To make a quality 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. Fibrosis is not a condition that happens in some people only. It is generally the outcome of overly aggressive Liposuction, removing almost all the fat And this causes increased scar tissue. Increased scar tissue by itself is usually not an issue if there is a sufficient amount of subcutaneous fat left behind to buffer the scar tissue. Went too much fat is removed. Then all that’s left is excessive scar tissue, skin and muscle and this is what most people refer to as fibrosis. The entire purpose of heating up the tissues using Renuvion, a.k.a. J plasma is in fact to create fibrosis or more scar tissue. It is the scar tissue that theoretically will contract and create skin tightness. I am not a fan of J plasma.I purchased the device early on and used it for a year. It literally created zero visible or measurable skin tightening and not a single patient felt that it gave them improved skin tightening. What the device did deliver was increased pain during and after the procedure and an increased complication rate. The purpose of this device is simply to make more scar tissue. It is inherently conceptual advice. Delivering consistent quality Liposuction results turns out to be much more difficult than most people realize. The number of plastic surgeons who truly mastered this procedure is very small. Being board-certified in plastic surgery with years, civics experience, and an overall good reputation does not mean somebody has mastered any single procedure, has Liposuction skills, is good at Liposuction, or even likes doing the procedure. I know a lot of plastic surgeons, who simply hate doing Liposuction, but do it because it pays the bills. With this attitude providers are never going to get great at doing this procedure. There’s more variation in skill experience for Liposuction than I think just about any other plastic surgery operation. This is just my opinion, but it seems quite consistent because I see cases being done by other providers on a daily basis. Results vary from spectacular. Truly magical body transformations to people being left refigured. Unfortunately, Liposuction is very much a permanent and more or less irreversible procedure. if the procedure wasn’t unwell the first time, it is very difficult to improve on the outcome. There are no treatments for fibrosis. Doing more surgery will only create more tissue. Doing more Liposuction removes the last bit of precious fat someone has venting scar tissue from becoming more symptomatic. Attempt at revising poorly done. Liposuction can sometimes lead to some improvements. Those who are candidates for revision work tend to be individuals when the first procedure was not done in an overly aggressive manner. If a significant amount of fat was left behind then there is tissue to work with. The most difficult cases to improve with revision surgery are going to be those who were grossly over treated and developed fibrosis. Next I’d like to point out that revision work is generally many times more challenging and difficult compared to primary Liposuction. A provider who doesn’t have the skill to do quality Liposuction is not the right provider to be doing revision work because revision work is much more difficult than primary Liposuction. Simply finding sufficiently experienced provider to do quality revision work isn’t itself very difficult. To find the right provider, I suggest patients schedule multiple in person, consultations with plastic surgeons in their community, who seem to do a lot of liposuction. 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. an experienced provider should have no difficulty showing you the before and after pictures of at least 50 previous patients. Being shown a handful of free 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 that 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. Never assume that being certified in plastic surgery with an overall good reputation and some good reviews is sufficient to confirm that somebody has mastered any single procedure 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. Considering how much variation there is in Liposuction skills and how difficult doing quality revision work is I suggest patient start the process by having five or six consultations before considering choosing a provider. I wish I could be more optimistic for you, but I also know that patience had bad experiences with cosmetic surgery or have been left deserve to hear the truth should be protected from predatory providers, offering to be able to easily fix a problem, which is inherently almost impossible to correct. Be very leery of individuals claim this is easy to fix, that some specific equipment or technology will fix your problem, etc. etc. Insist on seeing evidence of similar work. You may not find providers who can show you hundreds of before and after pictures of revision work similar to your situation. Revision work tends to not be nearly as common as primary Liposuction. Generally, the best providers for revision work are the same providers who do the best primary procedures. The only exception to this is when fat transfer is needed to revise poor Liposuction outcomes. When that’s the case you need to vet the provider for their skill and experience with fat transfer. Correcting overzealous Liposuction results with fat transfer is also inherently difficult and often takes multiple procedures to get partial improvements. To get an accurate assessment you need in person consultations. Best, Matt Hagstrom, MD