Dents and uneven liposuction, can a second round of liposuction fix this? (photos)

Question

I got 360 lipo about a year & some change ago. After the procedure I saw the dents and what seemed to be more fat on one side of my stomach. Could redoing lipo correct this? I spoke with the doctor and he mentioned that the only way I would be able to have my stomach even and flat was to do a tummy tuck and that is was my skin rippling but I can almost feel the fat underneath. I asked if liposuction again could correct this to make it even and he said he couldn’t make any guarantees. Advice?

Daniel Barrett, MD · Answer

Dear Jessica801,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Andre Levesque, MD · Answer

Thank you for your question and photos.  I would agree that no surgeon can guarantee results and that even a true expert performing liposuction can result in some irregularities.   From your photos it does appear that you have some difference in adipose (fat) tissue not just a difference in skin elasticity.  I would recommend seeing a couple board certified plastic surgeons for an in person examination and consultation.

Secondary liposuction when irregularities already exist is incredibly hard.  In my experience improvements are usually made but perfectly smooth results are the exception rather than the rule.  I could see surgeons recommending VASER or SAFE liposuction and possibly needing fat grafting in some of the depressed areas.  After revision liposuction there would certainly be a need for lymphatic massage, appropriate garments, and close follow up to make sure there are no undiagnosed fluid collections.

Darryl J. Blinski, MD · Answer

Nice posted photos! All surgeons can never guarantee results. But round 2 lipo of abdomen with aggressive superficial lipo sculpting is indicated with 1 drain and compression with multiple postoperative massages. Fee $6,000. Best to virtual consult with...

Mats Hagstrom, MD (license on probation) · Answer

Delivering consistent quality liposuction results is more difficult than most people believe.
You chose a provider who does not appear to have sufficient skill and experience to deliver quality results.
It’s very important that you properly vet providers including one certified plastic surgeons with overall good reputation and years of experience. having those credentials does that mean that someone knows how to do liposuction well.
It is a more difficult procedure to do well at them people believe it despite being inherently simplistic at the same time.
For many people who have had a poorly done liposuction the results are just figuring it and further improvements cannot be made.
That is not the case for you.
Your surgeon under cheated you and while you were not content with the results it means that you are a candidate for having a quality liposuction procedure that can get you the results you were hoping for including creating normal contours of your abdomen and torso.
To do this you will however have to find a provider who is far better at Liposuction than your current provider.
Begin the process by printing out pictures of your body or bring proper before and after pictures to any new consultations.
Look for providers in your community and seem to do a lot of Liposuction based on the quality and quantity of before and after pictures on their website. Look for people who specialize in liposuction.
Schedule at least five in person consultations. During each consultation ask each provider to open up their entire portfolio and show you all of their before and after pictures. providers may be apprehensive to do this and will instead prefer to show you preselected pictures representing the best results of their career.
This however is insufficient to get a clear understanding of an average results look like in the hands of each provider.
As providers to only show you pictures of previous patients who had similar body characteristics to your owner. this is why I am bringing pictures of your own body and your before and after pictures is important to use as a reference. 
Ask the provider to show you examples of excellent results, average results and results that did not turn out as well as they had hoped. We all have a variety of outcomes and it’s fair game for patients to ask to see a variety of results. Ask specifically what each providers revision rates and revision policy is.
An experience provider should have no difficulty showing you a minimum of 50 sets of before and after pictures of commonly performed procedures like abdominal liposuction. 
Personally I view the torso as a single anatomic unit and generally treat the entire torso when doing liposuction. Treating the entire torso as a single unit illuminates people from having transition areas between treated and untreated areas. That is in a sense what your current problem is. The Liposuction was really don’t need done on the central abdomen and if the fat layer transitions into your baseline is thicker fat layer on the sides it doesn’t look natural. If you’re going to thin out the fat layer on your torso your entire torso needs to have a thin fat layer. A full torso includes upper abdomen, lower abdomen, love handles (all the way down to the top of the hip dip area), waist, full back and under arms (armpit) all the way to the side of your breast.
Look carefully at before and after pictures to make sure there are no skin contour irregularities in any treated area.
Ask the doctor to review the pictures with you and ask them to point out exactly what areas were treated and what areas were not treated. Then look carefully at transition zones between treated and untreated areas to make sure they look natural.
Get familiar with what quality liposuction results should look like based in reviewing lots of before and after pictures on this website. Look especially for other patients with similar body characteristics to your room in the before pictures.
In reality highly experienced surgeons should have hundreds or even thousands of before and after pictures and should be able to show you what seems like an endless stream of the results.
If you have any concerns or questions about the provider you’re consulting with having mastered this procedure and simply continue having more consultations until you feel confident you found the best provider,
There are only two variables that matter when it comes to liposuction results. They are patient candidacy and provider selection.
You appear to be a good candidate for Liposuction so don’t anything missing is finding that one plastic surgeon who really knows how to do liposuction well.
Simply choosing a board-certified plastic surgeon with years of experience and overall good reputation is insufficient to confirm that they have mastered this procedure.
Patient should be more selective than they may think they need to be when it comes to choosing Liposuction providers.
When in doubt slow down and schedule more consultations.
I do not recommend you having revision work with your current provider.
He or she has already shown you their lack of competence with Liposuction.
Best,
Mats Hagstrom, MD

Dents and uneven liposuction, can a second round of liposuction fix this? (photos)

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