Need revision liposuction & guess I need fat grafting? (Photos)

Dear AndreaMaria90,
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

Delivering consistent quality liposuction results is more difficult than most people believe and this includes most plastic surgeons.
Liposuction results are permanent and irreversible. For that reason patients need to be very selective on who they allow to do these procedures. Unfortunately I see your tube of results far too often and it baffles me how providers have never been taught how to do this procedure and still feel justified in doing a liposuction.
Liposuction is very deceptive in that it seems like a very simple procedure to perform and on a basic level it is. It doesn’t even require using sutures you simply push the probe back-and-forth.
The fact that Liposuction is quite easy to do leaves an unfortunate number of people believing that Liposuction is easy to do as a procedure. The truth is liposuction is easy to do but it is one of the most difficult procedures to do well delivering consistent quality results on a regular basis.
Revision work as many times more difficult than primary Liposuction so the importance of finding the most talented provider is even greater for revision work.
Treatment options typically come down to revision liposuction, fat transfer or converting the procedure to a skin tightening operation like a full tummy tuck. The problem with revision Liposuction is that too much fat was removed in the first place so doing more of the same can easily make things worse. With fat transfer the areas that need volume the most are now devoid of host tissue which leads to a high percentage of graph failure.
Some improvements can always be made but it typically is only a partial improvement and to get a significant improvement when most likely require more than one operation. And the hands of someone like the surgeon who did your previous procedure revision work would most likely make things much worse.
For patients interested in Liposuction I recommend having multiple in person consultations to put local board-certified plastic surgeons in their community. During each consultation ask each provider to show their entire collection of before and after pictures. Being shown a few simple pictures which most likely represent the best results of the providers career is insufficient to get a clear understanding of what the average results look like in the hands of each provider. And experience provider should have no difficulty showing you at least 50 sets of before and after pictures. Highly experienced providers will have hundreds or even thousands of before and after pictures for this commonly performed procedure.
Revision Work is not as common as primary Liposuction so you’re probably not going to find a plastic surgeon who can show you that many before and after pictures of Revision Work. remember also that fat transfer results take time and if that transfer was done patients need to make absolutely sure after pictures were taken at these three months from the date of the procedure. early fat transfer results can look very impressive but do not at all represent final results.
Not all plastic surgeons even if they have the skill and experience may be interested in taking on Revision Work. It is extremely time consuming and patients are often very apprehensive of having more surgery. Patients who have been previously disfigured by other surgeons can consume enormous amounts of time and resources and often end up not scheduling for surgery.
Still, the process is the same more or less for revision work as it is for primary Liposuction. You simply need to continue having more consultations until you found a plastic surgeon who has sufficient skill and experience that you feel confident they can deliver enough results to justify having the procedure.
Anybody who thinks this is easy to fix or is going to use some high technology energy device such as VASER and that is the secret to correcting Liposuction results is probably also going to leave you disappointed.
Finally I recommend reading all reviews on various physician review websites avoiding providers with any significant number of justified negative reviews.
The absence of justified negative reviews is more important and more telling them having an abundance of positive reviews.
Best,
Mats Hagstrom MD