Dr. Chia: Question and Answer

rodriguezandrea | Venezuela, VE

i got a arm lift about a year ago, and the scars got really red, big and wide. i’d try almost every cream but it dosent work. Im thinking about getting a second operation to fix this one what dou you think. it was me that didnt heal well or was the surgeon? (sorry for my bad grammar)

Doctors Answer
January 21st, 2015

Scars are noticeable because they

1) are a different color (redder or darker) than the surrounding skin,

2) have a texture change such as roughness or bumpiness or

3) are raised or depressed so that they cast shadows making them more visible. Scars generally get better after a year, but, if they persist, can be improved by targeting these qualities.

There are numerous non-surgical techniques which should be approached first and include lasers which may help the redness and surface irregularities. Scar revision is usually a last resort after all other options are exhausted. Scar management is something that you should discuss with your aesthetic surgeon and good luck with your brachioplasty as it continues to remodel.

anon4894802

Hello, I have a large tattoo covering majority of my back. I am getting liposuction on my lower back and bra rolls for a BBL. Will that ruin my tattoo or leave healing holes from the lipo? Can the PS stick the suction somewhere on my back to not ruin it or if there is a certain place the suction has to be in order to remove the fat?

Doctors Answer: BBL and Tattoos
August 8, 2017

Many patients undergoing BBL have existing tattoos and other body art adornments. Removing fat and contouring should not significantly change the appearance of tattoos. They actually may provide excellent camouflage for the small access incisions used for the fat harvesting and/or injection as the ink covers the scars.

Doctors Answer
May 30, 2017

It is difficult to figure out the source of your weight loss since you started out at a relatively small size before the BBL surgery. I recommend you check with your surgeon to see how your body has changed based on the preoperative photos. You can also see the approximate amount of fat that has taken since you are two years out of surgery.

Doctors Answer
May 9, 2017

In patients with uncomplicated C-section deliveries, BBL afterwards is not a problem. Your qualified plastic surgeon will make sure that you are a candidate for BBL after he or she sees you in person to make sure that you don’t have anything that would rule you out as a candidate.

SexyLibra326 | Ravenna, OH

4wks post op after bbl. My entire body looks amazingly different. I had fat taken from my back, hips, and sides. Before my precedure, when ever id gain weight id gain only in those ares. Now that those areas have been lipoed, if I were to gain weight will I gain in those same areas as I did before? My waist has never been this tiny and ive never been so well proportioned. I just love it! Ive noticed that my eating habits has changed. I fear that I will gain the weight back in those areas.

Doctors Answer: Weight Gain after BBL?
January 12, 2020

Your question encapsulates a few important concepts regarding body contouring. First, the fat removed from the areas will never come back because we do not gain fat cells in number (to any significant degree) after puberty is completed. That means the fat cells removed are gone forever from that area but the remaining fat cells can still expand with weight gain but the area overall will gain at a less rapid pace than other areas of the body that haven’t been liposuctioned. Second, the fat that is injected and has stayed after a long period of time will behave as fay would anywhere else and is subject to your eating habits as well. I’m glad you had a good outcome and thanks for the question

Doctors Answer
April 26, 2017

Since you have a faster than normal heart rate and are on medication for it, getting medical clearance from your cardiologist will be the first thing to do. You had an operation previously and fortunately, everything went fine so your cardiologist will tell you if you are a candidate for the next BBL procedure.  One option is to do the operation under local anesthesia where with an anesthesiologist you have a physician who is dedicated to monitoring your heart situation continuously but you are not asleep or under general anesthesia or even IV sedation. Check with your plastic surgeon if he or she offers this option. In any case, make sure you are cleared medically and that your surgeon has a definitive plan for you.

delarosa1503 | Huntington Beach, CA
I’m 29 year old. I have been really looking forward to getting abdominal liposuction and BBL, I have the following concern; I have irregular heart/slow beats, and I often have a fluttering feelings in my heart. I have inform my doctor and have been refer to a cardiologist, but nothing has been found. Im tired of dr’s not giving answers. should this stop me from getting my procedures done? I’m just afraid ofa hear attack while under anesthesia or just never waking up because of a hear failure.

Doctors Answer: BBL and Irregular Heartbeat
April 26, 2017

No matter what operation you are considering, getting medical clearance from your cardiologist will be the first thing to do. The good news is that many irregular heart rhythms can safely be managed with when all parties involved communicate well and have a plan. An option is to do the operation under local anesthesia. I have done many body contouring procedures with patients who are awake with the addition of an anesthesiologist in the room. That way, you have a physician who is dedicated to monitoring your heart situation continuously but you are not asleep or under general anesthesia or even IV sedation. Check with your plastic surgeon if he or she offers this option.

Doctors Answer
April 26, 2017

It’s not so much the type of pants you wear after BBL but the fit-how tight they are. In general, it is preferable to wait about 8 weeks to be on the safe side but if the jeans are loose-fitting, six weeks should be sufficient. Surgeons are particular about the postoperative course, so please check with him or her.

Sandra80 | Los Angeles

I am wondering if the fat put into the butt surgically could melt away with time. Since I’m considering that procedure I want to know how long does it last.

Doctors Answer: How Long Do BBL Results Last?
April 11, 2017

The fat that survives long term (over three months postop) following a BBL behaves just like fat anywhere else in the body and is permanent. However, there are a lot of factors going on shortly after the operation is done that confuse the situation. First, there is swelling from the operation itself and, second, the amount of fat that survives for the long term is not 100%. Third, mechanical factors during the first several weeks of the operation will also affect how much survives. All these things come together to end up with a very dramatic early postop result which, with good technique and care, should result in a natural and improved shape and volume of the buttocks that lasts permanently.

Doctors Answer
April 3, 2017

I don’t know what kind of cellulite treatment you are referring to but in general I would wait 6-8 weeks after BBL to manipulate the areas where the fat was injected. I would check with your plastic surgeon so that everyone is on board with your plans.

Doctors Answer
March 23, 2017

It is completely normal to have a larger than expected buttock size right after a BBL. This is due to swelling and the amount of fat injected which will normalize in a few weeks into the size you want. It is customary to injected about 50-100% more fat than the expected final volume to account for the fat that does not survive permanently over time. It should settle close to where you wish the size to be.

Doctors Answer
March 23, 2017

BBL has become an increasingly popular as well as affordable procedure for many. In NYC, there are many qualified plastic surgeons who perform the procedure and may offer finance plans or other options. For patients who are candidates, for example, BBL may be done under local anesthesia with excellent results while avoiding the costs associated with anesthesiologists, additional staff and OR materials costs. This is something that more and more of our patients are looking for which can be done safely and comfortably with a shorter recovery period as well. 

Doctors Answer
March 23, 2017

While prices for BBL vary widely within the US, there are reasons why costs are higher here than overseas. These include licensing of both the physician and proper accreditation of the operating room, the experience/training of the surgeons, anesthesiologists and nurses, regulatory issues, maintenance of the facilities and many other costs that overall work toward a safer environment for the patient. While it can be a large investment, you may find qualified and experienced surgeons who can give you what you are looking for if you do enough research.

sexibod9 | New York, NY

I know it’s not recommended to sit on my rare after bbl surgery but I’m planning on getting work done then quickly returning home to heal and get get from loved ones. How safe is it flying home two days p/o? How will that affect my bbl and my lipo, when should I anticipate going back to work? What should I get to prepare for my 2.5 hr return?

Doctors Answer: Flying 3 Days Postop Following BBL
March 23, 2017

I would recommend giving yourself more than three days to fly following BBL. First, prolonged pressure (sitting) on the fat grafts will decrease the amount of fat that survives. Second, complications decrease in general the more time passes from the time of operation. Third, if you need to see your surgeon for any reason, he or she is not available. I would discuss this with the plastic surgeon.

Doctors Answer
March 23, 2017

While BBL has been shown to be a good way to predictably enhance one’s buttocks using your own fat, in my experience using fat alone for breast augmentation has been less successful because the breast is a less reliable recipient site. In other words, the amount of fat transferred in the breast over time does not stay as well as in the buttocks. However, using smaller amounts of fat in addition to a breast implant injected near where the implant ends and the natural tissue begins helps to smooth the transition, giving a more natural appearance. This is a called a Composite Breast Augmentation (CBA).

bellas27 | New York, NY

I would like to know what vitamins to take before my surgery (Ex. Iron, vitamin C, zinc. Etc) also what should I continue to take after surgery

Doctors Answer: Vitamins Before BBL
March 23, 2017

In general, patients who eat a wide variety of foods and do not have any major illnesses will have sufficient vitamins from their diet. However, certain herbal supplements may actually cause more bruising with surgery and should be stopped some time before surgery. As each surgeon has a different protocol, contact the office directly to see what items are of concern, if any.

Doctors Answer
March 23, 2017

If I understand your situation correctly, your doctor did not use all the fat that was harvested when he injected your buttocks the first time and saved the leftover fat for future use. I do not believe that fat that is stored for a length of time after harvesting is good material to inject. However, staging injections as in BBL under local anethesia is a viable option and something that can be done over several small procedures to get the desired effect and can be done in relatively short time frames (as in weeks). The idea is that a goal is set with a plan to achieve that effect. I do agree that 215cc in each buttock is a modest amount.

Doctors Answer
March 22, 2017

BBL as you probably already know involves both liposuction and fat transfer so that you get two benefits: the improved contour from both the areas of fat reduction as well as increased volume and better shape in the buttocks where the fat is injected. Many factors go into the cost including time, areas harvested, where the operation is performed, experience of the surgeon, and type of anesthesia. For example, local anesthesia BBL presents a significant cost savings to the patient but isn’t for everyone and most surgeons do not offer it. An experienced plastic surgeon can give you all the options during the consultation.

Doctors Answer
March 22, 2017

Thank you for your question as BBL under local anesthesia is an opportunity for many patients who have specific goals in body contouring which may not necessarily require general anesthesia. In my practice, my partner and I have performed over 3000 liposuction cases under local (awake) anesthesia and take great stride to ensure safety first and patient comfort as a close second. This technique has been successfully translated to BBL under local anesthesia where you do not need a high tolerance for pain because once the tumescent anesthesia is in, there is complete analgesia (numbness). Please make sure your surgeon has extensive experience with body contouring under local and good luck. I hope you find the web reference videos to be helpful in your decision making process.

Doctors Answer
March 22, 2017

In general, pain 9 days after BBL would be unusual but not unheard of and is generally widely distributed among the areas of liposuction and/or injection into the buttocks. The key is that the pain should gradually get better and is not isolated to any one area because that would be suggestive of a specific problem. Also, the menstrual cycle can also make you more sensitive to pain that would otherwise be not as bothersome. Since you have specific pain that radiates to one side and region, I would make an appointment to see your surgeon. That way, you can be assured that it is something that is not to worry about or take care of any issue that may come up. Either way, you should be seen in person and good luck.

