What are the different methods of liposuction revision? Which is most effective dealing with fibrosis on the abdomen? (Photo)

Dear Grace_03,
while there is always a chance for contour irregularities with liposuction, someone who takes their time and uses the appropriate sized cannulas should give you a superb result.I have all my patients wear compression garments and I use multiple sized cannulas to feather out the result.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thanks for the posted photos demonstrating post liposuction fibrosis with denting. There are very few boarded PSs offering to operate or treat this issue. I do 2-4 sessions of surgery (1 session initial), 2 sessions injections of hyper diluted Radeisse. Best to virtual consult with...

Your surgeon is responsible for the outcome of your procedure. Providers are obligated to see patients after surgery and acknowledge their concerns. Not doing so it’s considered abandonment which is considered highly inappropriate. Patient abandonment is a form of malpractice that can be sued for.
I’m not an attorney but I know it is quite serious and considered highly inappropriate.
It appears your surgeon attempted high definition Liposuction which is a procedure I’m not a big fan of.
To some extent Liposuction delivers permanent and irreversible results.
Correct and poorly done Liposuction is extremely difficult and often only partial improvements can be had.
This is especially true if someone was over treated.
Usually treatment options come down to revision Liposuction(removing more fat), fat transfer a.k.a. fat grafting and occasionally converting the procedure to a skin tightening procedure like a full tummy tuck.
Sometimes it’s done as a combination of revision Liposuction with fat transfer. The problem with fat transfer is that the areas that need the volume are typically devoid of host tissue to support the graft leading to Low percentages of graft survival. Providers who attempt high definition work purposely overly treat areas of muscle intersections with the attempt of having subcutaneous fat look like accentuated muscle.
To me most of the time it looks disfiguring, unnatural and it is very difficult to correct.
It is promoted by certain individuals and all the national conferences so I’m not surprised more and more providers are attempting this procedure.
It is especially inappropriate for anybody who is not extremely lean, young with tight skin.
It works best for young male athletic type patients.
Delivering consistent quality Liposuction results it’s far more difficult than most people including plastic surgeons believe.
For that reason patients need to diligently do thorough investigations to find the most talented and experience provider in their community.
This requires having multiple in person consultations.
During consultations patients should ask each provider to share their entire collection of before and after pictures for the procedure you’re interested in. Simply seeing a handful of pre-selected pictures which most likely represent the best results of the providers career is insufficient to get a clear understanding of what average results look like.
As the provider to show as many pictures as possible of patients with similar body characteristics to your own.
An experienced provider should have no difficulty showing you at least 50 sets of before and after pictures and highly experienced surgeons will have hundreds or even thousands of before and after pictures to choose from.
I also recommend patients read all reviews on various physician review websites avoiding providers for any significant number of justified reviews. The absence of justified negative reviews is more important than having an abundance of positive reviews.
Continue having consultations until you feel quite certain you find the most talented and experience provider.
Conscientious committed talented providers tend to be detail oriented and typically spend sufficient time with their patients during in person consultations to clearly explain the procedure and the results patients should expect.
Experienced providers should deliver consistent quality results and should know well in advance exactly what the results will look like.
Consider that revision work is many times more difficult than primary Liposuction so they need to find the most talented and experienced provider is even greater.
With revision work you will not find providers that have as many before and after pictures a revision work since that is less common.
Some providers may not be willing to take on your case and that is acceptable, reasonable and their choice.
Recognize that when you take on revision work these patients often consume huge amounts of time and effort and often the amount of improvement that’s possible still it leaves the patient not feeling well or that they got the results they had hoped for.
Often to get improvements may require doing multiple revisions. It’s not uncommon to have to do three or four operations to restore someone’s contour and this still will not get someone back to pre-liposuction or what they had hoped for.
In the end your surgeon is responsible for the outcome of your procedure and you are responsible for producing that surgeon.
Consider sharing your experience on various physician review websites writing an honest accurate and professional review.
I’m sure you would’ve appreciated other patients who have gone through similar experiences sharing what they went through for you to read before choosing that provider.
Best,
Mats Hagstrom MD