Is It Safe to Have Abdominal Liposuction if There Are Adhesions and Scar Tissue?

Question

I have had previous abdominal surgeries and hernia repairs however have been left with adhesions and scar tissue, is it safe to have liposuction, I have no existing hernias present. Does the lipo instrument penetrate the scar tissue?

Otto Joseph Placik, MD · Answer

Certain forms of liposuction may penetrate scars more easily than others such as ultrasonic assisted lipoplasty or PAL. However, the scars to which you refer are insdie your peritoneal cavity and liposuction is NOT performed in this space.

David Shafer, MD, FACS · Answer

Any previous surgery complicates any further surgery. However, after a full examination by your surgeon and possibly some imaging studies (CT Scan), if everything turns out to be okay, then there is no absolute contraindication to surgery. Good luck with your procedure.

Martin Jugenburg, MD · Answer

mac121,

Previous surgical scars on the abdomen do increase your potential risk of injury during liposuction.

You should discuss your situation with your board certified plastic surgeon who has general surgery experience (liposuction can be performed by various doctors that may not have sufficient surgical experience).

The risk you want to avoid is that of accidental injury to your abdomen and abdominal cavity.  Previous surgeries may have left behind openings or weaknesses in the abdominal wall that would allow the liposuction instrument to enter the abdominal cavity which would lead to unwanted injury.

Sincerely,

Martin Jugenburg, MD

Ron Shelton, MD · Answer

Bruising and bleeding can be increased if the insertion scars go through the prior scars but if there are no hernias then there shouldn't be any significant further risk.

Kenneth D. Steinsapir, MD · Answer

Hi Mac

	Any number of specialties perform liposuction.  Generally, it is a very safe procedure.  However, prior surgery definitely increases the risk.  The risk that is of concern is perforation of the bowel that is adherent to the abdominal wall at the site of hernia repair.  Much depends on the nature of your hernia repair, the thickness of the fat on the abdomen etc.   While a number of surgical specialties perform excellent liposuction, you situation calls for a general plastic surgeon.  However, not any general plastic surgeon.  You really will benefit from a double boarded general plastic surgeon.  They should be boarded in general surgery and general plastic surgery.  Ideally your surgeon should devote a large portion of their practice to plastic surgery of the abdominal wall including precisely abdominal liposuction following hernia repair.  Just be aware that even general plastic surgeons have caused bowel perforation in this type of setting.  A careful and through evaluation of your particular situation will be necessary to allow your potential plastic surgeon to determine what you will need.

Robert L. Kraft, MD, FACS · Answer

I would be very apprehensive about performing liposuction in an area full of adhesions and scar tissue.  This would entail risks not normally encountered in liposuction.  It would be useful to know what type of hernia repair you underwent and whether mesh was used in the process.

Olivia Hutchinson, MD · Answer

Abdominal liposuction may be performed safely after previous abdominal surgery and hernia repair, but the operation will incur somewhat higher risk of complications as well as possibly suboptimal results due to previous scarring. Adhesions usually refer to intra-abdominal scar tissue which is outside the area of liposuction.

Steven Wallach, MD · Answer

If you have had previous abdominal surgery, I assume that you had a CT scan or other study to let you know that you have no hernias. I f this is the case, in most cases,liposuction can be performed carefully to avoid problems.

Darryl J. Blinski, MD · Answer

As most of the expert posters have stated it take excellent technique and experience. Also there can be increased bruising and healing time. But the final result may be limited by the scar tissue. Seek in person opinions.

Peter E. Johnson, MD · Answer

Abdominal scars and adhesions can increase risks with liposuction, not only for injury inside the abdomen, but for dents or contour imperfections. During liposuction the 'tumescent ' fluid used to numb the area will also expand the fatty layer and allow easier and safer passage of the liposuction instrument. With care, liposuction can be safely performed. Scar adhesions are often treated this way, in combination with ultrasound which will penetrate the scar and help with uniformly contouring the area. Scar tissue certainly will increase the risk for a mishap and you should seek out a very experienced surgeon.
	Best of luck,
	peterejohnsonmd

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