To make an assessment on the outcome of a plastic surgery procedure we always need to see proper before and after pictures. If you do not have formal before and after pictures and please contact your provider and ask them to forward the pictures they took. Delivering consistent quality, Liposuction results is far more difficult than most people realize. The number of plastic surgeons who have truly master this procedure is a small minority. Liposuction has more skill variation than any other plastic surgery procedure I’ve ever seen. Being bored certified in plastic surgery with years of experience, and even excellent reputation does not mean somebody has mastered Liposuction or is even good at the procedure. Liposuction results are permanent and irreversible. Correcting poorly done Liposuction is very difficult and many times more difficult than doing primary procedures. This is especially true for people who have been over treated. Treatment options are limited and generally come down to Revision Liposuction, fat transfer, a combination of both, and in some cases converting the procedure to a skin tightening operation like a full tummy tuck. All of these options have major drawbacks, and are inherently limited. Some people are better candidates for Revision Work than others. Generally speaking the more overzealous or aggressive the first procedure was on someone who is not a good candidate makes improving the outcomes the most challenging. Recognize that revisional work is many times more difficult than primary Liposuction. Simply finding a plastic surgeon who can deliver consistent flawless Liposuction results is hard enough. Generally speaking the best doctors in doing revision work are the same doctors who do the best primary procedures. If fat transfer is needed, then you need to vet providers not only in their skill for Liposuction, but also for fat transfer. To find the best provider I recommend patients have multiple in person consultations with local board-certified plastic surgeons in the area who seem to have a lot of experience doing both Liposuction and or fat transfer. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients who have similar body characteristics to your own. Being shown a handful of pre-selected images, representing the best results of a providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider or how many of these procedures they’ve actually performed. An experience provider should have no difficulty showing you the before and after pictures of at least 50 previous patients. I recommend patients avoid having a virtual consultation and highly recommend against traveling long distances for elective surgical procedures, unless patients are willing to fly in to have in person, consultations and appropriate follow up visits. There’s no correct number of consultations needed to find the best provider. The more consultations, you have the more likely you are to find the best provider in your community. Considering how much variation there is in Liposuction skills, and the consequence of insufficient vetting of plastic surgeons and the potential consequences. I recommend patient start by having at least five in person consultations, but consider scheduling more unless they feel very confident they found one of the best providers. Finding the right provider for revision, work is more or less, the same as finding the right provider for primary liposuction, with the exception of providers are not likely to have nearly as many pictures of previous patients who had revision work, since that is not nearly as common as primary procedures. As mentioned earlier, if fat transfer is selected, then you need to definitely make sure they have skills with that procedure as well. Correcting poorly done Liposuction with fat transfer is inherently difficult because the patient often lacks sufficient host tissue to support grafted fat. This may mean the patient may need multiple procedures to restore the area towards looking more normal. In the end, sometimes partial improvements are the best we can expect. Good luck, Mats Hagstrom MD