Liposuction Revision

Liposuction revision encompasses several surgical procedures to correct irregularities or undesirable results from a previous liposuction procedure. The revision is generally performed due to the prior liposuction removing too much or too little fat. Commonly treated areas for liposuction revision include the thighs, abdomen, buttocks, back and arms. Corrections may include fat grafting, excision or additional liposuction. Poor liposuction results are often caused by an unsuitable initial evaluation or poor surgical technique because liposuction is considered an “operator dependent” procedure. This means that the results depend on the surgeon’s skills, judgment and experience. When issues occur, liposuction revision may be able to help correct results that are not desired by the patient.

Am I a Good Candidate for Liposuction Revision?

A GOOD CANDIDATE for liposuction revision is typically:

• Anyone who has already had liposuction but is unhappy with the results and desires to correct the imperfections or optimize the results
• A patient who was left with depressed areas, due to over-suctioning, may be a good candidate for revision with fat grafting to add volume back into the region
• A patient who was under-suctioned, meaning the initial goal was not achieved, may need additional liposuction to remove more fat
• Any patient who had liposuction that resulted in a bulge of leftover fat may need additional liposuction to remove the pocket of fat
• Patients with irregularities of the skin due to an uneven blend between the suctioned region and the adjacent areas
• Patients who had liposuction, which resulted in dimpling, may choose a revision with fat grafting to correct these skin flaws
• Any patient who incurs loose hanging skin after liposuction, due to the laxity of the skin in the treatment area, may benefit from a revision to remove the excess skin
• Any patient with asymmetric results of two symmetric regions may benefit from either fat grafting to increase volume in the lacking region, or targeted liposuction to decrease the fuller region, in order to create overall symmetry

Patients who are NOT GOOD CANDIDATES include:

• Patients who thought liposuction would be a weight loss treatment
• People without a good amount of lax or supple skin
• Someone who is not in good overall health

How is Liposuction Revision Performed?

The way liposuction revision is performed depends on the reason for the revision. The surgery is usually an outpatient procedure and is typically performed under general anesthesia. The procedure can take anywhere from 1 to 4 hours.

• Under Correction – An additional liposuction procedure can be performed and is similar to the initial treatment. However, this additional liposuction is more targeted to the specific region. The treatment area will be infiltrated with the infusion of tumescent solution to help loosen the fatty tissue. The surgeon makes small incisions and uses a cannula, which is connected to a vacuum-like device, to suction out more of the fat.
• Over Correction – Fat grafting may be performed to restore lost volume. With fat grafting, the surgeon will remove fat from another area of the patient’s own body. The fat is separated from the fluid, purified and then re-injected into the treatment area with microinjections in order to improve volume. Small areas of volume restoration may be done in one fat transfer sitting. Significant volume restoration may require multiple sessions of fat grafting.  
• Loose Skin – If a patient has loose skin, especially on the abdomen, the doctor may need to surgically remove the excess tissue to tighten the skin. An abdominoplasty, or tummy tuck, can be done in conjunction with liposuction to remove excess tissue while tightening the loose skin.

Incisions

The surgeon can usually reopen the previous incisions, and work through them, without the need for new incisions. If the new treatment area is too far away from the initial incisions, new incisions may be needed for liposuction revision. The incisions are sutured closed and a compression bandage is placed on the treatment area. Scarring is generally minimal since it can be within the original scar. Any additional scarring is typically hidden within the natural creases of the body.

Combined With Other Procedures

Liposuction revision can be done in conjunction with other skin tightening procedures such as:

• Laser Therapy (especially when the superficial layer of fat has contour irregularities which cannot be addressed simply with additional liposuction)
• Panniculectomy (which is a surgery to remove an apron of skin that hangs below the abdomen)
• Body Lift (targets the thighs, buttocks and abdomen to lift sagging skin and tighten damaged muscles)

What is the Cost of Liposuction Revision?

The cost of liposuction revision depends on the type of revision and the complexity of the procedure. In general, the cost ranges from $4000 to $15,000. The variation in cost also depends on the skill of the surgeon and the geographic location of the surgery. If the revision is accompanied by another surgical procedure, such as a tummy tuck or panniculectomy, the costs will increase considerably.

Recovery and Downtime

The length of RECOVERY depends on the type of revision performed by the surgeon. If the revision involves additional liposuction, the recovery time is usually easier than the initial liposuction since it is at a smaller capacity. Some patients can resume normal activities within a few days but will still need a few weeks before heavy lifting or exercise can resume.

If the amount of fat taken out is equivalent, or a little larger, than the initial liposuction, patients can expect a similar recovery and downtime than what they initially experienced. If the goal of the revision is to restore volume with fat grafting, the recovery time depends on how much fat needs to be restored. With either procedure, patients can expect some pain or discomfort which can be managed with pain medications. Swelling and bruising are common but vary depending on the circumstances. Also, there is a greater chance of increased or prolonged bruising since the surgeon is working through scar tissue from the initial procedure. The swelling can last several weeks or months but an elastic garment placed on the treatment areas helps maintain the swelling and bruising. The compression garment will be worn for about 2 to 3 weeks. Patients should plan to miss about a week from work for recovery.

Results

Patients can usually see immediate improvements after liposuction revision but the results will become more apparent after most of the swelling and bruising has subsided. Each patient heals differently depending on their age, genetics and skin elasticity. Bruising usually fades between 7 to 14 days but swelling can persist for up to 6 months. It can take a year for the body to heal and for the results to be considered final. Patients should be at, or near their ideal weight, to maintain the results since weight fluctuations can impact the lasting results. It is important to understand that aging can eventually affect the results since the skin will become lax and not appear as tight.

Limitations and Risks of Liposuction Revision

A few LIMITATIONS of liposuction revision include:

• Time elapses from the initial procedure - Liposuction revision should not be performed any sooner than 6 months after the initial liposuction since the body needs time to heal. Performing liposuction revision too soon can interfere with the revision outcome because of the residual swelling.
• Complexity - Revision procedures are more challenging than the initial liposuction since their purpose is to perfect contour irregularities that occur due to the first surgery.
• Depth factor - Irregularities within the superficial fatty layer are more difficult to correct than contour deformities located in the deeper fatty layer. Therefore, damage within the superficial fatty layer may be limited with the amount of correction which can be done.
• Fat grafting - It is limited with the amount of fat that can be injected in one session because the fat must “take” with the residing, viable fat cells to create circulation and blood flow.

Liposuction revision surgery may include the following RISKS:

• Unpredictability of the outcome due to the fact that scar tissue has already formed from the initial surgery and the surgeon must work through this fibrous tissue
• Unsatisfactory results which might mean more surgery
• Bruising
• Bleeding
• Infection
• Fluid collection
• Dimpling
• Asymmetry
• Damage to deeper structures such as blood vessels, muscles, lungs, nerves or abdominal organs

Choosing the Right Surgeon

When considering liposuction revision, patients should consider choosing a different surgeon than the one who performed the initial liposuction. Surgeons who offer a revision procedure for free, or at a lower cost to correct an issue that occurred during their first procedure, may not be adequately skilled in the first place and might make things worse. During a liposuction revision consultation, the surgeon should be able to distinguish whether the cause of the issue is from the initial liposuction or post-operative weight gain. While liposuction does rid the body of fat cells in an area, weight gain in the treatment area can occur due to the remaining cells increasing in size by storing more fat. The surgeon should discuss each treatment option and the possible need for a combination of procedures to optimize the outcome.

Written by Cosmetic Town Editorial Team- MA

Based on exclusive interview with Jean Loftus, MD in Cincinnati, OH