What can I do to correct Irregular contour and dents 6 months after liposuction? (photos)

Question

Hi, I had liposuction on my legs, stomach and lower back to improve my contour and for fat transfer to my breasts about 6 months ago. After the swelling went down I noticed that too much fat was removed on my inner thighs. I feel like my legs have a weird contour now. Also I have asymmetry on my upper thighs (one side still has some fat and the other side looks flat) and I have some dents. I've never been more unhappy with my legs as I am now.. Is there anything I can do for improvement?

Dennis Wolf, BScHons, MBBCh, MRCSEd · Answer

The areas that still have fat can be adjusted with more lipo.The areas that have dents should either be left or filled with fat transfer.

Jerimiah Mason, MD · Answer

While your legs can very likely be improved, it usually isn't a simple fix.  It will likely require a few sessions of fat transfer procedures to fill in the dents.  I would probably recommend going to see a different surgeon, someone with more experience with liposuction.

Giuseppe Fiore, MD · Answer

Hi,

Thank you for your inquiry and photos. 
I'm sorry to hear that you're not satisfied with the results of your surgery. The first step is to discuss your concerns with the surgeon who performed the procedure. They should be able to provide you with options for improvement, such as revision surgery, fat transfer, or other non-surgical treatments.
In my opinion, surgical revision may be a suitable option if the asymmetry is significant. The procedure involves transferring fat to the over-liposuctioned areas (indentations/depression areas) and removing fat from areas that were not adequately addressed. This procedure should help to "smooth" the areas of concern. However, revision surgery carries additional risks and may not always meet your expectations.
If you prefer to explore non-surgical options first, collagen-stimulating products such as Sculptra, Radiesse, or dermal fillers can be used to add volume and improve the appearance of dents or asymmetry.
I recommend making an appointment with your surgeon to discuss your concerns and explore several options for improvement, both surgical and non-surgical.
I hope this information helps.

Best regards,
Dr. Giuseppe Fiore

Alan Gonzalez, MD, FACS · Answer

Hello @laurel237, thank you for your question. Your concern is understandable. It is important to recognize, however, that there are opportunities for improvement. Numerous aspects must be taken into consideration, including the surgical technique applied since a lot depends on it. It is vital to carefully examine your case, to have a consultation, and to consider factors such as your body features, age, needs, expectations and what the specialist can do. Best wishes! Alan Gonzalez MD, FACS. International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)

Anuj Purbey, MBBS · Answer

I'm sorry to hear about your concerns following your liposuction procedure. It's essential to address these issues to achieve the best possible outcome. Here are some steps you can consider:Consult with Your Surgeon:Schedule a follow-up consultation with your surgeon to discuss your specific concerns.Share your observations regarding the contour irregularities, asymmetry, and dents.Express Your Concerns Clearly:Clearly communicate your dissatisfaction with the results, specifying the areas that are problematic for you.Discuss your expectations and desired outcome.Explore Revision Options:Your surgeon may propose revision options to address the asymmetry and contour issues.Revision surgery may involve additional fat grafting or adjustments to improve the overall result.Consider Non-Surgical Options:In some cases, non-surgical treatments such as dermal fillers or Sculptra may be suggested to improve contour irregularities.Seek a Second Opinion:If you're uncertain about the proposed solutions, consider seeking a second opinion from another qualified and experienced surgeon.Evaluate Realistic Expectations:Discuss realistic expectations and potential improvements with your surgeon.Understand the limitations and possibilities for further enhancement.Review Pre- and Post-Operative Care:Ensure that you followed the recommended pre- and post-operative care instructions.Discuss any factors that might have contributed to the outcome.Remember, open communication with your surgeon is crucial for addressing your concerns and exploring potential solutions. It's important to work collaboratively to achieve the best possible results.

David Guarin, MD · Answer

Hello Laurel, it is sad to hear that you are not happy with the current outcome. You should first ask your surgeon about this. There is still a swollen area&hellip; to have a better assessment and treatment ( if needed) you should wait at least one year after the surgery. 
David Guarin MD

