Bigger on left upper and lower abdomen 2 years post op. What happened to me? (Photo)

Question

I had laser liposuction on my upper and lower abdomen. So here's an enormous issue I've run into: I'm bigger on my left side and for me it's unquestionable. Its highly uncomfortable and inconvenient for me and I am nothing short of furious. On the day during my operation the surgeon was aggressive on my left side and noticed being bigger on my left side at least a week later. I remember significantly more pain there as well during. What's happened to me?"

J. Timothy Katzen, MD, FACS · Answer

Thank you for reaching out with concerns about asymmetry in your upper and lower left abdomen two years following laser liposuction. Your shared history and photographs are valuable, though they offer limited insights without a full physical examination.
Physical Examination: A comprehensive physical examination is crucial for a definitive assessment. This would provide more clarity on the underlying cause of the asymmetry you're experiencing.
Intraperitoneal or Visceral Fat Consideration: Your description suggests a significant presence of intraperitoneal or visceral fat, which is located inside the peritoneal cavity and cannot be addressed with liposuction. Understanding whether this condition existed before the surgery or developed afterward is important.
Body Fat Analysis: An assessment of your body fat percentage could offer insights. Ideally, this should have been part of the pre-surgical evaluation process to establish a baseline for comparison.
CT Scan for Subcutaneous Fat: A CT scan might help in determining the distribution of subcutaneous fat versus visceral fat. This could explain the post-operative appearance and guide further treatment plans.

Follow-up with Your Surgeon: It's essential to consult with the surgeon who performed your liposuction. They can provide specific insights based on your surgical history and the changes observed post-procedure.
In summary, the asymmetry you notice might be due to factors like visceral fat or changes in body composition post-surgery. A detailed evaluation by your plastic surgeon, supported by appropriate imaging studies, will be the best course of action.
I hope this information assists you in understanding the possible reasons for the changes in your abdomen and guides you in seeking further medical advice.
Good luck, and feel free to reach out for any more assistance.
Sincerely,
Dr. Katzen

Mark Edward Hennessy, MD · Answer

One half of a person's body is not a mirror image of itself. Organ sizes differ, nerve locations differ, and fat deposits are not equivalent. That being said, the bigger question is what would help improve the aesthetics of the appearance of your abdomen. #1 Lose weight! It may be simply a difference in the angle of the camera, however I would guess that you have not lost weight during the past two years and I will also go out on a limb and state that in all likelihood that you have gained weight. The most important advice that I share with my patients prior to undergoing lipo is: AVOID gaining more than five pounds post op. The residual fat cells hypertrophy at a variable rate which results in one side being large, lumps and bumps and an uneven appearance of the skin. It is definitely an option to repeat Lipo, go for a laser or electromagnetic therapy, but I would advise investing in personal trainer and a dietician first.

Daniel Barrett, MD · Answer

Dear Rational936524,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Mats Hagstrom, MD (license on probation) · Answer

Your pictures shows someone who is obese and has a substantial amount of excess visceral fat. The musculoskeletal torso is not symmetrical. Your assistant and neither is anyone else.
I don’t think your subcutaneous fat layer is the problem at all.
I bet if you measured it accurately it would be very consistent on both sides. if anything it may be thinner on your problem side since the surgeon was more aggressive on that side.
Lots of people have a symmetry of their torso and yours isn’t any different.
Reducing your visceral fat will get you much closer to looking better than Liposuction.
I question if you were even a good candidate for Liposuction at all in the first place considering what appears to be a substantial amount of excess visceral fat.
My best guess is the only thing your provider didn’t do right was explain to you that you may not be a good candidate for Liposuction and that your underlying musculoskeletal structure is highly asymmetrical.
To get a more accurate second opinion assessment and suggest having multiple in person consultations with other local board-certified plastic surgeons.
Patience for consulting for a second opinion assessments should come prepared bringing with them proper before and after pictures and a copy of your operative report. These are all available from your provider‘s office upon request.
Always show before and after pictures when asking for an assessment.
Your body asymmetry and visceral fat was probably clearly visible on your before pictures.
Asymmetry is almost always based on skeletal or muscular skeletal structure and rarely is fat layers the basis for asymmetry.
Best,
Mats Hagstrom MD

Randy Dean, MD - Account Suspended · Answer

Hi and welcome to our forum!
Unfortunately, your photos depict only anterior views of segments of your abdomen without frame of reference to adjacent structures.  There is no height / weight information provided. From anterior views alone, I cannot judge symmetry. 
The photos appear to demonstrate a full abdomen. Abdominal fullness may be due to superficial fat excess, lax stretched out abdominal muscles following pregnancy, or excess visceral (internal) fat.  Superficial fat is addressed with liposuction, abdominal wall repair is accomplished with abdominoplasty, and visceral fat is addressed with a regimen of diet and exercise. A physical examination is required to differentiate among these entities. 
The source of your discomfort needs to be investigated as well.
15% of cosmetic surgeries can be improved with a secondary touch up procedure. 
Visit a board certified plastic surgeon for evaluation and discussion.
Best wishes...

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