Doctors Answer
March 10, 2017

BBL involves swelling of the areas of liposuction as well as the areas injected with fat and is part of the normal recovery process. If you went back to work the day after BBL, that may be too early and can contribute to the swelling. The garment and padding that is worn after  BBL don’t affect the final results but may change the shape and appearance due to the swelling temporarily. If you have any concerns, visit your plastic surgeon to have your questions answered.

Doctors Answer
February 22, 2017

Thanks for your question. The best answer would be one that is done in person with a qualified plastic surgeon who does body contouring for the majority of his or her practice. You have specific needs that won’t be addressed unless you communicate them in the office. Good luck.

Doctors Answer
February 21, 2017

You’ve asked a great question because BBL is not only for patients who want a very large difference in size in their buttocks but can also be done in a more subtle manner to achieve an improved shape and fullness to the quality of the buttocks with a more modest size increase. This can also be done under local anesthesia which has many benefits. The limiting factor is how much fat can be harvested because slimmer women are candidates and naturally have less fat to give. Filling the “envelope” of the buttocks with fat helps to fill out minor contour issues and lessens the appearance of laxity by increasing the volume. The local anesthesia option is ideal for moderate gains in volume for women who want to smooth slight imperfections and help with the shape of their buttocks over sheer volume increase. This is an excellent choice which has much less downtime and has an excellent safety profile. I encourage you to get a consult with a plastic surgeon with a lot of experience in both BBL and local anesthesia body contouring to see if your goals are within reach of the operation.

Doctors Answer
January 20, 2017

The obvious benefits of BBL in general are two-fold: first, removing fat from unwanted areas and second, placing the fat to enhance other areas to improve the results. The less obvious benefits of the BBL is to improve the appearance of the overlying skin which may have been “deflated” beforehand as well as smoothing out minor contour deformities that occur as skin loosens. 

For some patients who desire these benefits but with more subtle changes, BBL under local anesthesia (awake) is available as well. The safety profile is excellent with a short recuperation while still being able to get all the benefits of a BBL. This may be the right operation for you but I encourage you to consult with a qualified plastic surgeon since this is a relatively new technique.

jannetv | Bronx, NY

Is my compression garments not tight enough? The skin was sticking to the muscle but now seems loose. I wear my compression garments religiously.

Doctors Answer: 5 Weeks postop BBL and Lipo with Looser Stomach Skin
January 3, 2017

You are still in the healing phase following the operation and there will be fluctuations in the swelling and the skin ‘redraping’. Five weeks is too early to see the final results. The most important criterion for anticipating how the skin will look afterwards is how elastic it is before the operation. Large swings in weight, multiple pregnancies and other factors will affect how well the skin will retract afterwards. The short answer is to wait and see how you will heal after giving it at least three or four months. If you have any questions, see your plastic surgeon.

Doctors Answer
January 3, 2017

Thank you for your question. I believe that in certain circumstances, optimal results can be achieved by staging the procedures. For example, in your case, performing liposuction will certainly enhance your overall outcome and BBL’s, even moderate volume ones (less than 600cc per cheek) improve proportions, shape and possibly the appearance of the overlying skin. Staging the lipo and BBl first also shortens the anesthesia time required and the slightly more complicated recovery process of dual procedures. Smaller BBL’s can also be done under local anesthesia by experienced surgeons. The lipo and BBL are done first and the MMO can be performed two months later when you are fully healed and the slimmer profile enables the surgeon to make the thinner flap mobilize more and possibly result in a lower incision than otherwise possible. All these benefits can be discussed with a qualified plastic surgeon and good luck. 

Doctors Answer
October 25, 2016

According to your photos, you look to be an excellent candidate for BBL. As far as expectations go, please consult a qualified plastic surgeon so that a face to face evaluation of how much fat you can reasonably expect to have transferred. Techniques have greatly improved both the removal and addition of fat as well as the long term viability. As far as the tummy tuck and BA, I would recommend that they be done separately for several reasons: operating time and recovery time being prominent. Good luck with your plan and thanks for the question.

Doctors Answer
December 6, 2016

The volume of fat that is injected into the buttocks in a BBL is determined by 1. how much fat is available 2. the desires of the patient and 3. the overall size and frame of the patient and 4. the priorities that surgeon makes during the operation about injecting fat into areas that may need more fat relative to other areas. With that in mind, 5-675cc per cheek is generally a good amount to achieve a sizeable increase in volume for someone of your size. Of course, opinions vary where one patient will be happy with a smaller increase but others are looking for a much more dramatic change. It looks like you have a good early result but that will change as the swelling reduces and the final graft ‘take’ is visible in a few months. Good luck and continue to communicate with your plastic surgeon.

claudia0726 | San Jose, CA

My question is if can I have a bbl with fat from my arms and back, I have 6 month with smart liposuction in my stomach, but I don’t like my back and arms, I want to do one more liposuction, but first I need know if is possible have the bbl with that fat,weight 150,high 5.3,36 old, thanks.

Doctors Answer: BBL Using Fat from the arms and back
December 6, 2016

Yes, you can transfer fat from just about anywhere in the body to the buttocks for a BBL. The question that is addressed is volume or how much fat you are able to harvest. For that reason, the flanks and abdomen are among the most popular areas for harvesting but the arms and back are also good sites. Remember, BBL is not just for size and volume increase but also to enhance the appearance of the butt in terms of smoothing out minor texture issues and dimples. A relatively moderate volume increase with a BBL can yield great results in not just ’rounding out’ the seat of your pants but also improving how it looks.

Doctors Answer
September 8, 2016

I assume that you had undergone a BBL with fat transfer and not injected with anything else. Although difficult to know for sure, it does look and sound from the history to be fat necrosis. It also may be a cyst which is may contain fluid like substances. Fat necrosis represents fat cells that have not gotten a blood supply and died off with hardening due to ‘calcification’. Usually, this will go down with time and gentle massage may speed it up. Either way, try to contact your doctor presuming that you have his name and he is still practicing or see a qualified plastic surgeon and good luck.

Doctors Answer
September 6, 2016

It is good that you know the shape of buttock enhancement that you want because communicating that to your plastic surgeon will help achieve the results you want. The flanks, midback and presacral area (the area just above the buttocks in the small of the back) are key areas of removal to start the shaping process. Of course, the abdomen suction is a good source of fat as well as flattening the front aspect of the body. Considering injecting the fat specifically, it is important that the surgeon knows where the patient wants the most volume enhancement. Some want more projection backwards where others may want to be more “hippy” or wider in the front-to-back view. Almost all patients want more fullness in the seat. Please get a consultation with an experienced plastic surgeon so that your questions are answered.

jlou11 | United Kingdom, GB

I’m around 120lbs I wanted to know if I am too thin for bbl?

Doctors Answer: Too Thin for BBL?
March 6, 2017

With the growing popularity of BBL, more patients are interested in fat grafting to the buttocks than before and many may think that they may not have enough fat to get a good result. The most important consideration is managing your expectations: how large do you want to be? is the fat transfer more for shaping and filling out a certain area than for pure volume? A consultation with an experienced plastic surgeon is critical to setting up for success. For example, modern techniques of liposuction and fat harvesting enables the surgeon to get more useable fat than one may think. Fat can be removed by multiple areas as well to get a reasonable amount for transfer as well. On the other hand, the surgeon can give you an opinion stating that what is desired may not be achievable with what you have and that is just as important to know. Thanks for the question and good luck. 

teresa9413 | Sacramento, CA

I have found a surgeon by the name of Dr. Frank Lamadrid on Instagram, he is on other social media such as Facebook and Twitter, but not Realself.I am questioning his credibility since I can’t find him on any other site. I like his work and he as given me an estimate of 5k for the BBL, which is very inexpensive in comparison to 10k and up,but I’m so unsure… Is there any other site I can find more about him?

Doctors Answer: Possible Travel Out of Country for BBL
July 22, 2016

Thanks for your question because there is an increase in medical tourism where many Americans travel to other countries for cosmetic surgery because it is cheaper overseas. While there are many good surgeons internationally, there are important considerations to take. First, not all plastic surgeons are subjected to a rigorous training and certification program as in the US. Second, cosmetic surgery internationally is often performed by physicians other than plastic surgeons. Third, the anesthesia and nursing services as well as the place where the procedures are performed need to be to the same standard. Even when everything goes well, complications may occur which need to be taken care of. If you return home and have a problem, it may be difficult to find a doctor willing to take your case (and will be an added expense). In addition, there are some very difficult infections that are endemic to certain parts of the world such as the Caribbean that can occur. Overall, one has to make a decision whether these concerns are worth the cost difference which in the end may not be realized at all.

Doctors Answer
July 7, 2016

Congratulations on your first race which caps off a healthy lifestyle. From a medical standpoint, one week after such a race is sufficient for recovery (barring any unexpected injury) for healthy patients. From a BBL standpoint, you may have less available fat for transfer but that does not prevent you from safely undergoing the procedure. The body contouring and lipo aspect will be enhanced by your running in the weeks and months to come after the procedure as they fat removal and running go hand in hand. Good luck with both the race and operation.

Doctors Answer
June 9, 2016

Thank you for your question because it brings up the important fact that there are several distinct body types and buttock shapes that may impact the technique should you decide to get a BBL. For example, having a high pelvis does not prevent you from having the desired inverted heart shape but your plastic surgeon should plan accordingly. In your case, more lateral and inferior buttock fullness is needed to avoid a blocky or squared off appearance. Just putting fat alone in those areas is often not enough because as a soft, low density filler (which is part of the reason it is good for natural enhancement) fat on the other hand by itself may not end up in the areas you want. Please discuss this with an experienced plastic surgeon who will recognize your anatomy from the time of consultation so that you will get the best possible outcome.

Doctors Answer
May 12, 2016

Although normal postoperative swelling of an area that has been liposuctioned (whether it is for BBL or not) will temporarily conceal some of the results of improvement, you should have a good idea of what the final appearance will be at two months. I recommend that you go back to your surgeon to discuss the factors that are in play. Besides the absolute amount of fat that is removed, other factors such as the tone of your abdominal muscles will affect the result. For example, if you have had children or experienced a lot of weight loss, the muscles become stretched and may not retract to where they were previously. As a result, your internal organs and intra-abdominal fat (the fat not touched by liposuction) may cause your belly to protrude even though most of the subcutaneous fat (the fat under the skin that is treated with liposuction) has been taken out. Your surgeon can manage your expectations and give you an idea of what to expect.

Doctors Answer
May 5, 2016

You are a very good candidate for BBL because the two direct benefits of BBL both slim down the areas that you want (bodysculpting) while taking the harvested fat and injecting it into your buttocks. Not all BBL’s are geared to just increasing volume but, more importantly, are designed to enhance the shape of your buttocks. This looks like what you are looking for since you already have naturally wide hips. Filling the shape and carefully increasing volume to increase definition (especially in tight clothing) will make for a nice looking silhouette. Fat from your lower abdomen will help flatten it and removing from the arms in itself increases defintion (although I can’t see you arms directly). Please consult with a qualified plastic surgeon to see how your goals can be achieved and good luck.

