January 19, 2010 | Liposuction, Surgery Revision
4 minute read
CONTOUR IRREGULARITIES
The most common postoperative sequelae of liposuction that I encounter are contour irregularities (i.e. “dents,” “grooves,” or “dimples”) seen under the skin. If you’ve recently had liposuction and are concerned about slight abnormalities or “waves,” in your skin…relax. These initial defects can be normal, may be caused by postoperative swelling and skin elasticity, and may resolve over the next six months. To ensure optimal results, it is imperative to wear the postoperative compression garments as prescribed by your plastic surgeon. Some patients have also found manual lymphatic massage and Endermologie (LPG Systems, Valence, France) beneficial in reducing postoperative swelling and bruising. Always consult with your treating plastic surgeon prior to use of these, or any other, therapies. However, if your contour defects are caused by inadequate or overly aggressive liposuction and persist over nine to twelve months, they are unlikely to resolve without some form of intervention.
To correct contour irregularities caused by inadequate initial liposuction, I perform revision (secondary) liposuction or liposculpture. During this procedure, I use small liposuction cannulas to delicately remove the areas of excess fat, being sure to “feather” into the surrounding areas, ensuring an even, invisible transition. For small areas of concern, it may be possible to perform the surgery under local anesthesia in some cases; for larger areas, this may require a formal trip to an operating room. The correction of defects caused by overly aggressive initial liposuction, which is usually the case, is a little more complicated. In this case, I perform fat-grafting (aka liposhifting). Fat-grafting is a procedure I enjoy and use routinely for gluteal augmentation/gluteal lift (learn more about Brazilian Butt Lift, reconstruction, and for revision liposuction. During this surgery, I use liposuction cannulas to harvest excess fat, usually from an area untouched by the initial liposuction procedure, then use the collected fat to fill-in and smooth-out the irregularities that are most concerning to you. This two-step process allows me the opportunity to reduce “bulges” and augment “dents,” providing you with a smooth, silky silhouette. This surgery is performed in an outpatient surgery center and takes approximately one hour. Following this procedure, special compression garments must be worn for at least six weeks postoperatively.
EXCESS SKIN
Occasionally because of age, pregnancy, weight gain/loss, or genetics, a patient’s skin may not have enough elasticity (i.e. ability to recoil) to retract and conform to the newer, smaller curves achieved with liposuction. Following liposuction, patients with poor skin quality may be left with baggy, excess skin. This most frequently occurs in the arms, medial thighs, or abdominal area where the skin is thinnest. In these instances, direct excision of tissue may be required.
It is still possible to obtain a smooth figure with tighter skin. Unfortunately, this will likely require a new incision to remove the excess skin. I tailor these incisions to the patient’s need and body in order to provide the most aesthetic result while minimizing visible scars.
PREVENT LIPOSUCTION COMPLICATIONS
While it is impossible to guarantee surgical results, there are things you can do to improve your chances of a beautiful outcome. Most importantly, I have all my patients wear specially-fitted compression garments for at least six weeks postoperatively. Compression helps to reduce swelling and support tissues while they are healing. Additionally, to prevent hyperpigmentation (i.e. darkening) of scars, sunlight should be avoided and all scars meticulously covered with sunblock for one year after surgery, when possible.
If you are currently experiencing a complication following liposuction, it is normal and understandable to feel depressed or regretful. The thing to focus on, however, is that you still have control over the situation, and there are options available to improve your results. This is merely a temporary delay on your way to a more beautiful you. Prior to any intervention, you and I will have a long conversation in order to ensure I understand what bothers you most, your goals for revision surgery, and that you understand and are comfortable with the corrective options available
Jaime Perez, M.D.
Plastic Surgery Center of Tampa