Can this be revised and look normal or is it to late? (photos)

Question

I had smartlipo about 7 yrs ago and had a terrible turnout. I was even burned from the inside out on my skin... (Notice in photos on left side). I have had 3 kids since then, hoping it would go away... My stomach has remained flat, these pictures are 2 months post baby... But it's super rippled and indented.. It's hard in some areas... Is this fixable?

York Jay Yates, MD · Answer

Smartlipo deformity is something we see all too often after smartlipo, literally on average one patient a week with a very similar story and outcome.   Smartlipo uses a laser to burn the fat deep to the skin prior to liposuction.   When done in an irregular or aggressive fashion the burned subcutaneous tissue produces severe indentations.   With time, the skin above these indentations can sag over the "stuck" scar.   This is a unique deformity in liposuction as other modalities do not cause as much tissue injury as the laser and do not cause as much scar tissue.This is a difficult thing to fix generally requiring some combination of scar tissue release, fat grafting, fat removal or skin removal.  There are many manufacturers of "tools" to help the plastic surgeon do liposuction, smartlipo is one of those tools.  The truth is that an expert can get similar results with any of them.  It is not the brush that the artist holds but rather the artist himself that creates the masterpiece.

Marco A. Pelosi III, MD, FACOG, FACS · Answer

What a mess! Various corrective options are available for the upper abdomen and they may need to be combined or staged to improve your appearance. If you are a smoker, these options will probably not be valid. If the tissues are semi-elastic and improve with traction, a reverse abdominoplasty combined with corrective lipo and fat injections might be reasonable. Fat injections may need to be repeated. Liposhifting and fat grafting would be a less invasive option which may also require more than one session. Don't expect perfection.

Daniel Brown, MD, FACS · Answer

Hello Imdthomas79,,Thank you for you questions and photos.  I'm very sorry that you are going through this!  Unfortunately, Smart Lipo can cause significant contour irregularities and scarring all too often.  The good news is that it is most usually fixable.  The rippling and indention can certainly be significantly improved with aggressive lipocontouing, and may require fat grafting to correct some of the deeper indentations.  I would encourage you to schedule a consultation with a board certified plastic surgeon in your area with extensive liposuction experience in order to discuss your treatment goals and options available to get you the best result possible.Best Wishes!Dr. Brown

Paul J. Leahy, MD · Answer

Thanks for your question. My answer would be that it could be improved, but not eliminated. I think that your surgeon could carefully mark out the areas that are more full, and aim to blend them in with the depressed areas. It would not be perfect, but should help. Best wishes.

David E. Berman, MD (retired) · Answer

if Smartlipo is done by a board certified Plastic Surgeon this type of problem should almost never happen. You should definitely see a board certified PS who can assess  you in real life. A repeat Smartlipo may be helpful. You may need some fat grafting too. It is also a lot trickier to fix a problem than to do it correctly the first time.you should be realistic in your expectations.good luckdavid berman md

Robert L. True, MD, FACOG, FACS (in memoriam) · Answer

From your photos, I would recommend that you have a tummy tuck performed. The indentations must be release from under the fat, the area smoothed out, the muscles plicated, the skin stretched, and the excess skin removed. Simple liposuction and fat transfer most likely won't give you the best results.

Can this be revised and look normal or is it to late? (photos)

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