Doctors Answer
February 24, 2016

Thanks for your question but it is hard to answer your particular situation without photos and more information. In general, patients may have a BBL after liposuction as long as there is enough fat to harvest and then transfer to get a satisfactory volume. Liposuction is a very popular procedure so that many patients that are consulted for BBL have had some lipo before. Almost all of those patients are still candidates for the BBL as long as the expectations are able to be met by the surgeon doing the consult. Please seek a qualified plastic surgeon and good luck.

truth42 | Flagstaff, AZ

I am 198 lbs 5’4. How much fat can I have transfered to my buttocks? I want a big butt – knowing I will lose some fat transfer, it makes feel more is better than less. I been saving for this surgery for so long, I dont want to be disappointed.

Doctors Answer: How much Fat Transferred in BBL
April 14, 2016

This is a common question and depends on several factors such as the amount of fat available for harvesting, the size of the patient and the recipient site (buttocks) among other things. The good news is that there are many advancements in BBL which allows larger amounts of fat to be harvested as well as transferred to maximize your results than not so long ago. Of course, there are limitations to the amount and this is something that you should discuss with your plastic surgeon during the consultation. Thanks for the question and good luck. 

Doctors Answer
February 16, 2016

I would recommend that you give yourself about a week or longer to optimize your results and reduce your risks. For example, prolonged sitting early in the postoperative period may hamper your fat graft survival and overall outcome. Staying out of work varies from person to person and depends on how quickly you regain your strength. While spending time standing as a server is ideal for a BBL patient, make sure you are ready to take on the physical demands of work overall before returning (we know how hard the service industry can be) so that you recover adequately. A week to ten days should cover it but discuss it with your qualified plastic surgeon and good luck. 

Doctors Answer
February 16, 2016

Thanks for your question. Yes, you appear to be good candidate in that ares of liposuction for harvesting the fat will benefit in a slimmer profile while using the fat to augment the buttocks in a natural way. While you look to be in good shape for a mother of three, the skin over the stomach appears to have stretch marks and may not be right for liposuction. You may need to have a tummy tuck for the best result and this is something a qualified plastic surgeon can discuss with you in a consultation. Regarding prices, this will vary with the surgeon’s credentials, training, experience, where he or she performs the operation and what type of anesthesia is used. For example, some experienced body contouring surgeons familiar with the local anesthesia option may offer a smaller BBL with liposuction in the awake patient. This can be done in stages safely and effectively as well as the traditional anesthesia means required for larger and more dramatic BBL changes. Good luck.

bellanatasha | Atlanta, Georgia

I am afraid of getting general anesthesia, but want to get a brazilian butt lift. Can it be performed under local anesthesia?

Doctors Answer
February 10, 2016

Because of increasing popularity, patients may seek BBL to be done under local anesthesia. Traditional anesthesia is a safe option for healthy patients and is required in order to harvest a large amount of fat from multiple areas. For patients seeking a dramatic increase in the buttocks with the simultaneous reduction of multiple other areas such as the waist for a maximum result, traditional anesthesia with sedation is needed.

For patients who do not want to undergo general anesthesia and only desire a moderate increase in the buttocks with one or two areas of liposuction, local anesthesia is a safe option in the hands of surgeons with experience with both techniques. It can be done effectively and with little or no discomfort if done properly with minimal downtime and a much faster recuperative time. However, it is important to stress that smaller amounts of fat are injected at one time. Many of our patients who have it done under local tolerate it so well that they return on multiple occasions to gradually increase their buttock size in stages. With this option, BBL can be done safely, comfortably and with a shorter recovery time and at a lower cost because an anesthesiologist, extra nursing staff and excess operating room costs are avoided.

Traditional and local anesthesia BBL achieve different goals for different patients. Please get an in person consultation with a qualified plastic surgeon to see which is appropriate for you and good luck.

SimplyNish | Brooklyn,NY

I’m 200 lbs and I’m 5’3″. I like being “pleasantly plump” but I lack in the derriere department. I dont have much of a bulging stomach, it barely sticks out but I have love handles and back fat for days. I don’t want to be skinny just want to improve my shape. I have a wide shape with hips in which I’m in love with. Looking for something between $2500-$7500 for a Brazilian Butt Lift in NYC or somewhere not too far. You can also post if your farther, I’m still contemplating traveling.

Doctors Answer: Affordable BBL in NYC
April 23, 2016

Your question is something that many people have asked when considering a BBL (and any other type of cosmetic surgery). Since it is elective, it is an out of pocket expense. Please keep in mind that the total fees include not just the surgeon but the anesthesiologist, operating room expenses and nursing staff who are committed to taking the best care of the patient. Importantly, not all surgeons who perform BBL have the same level of experience and expertise as those of us who focus on body contouring as a significant part of our practice. While cost is a factor just like in any decision, focus on the quality and experience of the doctor as the most important one and good luck.

Doctors Answer
February 3, 2016

The Brazilian Butt Lift has gained a lot of popularity in the past few years and continues to grow, especially in the NYC and NJ greater metro area. Just as in any plastic surgery, research qualified and experienced surgeons who perform this on a regular basis. For example, plastic surgeons who regularly lecture and publish articles on body contouring in peer reviewed journals tend to concentrate their practices on these types of procedures and naturally will have a large number of cases and experience with them. It is important to get an in-person consultation so that your expectations can be matched with what the operation and surgeon can deliver.

Doctors Answer
February 4, 2016

Thanks for your question. When researching plastic surgeons who perform both liposuction and BBL, after checking their credentials, look at what the focus of the practice is. For example, not all plastic surgeons are fellowship trained in cosmetic surgery (extra training) and also may divide their time with reconstructive surgery. Lipo and BBL may appear to be straightforward operations, but experience and a large number of cases performing them (just like anything in life we focus on) will really impact your result. Doctors who also spend time to publish their results in journals where other plastic surgeons can read about them and lecture internationally on the topic means that they spend a lot of time thinking about the operation so that it can be continually improved to the benefit of the patient. Please get a consultation with a qualified plastic surgeon and good luck. 

Doctors Answer
February 2, 2016

Your estimate of at least 600cc in each buttock is a good general number in estimating the result, depending on your personal preference. While you have a normal BMI, an experienced plastic surgeon can find the fat from the donor sites to both improve the liposuctioned areas as well as getting enough material to transfer for a meaningful improvement in size and shape. Most surgeons will not remove from the breast area except under special circumstances. Please consult with a qualified plastic surgeon.

Doctors Answer
January 29, 2016

Liposuction is required to obtain the fat from the donor site that is to be transferred or injected into the recipient site such as the buttocks. In order to do so, saline is required and most surgeons use epinephrine (to reduce bruising) and lidocaine (for pain relief even if done under general anesthesia) and sometimes a buffer agent sodium bicarbonate. Occasionally, some will add antibiotics as well to ‘wash’ the fat. There may be some blood and other naturally occurring fluids from the patient mixed in to what is suctioned. The preparation that the OR nurse does to get the fat ready for injection removes most of the saline and blood by-products. The other medications are broken down and/or metabolized by the body in the next day or two completely. Fat preparation may be simple such as letting the fat separate from the aqueous (water) fraction with time to centrifuging the fat, using processing bags and manual straining. How it’s done varies greatly from surgeon to surgeon. Overall, there should not be any concern about anything else that occurs with your fat transfer and if you have any questions, please ask your qualified plastic surgeon and good luck. 

Doctors Answer
January 20, 2016

Regarding the fat harvesting where liposuction is used to remove fat from unwanted areas for use in the buttocks and breasts, the more fat available there is, the better. You have more fat to augment your buttocks and breasts at your current weight so that your surgeon may make the volumes larger and, therefore, more dramatic. Surgically significant weight loss (30-50 pounds or more) will affect the skin’s ability to re-drape the liposuctioned areas and can affect the result as well as decrease the effect of the transferred fat. However, it appears that the weight loss you plan to take with the good elasticity of your skin will end in a good result while maximizing volume for the fat transfers. Gradual and sustainable weight loss that is done in a healthy manner is the best way to optimize results and can be done postoperatively in your case with excellent outcomes. Ask your plastic surgeon these questions so that your concerns are met and good luck.

Doctors Answer
January 19, 2016

Judging only from your photos, you look like a good candidate for BBL where harvesting the fat from your abdomen and sides will obviously slim your silhouette and transferring the fat to your buttocks will increase projection and improve shape. The most difficult part of a plastic surgeon’s job is to manage their patients’ expectations and that is where an in person consultation with a qualified plastic surgeon can give you answers to the questions you may have. The first question is how much fat can be transferred and the second is whether that will be enough to match your expectations. 

While it may not be what you are looking for and BBL’s are routinely and safely performed with traditional anesthesia, a local anesthesia option for smaller amounts of fat transfer is also available by experienced BBL surgeons. Also, evolving techniques such as fat redistribution and preparation of the recipient site (buttocks) have improved outcomes and the amount of fat that may be safely injected. Good luck

Doctors Answer
January 12, 2016

Thank you for sharing your experience. It is much too early to make any judgments regarding the final result (which takes months) to achieve but there are a few considerations regarding BBL that you probably already know but are worth mentioning again. First, the inflammation from surgery, the volume of saline the fat is injected with as well as other factors such as the percentage of surviving fat takes months to figure out. As long as you are healing as expected, discuss with your plastic surgeon during your follow up appointments. In almost all cases, your questions will be answered with time.

sharonwalker | 02122

My hips are about 40 inches. I would love my dimensions to read 36-30-46. That’s what I would love… would this be achieveable this with a Brazilian butt lift? How much does the procedure cost?

Doctors Answer: BBL Cost and Expectations
January 9, 2016

Thanks for your question. Regarding any plastic surgery procedure, the most important thing after safety and effectiveness is managing expectations. Although numbers and clothing measurements are helpful, they are not directly translatable or guaranteed by surgery. There are factors such as bone structure and muscle mass besides fat that would not change after surgery that contribute to the overall result. In estimating reducing size by liposuction and transferring fat to the buttocks, an experienced plastic surgeon who performs the procedure often can give you a very good idea of what to expect once you are evaluated in person. As far as procedure costs go, please keep in mind the experience and training of the surgeon as well as all the support staff, the location of the procedure (i.e., an accredited surgery facility) and where the office is located. While most BBL’s are done with anesthesia, a local anesthesia BBL option is also available. Please consult with a qualified plastic surgeon and good luck. 

Doctors Answer
January 5, 2016

You are already aware of the benefits of the Brazilian Butt Lift (removing fat from areas that you don’t want and then adding the natural filler to the buttocks) so the managing of expectations is the most difficult thing we as plastic surgeons face during consultations. As you’ve mentioned, having a straighter body type presents challenges but the BBL is a powerful tool in achieving your goals. An in person consultation with a qualified plastic surgeon is key. Part of that consultation will include estimations on the amount of fat removed and subsequently injected.

lizmimi | West Palm Beach, FL

I requested the wrong type of shape I was going for and now I look dumpy because I thought what I was requesting was what I wanted. Come to find out it’s not! Now I have a bbl I’m not satisfied with. I wanted more fat transferred to the bottom of my buttocks but it’s more at the top of my buttocks. It made my waist much shorter now. What can I do to reshape it?

