Lumpiness 2 years after lipo. Is there anything I can do apart from a liposuction revision? (photo)

Question

I had a fat transfer to my breasts almost two years ago and I still have lumpiness and some hardness under the skin. I’ve done 6 velashape treatments since the procedure and that helped me slightly. I cannot go back to the original surgeon. I want to know if there is anything I can do apart from getting a whole liposuction revision. Would getting a kenalog injection into the scar tissue help? Would massage or cupping for scar tissue work? Would losing weight lessen or worsen the appearance?

Donovan Rosas, MD · Answer

Your issue is multifocal. The lumpiness is a function of irregular liposuction with more taken from some areas than others leading to uneven contouring. This is more commonly seen in the setting of aggressive liposuction often times for fat harvest where the goal is less contouring and more maximizing fat yield. Additionally, there is an issue of skin laxity. This also commonly seen in the setting of aggressive liposuction. There is inherent recoil in the skin following liposuction. However, there is a limit to the degree of elasticity. Skin quality plays a role and tissue which has been stretched (striae/stretch marks) secondary to weight gain/loss and pregnancy may not respond as expected.The solutions to these problems will vary as well, with additional liposuction and fat transfer to smooth irregularities and skin tightening (RF such as Thermi/Bodytite).As always, discuss your concerns with a board certified plastic surgeon (ABPS).

George Marosan, MD · Answer

Thank you for your question and photos. Based on these photos, you have two issues: 1. irregular liposuction and 2. loose skin. Your surgeon collected fat not respecting the underlying muscle and bony anatomy to leave you withe an athletic hourglass figure. To correct these, you will need liposuction and skin tightening. In my practice, I use the VASER Hi Def Liposuction technique to release the skin and even out the irregularities. At the same time, J-Plasma can be used to tighten the skin.  This operation is more challenging than the original "fat collection" liposuction. I would not recommend Kenalog injections or cupping.See a board certified plastic surgeon experienced in advanced body sculpting for an in person consultation/evaluation. Good luck.

Daniel Barrett, MD · Answer

Dear Amanda.26,I would have to examine you but it appears that this is a contour irregularity after liposuction.  This happens often when areas the undergo liposuction are not feathered appropriately.
The good news is that it can be fixed and I have done so with good results before. The revision can often be done under local as well.While there is always a chance for contour irregularities with liposuction, someone who takes their time and uses the appropriate sized cannulas should give you a superb result.I have all my patients wear compression garments and I use multiple sized cannulas to feather out the result.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Very carefully done fat transfers can help decrease the lumps and increase the smoothness. Do find someone who treats scar tissue.

Curtis Wong, MD · Answer

then you must find another and let your surgeon know of specifically what you concerns are and what you wish to achieve as that would dictate just what is done.  You have lax skin and ridges and there are different solutions to each issue.

Lumpiness 2 years after lipo. Is there anything I can do apart from a liposuction revision? (photo)

Answers (5)

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