How to repair wavy skin after BodyTite damage? (Photo)

Question

Hello. This area of my abdomen has not responded well to scar tissue release under the skin with a canula or fat grafting in an attempt to correct the irregularities from a BodyTite procedure a cpl yrs ago. How can this actually be corrected? C02, Renuvion, Microneedling? It seems the issue is IN the skin, not just underneath it.

Camille Cash, MD · Answer

I'm sorry to hear of your contour irregularities after your BodyTite procedure.  If you have not had improvement with fat grafting you may be a candidate for Morpheus8.  This minimally invasive procedure uses RF technology combined with microneedling to improve overall skin tone and texture.  If there is skin laxity a tummy tuck may be recommended.  Visit with a board certified plastic surgeon near you to learn more.

Mats Hagstrom, MD (license on probation) · Answer

This response was dictated.
I apologize in advance for grammatical errors.
Body tight is a secondary treatment aimed at skin tightening that is done in conjunction with Liposuction.
The procedure is generally not done alone and the primary procedure is almost always liposuction and body tight is a secondary add-on treatment done in conjunction.
The two newest modalities of secondary skin tightening, add-ons are body tight, and Renuvion a.k.a.J plasma.
In my opinion, both of these treatments fail miserably at delivering what they claim are possible.
I personally owned the Renuvion device and used it for one year.
There was zero measurable or noticeable skin tightening and not a single patient appreciated, or could acknowledge any improvement and skin tightening.
EventuallyI simply could not recommend adding the treatment because I knew it did not deliver any value to my patients and only created increased pain and risk.
In my opinion, these two devices are quackery, sham medicine, and it is my belief that both companies will eventually go bankrupt. I find it quite interesting how few plastic surgeons are willing to acknowledge that devices they paid over $100,000. for actually does not deliver any benefit.
I seem to be the outsider when it comes to calling the bluff on these devices. 
I have since sold the device at a substantial financial loss.
Liposuction results are based on two variables.
The first is the patients candidacy for the procedure and the second is the skill and experience of the provider.
Not everybody seeking Liposuction is a good candidate for the procedure.
I’m going to refer to your procedure as Liposuction, because that is really what you had. (I’m making some assumptions) 
 The addition of body tight in reality probably didn’t really change anything in regards to your outcome. 
That is an assumption.
Generally speaking the best candidates for Liposuction are young individuals with tight skin, who have excess slightly pudgy, undesirable, subcutaneous fat.
The opposite is also true.
Older individuals or those with skin laxity or loss of skin elasticity tend to not be good candidates, and don’t have the potential forgetting quality outcomes.
 The next variable after patients candidacy is provider selection.
Delivering consistent quality Liposuction results is more difficult than most people realize.
The number of plastic surgeon’s who have truly mastered this procedure is small.
Mastering Liposuction includes not only the ability to technically perform the procedure well, but to also make accurate assessments and deliver predictable outcomes.
There should be no guessing game in what Liposuction results look like in the hands of the right provider.
Most plastic surgeons, think that they’re better at Liposuction than they actually are.
There are plenty of talented providers, but there is unfortunately a significant percentage of well trained properly credentialed well intended experienced plastic surgeons, who simply do not do well with Liposuction.
In the end, patient candidacy, and provider selection are the two most important variables that determine plastic surgery outcomes.
To find the right provider, I generally recommend patients schedule multiple in person, consultations with plastic surgeons in their community who seem to have extensive experience and a solid track record for doing Liposuction.
Bring pictures of your own body to use as a reference during consultations.
During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who had similar body characteristics to your own.
This means Individuals who had the same skin laxity, same age and overall same body types.
An experienced plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients.
Highly experienced surgeons should have access to hundreds or preferably thousands of before and after pictures.
 Being shown a handful of pre-selected images, representing only the best results of a providers career may be insufficient to get a clear understanding of what average results look like in the hands of each provider what your results are likely to look like or how many of these procedures they’ve actually done.
There’s no correct number of consultations needed to find the right provider.
The more consultations you schedule the more likely you are to find the better provider for your needs.