Doctors Answer: Reshape Buttocks After BBL?
November 13, 2015

Yes, you may reshape the buttocks after BBL after enough time has passed to allow full healing and the shape due to fat survival stabilized. The questions are if the upper part of the buttocks need to be reduced or will putting more fat into the lower pole of the buttocks enough to bring the proportions together correctly? If more fat needs to be harvested, do you have enough to make a difference? Fat is the ideal material for buttock augmentation for many reasons, including the fact that it may be reshaped or moved even after previous BBL’s. An in person consultation with an experienced plastic surgeon will determine if you are a candidate for a secondary BBL; good luck.

MrsJade | Brooklyn, NY

26yr old, 110lbs, birthed 2nd child June ’15 I love my butt. The bottom forms a nice cuff, but it’s like my back almost goes straight into my butt. My tailbone sort of protrudes the top of my butt. I would just like enough fat to diminish that and I wouldn’t mind taking from this postpartum pooch I have in front of me.

Doctors Answer: Thin and Would Like a BBL
November 11, 2015

Congratulations on the birth of your second child. It looks like from the photos that you have really put in the time to get back into shape. Fortunately, you have a good shape to the buttocks and it appears that a BBL will benefit you because of the fat removal from the areas you don’t want it and the volume enhancement to where you do want it. Consulting with a qualified plastic surgeon is important because if you wish to have fat removed from the abdomen, an experienced surgeon needs to assess whether the skin will be able to retract enough after fat is removed. Also, it may be necessary to wait longer so that your post-pregnancy hormones have normalized long enough so that your body has stabilized. 

Doctors Answer
November 11, 2015

Based on your photos and the fact that you don’t have stretch marks and haven’t had children yet, you look like a very good candidate for BBL. You will get significant reduction of the areas suctioned such as the abdomen, love handles and bra rolls and have the fat carefully placed into your buttocks to give it volume and an improved shape. The combination of slimming down and enlarging areas proportionately works well together to make striking changes in many patients with your body type.

Please consult in person with a qualified plastic surgeon who performs this on a regular basis to get all the important information.

Doctors Answer
November 5, 2015

As BBL has become increasingly popular in recent years, we have seen more patients who had a good experience with it desiring a repeat injection to enhance their buttocks further. As long as there has been enough time for the fat grafts to take and the final result is achieved, it is safe to repeat the procedure. In your case, a year and a half after an uncomplicated BBL is sufficient time. I have seen patients now that desire more fat placed years after an initial BBL because their bodies may have changed with weight gain/loss, etc. and they can benefit just as much as the first time BBL patients.

Also, smaller volume BBL’s can be done safely and effectively under local anesthesia (no general anesthesia). Ask your plastic surgeon if this is offered

Doctors Answer
November 4, 2015

There are many variables to consider with the BBL in terms of long term fat survival which includes what technique is used to harvest, the time the fat is out of the body, how much fat is placed and where, etc. After about two months, an assessment of the fat ‘take’ or survival can be made although the final results may require a few more months. Although surgeons who frequently do BBL’s make an effort to inject the right amounts on each side to attain the best symmetry and volume, unpredictable factors may cause the grafted fat to be absorbed more on one side than the other. Regular follow up appointments with your plastic surgeon are good times to talk about your concerns so that he or she may explain the process to you in more detail.

We offer BBL’s in large volumes under traditional anesthesia for patients who want a more dramatic result and local anesthesia options for those who want more subtle reductions in their waistline and increase in the buttocks. This awake technique can also be helpful to correct minor asymmetries as well.

Doctors Answer
November 2, 2015

The Brazilian Butt Lift (BBL) has many advantages because you can generally choose the areas where the fat is taken or harvested from so that you get the fat reduction benefit of liposuction there. The waist is a common area to target, for instance. There are a few limitations that you should be aware of and those include the amount of fat removed depends on how much there is to take. The more fat to remove, the greater the size reduction of the liosuctioned area and the more fat graft there is available to inject (increasing the buttock size). However, not all of the fat that is injected into the buttocks will survive long term so plastic surgeons generally ‘overfill’ or inject more than the final result is anticipated depending on how much of the fat ‘takes’. A consultation with a plastic surgeon will hopefully answer all your questions tailored to your body and personal aesthetic.

Overall, this is a great body contouring procedure that has the dual benefit of slimming areas of unwanted fat and enhancing the buttocks with your own natural feeling and appearing fat. 

Keep in mind that for smaller buttock enhancements with fat and liposuction may be performed under local anesthesia with an excellent safety profile and faster recovery than with general anesthesia.

Doctors Answer
October 29, 2015

The Brazilian Butt Lift, or BBL, works in two ways to make the butt look perkier and rounder. First, removing the fat from the love handles, abdomen and the small of the back to harvest the fat will make the everything look more proportional, making the buttocks appear more defined and perky. Second, placing the fat into the buttocks carefully and exactly where the patient and surgeon feel that it would have the greatest cosmetic benefit will help ’round out’ and ‘lift’ the buttocks. While you look like a good candidate from these limited photos, a consultation with a qualified plastic surgeon will answer questions regarding the details of the procedure including how much fat you can reasonably expect to remove and transfer which impacts the results greatly.

While most BBL’s are done under traditional anesthesia, smaller amounts of lipo contouring and moderate fat transfer can also be performed safely and effectively under local anesthesia with much less down time and cost. Good luck

mjd6776atyahoo.com | Orlando, FL

I am 5’5 and weigh 125 lbs i am very slim and have a hard time putting on weight and feel very insecure about my lower body. Since my legs are not as thick I want curvier hips and rounder/bigger butt. However I don’t want to over due it since I have thin legs, and I want it to look as natural as possible

Doctors Answer
June 16th, 2015

For your height, you are a good weight and have a slim or athletic build which, as you’ve pointed out, works against giving you a curvier figure. While you are a candidate for fat transfer, you do not have a lot of extra fat with which to transfer so a dramatic change would only be achievable with buttock implants. However, the most natural look in my opinion is achieved with your own fat and you are benefit from the slimming effect of the liposuction performed to harvest the fat as well as the direct volume increase into the buttocks from the fat injections. The key is to have a discussion about how much increase you can expect with the BBL. Smaller fat transfers and liposuction harvesting are also possibly done under local anesthesia in the right patients by surgeons who have a lot of experience with the procedure. Please consults with a qualified plastic surgeon to get an in person consultation to answer your questions.

megggoo | Houston, TX

I got a BBL a little over a year ago and everything was perfect. Recently, I lost 7-8 lbs due to stress and my butt is significantly smaller 🙁 my question is… If I gain the weight back will my butt look like it did after the surgery?

Doctors Answer
June 2nd, 2015

You’ve asked an excellent question regarding how fat after BBL behaves. The short answer is that once the fat has established a blood supply and is viable (alive) after a year, it should last for many years and act just like any other fat cell in the body. If you lose weight, you lose weight throughout your body more or less including the transferred fat to the buttocks so that the cells shrink. On the other hand, if you gain weight again, the transferred fat cells (just like any other fat cell in the body) will expand as the calories turn into lipid (fat) that are stored in the cells. I hope that answers your question and you can expect to buttocks to enlarge as you (carefully) gain weight.

pineapple2223 | Gainesville, FL

I want a Brazilian butt lift fat transfer but I am scared I do not want to waste my money if it’s not going to work on me please help…

Doctors Answer
June 1st, 2015

The Brazilian Butt Lift using your own fat to augment the buttocks is gaining in popularity because it both reduces areas of unwanted excess fat and, instead of throwing it away, using it as a natural and soft filler for the buttocks where it helps to enhance your curves and fill out the seat of the pants, etc. As in any cosmetic procedure, your surgeon needs to address your goals realistically so that you are on the same page with what you want. This includes the fact that some of the may not survive long term; surgeons will often ‘overfill’ the area to make sure enough remains permanently so you have to have enough to transfer. Also, one person’s idea of a large buttock is not the same as another’s. That being said, the photos you sent appear to make you a good candidate for the operation. Talk to an experienced plastic surgeon who does this on a regular basis and good luck.

Beauty81980 | Dallas, TX

I would like to be close to my ideal weight of 165-170lbs after the surgery. Should I lose weight and if so how many lbs. I don’t want to lose to much that I won’t have enough fat for the transfer.

Doctors Answer
May 26th, 2015

At your current height and weight, your BMI (Body Mass Index) is 26.6. Getting below 170 brings you to the normal category but if you are planning to maximize the fat transferable for the BBL, you do not need to lose the weight beforehand. This is because the 10-15 pound weight loss, although good for health reasons, will not impact the results significantly. In fact, your surgeon will likely be able to remove more fat.

mamaju | Edmonton, AB

I want kim kardashian butt for long time , I weight 140 ‘ . . I can exercise loose weight off easy . But I decided to save up and keep the weight to undergo bbl . I am nervous and don’t want to be disappointed to have all that money spend I have saved over few years and I don’t achieve kim kardasian butt or at least something close to get , I want 2000 cc in each butt cheek , is it possible ? I have huge far between my thighs and huge belly fat back fat , arm oit fat , arm fat and chin fat , please help

Doctors Answer
April 3rd, 2015

BBL or Brazilian Butt Lift involves liposuction of fat from one or more areas of the body and then carefully transferring that fat to the buttocks to give a natural, soft augmentation. In order to get 3600-4000cc’s of quality fat, the patient must undergo a large liposuction volume-wise and have enough in the first place. Second, we don’t expect all of the fat to survive no matter how carefully it is done so about twice as much fat as desired in the final result is injected. However, the more fat that is injected, the lower the ‘take’ of the surviving fat because each fat cell has to be near blood supply to live. The more fat is injected, the more crowded the recipient site becomes. In addition, pressure increases with more volume and that is also bad for the fat. Judging from your photos and description, a buttock implant and liposuction will be required to get the waist line reduced and the projection of the butt that you want. A BBL will get a great result as well, but the more dramatic volume you desire may not be achievable with your frame. Good luck

valen123 | Michigan, MI

I just turned 18 and I want a BBL. I don’t think I have enough fat for the amount of fat I’m thiking about transferring, so I will have to gain some weight. Is 18 too young? Is it better, worst or it doesn’t matter if you are younger than most of people who do this procedure? Thank you doctors.

Doctors Answer
April 2nd, 2015

While 18 years is legally the age of consent, patients will vary widely in their expectations and understanding of what any elective surgery like BBL entails. Physiologically, your body may continue to change because puberty ends at different ages for different people. Just as important, your feelings about your body image may also change over time. Obtaining a consultation with a qualified plastic surgeon will help answer a lot of your questions such as how much fat you may need to get a good result should you decide to proceed. Remember that doctors are humans too and will have personal opinions about what to recommend keep in mind your objectives and goals as you get information. Good luck

Lisaham | Toronto, ON

Doctors Answer
March 28th, 2015

The short answer is yes because they both involve harvesting fat to inject elsewhere such as the buttocks and lips. Generally, BBL is done under traditional means of anesthesia but both fat transfers to the butt and lips also may be done under local anesthesia under certain circumstances. Talk to your plastic surgeon for more detail but this is a straightforward combination procedure.

pdeshield | Houston, TX

Can any help me to do BBL with Epidural?

