Hardening 6 months post lipo? What can be done to fix it? (Photo)

Question

I had Vaser with bodytite 6 months ago on my abdomen. One side of my oblique line has a hardening area that's circled in yellow that pops out compared to the other side. The other side is flat and nicely indented like it should be. I noticed it about 3 months into my recovery and since then I have done carbo therapy and massages in the area to reduce it. It has gone down but it's 6months and it's not gone away or flatten. What can this be and what more can I do to fix it? Can't find anything.

Harry T. Haramis, MD, FACS · Answer

Some firm spots are part of normal healing process. Usually temporary, but firm areas after liposuction can take 12 months or longer to fade.

Sometimes, repeated treatments prolong the healing process. After total healing, reevaluation is indicated for any further options.

Gentle massage, compression as needed and close follow up with your plastic surgeon during this time is recommended.

J. Timothy Katzen, MD, FACS · Answer

Hello JMO25, thank you for your question regarding hardening, six months after Vaser abdominal liposuction with bodytite and what can be done to fix it. Thank you for your history and your picture. You mentioned in your history that this harden area “pops out"; this is statement is concerning to me. This means that the mass is dynamic and "comes and goes". If the mass does "come and go," I would highly suggest you have an ultrasound to make sure this is not an abdominal hernia. Hernias can occur almost anywhere on the abdominal wall. If it is not a hernia, then this is probably scar tissue. If you have liposuction without first confirming that it is not a hernia, you may have serious complications.  The best thing for scar tissue is to redo the liposuction with the VASER.  The VASER is the best when it comes to re-dos and scar tissue.  Also, they are special liposuction cannulas, which break down and remove scar tissue. Since you claim this area has not improved at six months, I think you could undergo the surgery now. However, there is no harm in waiting to undergo revision of your VASER liposuction. Thank you for your question regarding hardening six months after VASER ab etching liposuction with bodytite. Good luck.

Anuj Purbey, MBBS · Answer

I'm sorry to hear about the persistent issue you're facing following your Vaser with BodyTite procedure. It's commendable that you've already explored treatments like carboxytherapy and massages. Here are some suggestions:Consult with Your Surgeon: Schedule a follow-up consultation with your surgeon to discuss the specific concern. They can assess the area, review your medical history, and provide insights into the cause of the hardening.Imaging Studies: Depending on the situation, your surgeon might recommend imaging studies, such as ultrasound or MRI, to get a more detailed view of the affected area.Second Opinion: If you haven't already, consider seeking a second opinion from another experienced Vaser surgeon. They might provide additional perspectives and potential solutions.Lymphatic Drainage Massage: Lymphatic drainage massage, performed by a skilled therapist, can sometimes help with reducing swelling and promoting proper fluid drainage.Continue Follow-Up Treatments: If your surgeon recommends a specific treatment plan, continue with the prescribed interventions. Some issues may take time to resolve, and consistent follow-up care is essential.Explore Non-Invasive Options: Depending on the nature of the issue, non-invasive treatments like radiofrequency or ultrasound therapies may be considered to address the hardening.It's essential to work closely with your surgeon to determine the cause of the concern and develop an appropriate treatment plan. If the hardening persists, further investigation and adjustments to the treatment approach may be necessary.

Mats Hagstrom, MD (license on probation) · Answer

To make an assessment of cosmetic surgical outcomes we generally need to see proper before and after pictures. If you don’t have before, and after pictures, then ask your surgeon to forward the pictures they took. Delivering consistent quality liposuction results is more difficult than most people realize. The number of plastic surgeons who can do these procedures well on a consistent basis are in a small minority. Mastering this procedure is not easy and takes a lifetime of commitment. 
It looks like you had a very aggressive treatment in an attempt to remove almost all your subcutaneous fat. Doing that with energy equipment such as VASER and bodytite is going to create excessive scar tissue. The buildup of scar tissue is usually not a problem after liposuction as long as sufficient thickness of subcutaneous fat is maintained. When too much fat is removed, then what’s left is scar issue, which may feel unnatural and have a very surgical appearance.
Correcting poorly done, Liposuction is difficult, and sometimes not possible.
This is especially true if the procedure was done aggressively removing most of the fat.
Postoperative treatments, generally don’t change the final outcome which is primarily based on your candidacy for the procedure in the first place, and how the procedure was performed. In other words, applying massage or other postoperative treatments aren’t really going to have an affect on what was done during surgery.
Attempt at improving poorly done liposuction results is generally done with either further liposuction, fat transfer, or a combination of both.
Sometimes converting the procedure to a skin tightening operation like a full tummy tuck for the abdomen may be a solution for some patients.Liposuction is it very permanent and more or less irreversible procedure.
If it’s not done correctly, the first time patients are left with limited options on improving the outcome.
I cannot emphasize enough the importance of provider selection when it comes to having liposuction. I generally recommend patients have multiple in person consultations before choosing a provider.
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.
An experienced provider should have no difficulty showing you the before and after pictures of at least 50 previous patients.
Considering that revision work is more difficult, then primary Liposuction, the importance of choosing the right provider for any type of surgical intervention to improve liposuction results should be done with great emphasis on provider selection. Anyone who thinks this is easy to fix for the use of some special device Can fix the problem it’s probably not the right provider to seek help from.
To get an accurate assessment, I suggest having multiple inperson second opinion consultations.
To get a quality assessment, I suggest coming prepared bringing with you a complete set of before and after pictures and preferably a copy of your operative report. You should be able to candies from your current provider.
Best,
Mats Hagstrom, MD

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