Had Smart Lipo 6 months ago with no results - what should I do? (photos)

Question

I had smart lipo in July 2021.. I wore my faja faithful for 3 months, I got massages and I have been watching my diet. Today was my 6 month visit. I was already feeling like I didn't get much results. Then seeing my before and after pics really made me depressed. The surgeon suggests I do ultherapy but I really don't wanna throw away anymore money with him.. What should I do?

Harry T. Haramis, MD, FACS · Answer

Unfortunately, not everyone responds or heals the same after surgery. While you appear to have some results, Smart Lipo can take up to 1 year for swelling, final healing.

Close follow up with your plastic surgeon is recommended during this time to determine swelling vs residual/recurrent fat and a possible revision if indicated.

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

Lipo was a poor choice for your belly. You have obvious loose skin which doesn't improve with lipo. You have obvious loose and separated abdominal muscles (aka diastasis) which don't improve with lipo. And now you have wrinkled skin that looks worse than when you started. Don't despair. You still need a tummy tuck and it will fix all of these issues. You also would benefit from liposuction of the waistline. All of this should have been explained to you and I would be surprised if your surgeon didn't know how this would turn out. Check out the video to learn more about tummy tucks and why they are done for people that look like  you.

Daniel Barrett, MD · Answer

Dear Macknicole77,
based on your photos, you look like a good candidate for a TT. Full tummy tuck should tighten your abdominal muscles and remove the excess skin. Flanks liposuction would give you a better shape. I would suggest you to consult a board-certified plastic surgeon because only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gregory Chambon, MD · Answer

Before pursuing additional procedures with this surgeon, I would get a second opinion with a different surgeon to consider a "tummy tuck."

Karol A. Gutowski, MD, FACS · Answer

Sorry, but you need to see a different surgeon. SmartLipo is not the first choice for your situation. You should have been offered a tummy tuck, or at least discussed the need for it after lipo. No energy device will tighten you skin.

Darryl J. Blinski, MD · Answer

Sorry for poor results. But I have so many questions: Was the surgeon a Plastic Surgeon? Were you awake or under anesthesia? How much lipo aspirate was removed? To me appears as if you had a non Plastic Surgeon use a questionable type of lipo techniques under local anesthesia with limited amounts removed of fat. I recommend a round 2 liposuction under general anesthesia to remove at least 4 liters of fat. The issue is your skin will wrinkle thus you will need a 3rd surgery of a Full TT.

Mats Hagstrom, MD (license on probation) · Answer

Is your provider a board-certified plastic surgeon?

The truth is you are not a good candidate for Liposuction in the first place and the procedure on top of that wasn’t done very well.

There are board-certified plastic surgeons who aren’t particularly good at liposuction but almost 100% of plastic surgeons should have at least mentioned a tummy tuck as the more appropriate or at least alternative procedure.

Someone not trained in plastic surgery can’t offer a tummy tuck and in that case may Luer you into liposuction since that is the only tool they have in the toolbox.

To break this down so you have a better understanding regarding just the front of your abdomen which is probably what bothers you the most there are for individual variables that contributes to shape and contour.

In order these are skin laxity typically due to previous pregnancies, age or weight fluctuations. Excess subcutaneous fat(The fat you can pinch when you pinch your skin), muscle separation from previous pregnancies call to diastasis recti.  Lastly excess visceral or intra-abdominal fat.(this is fed around our internal organs that cannot be removed with Liposuction)

Based on your before pictures you have all four of these and all four of them are probably contributing equally.  If there are two prominent variables it is skin laxity and muscle separation from previous pregnancies.

Because excess subcutaneous fat it’s only one out of four variables and it is not the primary problem treating it is going to be a very partial solution and will not address any of the other variables.

To get the best result you should’ve been instructed to lose weight in order to reduce your visceral fat content and subcutaneous fat to some degree then have a full tummy tuck which primarily treats skin laxity and muscle separation from previous pregnancies.

A 30 pound weight loss followed by a full tummy tuck would’ve looked stellar.

You can still have that procedure and you can still lose weight.

I am curious to what provider would have offered you liposuction since you’re not at all a good candidate for the procedure and then when the results don’t turn out(very predictable) recommend ultherapy.  I just can’t imagine that recommendation came from a board-certified plastic surgeon.

At this point start the process correctly by scheduling multiple in person consultations with local board-certified plastic surgeons.

Insist on meeting the surgeon in person.

Ask each surgeon to show their entire collection a before and after pictures for the procedure you’re interested in. An experienced surgeon should have no difficulty showing you hundreds of before and after pictures including patients whose bodies look like yours.

I think it’s also reasonable to write an honest professional review regarding your first provider letting them and the public know what your experience was so other people can be spared having to go through the same process.

If you opt for having a tummy tuck then judge plastic surgeons results by who gets the most natural looking belly button with Loseth scars that naturally follow each persons body anatomy.  In the after pictures the body should look good from all angles including the side and back.

I don’t think there are any other appropriate treatments for you but I suppose I don’t know what you’re trying to achieve.

Best,

Mats Hagstrom MD

David E. Berman, MD (retired) · Answer

you do appear to have a bit less fat in your abdomen. However, if you wanted a flat abdomen, you should just have had a tummy tuck. I will bet, you did not see a board certified plastic surgeon. I fail to understand why anyone wanting to do any type of cosmetic surgery on their body would see anyone else than a board certified plastic surgeon. Besides obvious safety and experience, a plastic surgeon has numerous options that a non-plastic surgeon will not have. If you would have come to me, I would have explained the advantages and disadvantages of both a TT and Smartlipo would offer you. This would you could have made the right decision for you!!!! Do not waste your money on ultherapy. Go see a board certified plastic surgeon.

david berman md, frcsc

david berman md, frcsc

Randy Dean, MD - Account Suspended · Answer

Hi and welcome to our forum!
From your photos, I note a significant reduction in the amount of subcutaneous fat in your soft tissues following the liposuction procedure. However, you demonstrate a significant amount of loose skin and stretch marks.
Stretch marks indicate the presence of permanently damaged overstretched skin usually following pregnancy or significant weight fluctuation where the dermal elastic fibers have ruptured resulting in the loss of elasticity. The skin will stretch over a greater surface area, predisposing to sagging.
In order to eliminate the loose skin, a tummy tuck is required.
Visit a board certified plastic surgeon for evaluation, examination, and discussion.
Best wishes...

Kristine Brecht, MD (license suspended) · Answer

Dear Nichole,
Liposuction will remove fat, but not address the large amounts of excessive skin.
A tummy tuck removes the skin permanently, but then the incision needs to heal over 6-8 weeks, with restrictions on lifting and activities during this time. Renuvion skin tightening can help a lot with liposculpting, but it will not remove the cellulite, stretch marked and excessive loose skin.
Best. DrBrecht 
Seattle, Wa

Had Smart Lipo 6 months ago with no results - what should I do? (photos)

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