​1 year post op of Liposuction, my flanks are uneven. Do I need a another Liposuction or a Tummy Tuck? (photo)

   As a bodybuilder, I can appreciate the results of working out. As a
plastic surgeon, I also know that many patients can benefit from
liposuction. You may benefit from additional liposuction or a tummy tuck.  An exam will be necessary to make that determination.Find a plastic surgeon who performs hundreds of
liposuction procedures, has great reviews, and has great before and
after pictures.Kenneth Hughes, MDLos Angeles, CA

Thanks for your question, and I'm sorry
to read you are unhappy with your results. It's difficult to tell from your
photos alone, but you may benefit from a bit of additional liposuction or even
a tummy tuck. If your additional time in the gym isn't paying off, I recommend
scheduling a face-to-face consultation with a board-certified plastic surgeon
who is experienced in body contouring. He or she can help you decide on the
best course of action for your specific circumstances. Good luck.

It's quite difficult to say using pictures alone--you really need a face to face evaluation and discussion as to options. Depending on several factors (amount of fat removed, age, skin quality, history of obesity, etc), you may or may not simply have residual excess skin leftover after your liposuction and yes sometimes this does necessitate skin excision (such as tummy tuck) for management. Occasionally, if the skin laxity is mild or moderate there are special energy devices that can be used to try to tighten up the skin. One of the newer devices we have been trying for this problem is called Thermi where small incsions are made similar to liposuction and a small probe is run against the back side of the skin to heat it in a controlled fashion. This heat helps to initiate a response where the skin tightens up, sometimes to a large degree.  You could potentially be a candidate for trying that option if you want to avoid a tummy tuck and if your laxity is not significant.  Some slight asymmetries are not uncommon after liposuction especially given we are not perfectly symmetric to start with before surgery.  Often times, small touch up procedures can be done to tweak the results and make things more symmetric.  Your best bet is to seek out a board certified plastic surgeon with experience in body contouring and skin tightening technologies to have an evaluation and recommendations for the best management.  Good luck!