Uneven lipo - need help! Is this fixable? Would Kybella work? (Photo)

Question

I’m 58. It’s been one year since I’ve had liposuction. I exercise three times a week. Had liposuction on my flanks and stomach. As you can see, I have uneven flanks and stomach. Is this fixable? Wondering what non-invasive treatments that could be used off label to correct this. Would Kybella work? Or does it look like I need surgical revision?

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Falguni Patel, MD, FACOG · Answer

Kybella can help target stubborn areas of fat. In our practice, we use a combination of Kybella and morpheus 8 microneedling with radio frequency to destroy fat cells in these stubborn areas. This is safe to do even after surgery and can provide you with the finished look you desire.

Mats Hagstrom, MD (license on probation) · Answer

The human body is pretty asymmetrical.
To make an accurate assessment regarding the outcome of any plastic surgery procedure we need to see proper before and after pictures.
Liposuction only reduces subcutaneous fat.
In order for Liposuction results to be even the fat layer needs to be even on both sides.
If the musculoskeletal structure is a symmetrical, then Liposuction is not going to correct this.
To assess the outcome of Liposuction, you need to feel the thickness of your subcutaneous fat layer, and see if these are even on both sides, not if your body is symmetrical which it is not.
 You have substantial asymmetry which is not due to the subcutaneous fat layer, but to muscular skeletal structure.
Your right side is substantially wider than the left side, and this was most likely also evident in your before pictures if you look carefully.
Plastic surgeons could not, and should not attempt to treat body asymmetry by doing Liposuction asymmetrically. In other words, removing more fat from one side, simply creates two separate asymmetries.
You have a fair amount of skin laxity which reduces the chance of quality liposuction results.
Always include before and after pictures when assessing plastic surgery outcomes.
If you don’t have before, and after pictures, then ask your surgeon to forward the pictures they took.
Did you follow up with your provider?
What did they have to say?
While Your liposuction results are not the best they do look fairly even and I think the biggest reason for potential lack of results is more related to laxity than anything else.
The best candidates for Liposuction are generally going to be individuals who are young, chubby with tight skin.
A tummy tuck might have been a better procedure.
To answer your question, if Liposuction didn’t do the trick, then Kybella is most likely going to do much less and isn’t going to address the issue at hand.
You don’t have a problem related to fat distribution.
Your issue is skin laxity and asymmetry of your muscular skeletal structure.
Best,
Mats Hagstrom MD

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