Doctors Answer
March 28th, 2015

Many anesthesiologists are skilled with placement of epidural catheters and they are helpful for many cosmetic procedures such as tummy tucks to reduce the need for other anesthesia agents during the procedure and may be helpful in reducing risk for pulmonary embolisms in certain situations (good reasons to offer this to our patients as an option). A careful discussion with your surgeon and anesthesiologist is important to determine if the benefit of this technique is warranted. For example, many surgeons use lidocaine in the tumescent fluid for liposuction during the fat harvesting phase in the BBL and this must be accounted for in the total dose calculation for the patient. Also, the presence of the catheter in the back may be cumbersome during turning of the patient when she needs to be positioned. Plastic surgeons who perform BBL’s on a regular basis are able to have the patient recover well afterwards with a variety of pain management techniques together with his or her anesthesiologist so that the recuperation can be done as smoothly and comfortably as possible.

beccav | Georgetown, TX

Doctors Answer
March 9th, 2015

Temporary numbness in the areas where the fat was harvested or liposuctioned is common and resolves in about four to six weeks. This may also occur in the areas where the fat is injected. This is due to the mechanical effects of liposuction and/or injection causing the sensory nerves to go into a mode where they are not firing as they usually do. This almost always gets better with time. If there are any associated symptoms or signs such as swelling or severe bruising that is out of the ordinary that accompanies the numbness or if the numbness persists for much longer than expected, contact your surgeon immediately.

queenbodygoals | Durham, NC

I am 20. 220 lbs & 5’6. My bmi is 35.5 I have very thick thighs & fat stomach. I’ve hit a plateau. I have decided that I have done all that I can do weight wise without going insane. things I want to change: 1. I want a flat stomach 2. I want my back fat &love handles gone 3. I want arm fat gone 4. I want my body contoured to the point where my curves are very noticeable 5. I have no shelf on my butt. I Want volume at the top. 6. I have no cuff on my butt. I want volume at the bottom.

Doctors Answer
March 7th, 2015

Based on your BMI and photos, it appears that BBL would be a very good option to achieve two goals: 1. improve the contour by reducing areas where the fat is not wanted to improve your figure (make your waist smaller, for example) 2. add fat to add volume exactly on the buttocks where you want it to be. BBL is an excellent technique to not only add absolute volume to the buttocks but also to shape. In your case, you appear to have good volume in the lateral (side) aspects of the buttocks but can use volume superiorly (top) to get a more pronounced “shelf”, as you’ve mentioned. Fat can also be accurately placed on the bottom for more volume, too. You should have enough fat to get a nice result because, as you may already know, the surgeon will place about twice as much fat as ultimately required during the operation to make up for the amount of fat that will not ‘take’ or survive after transfer (this is normal). Getting a consult with a qualified plastic surgeon will inform you of your options and BBL appears to be a great choice.

Cute tum | Los Angeles, CA

Hi! I had a bbl performed five days ago. The lipo sites are doing fine, but my bottom is so huge that I’m embarrassed to leave the house. I only had 200 ccs in each side, so I know it’s swelling and not fat graft making it look huge. My children are laughing at it, my husband is freaked out. I understand that it can take up to a year for swelling to subside, but I want to know when the majority will go down so that I can get back to my life. So worried, considering sitting on it to kill the fat!

Doctors Answer
March 3rd, 2015

As your surgeon probably pointed out, more fat is injected than is needed because no matter how carefully and technically advanced the fat is transferred from one place to another, a certain percentage will not survive over the long term. Also, in the short term (as you’ve noticed) there is swelling simply from the injection of the fat. The swelling is mostly visibly resolved in about 4-6 weeks (although you correctly noted it may take longer for all of it to go away) leaving a reasonably good estimation of the early fat ‘take’. The total volume may go down over the next few months then settle in the final volume. Please don’t do anything at this early juncture to encourage fat destruction since you have time for everything to settle down and good luck.

Eyes Like a Fox | North Carolina, NC

Doctors Answer
March 5th, 2015

Almost all qualified plastic surgeons are trained to perform fat grafting to the buttocks. However, there is a large variation in the experience any individual surgeon has with the technique. Fat grafting for buttock augmentation coupled with liposuction (Brazilian butt lift) is a cosmetic procedure and doctors who specialize in this naturally will feel most comfortable with it and can give you a reasonable expectation for the result. While a straightforward procedure, I believe it requires understanding the patients desires, investing in the right equipment and staff training, and having done a large number of cases to put the patient in the best position for a great outcome. After all this, you must feel comfortable with him or her so that you have a ‘meeting of the minds’ where your goals are the same. Good luck and I encourage you to get more than one consult.

smmashuque | Jharkhand

I dont want implants. I may opt for fat transfer but i am a bit scared of it. Want to know more about medicines or other options for breast enhancement. Details of Fat transfer s also welcome. I recently got married. Please help

Doctors Answer
June 16th, 2015

Without implants, the only other option for breast augmentation is with transferring fat from where you don’t want it to the breasts. You will have the dual benefit of slimming down an area that is larger than you want and increasing the breast size. The variables that are not in the surgeon’s control include how much fat you can harvest (how much fat you have to begin with) and how much or what percentage of the fat will ‘take’ and stay for the long term. In general, because fat cells are fragile, the surgeon will overfill or put about twice the amount of fat into the recipient area in order to compensate for the fat cells that do not survive. The surgeon also may utilize a device called the Brava which applies suction to the breasts for a few weeks before surgery. The goal of this device is to increase the amount of fat that will survive over the long term. Congratulations on your recent wedding and good luck.

PixieDust_2015 | OH

Will I have good results with augmentation alone? What profile implant, size, placement do you suggest? I am 5’3 currently 159 pounds (planning on loosing 20-30 more) 600cc Mod Plus Saline Implants have been discussed, will this help me fill out the upper portion that has lost all the volume from breastfeeding?

Doctors Answer
February 16th, 2015

Many factors go into deciding whether an augmentation alone or an implant with a breast lift (mastopexy) is required and can only be assessed with an in person consultation. That being said, your photos and your planned weight loss suggest that the skin needs to be addressed to get the results you want. Nipple position centered on the breast mound and recreating the upper pole (top half) fullness are what we look for in enhancing the breast aesthetic. Talk to your surgeon about your options and best of luck.

apg | Bronx, NY

My skin is relatively good for my age. I would like to also define my jawline. What would your suggestion be. I understand I would need to see a Dr for an consultation. Just wanted some advice here. Thanks

Doctors Answer
February 17th, 2015

There are many factors that go into chin contouring including the bony jawline, skin laxity, excess fat and other structures such as salivary glands and the platysma muscle of the neck. The treatment should be directed to the underlying problem in consultation with a qualified plastic surgeon. For example, if you have a ‘weak’ chin, the skin won’t necessarily improve as much as wanted. If the skin is too loose, liposuction will make it worse, not better. The presence of muscle bands or ptotic or lax glands will be more obvious with the wrong operation. The plus side is that there are many good techniques that have been developed that may get the results you desire with the right doctor. Good luck

Doctors Answer
March 23, 2017

Thanks for your question. Many women could benefit from the BBL, TT and breast surgery but I would recommend that the BBL be done first to provide contouring as well as reducing your size for the following TT and breast augmentation and mastopexy. Besides enhancing the overall result of all the procedures, staging the operation will also reduce the operating time and enhance your safety profile and make the recovery easier than doing them altogether. 

Doctors Answer
April 3, 2017

Many surgeons perform laser and traditional liposuction but not all are experienced with hi-def liposuction which takes more experience and time. Also, hi-def doesn’t mean the same thing to both patients and doctors. For example, high definition may be confused with ‘etching’ where fat is intentionally left behind to give the appearance of muscles as in the abdomen. In my practice in NYC, high definition liposuction is careful liposuction which is aggressive in the areas of normally occurring anatomic elements to enhance their appearance as well as carefully removing fat in other areas in patients otherwise close to their ideal weight.

Doctors Answer
March 1, 2016

This is a common procedure that can be done safely and effectively under local anesthesia with a shorter recovery than with traditional anesthesia methods. Patients are dressed and typically ready to leave the office after the operation within 20 minutes. I recommend that they take the next day off from work but almost all patients are able to resume normal daily activities by then (except for heavy exercise). Please check with your plastic surgeon for his or her particular instructions and thanks for the question.

Doctors Answer
January 22, 2016

While both liposuction and Coolsculpting remove fat, the degree and precision of the fat removal is very different and depends on the patient’s body type and expectations. For example, cryolipolysis will remove about 20% of the treated fat while liposuction typically removes 60-70% or more of the fat. Second, the areas treated with lipo are done much more precisely because only the fat that is suctioned with the cannula is removed. This allows the surgeon to sculpt and refine areas; more experienced surgeons can create a high definition look as well.  Cryolypolysis treats the fat that is positioned inside the device.

So what’s the right procedure for any patient depends on their wants. Cryo is non-invasive but usually takes several (3 or 4 or more) sessions to complete an anatomic area. Lipo can be done in one setting and under local anesthesia which avoids the time for recovery, costs and risks of general anesthesia. 

Cryo is offered to patients who are generally larger (higher BMI) who simply want to look better in clothes with enough fat to start with that a modest reduction in percent will yield a satisfactory result. For patients near their goal weight and who want more sculpting and definitive fat removal, lipo (under local) is right for them.

Please get a consult with a qualified plastic surgeon and good luck.

supermansgirl | London, TX

Doctors Answer
January 22nd, 2015

Your surgeon will be able to give you a good estimate of operating time during a consultation. In general, factors include how many areas are treated, the anticipated amount of fat to be removed, whether energy such as laser or ultrasound are used, and what type of anesthesia is used. For the areas you mentioned, two to three hours is typical for the operation. If done under local anesthesia, recuperation and return to work or normal activities (outside of vigorous exercise) may occur in a few days while the operation done under general anesthesia may take longer.

Fabulous172494 | İstanbul, Turkije

In 2020 I underwent laser lypo for my belly and love handles. agressive and I developed fibrosis. It’s visible on my lower area of the abdomen. I have an area that is indented and area where you feel the lumps.I tried to suck a little more fat in a second non invasive procedure from the two bags right under my belly button to even it more out,but it didn’t work,als I really have an indention below. both doctors said it I have very hard tissue underneath my skin,difficult to go trough

Doctors Answer: Belly Lumps 3 years after Laser Lipo
May 21, 2025

Fibrosis, or firm areas, in the soft tissue following liposuction, especially with laser is not uncommon as inflammation and swelling is part of the healing process. However, this should usually resolve after several weeks or a few months on its own. Hard, outlined areas that persist for years are due to scar tissue under the skin which may have resulted from improper laser application, fluid and blood collection (which is highly irritating to the soft tissue) or technical misadventure. If non-invasive maneuvers such as massage, steroid injection (not recommended), or external ultrasound are not successful, you may need another procedure.

