Untether Skin from Muscle to Fix Bumps/pitting Caused by Lipo?

In my experience this is loose skin and best treated by a thigh lift. However, most pateints are reluctant to undego this extensive of a procedure. Fat injecting alone could make the dimpling more prominent.

Although fat injections are very good for depressions in the subcutaneous compartment after surgical or traumatic events, some depressions are anchored by your collagen bands and the fat won't displace the epidermis and dermis high enough. In fact, if this situation exists, the fat could extend outwardly beyond the depression which can raise the normal skin and make the depression look deeper! Your plastic surgeon has examined you and has a better idea if fat injections without the untethering (subcision) could help or if the subcision is necessary.

If you have some areas of dimpling and depression, fat injecting alone may help. Sometimes the skin needs to be released.

There are many things to consider when evaluating a patient who is unhappy with their prior surgery. An assessment of the following is critical: 1. how much fat will be required to fix the deformity; 2. Is the overlying skin mobile or fixed to the deeper tissues ( if the latter some "release" will be required; 3. Quality of the overlying skin - if it is poor, you may require some type of excisional surgery to accomplish your goal. 

I agree with Dr. Wilke.  If the skin is stuck to the muscle, it has to be released and then the area filled with fat.  Remember, without the fat the skin may be loose and wrinkly, but with the fat filling the area, the chance will be minimized (think of an under filled balloon which is being filled).

Fat injections are helpful in the correction of irregularities from liposuction.  If there is scar contracture causing a tethering effect on the skin, then release of this tethering is needed in addition to lipotransfer.  The type of localized release of the skin needed for this is not likely to result in worsening of skin looseness or sag.

The transfer of fat from one area to areas of depression work well for divits after liposuction.  Any bumps would require some additional liposuction to get them to smooth out.

Good luck!

Depressions of the skin following liposuction can be repaired with fat grafting (injections), or Liposuction of the surrounding areas to even things out!

You can try to have just the fat injections but sometimes you also need to untether the skin if it is really stuck down.