (fluid collections).

	The best methods for treating the fibrosis is 1)prevention and 2)early detection and treatment with massage, external ultrasound, possible fat grafting, and (infrequently) steroid injections.

Ron Shelton, MD · Answer

Some patients need fat injections to fill in dents and others need more lipo in focal areas for under-corrected areas and some patients need both. If scar tissue is hard but not bound down to the underlying muscle the firmness may improve with deep massage, Endermolorie, Velashape, and external ultrasound. Some physicians might use injectable corticosteroids into the area and this may soften the scarebut there risks including depression!

Otto Joseph Placik, MD · Answer

The attached video shows the results of a tummy tuck to correct skin irregularities caused by agressive liposuction.

David Shafer, MD, FACS · Answer

It sounds like you have had a very unusual and very unfortunate outcome to your liposuction procedure.  Without pictures or seeing you in person, it is impossible to give you specific advice.  However, there are often a combination of procedures which may help, including additional liposuction, fat grafting and RF and US treatments.  

	 

	Good Luck.

George Marosan, MD · Answer

I'm sorry to hear that you still have hardened areas after your power assist liposuction. I do not believe it is the garment's fault. As I often say, it is not the tool but the person using the tool that makes the difference! It sounds that your surgeon oversuctioned the area and devascularized or injured the vessels under your skin. You do not state what body part is injured. I personally see this on the abdomen, when patients come in for a second opinion, and often the only correction is to surgically remove this tissue like an abdominoplasty. This scarred tissue is inelastic, feels like leather and it is a poor recipient site for fat grafting. Some of the fat that survives, will give you some improvement, but it is almost impossible to fully correct the lumpiness.

Jeffrey Kenkel, MD · Answer

it sounds like your situation of scar tissue 3 years after liposuction is an unusual one. It may be scar or possibly even fat necrosis that has become hard. I would try to address this nonsurgically if at all possible. Beginning with ultrasound treatments and aggressive massage. More surgery could give you even more irregularities.

Robert Brueck, MD · Answer

This is tough no pun intended.I would try non surgical method because anytime you cut or do surgery you are creating more scar tissue so I would try heat,massage and ultrasound to see if this tissue can be softened.

Robert Whitfield, MD · Answer

Firm areas of fat from scarring or fat necrosis can be treated in a number of ways. My preferred method is to use ultrasound-assisted liposuction for its ability to break up fibrous areas. I then use fat graft harvested from another areas to inject into these firm areas.

Scott E. Kasden, MD, FACS · Answer

You present a difficult situation.

	I assume your problem is in the leg, and likely distal thigh. Only an exam will tell what the problem is- fat necrosis ( I suspect), scar tissue, something else?

	I don't think PAL would be the best.  If anything is indicated, UAL, or laser lipo might be better.  Depending on exam findings, you may also need fat transfer, or even, leave it alone before it gets worse.

	If this is in your abdomen, a tummy tuck may be the best way to go.

	sek

How to Remove Hardened Scar Tissue 3 Years After Power-Assisted Liposuction?

Answers (14)