Corrective liposuction often deals with bumps and dents whose underlying cause may involve fibrosis (hardened fluids during the recovery process or internal scar tissue), under- or over-correction, use of large cannulas, or a combination of these factors, according to the California Surgical Institute website.
It is almost always a prerequisite to use microcannula, or narrow suction tube whose outside diameter is 2.5 mm or less, when doing some type of corrective liposuction surgery. Large cannulas, meanwhile, are best avoided because they offer less precision as they remove fats in bigger chunks.
For additional accuracy, leading Beverly Hills plastic surgeon Dr. Tarick Smiley may recommend power-assisted liposuction (PAL) in which the microcannula releases tiny, accurate vibrations to break up the fat prior to its extraction. For this reason, the technique is also highly ideal for removing fibrous fats, which are typically found in the back, flanks, upper abdomen, and male breasts.
During a corrective liposuction surgery, it becomes more important than ever to preserve a residual layer of fat right beneath the skin, with its blood vessels intact. Not only does it ensure a smooth skin surface, but it also reduces the amount of postop swelling and bruising.
Furthermore, the use of gentler liposuction techniques, which have become possible thanks to microcannulas and probes that release accurate vibrations, can also prevent excessive internal scarring.
Some doctors avoid ultrasound- and laser-assisted liposuction techniques when doing revisions because the thermal energy could increase the amount of surgical trauma and possibly the risk of bumps and dents as well.
While internal scarring typically resolves on its own as the patient moves forward to her recovery, when there is too much of this (usually due to aggressive liposuction techniques) it would be difficult if not impossible to achieve smooth results from surgery.
How long the microcannula stays in the area will also determine the surface of skin. A good rule of thumb is to move it at a relatively quick pace to prevent inadvertent over-removal of fats. When too much fat is removed, the affected area would collapse to the point that the skin would resemble a “Swiss” cheese.
Occasionally, corrective liposuction entails the use of fat transfer, which essentially is a liposuction in reverse. Doctors collect donor fats from one area of the body, remove all the impurities, and re-inject the highly purified fats into the area with skin asymmetries caused by over-correction.
While revisions often produce good results, it is important to wait for at least six months or until all the swelling has resolved, the internal scar tissue has “soften,” and the skin has shrink-wrapped around the new contour.