Liposuction alone may not be enough since there is scar tissue that is not amenable to it, as in your case. Internal ultrasound (VASER) and/or radiofrequency (BodyTite) have helped in certain cases but in extreme cases, the scar which is manifested as a capsule of tissue under the skin may be needed to be removed by direct excision to get the overlying skin and soft tissue to look and feel right. Good luck and look for a qualified plastic surgeon who has a large volume of body contouring cases in his or her experience since this is more than a run-of-the-mill situation.

Doctors Answer
February 22, 2017

You are right in saying that one month following SmartLipo of the abdomen and love handles is still early in the healing process but you should be able to appreciate some of the results by now. How much fat was removed will impact your contour results and hopefully your plastic surgeon maximized the suction portion of the operation. It is also important to distinguish fat that is under the skin and above the muscle (subcutaneous fat) that is able to be removed by this operation from visceral or intra-abdominal fat that cannot be removed by SmartLipo. That is fat that surrounds our internal organs that cannot be reached with lipo of any kind (and should never be). That may contribute to the belly area. The bottom line is that you have questions that are best answered with a follow up visit with your surgeon.

nyjane08 | Arlington Heights, IL

I had smartlipo 5 months ago. I have a bulge around my belly button area. There also appears to be an indent on my upper stomach. Could it be left over fat or scar tissue or lose skin? What could my possible options be to reduce this?

Doctors Answer: Bulge 5 Months after Abdominal SmartLipo
January 4, 2017

Thanks for the question. Although it is impossible to tell definitively from the photographs alone, swelling can be reasonably ruled out as the source of the excess. Regarding scar tissue, this generally resolves on its own and initially feels fibrous or thick. The process of remodeling and smoothing can be sped up by gentle massage. However, the peri-umbilical region is not an uncommon area of under-resection of fat which means that there could be leftover fat there that causes a “doughnut” or “bagel” deformity where the belly button makes the “hole” of the “bagel”. The reason this occurs is because the umbilicus has a stalk that runs deep to the abdominal muscle and tethers/supports the umbilicus to some degree. If the fat surrounding it is not aggressively removed, any residual fat is accentuated and causes the fullness. The good news is that a small secondary SmartLipo procedure can easily correct this (if this is the case for you). Make an appointment with your plastic surgeon who I am sure will be more than willing to make the overall outcome for you as optimal as possible.

chevy66 | San Jose, CA

I have now had a second session of smart lipo because the 1st time did Not have satisfying results. Considering I have now had smart lipo twice done on my upper and lower abdomen area. Do you think it will keep away fat cells from forming ever? And when can I see final results? It still looks like a fat problem area…

Doctors Answer: SmartLipo to Abdomen Twice
January 3, 2017

Regardless of the number of operations you have, you still have to give the skin enough time to heal and re-drape in order to see the final results. This includes the temporary swelling that masks the results and may last up to four months. How long did you wait in between surgeries? The natural tendency is to try to go back and maximize the result right away but it is important to wait enough time in between. The bottom line is that the amount of fat removal will determine the result from a volume reduction point of view and the skin re-draping will determine the quality of how well it looks afterwards. The fat cells that are removed are gone forever but the fat that remains still can expand so it is important to maintain a healthy diet and exercise regimen.

Doctors Answer
December 6, 2016

Laser-assisted liposuction is lipo that involves a laser to break up the fat cells before it is removed by liposuction. SmartLipo is the trade name of the most well-known company laser company but it is one of many brands. All laser-assisted lipo involves three basic steps: 1. injection of the tumescent fluid to numb the area first, 2. application of the laser on the fat and possibly the skin and 3. removal of fat using cannulas (standard lipo). The benefit that plastic surgeons find with the laser is its ability to break up the fat and its connections to make the eventual removal of fat easier. Some surgeons find that the laser increases the skin tightness as well but that is subject to debate. Also, SmartLipo is almost always performed with the patient awake and under local anesthesia which greatly reduces the down time and costs of effective body contouring.

Doctors Answer
October 26, 2016

You are maximally swollen during the first week after any surgery, and especially with liposuction surgery. The biggest reasons are because of the water you retain in other tissues of the body because of the surgery and due to the tumescent fluid that was injected into the fat space in order to aid in its removal. The body and kidneys have a tendency to retain fluid after the ‘stress’ of surgery until a natural diuresis (urination) occurs after a few days. Secondly, you may have had several liters of tumescent fluid injected and not all of this fluid is removed with suction (fat is less dense than water). While one liter of fluid is 2.2 pounds, the remainder will also be released with urination. 

Finally, the complete process of swelling resolution doesn’t occur for several months although you can expect to be rid of about 3/4 of it by a month and a half or so. In short, this is normal (although 9 pounds is more than average ‘water’ weight gain) and will go away on its own. Also, please remember liposuction of any kind is not a weight loss procedure in itself although many patients end up losing weight because they are happy with the results and build on that.

Doctors Answer
October 5, 2016

Knees, calves and ankles are excellent areas for treatment by liposuction with and without laser and is often not addressed by most plastic surgeons because of limited experience. Knees are improved when your legs are crossed and magnified when wearing skirts, shorts, leggings or yoga pants. Calves and ankles benefit greatly when certain styles of boots are not able to be worn comfortably due to excess fat. In addition, these problem areas are usually the last areas to improve when losing weight by diet and exercise alone. Targeting them with a small procedure such as laser-assisted lipo is highly effective. 

They can also be treated under local anesthesia to minimize downtime and expense as well. Please seek an experienced plastic surgeon who has a lot of experience because these are less common areas of treatement (I have developed training videos and given talks to fellow surgeons on the proper technique of knee, calf and ankle contouring under local anesthesia). Also, the calf and ankle areas may have longer swelling periods following surgery due to the dependent (low on the body) position. Once this is resolved, however, the patient satisfaction with the contour improvement is very high.

Doctors Answer
September 28, 2016

Five days after laser-assisted liposuction of the abdomen is much too early to make any judgments on the aesthetic outcome. You are most swollen the first week after the operation but it begins to subside over the next several weeks. You will see an improvement in about one or two months but the entire process takes up to four months to fully resolve. The good news is that the fat that is removed is gone forever and the swelling that is temporarily obscuring it will go away eventually. However, if you have significant fat internally (intra-abdominal fat) that is not addressed with this procedure. Take the opportunity to lose weight safely during your recovery period so that your cosmetic results will be that much better. In my practice, patients are encouraged to visit with a weight loss specialty physician who can assist with obtaining the best results possible. 

jservice87 | London, GB

Did not have aspiration on the area as the surgeon didn’t recommended it as the body will naturally get rid of it, just wanted to know roughly when I can expect to see some results. only had procedure 3 days ago. Thanks

Doctors Answer: Results after SmartLipo of the Chin
September 6, 2016

The SmartLipo laser does destroy treated fat cells by heating. However, three days is not long enough to judge the outcome, especially since the swelling that occurs naturally after surgery will temporarily mask the result. While good results may be seen as early as four to six weeks, the final results takes three to four months. An important distinction with your case is that I always suction fat to allow contouring of the neck at the time of surgery. In my experience, this is a more reliable way to get the results you want because fat is physically removed and does not rely exclusively on the laser by itself. 

LisaKK | Lewisville, TX

I had smart lipo done a week ago on my upper arms, bra roll, lower back, flanks/muffin top, upper abs, and lower abs, and only 1.5 liters of fluid/fat was suctioned out with less than half of that actual fat. I realize I still have swelling and that will go down over time; however, I feel like there is still a lot of fat rolls on my back/flanks and am afraid those will not go away after a few mo. Will my FAT ROLLS get much better than this? What is normally the % of fat that can be removed?

Doctors Answer: Avg % fat removed with SmartLipo?
August 2, 2016

Your question includes many important points. First, as you’ve mentioned, you are only one week postop and you of course are still swollen from the operation which will temporarily mask the results. Second, the number or volume of aspirate (fat and fluid suctioned) is not an absolute number. The surgeon end points include this as well as the pinch test (how much fat can be felt with a pinch), contour of the area, smoothness, and how it looks. Similarly, percentage of fat removed is also an estimate and can range from 50% to 75% depending on the anatomic area (different areas have different amounts of fat). It is not possible to remove all the fat by liposuction even with laser nor is it advisable to do so: we need fat as a glide plane between the fat and underlying tissues to look normal and smooth. However, an experienced plastic surgeon will try to get as much out safely and in proportion to the rest of your body to get as dramatic result as possible. Third, the skin that remains will retract to varying degrees following lipo and that depends on how elastic or loose it was before. In most cases, the areas will look much better. Areas such as bra rolls will smooth out significantly but it’s important to note that they will not go away 100%. Your questions are not unusual and your plastic surgeon should be able to answer them readily on your postop visit.

Doctors Answer
July 20, 2016

Thanks for your question. SmartLipo as done by most plastic surgeons actually involves liposuction but with the addition of laser. Also, it is usually done with the additional benefit of local anesthesia where the patient has the operation while awake, avoiding general anesthesia. This leads to a faster recovery. It’s difficult to tell by the pictures, but targeted fat removal with liposuction or SmartLipo alike is an excellent technique to improve your figure if the skin is tight enough. This is best determined in consultation with a qualified and experienced plastic surgeon.

Doctors Answer
July 7, 2016

One month is generally too early to determine the final result after liposuction of any area, especially of the ankles. Calves and ankles respond well to liposuction but usually take the longest to have the swelling resolve. This generalized edema lingers because the ankles and feet are the lowest part of the body while standing and have the farthest to go to have the fluid disappear. This is worsened with long walks and inactivity and improved with elevating the feet above heart level. The photo is not helpful because there is nothing to compare it with and because of the angle it was taken but the large amount removed is suggestive that if you wait long enough, you should see a significant result. Compression stockings may help and if you don’t see a result in over four months or longer, check with your surgeon.

Doctors Answer
June 10, 2016

Often, the mons pubis, or the area of fat just above the genitals and below the lowest crease of the abdomen, is not addressed enough and may persist after liposuction. In fact, liposuction of the abdomen will actually make a large mons pubis even more noticeable and cause some degree of self-consciousness. The key is to remove fat from the entire anatomic region and not just the top because that, again, will just draw more attention to the area that had not been adequately suctioned. 

This can be done under local anesthesia safely and with minimal downtime. In our NYC office, I often use laser (SmartLipo) or ultrasound (VASER) energy to assist in breaking up the fat further.

Doctors Answer
May 12, 2016

At two and half weeks, swelling such as yours is normal and does indeed descend with gravity (since we are usually standing or sitting while awake). Mild tenderness is normal as well as the sensory nerves that have been temporarily affected by the procedure normalize. Also, mild firmness in the area especially in the area around and below the belly button (more common in men) is also to be expected and will go away on its own. Gentle massage (with the index and middle fingers in a circular motion) a few minutes a day will help speed its resolution. I am glad that you are already having a good result and I would expect it to improve as the swelling continues to diminish.

evelynw11 | Wichita, KS

Doctors Answer: High A1C and SmartLipo
May 12, 2016

Thanks for your question because, unfortunately, diabetes is a common malady for many people. Your overall health and control of blood sugar comes first and elective procedures can be performed once you have achieved that. Complications such as infection, although very rare, are increased in cases of poorly managed diabetes. In addition, this is an issue in the long term life expectancy as well as quality of life that should be discussed with your primary care physician. Good luck and seek a qualified plastic surgeon after you have this sorted out and your A1C lowered. 

