Lipo 2019, is this fibrosis? I have periumbilical rippling

Question

Lipo 2019. Wore garment, did a few sessions but stopped prematurely do to almost passing out during all of them. Anyway, would love input on the best way to revise this? Fat grafting ? Sculptra? Laser for skin tightening - if so which one is the best? I don’t want to harvest my own fat via lipo again for a revision, so that’s not my first choice. But open to suggestions.

J. Timothy Katzen, MD, FACS · Answer

Thank you for reaching out with your concern about periumbilical rippling following liposuction in 2019.
Assessment of Condition: Based on your provided history and photographs, it appears the issue stems from the loss of fat beneath the skin in the periumbilical area, likely due to liposuction. This fat loss has resulted in the observed skin irregularities. Your condition is not fibrosis, which is medical terminology for scarring, but rather a consequence of fat depletion.
Potential Solutions:
Skin Removal: One option to consider is the surgical removal of the affected skin. This would involve an incision from the belly button upwards, effectively eliminating the rippled skin. However, this approach would result in a permanent scar.
Fat Replacement: Another option is to replenish the lost fat through a fat grafting procedure. Fat could be harvested from other areas of your body, such as the love handles, lower back, or inner thighs. This technique would not require a large volume of fat.
Alternative Treatments:
Sculptra: While Sculptra injections could provide some improvement, this method can be costly and requires multiple sessions. Additionally, the results are not permanent and may diminish after about five years.
Laser Skin Tightening: This method might not offer significant improvement due to the nature of your skin's laxity and the extent of the irregularities.
In summary, surgical intervention or fat grafting seems to be the most effective course of action to address the rippling in your periumbilical area following liposuction. It's crucial to discuss these options with a qualified plastic surgeon who can provide a personalized treatment plan based on your specific needs and desired outcomes.
I hope this guidance has been helpful in addressing your concerns about the rippling effect post-liposuction.
Good luck on your journey to a satisfactory resolution.
Sincerely,
Dr. Katzen

Steven H. Wiener, MD · Answer

Thank you for your question and photos.  The rippling you have is common after abdomen liposuction.  Your bellybutton is attached to your abdominal wall and is a point of fixation.  You have excess skin above your belly button.  This can be improved by releasing your belly button so that it floats, at the same time the excess skin can be excised and sutured to the bellybutton.  This can be performed under local anesthesia and will help smooth your rippling.

Ira H. Rex III, MD · Answer

your photographs show a significant complication which needs evaluation by a plastic surgeon. Perhaps a combination oof liposuction and adjacent graftingmay be a good approach. The revision would depend upon the amount of scar tissue present.

Justin Yovino, MD, FACS · Answer

Sculptra, Renuva, and Morpheus8 are all good options to approach this situation in a non-surgical fashion. This finding is typically associated with a natural decrease in elasticity (post pregnancy, weight changes, genetics) combined with surgical procedures (liposuction) that deflate the soft tissue overzealously. If an abdominoplasty (tummy tuck) is not an option, then restoring the volume deficits and promoting skin tightening is the approach. Fat transfer is the most permanent volume enhancement but that does require additional surgery. Sculptra and / or renuva are easy non-surgical office procedures that require a few treatment sessions to appreciated results. Morpheus8 is a combination of microneedling and radiofrequency that promotes skin tightening. With that all said, these non-surgical above treatments are typically associated with subtle to mild improvements.

Luis A. Mejia, MD · Answer

Dear sunnydays345543, thanks for sharing your pictures and concerns, an in person consultation will be great to properly determine the best optin for your issue, by this way Smooth Vaser looks like one of the main and better options to help with your issue. an dimprove tyour abdomen look. . Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks. Dr. Luis Mejia.

Gary M. Horndeski, MD · Answer

This may be corrected by doing a umbilicoplasty.  An incision is made around the umbilicus, most on the top, and the skin is pulled down.  You may also need fat transfer at the same time.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear sunnydays345543,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. You might need fat transfer to improve belly button area. 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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Shitel Patel, MD · Answer

The above the belly button skin looks like it has loosened and created a few creases. Starting with a series of RF microneedling to tighten the skin would be the first thing and then see if any volume is needed.

Ajaya Kashyap, MD · Answer

Thank you for your query! The best option for this rippling maybe  invasive radio frequency skin tightening ( Thermitight or Bodytite) with a small amount of autologous fat grafting, after freeing the scarring. Please find an experienced Board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

John Michael Thomassen, MD · Answer

I would recommend fat grafting to this area.  You may need multiple sessions but it can be done under local anesthesia.

Lipo 2019, is this fibrosis? I have periumbilical rippling

Answers (17)

More Liposuction Revision Questions

Which procedure would help remove lumps caused by laser liposuction? 3 years post op (photos)

Dents and unevenness after liposuction - do I need revision lipo, a tummy tuck, or fat grafting? (photos)

Fat distribution- 30 yo, South Asian, 5’3, 129 lbs (Photo)

Disappointed with lipo results and irregularities - normal or unrealistic expectations? (photos)

My stomach is firm & lumpy one year after lipo. Can this be fixed? (Photo)

WE SEND PRETTY
EMAILS