Had a tummy tuck and lipo. The lipo appears to have been done poorly. My stomach skin (about 70%) has no extra skin. In fact it feels like it’s stuck to my insides. I can’t pinch the skin at all. Feels like a balloon in my stomach is about to pop. I’m 5 years out and it’s weighing on me everyday. In addition to the hardness there’s other areas with more fat and lumpy like photo shows. It’s so unattractive and uncomfortable. I have had in person consults with several local doctors and have been told everything from do more lipo, fat graft, to use kybella to kill more fat cells. Help please. I really want to correct this. Am I just sol?
Answer: Uneven after lipo Dear revisiongalinwashington, I would have to examine you but it appears that this is a contour irregularity after liposuction. This happens often when areas the undergo liposuction are not feathered appropriately. The good news is that it can be fixed and I have done so with good results before. While there is always a chance for contour irregularities with liposuction, someone who takes their time and uses the appropriate sized cannulas should give you a superb result.I have all my patients wear compression garments and I use multiple sized cannulas to feather out the result. Daniel Barrett, MD Certified, American Board of Plastic Surgery Member, American Society of Plastic Surgery Member, American Society of Aesthetic Plastic Surgery
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Answer: Uneven after lipo Dear revisiongalinwashington, I would have to examine you but it appears that this is a contour irregularity after liposuction. This happens often when areas the undergo liposuction are not feathered appropriately. The good news is that it can be fixed and I have done so with good results before. While there is always a chance for contour irregularities with liposuction, someone who takes their time and uses the appropriate sized cannulas should give you a superb result.I have all my patients wear compression garments and I use multiple sized cannulas to feather out the result. Daniel Barrett, MD Certified, American Board of Plastic Surgery Member, American Society of Plastic Surgery Member, American Society of Aesthetic Plastic Surgery
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April 22, 2025
Answer: Very difficult situation I'm trying to imagine you sitting in my exam room. Your problems: 1. too little fat everywhere. 2. Irregularities in subcutaneous thickness. 3. Scar tissue. Unfortunately, I can't really get a sense of how shallow your subcutaneous layer is. If I deemed it sufficient, I would recommend SAFElipo, a trademarked term for Separation, Aspiration, as Fat Equalization. In your case, there would be no aspiration (true liposuction). This concept was put forth in 2008 by Simeon Wall, Jr, MD, a world renowned plastic surgeon who practices in Shreveport, LA., and it is perhaps the greatest advancement in both primary and revision liposuction. The process involves using an expanded basket type canula attached to a power assisted hand piece to break up the scar tissue, which is causing at least 50% of the deformity. I would highly caution against the use of Vaser, ultrasound, or any other energy based system that creates heat. Once the offending scar tissue has been broken up, a judicious amount of fat should be grafted, and herein lies the rub: the surgeon won't be able to put in as much as you need in one sitting. You will need at least one more session, and probably two, to get to a good place; I would imagine a 80% to 90% improvement. At that point, spot treatments in office under local anesthesia can be performed injecting Renuva into local depressions. Once again, it would not be a simple injection, but a local separation of scar tissue using fine, syringe based canulas with a 'pickle fork' tip (the Separation phase of SAFElipo), and then injection.
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April 22, 2025
Answer: Very difficult situation I'm trying to imagine you sitting in my exam room. Your problems: 1. too little fat everywhere. 2. Irregularities in subcutaneous thickness. 3. Scar tissue. Unfortunately, I can't really get a sense of how shallow your subcutaneous layer is. If I deemed it sufficient, I would recommend SAFElipo, a trademarked term for Separation, Aspiration, as Fat Equalization. In your case, there would be no aspiration (true liposuction). This concept was put forth in 2008 by Simeon Wall, Jr, MD, a world renowned plastic surgeon who practices in Shreveport, LA., and it is perhaps the greatest advancement in both primary and revision liposuction. The process involves using an expanded basket type canula attached to a power assisted hand piece to break up the scar tissue, which is causing at least 50% of the deformity. I would highly caution against the use of Vaser, ultrasound, or any other energy based system that creates heat. Once the offending scar tissue has been broken up, a judicious amount of fat should be grafted, and herein lies the rub: the surgeon won't be able to put in as much as you need in one sitting. You will need at least one more session, and probably two, to get to a good place; I would imagine a 80% to 90% improvement. At that point, spot treatments in office under local anesthesia can be performed injecting Renuva into local depressions. Once again, it would not be a simple injection, but a local separation of scar tissue using fine, syringe based canulas with a 'pickle fork' tip (the Separation phase of SAFElipo), and then injection.
