Liposuction a second time around on the same area may involve certain challenges, although the possibility of achieving smooth results remains high with proper patient selection, surgical planning, and postop care, as suggested by renowned plastic surgeons at the California Surgical Institute.
Liposuction of certain body areas may pose a risk of over-correction. For instance, the outer thigh or saddlebag can be aggravated by incorrect patient position at the time of surgery, which could lead to inadvertent over-liposuction in which the skin becomes irregular and the natural contour is obliterated.
Because it is much harder to correct the effects of over-liposuction, some surgeons err on the safe side by removing just a conservative amount of fat, and then ask their patients to wait a couple of months—or until their postop swelling subside and their skin redrape to the final contour—to determine if a touch-up is necessary.
While a secondary liposuction on the same area is feasible for most patients, it is important that they have good skin elasticity, allowing it to shrink down to the new contour. If there is significant skin laxity, the surgery may only aggravate the problem.
But people who are experiencing yoyo weight loss have poor skin elasticity, so they are a bad candidate for secondary liposuction or any type of body contouring surgery because the real issue is their inability to maintain a healthy weight long term.
A small amount of weight gain will not have any detrimental effect on the results of liposuction, while larger fluctuations (25-30 lbs. or more) certainly can. As a result, a good candidate should understand the importance of healthy lifestyle as the only long-term solution for weight management.
Aside from skin quality, another issue is the underlying scarring that has occurred due the initial surgery, which could make it difficult to achieve smooth results. For this reason, some plastic surgeons prefer to use PAL (power-assisted liposuction) when performing a redo.
PAL uses a cannula or suction probe that releases tiny, rapid vibrations to destroy fats in the gentlest, most accurate manner. Also, this technique has been known to reduce the operative time, surgical trauma, and healing period.
Meanwhile, other plastic surgeons prefer laser liposuction in which heat energy is used to break up the fat cells before they are suctioned out of the body. Proponents suggest that it is ideal for patients with superficial problems such as internal scarring from previous surgeries, dimpling, and cellulites.