Doctors Answer
January 19, 2016

Occasionally, especially in the abdomen, patients may have temporary numbness that resolves on its own in about two months. Second, you still are swollen so that when you are in a sitting position, the skin and soft tissue may show a crease or fold at the point where the body is flexed. This will also go away. Finally, it is difficult to make any judgments on the final result at this time and with limited photos but it appears that you may benefit from more aggressive fat removal. These are all points that you should discuss with your plastic surgeon in person and good luck.

Geraldine95269 | Los Angeles, CA

Would smart lipo fix my (double) chin and (turkey) neck issues as pictured?? I’ll turn 50in June and I want both gone but not sure what’s the most effective procedure for this specific (problem) area. I need an honest, expert advise please?!?

Doctors Answer: SmartLipo or Ultherapy for Neck Contouring
January 13, 2016

Based on your pictures, you appear to be a good candidate for SmartLipo because the fullness appears to be due to fat and your overlying skin looks to have good elasticity. While laser-assisted liposuction permanently removes the excess fat from the neck, Ultherapy does not offer a long term solution. On animation, it’s important to note that the lines or cords you see vertically are due to the neck muscle called the platysma which causes the banding and is not treated by either SmartLipo or Ultherapy. An in-person consultation with a qualified plastic surgeon will answer your questions to see what will best benefit you.

Doctors Answer
January 5, 2016

Good luck with your upcoming procedures. Avoiding medications such as aspirin and NSAIDS as well as certain herbal supplements is important in order to decrease the chance of bruising. Massage is not helpful preoperatively but may be of use afterwards. Lymphatic massage is generally stronger than I recommend. Compression garments are helpful and should be worn according to your surgeon’s instructions to maximized the benefit. 

Doctors Answer
November 11, 2015

In your photos, you look like a very good candidate for SmartLipo. Since you exercise and eat reasonably well, targeting the difficult to change areas with surgery can make the changes you want happen that otherwise are resistant. 

SmartLipo is most frequently done under awake local anesthesia with an excellent safety profile and much quicker recovery than with general anesthesia. The type of anesthesia doesn’t directly affect how much or how well fat removal is performed; that is why a consultation with a qualified plastic surgeon is important to evaluate you for the procedure.

Doctors Answer
November 11, 2015

The good news is that once the fat is removed from the abdomen (as in any area), it is permanently gone. However, the remaining fat can still expand if you don’t watch what you eat and gain weight. The overlying skin still ages with time and becomes looser due to gravity. On the other hand, with good skin care and a healthy diet and exercise regimen, you can enjoy the benefits of the SmartLipo procedure for many years.

Doctors Answer
November 4, 2015

Although it is difficult to tell from the photo alone, it appears that the skin is loose in the belly and flanks because of the success you’ve had working out and losing weight (congratulations). If you’ve lost a lot of weight and possibly had children, the likelihood that the skin will retract enough following SmartLipo is low and the result may look even worse because the support from the fat on the skin will be taken away. Also, the muscle underneath in the abdomen should be assessed to determine if that is also loose, contributing to the overall “pooch” or fullness that also won’t be corrected with SmartLipo. 

Please consult with a qualified plastic surgeon so that you may be evaluated for the right operation (such as an abdominoplasty or tummy tuck) and good luck

Doctors Answer
November 2, 2015

Aesthetic surgery including SmartLipo and liposuction are not weight loss procedures and are ideally performed when a patient is near his or her goal weight. This is because the overlying skin may not retract enough as well as other reasons where there will be a less than a satisfactory result. However, a consultation with a qualified plastic surgeon might result in options that may get you jump-started on your way to losing weight and improving your health. In my office for example, we work closely with an endocrinology-trained physician specializing in weight loss who can take a multi-disciplinary approach to achieving your goals through medically-overseen diet, exercise and possibly surgical regimens. 

pinkprincessatj | Bronx, NY

wearing my garment all the time can get a bit depressing and I have to wear it they say for 6 months . I’m 11 weeks p/o and my tummyis not as flat as it was the first month. I don’t always eat right my weight has gone up few pounds. I work out 2x a week with a trainer. Should I be worried that it no longer looks flat or improves ? can Better diet fix this? I wear my garment and foam 24:7 and had 7 sessions of edermology is this swelling and I still have time? also had alot of loose skin before.

Doctors Answer: Eating Poorly after Laser Lipo
October 29, 2015

Although there are lots of factors that affect the overall result of any operation including laser liposuction, eating properly is an important one. In my opinion, wearing a garment for longer than a week or two does not change the result (but may make the patient more comfortable). The fact that you’ve gained weight by itself doesn’t mean your result will be worse because muscle weighs more than fat and many patients get more toned following laser lipo. On the other hand, a diet that is high in fat and sugar can ‘overwhelm’ the results of the operation and gain weight so that your results are diminished. A follow up appointment with your plastic surgeon should clear up a lot of your questions and good luck.

shatha k | Dos Rios, CA

3rd day after surgery (smartlipo)

Doctors Answer: When to Shower after SmartLipo
July 2, 2015

I close the small incisions with a suture so my patients may shower the next morning. However, they can’t take baths or swim where the incisions are submerged for a few weeks until the incisions are fully closed.

aew2015 | Atlanta, Georgia

I had Smartlipo 3 months ago and now have dark shadows on my inner thighs. I believe that they are a result of the contouring and not hyper-pigmentation, but would like to get an opinion please. What if anything can be done about the problem? Thanks,

Doctors Answer: Discoloration on inner thighs after SmartLipo
June 30, 2015

Rarely, hyperpigmentation or darkening of the skin may occur following SmartLipo or with any liposuction. Common areas are the inner thighs as in your case or in the upper outer arm and is usually the result of the breakdown products of a bruise that stains the undersurface of the dermis of the skin. The reason it occurs more frequently in the inner thighs is due to the thin and relatively inelastic nature of that skin where any darkening is more likely to show through. While it may take months or even longer than a year to clear, the body will eventually remove the dark areas. If it does not appear to get better with time, certain lasers may help speed the process up. In the meanwhile, go back to your plastic surgeon to make sure it isn’t some other issue that should be treated proactively and good luck.

tankr218 | Philadelphia, Pennsylvania

I’m 47 y/o female. 5’8″ and 144lb in good shape. Leaving for a vacation to Europe in 6 weeks. Want to lipo my abdominal/love handle areas, but concerned I won’t be fully recovered for the trip.

Doctors Answer: SmartLipo before vacation
June 22, 2015

SmartLipo, like any elective surgery, requires budgeting enough time to recover. The good news is that with it, especially when done under local anesthesia, recovery is faster than with other methods. However, everyone has a different capacity to recover, different goals, different schedule demands and varying activities. From a physiologic standpoint, you are well healed in a few weeks but will not see the full benefit of the aesthetic improvement. From a practical standpoint, this is elective surgery and the risks, although very low, are not zero so any unanticipated event can interfere with your plans. 

Doctors Answer
June 11, 2015

Thank you for your question because this is a very challenging problem that many women have. You are very perceptive to the possibility that liposuction of any kind to this area can make it worse. While this may seem counterintuitive because the roll looks like excess fat, removing this fat takes away some of the support to the buttock crease known as the infragluteal crease. This will cause the overlying buttock muscle and soft tissue to fall downward and exert pressure on the back of the thigh where the banana roll was and cause it to buckle. This makes the ‘roll’ more pronounced and is very difficulty to reverse. The buttock sags and looks like that of a much older person. In order to reverse this, fat has to be injected back to buttress (no pun intended) the weakened crease and fill out any oversuctioned areas that are dimpled and lax. In worse cases, the crease has to be surgically repaired and the extra loose skin below removed. In your case, it appears to be mild and strengthening the gluteal muscles and/or increasing volume may help.

Doctors Answer
June 11, 2015

The abdomen, bra rolls and arms may be treated at the same time with SmartLipo if done under general anesthesia. If done under local anesthesia, or awake, the amount of the numbing medicine (lidocaine) required to safely give you comfort while doing the procedure will determine whether it can be done in one or two operations. Safety is the most important factor so patients understand if the operation needs to broken up into two settings. A separate issue is if liposuction with or without laser is appropriate and this depends on the skin quality. In your case, the photos are difficult to determine this so an in person consultation with a qualified plastic surgeon will answer these and other questions (such as cost) you may have. Good luck.

Doctors Answer
June 11, 2015

While most patients see significant results after 40 days or about six weeks, the final results are not seen until three months or longer. The variability in swelling resolution is due to many factors. Aside from differences seen from person to person, the anatomic location in areas that are dependent such as the thighs and knees take longer because we spend most of our waking hours standing or upright. Gravity works against the lymphatics returning to the thorax, slowing the process down. Also, the larger amount of fat removed, the longer it takes in general for swelling to go down. In my opinion, external ultrasound does not speed up the process up. Also, compression garments this late into your recovery probably won’t affect things but your doctor may have a different opinion. To answer your question in a roundabout way, I expect that with the amount of fat removed, you should see a result within the next few weeks to months. 

Doctors Answer
June 11, 2015

While it is difficult to answer your question specifically without photos and a little more history, the results you have ten months after SmartLipo is likely going to be your final result. If the bumps to which you are referring are under the skin, they may be the result of either fat necrosis, fibrosis of the skin or uneven fat suctioning. If they are hard (nodular) and separate like small pebbles, it could be that sterile pockets of dead fat have become calcified or hardened. These will go away with time. Similarly, if the skin is inflamed or irritated such as with over-lasering a small area, it can become fibrotic or ‘ropy’ in some parts. This will also go away with time and massage. However, if there are areas of over-suctioning with other areas underdone, these contour deformities are unlikely to resolve on their own and may require a corrective procedure such as fat transfer to smooth out the defects. In any case, a consultation with a qualified plastic surgeon who does a lot of these operations will give you a plan of action. Good luck.

sheilalowman | Atlanta, GA

Doctors Answer: SmartLipo and High Heart Rate
June 4, 2015

Although more information is needed than was provided from your question, there are a few reasons that a patient can have a high rate called tachycardia during SmartLipo. The most common reason is simple anxiety but a rate of 160 is unlikely due to that. More commonly, a patient may have a sensitivity to one or more of the medications used during the procedure, especially epinephrine which is part of the tumescent solution injected into the fat space. Epinephrine is used to cause vasoconstriction where the small and medium blood vessels decrease in caliber to reduce bruising and bleeding. Some of the epinephrine is absorbed into the systemic circulation and may cause the heart to beat more quickly as a side effect. This can happen if the patient has an underlying sensitivity to the medication, is taking other meds which may cause the fast rate in addition to the epinephrine or have some disorder that warrants further investigation. The surgeon must make sure the patient is safe before proceeding and should address the situation. If the patient is having symptoms like shortness of breath or chest pain, he or she must be seen by the appropriate medical personnel immediately. Fortunately, this is a rare occurrence and usually resolve itself without symptoms. At any rate, the patient needs to have cardiac evaluation to rule out any previously unknown issues at the appropriate time. 

