I just had Smart Lipo and I don’t think they took enough off. Advice? (photos)

Question

Okay so I am 5’3” and had Smart Lipo done This week. I am no longer even draining. I had upper and lower abs flanks sides and back above bra area. I Went to clean and it looks like I have rolls that I didn’t have before. I have been massaging like they said and the fat on my back is all there and isn’t sore don’t think they did it they said they took a little one 3 liters is this event right?

Harry T. Haramis, MD, FACS · Answer

You appear to have a lot of swelling which can take months to go away. Close follow up with your plastic surgeon is recommended during this time for instructions including wearing of compression garments, etc.

Mark Edward Hennessy, MD · Answer

If the Cannister in your photo represents the total amount of fat removed...then no your doctor did not remove three liters of fat. Was tummy tuck a consideration prior to undergoing Lipo?

Jerimiah Mason, MD · Answer

Without a before and after comparison it's hard to evaluate the work that was done.  If 3 liters were aspirated, that is a pretty significant amount.  You will have a fair amount of edema in the immediate post-op phase, but that will improve with time.  
Your surgeon should have discussed expectations with you before the procedure, so you would know what kind of improvements you should see.

Marco A. Pelosi III, MD, FACOG, FACS · Answer

Lipo causes swelling and swelling needs to be managed for comfort and faster healing. The best way to manage swelling is with use of a compression garment around the clock and frequent professional lipo massages for the first month of healing. Your photo shows the right flank region and abdomen. The flank appears reduced, but your abdomen looks full - not from lack of lipo, but from a prominence of internal (visceral) fat which will only reduce with diet. You have loose lower abdominal skin which can only be addressed with a tummy tuck. I hope all of this was explained to you beforehand so that your expectations are realistic.

Jaime Bastidas, MD · Answer

Honestly, it's difficult to answer your question based on the photos and information you provided.  I am an expert with SmartLipo and I am a board-certified plastic surgeon, so I do have some comments and hopefully some answers for you.
SmartLipo is a procedure to help shape your body and it does so by removing fat.  The amount of fat depends how much there is under the skin and how it is distributed on your body.  For example, you can take 2 people with very full bellies.  Say the first one has fat mostly under the skin, the skin is thick and tight, and the stomach muscles are flat.  That patient would do well with Smartlipo and plenty of fat can be removed.  Now say the second person has very little fat under the skin, has stretched out stomach muscles, and a lot of fat around the abdominal organs which we call visceral fat.  That patient would not do well with Smartlipo because the problem in not related to fat under the skin and very little change could be obtained with lipo.  There are other options for that patient aside from liposuction.
Another factor that affects outcome is the quality of the skin and how it is attached to the body.  Loose skin will make rolls more obvious, even when there isn't significant fat.  Since you are a week out from your treatment, you still have swelling and that can make the rolls seem more obvious.  But there are some cases where removal of fat can make rolls more obvious.  I know this because I have seen it happen.
Overall, it's not the amount of fat that determines the overall result.  It's removing the proper fat, from the proper locations, for the proper reasons.  
In your case, you are only a week out from surgery, which isn't very long.  If 3 liters was aspirated, that was a significant amount.  That means you'll have plenty of swelling and your tissues have a lot more healing to do.  Wear your compression and continue with post-operative management as instructed by your surgeon.  Talk to your surgeon about your concerns. If you are still not satisfied, get consultations with other experienced plastic surgeons and make sure they are board-certified.  Best of luck to you.  Dr. Bastidas

Jared Mallalieu, DO · Answer

Thanks for posting your question. It is somewhat difficult to gauge from the limited photo, but it appears you have some skin laxity. This is best treated with a tummy tuck rather than liposuction. The lipo will remove the fat, but won't fix this degree of skin laxity. For now focus on healing up - use ice to decrease the swelling and wear your compression. You may need a tummy tuck in the future. Best, Dr. M

David E. Berman, MD (retired) · Answer

you will continue to improve for 6 months after Smartlipo. It is a great tool to help make you look better. However, if you want the best results, you need to decrease your total body fat through better eating (I am a big fan of the ketogenic like diet with ketogenic supplements. see my web site for details). You should also increase your exercising and the best ones are the HIIT (high intensity interval training). best of luckdavid berman md

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