How Effective Are Post-Liposuction Touch-ups?

Question

I had liposuction 6 months ago and up with a few contour irregularities. They look like mogul-type lumps, not dimply like cellulite. My plastic surgeon said he could do a touch-up with a cannula that resembles a cheese grater, but not remove any more fat.  He said this would help smooth the lumps. But he also mentioned that one complication of using this instrument could be damage to the blood supply to the overlying skin. He hasn't seen this personally, but it does worry me. Is this a good procedure to smooth out lumps, and are the risks to the skin worth it?

Otto Joseph Placik, MD · Answer

I am very impressed with your understanding of the subject. You have a much better understanding of the risks than most. You are correct in being concerned. You are approximately 7 months out and it is possible you will see some improvements but not likely complete resolution.
It comes down to how much it really bothers you and if you can live with it. No one will be able to tell you for certain that it will get better or worse. It sounds as if your surgeon has been straightforward in discussing these options.
In my limited experience, I know one aesthetician who uses the Accent on patients and has been unable to achieve significant improvement in "mild" irregularities caused by abdominal liposuction by another physician.
On a few instances I have proceded with small cannula liposuction over previously treated liposuction areas with subtle improvements. I have ccasionally employed fat grafting in areas where the fat seems excessively thin or the skin is adherent to the underlying tissues. I have achieved modest improvements. It would be unrealistic to expect a completely smooth result and I advise patients that I realistically hope to achieve a 30% improvement. Anything more than that is a gift. Of course this comes with the risk of vascular compromise and that is possible but fortunately rare.
I hope this helps.

Raffy Karamanoukian, MD, FACS · Answer

I advocate Hidef Liposuction revision for all touch ups; which includes laser tightening, Exilis multiplane tissue tightening, RF, lipocavitation, and fibrous release in addition to microlipo. Best, Dr. KaramanoukianLos Angeles

Steven Wallach, MD · Answer

6 months after liposuction, theings should lokk like they should although there still may be some changes in the next few months. A touch-up sounds perfectly reasonable to correct these minor asymmetries.

Reza Nabavian, MD · Answer

The bumps you are referring to could be either scar tissue that has formed after liposuction.  If that is the case, time and massage should provide some improvement. A persistently hard scar may respond to corticosteroid injection, however, this injection can have its own set of complications such as tissue atrophy and telangiectasias, so not a great choice.
If the bumps are due to under-suctioned fat deposits, then liposuction with a small cannula could be helpful.  The closer these deformities are to the actual skin, the less likely it is to achieve excellent correction.
Being prudent about revisional surgery is very smart.  In the case evolving scars, time is usually on your side.

Arian Mowlavi, MD, FACS (license on probation) · Answer

Your concern of your liposuction deformities are noted. As an official VASER trainer, we see liposuction deformities referred to our office weekly. The definitive gold standard correction technique for your deformities will require a combination of VASER liposuction and Renuvion skin tightening technology. Your deformities can be optimally and consistency corrected. Please consider a Skype or Facetime consulation with a VASER specialist to get accurate recomendation and pricing. 
Respectfully,
Dr. Mowlavi
Real Self 100 Hall of Fame Inductee

How Effective Are Post-Liposuction Touch-ups?

Answers (6)