Extensive contour irregularities from lipo 5 years ago. Can fat grafting fix my botched lipo? (Photos)

Question

I received overly aggressive lipo about five years ago. As a result, I have extensive contour irregularities on my stomach. This was my second liposuction, so I am hoping to not have to repeat the procedure again. I recently visited a plastic surgeon who let me know that a tummy tuck would be my solution. There are two main indentations that bother me the most ( I’ve noted the area on my photos). Can a fat grafting procedure helps solve the issue? I would rather not have to go through the extension coming procedure and recovery. Thanks!

David Hansen, MD · Answer

Micro liposuction of the whole abdomen and with quantum/morpheus at the same time is the best option to smooth out your tummy and is easy to undergo.  Fat grafting is unpredictable and won't really fix the whole tummy.

George Marosan, MD · Answer

Thank you for your question and photos. First of all, you state: "extensive contour irregularities from lipo" and you circle two small areas that you would like corrected. The whole abdomen looks scarred and irregular with peaks and valleys, all in the wrong places. If you would be my patient, I would do VASER release of all the grooves and depressions, liposuction the whole abdomen, remove fat off your rib cage, lateral chest wall (your bra is pushing down fat in this area), waist and hips to give you a more natural looking abdomen. It is difficult to tell how much skin laxity you have in this upright position, but I do not believe that an abdominoplasty will correct or improve these areas for you. Spot fat grafting will not work well due to the scarred areas that need to be injected. Fat will not survive well in a scarred recipient site. Basically, "patch work" will not fix this difficult situation. See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.

Darryl J. Blinski, MD · Answer

Based on your two nicely post of photos in your history, the better option would be directed fat raft if you have enough donor fat that can be treated and injected into the areas and or injection of the new ALLOCLAEFD approved fat injections. The issue with the new injections are their cost to treat you appropriately. You would need at least a minimum of 225 cc syringes Fee including injection would be $8000-$10,000. Best of virtual concert with for better explanation regards regards.

Mats Hagstrom, MD (license on probation) · Answer

I think I’ve responded to you about the same concern previously.
What I wrote then it’s probably still true.
That transfer test did not work well to correct areas over treated with Liposuction.
The problem is that the overt treated area is lacking host tissue to support the grafted fat so fat graft survival is very low.
 Sometimes there’s no tissue at all when the person is left with skin on muscle.
If there is fat, the grafted into then fat grafting can be a solution.
If you go this route, then expect to need at least three or four rounds of fat transfer.
The other option is to continue reducing the fat in the surrounding areas to make it look more even. Which is in a sense creating a more extensive problem but one that is more harmonious. 
The more fat that was reduced with previous procedures makes revision more difficult because there’s less tissue to work with.
Regardless of how you approach revision procedures, the most important variable is provider selection, and in the end that is most likely what’s going to be the limiting factor.
If provider selection was done correctly, he wouldn’t be in this situation.
It’s really hard to find plastic surgeons who can deliver consistent quality results.
I recommend you insist providers show you their entire collection of before and after pictures of previous patients who had a similar situation for whatever procedure the doctor recommends.
I wish I could be more optimistic, but I know how difficult these situations are to improve.
Mats Hagstrom MD

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