Patients often present to Dr. Goldberg with liposuction aesthetic complications performed by other physicians. As the number of liposuction procedures performed by non-board certified plastic surgeons has increased, iatrogenic fat tissue deformities have also grown significantly. What are fat tissue deformities from bad liposuction?
There are different types of deformities:
- Problem 1: Overcorrection liposuction can result in contour dimples and holes in the skin.
- Problem 2: Traumatic suctioning may lead to lumps and bumps from fat necrosis
- Problem 3: Undercorrection – Non-blending liposuction suction from one area to an adjacent area can create an unbalanced contour.
- Problem 4: Vasculopathy and cutaneous hyperpigmentation are results from internal trauma provoked by the liposuction cannula.
Each problem stated above requires a specific solution. Dr. Goldberg is a revision liposuction expert and can offer help for these difficult problems.
Problem 1: Overcorrection liposuction results in contour dimples and holes in the subcutaneous tissue. There are challenging areas in the body that are more prone to contour irregularities and these are upper abdomen, inner thighs, lateral thighs, buttock creases, calves, and ankles. Due to the thin skin and dense ligamentous attachments in these areas, even small mistakes may cause unfavorable outcomes. When a surgeon removes too much fat in these areas, the skin can scar down to the fascia creating divots in the skin. The course of action depends on whether the floor of the dent is above or below the ideal contour line. If it is above the ideal contour line, removing the fat in the residual lumps may be the best technique. If it is below the ideal line, Dr. Goldberg will inject fat in the area to smooth out the defects.
In most cases, however, it is both above and below the contour line; Dr. Goldberg combines techniques of removing the fat in the residual lumps and injecting fat into the remaining dents. Fat that is aspirated from the patient is the only product that carries no risk of allergy or rejections. However, patients should expect partial reabsorption of the injected fat and it may requires multiple injections for complete correction.
For deep skin depressions, Dr. Goldberg will release the scar adhesions to the fascia, a process called subcision, and inject fat around the scar to prevent reattachment.
Problem 2: Lumps and bumps from traumatic suctioning. SmartLipo is a great technique for this deformity correction. With the aid of a laser, the calcified necrotic fat can be gently emulsified and removed with ease. Dr. Goldberg also recommends a lymphatic drainage message after the procedure to improve circulation and decrease swelling.
Problem 3: Undercorrection (insufficient fat removal) is the most common problem with liposuction. Blending liposuction is an important key to creating a harmonious transition from one area to the next. Therefore, Dr. Goldberg uses a liposculpturing technique that allows precise measurement of the aspirated fat. During a procedure, an assistant keeps a map of the same markings as the patient and notes the amount of aspiration from each area. Dr. Goldberg also performs blending liposuction in the transition zone to create a smooth contour.
Problem 4: Vasculopathy and cutaneous hyperpigmentation are results from internal trauma provoked by the liposuction cannula. For this problem, prevention is always better than the available treatments. Therefore, it is important to schedule your liposculpture with a board certified plastic surgeon. Treatment can consist of hyperbaric oxygen sessions immediately after the complications. Hyperpigmentation may also be treated with 2% hydroquinone or glycolic acid and certain ablative lasers and phototherapy.