Mats Hagstrom, MD (license on probation) · Answer

Delivering consistent quality, liposuction and fat transfer results is more difficult than most people believe. The number of plastic surgeons who can do these procedures well and predictively make accurate assessments and deliver consistent quality outcomes is relatively small.
 Liposuction is a permanent and more or less irreversible operation. If not done well patients are stuck with the outcome and improving on. The results is often difficult.
Revision Work is many times more difficult than primary body contouring so the importance of finding one of the very best providers is paramount for anybody considering revision surgery.
A significant number of Wellington and board-certified plastic surgeons simply do not have Liposuction competence, despite having correct qualifications, including an overall good reputation and years of practice.
For all of these reasons, patients should be far more selective than they ever thought necessary when it comes to choosing plastic surgeons for permanent and irreversible body contouring procedures.
I suggest patients start the process by first getting a clear understanding of their own candidate seeing for the procedure in the first place. Not everybody is a good candidate for Liposuction or fat transfer.
In the end, patient candidacy, and provider selection are the two single most important variables, and are generally the two variables that determine if results are going to be quality outcomes or not.
Patients may not understand their own candidacy. Making an accurate assessment in regards to patient. Candidacy is a skill and its self and this too is something that requires mastering if someone is going to deliver, consistent quality results.
To find the right provider, I suggest patients have multiple in person consultations. For difficult procedures, like liposuction and fat transfer I suggest patient start by having at least five in person, consultations and consider scheduling more unless they feel very confident they found one of the best providers for these procedures in their community.
The process for finding a provider for doing a Revision Work is more or less the same as finding the best providers for doing Primary procedures. The surgeon to do the best revision work are generally the same surgeons, who do the best primary procedures. 
During each in person consultation, I suggest patients ask each provider to open up your portfolio and show all of their previous before and after pictures of patients who had similar body characteristics to your own, showing the same areas you’re interested in having treated.
I asked providers to show you only patient whose body characteristics are similar to your own. Ask providers to show you a variety of outcomes, including excellent results, average results, and results that did not turn out as well as they had hoped for. We all have a variety of results and it’s fair game for patients to ask to see Representative results. 
For reference and experience provider should have no difficulty showing you the before and after pictures of at least 50 previous patience for common procedures, like Liposuction and fat transfer. 
Extremity liposuction, is technically more difficult than treating the torso. Lower extremity liposuction, especially doing inner thigh. Liposuction is technically difficult, and should only be done by those who have sufficient experience. Provider to lack sufficient experience should use caution and not attempt, aggressive outcomes.
Being shown a handful of preselected images, representing the best results of a providers career is completely insufficient to get a clear understanding of an average results typically look like or how many procedures anyone surgeon has actually performed.
Mastering body contouring with Liposuction and fat transfer, takes a total commitment to excellence, years of practice, and doing thousands of cases.
Bing board-certified plastic surgery with years of experience and overall good reputation does not mean somebody has mastered Liposuction. most plastic surgeons think they’re better at these procedures that they actually are. 
A substantial number of plastic surgeons do not like doing Liposuction, and I are simply not good at it.
Patients should take the vetting process, seriously recognizing that you are hiring someone to perform a service for you and demand to see sufficient confirmation of previous work to get a clear idea of what typical results look like.
Providers who failed to show you sufficient quality and quantity of before, and after pictures should be dismissed, and the search needs to continue.
When finding a provider for Revision Work, the biggest difference is going to be the number of before, and after pictures providers have of revision cases gated primary work is far more common than doing revision work so expecting someone to show you 50 or 100 previous cases of Revision Work is not reasonable.
Treatment options for poorly done liposuction typically comes down to Revision Liposuction, fat transfer, and in some cases, converting the procedure into a skin tightening operation.
Restoring Aesthetic contours with Revision, Work, Sometimes requires performing multiple operations. This is especially true if that transfer is needed to correct poorly done Liposuction.
Patients who have been disfigured from poorly done cosmetic surgery, often have lack of trust and fear of having more procedures.
Different plastic surgeons will have different attitudes about doing Revision Work, correcting other providers poor performances.
Patient requiring Revision Work are often very time intensive and often are not candidates for surgery. 
What happened to you is unfortunate but is also not uncommon.
 Depending on your level of motivation to have corrective procedures, the process needs to begin by finding the best provider in your community for liposuction and fat transfer.
I following the previously stated recommendations is my best recommendation for finding the best provider. I generally do not recommend patients have virtual consultations, and generally speaking, avoid traveling long distances for elective surgical procedures, unless you’re willing to properly vent providers by having proper in person consultations. 
I recognize that sometimes there may not be local talent available and travel is sometimes inevitable. Initial screening can be done through virtual consultations, but there is no substitute to an in person proper consultation when it comes to properly vetting, plastic surgeons or plastic surgeons making an accurate assessment.
Assessments using pictures, always requires proper before and after pictures. If you don’t have your before, and after pictures and ask your surgeon to forward the ones they took.
Patients who have had poor outcomes in cosmetic surgery, should think twice about having the same provider attempt revision surgery, considering how difficult revision work is.
Best,
Mats Hagstrom, MD

What can I do to correct Irregular contour and dents 6 months after liposuction? (photos)

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