Abdominal revision liposuction poses some unique challenges. First and foremost, plastic surgeons often have to deal with skin irregularities caused by over-removal of fat, and the internal scar tissue from the previous surgery.
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted a Snapchat video showing a female patient who had botched liposuction that resulted in large dents below her navel, contour irregularity on the left flank, and less than optimal waistline.
The large dents and surface irregularities, according to Dr. Smiley, were primarily caused by over-liposuction or removing too much fat.
In the video, the celebrity plastic surgeon said a thin layer of fat must remain after surgery to ensure a smooth skin surface and to avoid a wide range of surgical stigmata.
To correct the ill effects of over-liposuction, Dr. Smiley performed fat transfer, which in essence is a reverse liposuction. After removing some fats along the flanks and waistline, instead of discarding them he injected them to smooth out the indentations.
To further achieve a smooth skin surface, Dr. Smiley released the scar tissue that was causing the skin to adhere to the muscle, which in turn also improved the contour of the left flank.
Moreover, he removed additional fat along the flanks to create a more hourglass silhouette (narrow waistline and wide hips).
Since revision abdominal liposuction is more complex than the initial surgery, Dr. Smiley always uses the tumescent technique combined with microcannula, or flexible hollowed tube with an outside diameter of less than 2-3 mm.
Tumescent liposuction involves injecting large amounts of tumescent fluids into the fatty area before the actual removal fat is performed. The idea is to make the fat cells swell up to pave way for a more precise, gentler extraction.
Furthermore, the tumescent fluids contain epinephrine that constricts the blood vessels and thus the amount of bleeding is reduced by up to 90 percent as compared to the “dry” or “no wetting solution” technique.
Precision is further improved with the use of microcannula during the actual extraction of fat, allowing the surgeon to remove excess fats in smaller bits, as opposed to larger chunks. For this reason, he avoids using large cannulas especially when doing some type of revision liposuction.
The female patient has presented Dr. Smiley her “wish pic” (Kylie Jenner’s voluptuous body). For this reason, he not just sculpted the four quadrants of the frontal abdomen and the flanks, but also the inner thigh and hips.
Overall, Dr. Smiley used 12 tiny liposuction incisions to meet the cosmetic goals of this particular patient; these are expected to fade into the background after 6-12 months.