The biggest mistake most patients make is scheduling only one consultation and then scheduling surgery.
Having only one consultation, more or less eliminates the ability to choose the better provider.
Assuming that being board-certified in plastic surgery is sufficient to deliver consistent quality Liposuction results is probably equally as common and often incorrect.
Correcting poorly done, Liposuction is highly complex and many times more difficult than primary Liposuction.
Some individuals have the potential for some improvements after the first procedure was done, poorly, inappropriately, or on someone who was not a good candidate.
Considering that revision work is many times more difficult and more complex than primary Liposuction. Patients should recognize that if the provider did not have the skills to do the procedure well in the first place, they most likely are not in the position to offer quality revision work.
 Generally plastic surgeons take responsibility for their own work and typically do their own revisions.
Sometimes this is appropriate and should generally be the correct approach.
Sometimes, however, patients need a higher level of care and should either be referred or self refer to get into the hands of a provider who has the skill and experience to make an accurate assessment, and help the patient through the process of decision-making and technical aspects of surgical revision. Correcting poorly done Liposuction is generally done with a combination of secondary liposuction and or fat transfer.
Fat transfer tends to not work very well in areas that are devoid of fat.
The reason for this is in order for fat transfer to be successful. There must be some “host tissue” to support the grafted fat.
 This means that the areas that needs fat grafting the most tend to be the same areas where the graft tends to fail.
Generally, some improvements are possible with revision surgery.
Whether revision surgery is a worthy endeavor and understanding revision surgery has potential for creating improvements is highly complex and varies greatly from person to person.
 Your pictures are insufficient to make a quality assessment.
To make an assessment regarding the outcome of any plastic surgery procedure we generally need to see a complete set of proper before and after pictures.
If you don’t have before and after pictures, then ask your surgeon to forward the pictures they took.
 Making an assessment for revision surgery is inherently complex and difficult and is not advisable via virtual consultations.
For that reason you are unlikely to get quality responses that are going to be of actual help from your post.
Considering how difficult it is to find the right provider for primary procedures, and how much more difficult revision work is compared to primary liposuction. It is a daunting task to find the right provider to do revision work for those who had poorly done previous Liposuction.
On individuals who were not good candidates to start with sometimes it may not be worthwhile to pursue revision surgery at all. 
There are a lot of variables to take in the consideration.
To get a proper second opinion consultation, I suggest scheduling those as in person, consultations with other plastic surgeons in your community who have a proven track record with both Liposuction and fat transfer.
for second opinion, consultations come prepared, bringing with you and complete set of proper before and after pictures and copies of your previous operative reports.
If you’ve already had revision surgery, then you should include before and after pictures of each of your previous procedures and operative reports of each of your previous operations.
You can obtain both pictures and reports by requesting them from your current providers office.
They are part of your medical record, which you have a right to.
I’m sorry you find yourself in the situation you are in.
I also apologize if my response seems negative or lacks enthusiasm.
I’ve been doing this for far too long to do anything but tell the truth, especially to those who’ve been hurt and disfigured from having cosmetic surgery.
Often individual who have been disfigured from these type of procedures Are apprehensive of trusting any doctor to do more surgery, have already paid at enormous burden, both financially and emotionally and guiding patients through this process is a big responsibility.
I can’t really tell you what you should do.
I don’t have a sufficient information to make a quality assessment. I don’t know what you’re trying to achieve or what you’re willing to go through.
All of these variables are important and must be taken into consideration when coming up with the reasonable treatment strategy.
Your provider most likely was well intentioned properly trained, but simply didn’t have sufficient skill and experience in this procedure.
This is not uncommon unfortunately.
For anyone reading this post of not yet had Liposuction, I cannot over, emphasize the importance of provider selection, and having a clear understanding of your own candidacy for the procedure before considering scheduling surgery.
Best,
Mats Hagstrom, MD

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