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April 21, 2025
Answer: Revision Liposuction options Ability to improve a poorly done Liposuction is difficult and often not possible. This is especially true if the primary procedure was overly aggressive and done unevenly. I’m guessing your provider used a very aggressive form of Liposuction possibly VAS ER. There’s really no fat left to work with so restoring your subcutaneous fat layer isn’t really possible. Fat transfer requires there to be some tissue to graft into. I refer to this as host tissue. Because you don’t have any tissue to graft into grafting fat is unlikely to be successful. Some minor improvements may be possible, but restoring your abdomen to what most people would say looks normal isn’t possible. Realistically wasting thousands of dollars ending up looking about the same or possibly worse probably isn’t a good strategy. I would absolutely not use any random aggressive, liposuction, or fat, removing treatment. If any form of fat removal is going to be done, it needs to be done very gently and only very small areas for the goal of improving consistency and evenness. There is no way to restore the inappropriately removed subcutaneous fat layer once it’s gone. Did you follow up with your plastic surgeon? Who did the procedure? Did you write any reviews about your experience? It may be good for other people to know to avoid that provider for Liposuction procedures. I’m sure you would’ve appreciated reading some reviews of other people who were disfigured Prior to your surgery. I really do think patients should share their experience when they’ve had horrific experiences directly related to plastic surgery competence. Your surgeon should either stop doing liposuction or seriously focus on improving their skill. It’s very important that your surgeon knows how bad your outcome is so they don’t do it again. Delivering consistent quality liposuction results is more difficult than most people realize. The number of plastic surgeons to approach mastery of this kind of work is in reality quite small. Revision work is many times more difficult than primary Liposuction so the number of providers were actually qualified to do quality revision work is really small. Simply the ability to find the right provider to be working with is in itself at daunting task. I’m sorry this happened to you. Best, Mats Hagstrom MD
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April 21, 2025
Answer: Revision Liposuction options Ability to improve a poorly done Liposuction is difficult and often not possible. This is especially true if the primary procedure was overly aggressive and done unevenly. I’m guessing your provider used a very aggressive form of Liposuction possibly VAS ER. There’s really no fat left to work with so restoring your subcutaneous fat layer isn’t really possible. Fat transfer requires there to be some tissue to graft into. I refer to this as host tissue. Because you don’t have any tissue to graft into grafting fat is unlikely to be successful. Some minor improvements may be possible, but restoring your abdomen to what most people would say looks normal isn’t possible. Realistically wasting thousands of dollars ending up looking about the same or possibly worse probably isn’t a good strategy. I would absolutely not use any random aggressive, liposuction, or fat, removing treatment. If any form of fat removal is going to be done, it needs to be done very gently and only very small areas for the goal of improving consistency and evenness. There is no way to restore the inappropriately removed subcutaneous fat layer once it’s gone. Did you follow up with your plastic surgeon? Who did the procedure? Did you write any reviews about your experience? It may be good for other people to know to avoid that provider for Liposuction procedures. I’m sure you would’ve appreciated reading some reviews of other people who were disfigured Prior to your surgery. I really do think patients should share their experience when they’ve had horrific experiences directly related to plastic surgery competence. Your surgeon should either stop doing liposuction or seriously focus on improving their skill. It’s very important that your surgeon knows how bad your outcome is so they don’t do it again. Delivering consistent quality liposuction results is more difficult than most people realize. The number of plastic surgeons to approach mastery of this kind of work is in reality quite small. Revision work is many times more difficult than primary Liposuction so the number of providers were actually qualified to do quality revision work is really small. Simply the ability to find the right provider to be working with is in itself at daunting task. I’m sorry this happened to you. Best, Mats Hagstrom MD
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