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