Audrey1961

My dr have suggested weight loss options due to my high cholesterol. I’ve tried to loose the weight BUT it has settled in my mid section. It has been suggested that the cholesterol levels will get better if I loose about 20 or more pounds. I had a consultation with my dr. I was told to find out from my insurance (UHC) what was needed and she would provide. But it seems that my dr did not document the weight loss & lipo consult; therefore insurance denied due to no supporting documentation.

Doctors Answer: SmartLipo and Insurance
June 1, 2015

Like all elective cosmetic procedures, SmartLipo is unlikely to be covered by insurance companies. Although the associated weight loss and improved healthy lifestyle that often accompanies SmartLipo are beneficial, I am not aware of any direct correlation that can be documented in order for it to be reimbursed.

zkp1 | Philadelphia, PA

I’m a 30 yo female.Diabetic since March 2012 using the insulin pump and metformin pills to treat it.1 csection in 2006 the other in 2013 which left me with the hanging fat in bottom of abdominal area(kangaroo sack is what us girls call it).Am I able to get any type of weight loss surgery?

Doctors Answer: Diabetes and SmartLipo
May 29, 2015

A patient with diabetes who has good control of his or her blood sugar for a consistent period of time can be a candidate for SmartLipo just like anyone else. In your case, the location of the insulin pump has to be taken into consideration because it may physically be located in the area of surgery. You may also be a candidate for the procedure to be done under local anesthesia where you are monitored by an anesthesiologist and made very comfortable without having the traditional methods of anesthesia and the attendant recuperation requirements. Having a hanging area of the abdomen may be better taken care of by other means besides SmartLipo so a consultation with a qualified plastic surgeon will answer all your questions. 

tiny_flower | Hlavní město Praha, Czechia

Its been 11 weeks after the operation of SmarLipo on lower abdominal and inner thighs. I add before pic, and the pic in the day of operation with the marks that surgeon did. I was wearing compression garment for 8 weeks 24/7. And went to 6 x LPG sessions. Abdominal is rather ok. But still I’m not happy with the result/progress of the operation on the inner thighs. I’m 30 years old, no kids, skin elasticity is normal, do pilates & some yoga, I have stretch marks but only at outer thighs.

Doctors Answer: 11 Weeks following SmartLipo inner thighs
May 30, 2015

While patients can have very nice results with SmartLipo, the inner thighs are difficult areas to treat in that the overlying skin is relatively thin and the fat usually suctions out quickly. This may result in some parts being overdone compared with others resulting in depressions and contour deformities if not done carefully. I recommend waiting at least 6 months from the time of the operation in order to allow the full result to show. It takes time for all the swelling to resolve, the skin to redrape and any fat destroyed by the laser not suctioned out to disappear. Although an in-person consultation is best, judging from your photos there is a depressed area that will benefit from fat transfer to fill it in as well as more suctioning toward the top of the inner thigh. These corrective cases are challenging so make sure the surgeon has experience dealing with them and good luck.

KKlyn | Mickleton, NJ

Im a 44 yr old woman, 115 lbs that was blessed with big arms. I had smartlipo done 2 wks ago. 2 days aftr surgery both arms appeared noticeably smaller. I had fat above my elbows & this fat looked to be gone at 1st site. Now it looks huge again & is very sore. Its so bad it looks like I have a growth coming out. Im fearing this is still fat & not just swollen as I havent seen any change in the size. Is it normal to have swelling above the elbow? I wear the garment 24/7. Please give me hope.

Doctors Answer: Swelling above elbow after SmartLipo
May 26, 2015

Despite not having photos, what you are describing is very common when it comes to SmartLipo of the arms. At first, you noticed that the arms were smaller, including the area above the elbow. After two weeks, swelling or edema of the skin and soft tissues settled to the lowest part of the treated area which lies just above the elbows. This is because gravity will tend to draw the swelling to the most dependent portion of the operated areas. Luckily, the fat that has been removed with the operation is gone permanently and the swelling that is temporarily taking up the space above the elbow will dissipate in a few weeks to months to allow the slimming result to show. Wearing the compression garment is helpful; just make sure it starts at the wrist because it will cause swelling just beyond the cuff.

Doctors Answer
May 1, 2015

The short answer is yes, SmartLipo is an excellent choice for arm contouring for the right patient. Just as in any liposuction procedure, the skin must be of good quality and have enough elasticity. This means that once the fat is removed, the skin has a reasonable likelihood to retract and not become loose. In conditions of very large weight loss or fluctuations, the skin becomes damaged and liposuction alone will make it look worse. On the other hand, absence of stretch marks, moderate fat removal requirements and good muscle tone underneath will yield great results in many patients in the hands of an experienced surgeon. 

Doctors Answer
May 1, 2015

It appears that your natural buttock crease has been disrupted following liposuction and is usually due to either crossing the normal attachments of the skin to the deep structures there blunting the crease or to suctioning the lower buttock. The latter reduces volume and the natural fullness needed to round out the buttock. It is difficult to know without examining you but it appears that further liposuction will likely make the problem worse.

Two questions are how long has it been since the operation when the photos were taken and did the doctor suction the lower buttock in addition to the thighs? If is is less than six months postoperatively, I would wait until everything settles down and you can determine a plan. Fat grafting will restore volume and fill out the deficit that is causing the double crease if it’s not disrupted. If the crease is disrupted, it may require more extensive repair such as suturing. These cases are challenging so I would encourage getting a second opinion from a surgeon who has extensive experience with this. Good luck.

GordonB1 | San Carlos, CA

Three months post-op and the the incision scars which are approx 2 mm long are still very visible and a darker shade . I’m using Mederma, scar healing creams, etc, etc.. How long does it typically take before they dissapear completely ?

Doctors Answer: How long do SmartLipo scars take to disappear?
April 27, 2015

The way scars generally heal are dependent on two main factors: 1. the technique which the surgeon has some control over and 2. how a patient heals which no one has any control over. Plastic surgeons make the effort to hide incisions in naturally occurring places to hide them such as the belly button or low in the hairline as well as making them as small as possible. In our practice, we use a needle instead of a scalpel blade to make a small, circular puncture rather than a line. Circular incisions tend to heal with a smaller overall length and still can accommodate the instruments needed for the operation . Also, the incisions are closed with fine sutures like the ones we use for facial lacerations. Finally, operating as gently as possible decreases the trauma that occurs at the incision site so that they heal better.As far as patient skin types go, the darker the skin (the higher the Fitzpatrick type) the longer the incisions tend to stay hyperpigmented or dark. In some patients, they may be dark for a year or more. Lightening agents are helpful in some cases but the key is to hide the incisions and make them as small as possible in the first place. Staying out of the sun is important as ultraviolet light can permanently darken the incision while it is in the healing phase.

Doctors Answer
April 15, 2015

While it is unusual to have pain one month after SmartLipo of the chin/neck, 300cc of fat is a large volume where there may be more associated discomfort. Swelling also usually resolves for the most part at 4-6 weeks and finalized around 4 months. That being said, the best thing to do is to check with your surgeon in person. It is never a bother for a patient who has a question to check with the doctor. The good news is that once you are fully healed, a nice change should be seen in your neck. Good luck.

Ms.D23 | Sacramento, CA

Hi, i had smart lipo done in Jan 27th, 10 weeks ago, I feel like my belly looks the same, but more firmer, do it look like my abdominal still swollen? Will I lose anymore fat? I do pilates almost everyday.

Doctors Answer: 10 Weeks After SmartLipo
April 9, 2015

With SmartLipo, as with any liposuction procedure, the skin and soft tissues over and around the area of fat have swelling that takes time to resolve. While the majority of the swelling is finished by around six weeks, the final result is not seen until three or four months afterwards. What looks like residual fat is edema or soft tissue swelling that should improve in the the next few weeks. The good news is that the fat that was removed is gone forever. 

hello2me | Elk Grove Village, IL

I have been to two different consultations about having smart lipo. One consult said that the tumescent they use to numb prior to the procedure is left in for over an hour and they begin the surgery. The other consult said that the tumescent is left in for only a few minutes before the surgery. Which answer is correct? Also, how long typically does a smart lipo procedure take from start to finish?

Doctors Answer: Tumescent Fluid with SmartLipo
April 9, 2015

This an insightful question. Tumescent fluid is sterile saline or salt water that is carefully injected into the subcutaneous (below the skin) fat space in order to 1. carry lidocaine to numb the area 2. carry epinephrine to constrict the blood vessels and reduce bruising, and 3. provide a larger, safer aqueous or watery medium or workspace in order for the liposuction to work best (liposuction works on the principle that fat is slightly less dense than water so that it is preferentially removed from an area when suction is applied). While it takes time for the medicines to work optimally, when SmartLipo is done in the awake patient, the tumescent fluid is injected very slowly and carefully to ensure that it isn’t painful. The time that it takes to do this (about 20 minutes or more) is more than sufficient to get excellent analgesia or numbness so that the next steps of laser-ing and suction are painless. As for time, it takes about 45 to 60 minutes per area for SmartLipo to be done in the awake patient or however much time it takes to get the best result. I hope this relatively long explanation is helpful and good luck.

Doctors Answer
April 8, 2015

For repeat, or secondary, liposuction after SmartLipo, some scarring is to be expected under the skin in the space where the fat is located. This amount varies from person to person and doesn’t mean that a patient can’t have lipo there a second or even third time. However, a surgeon’s experience with repeat liposuction with laser is important because it is more challenging than the first time. Use of energy such as laser (SmartLipo) or ultrasound (VASER) is helpful in loosening and smoothing the scar plane (space) as well as using special cannulas (such as a ‘basket cannula’) to safely loosen the tissue. All these considerations add up to giving the patient the best chance for a good outcome. Please consult with a qualified plastic surgeon who does a lot of these operations to see what your options are and good luck.

Doctors Answer
April 2, 2015

Numbness following SmartLipo (and any type of liposuction) is not uncommon and almost always resolves on its own in about four to six weeks. This is because the sensory nerves that travel within the space where the fat was treated are temporarily interrupted and restoration of full sensation may be preceded by tingling or “pins and needles”. 

Wearing a garment for longer than two weeks, in my opinion, does not have any benefit since most of the swelling that is amenable to compression occurs in the first week or two of surgery. The elasticity of the garment is also much less after this time (unless you keep changing to new ones). However, some patients like to wear the garment longer and that is fine as long as there are no wrinkles that may leave marks on the skin.

Doctors Answer
April 2, 2015

Thanks for your question but it is difficult to know exactly what you’re looking for regarding results without a photo. However, the non-invasive techniques are not designed for facial contouring and the ability to control the removal of fat (if that is what is desired) is much greater with laser assisted liposuction because it treats the fat directly. This is better for the chin but the jowls may respond better to a tightening procedure such as Precision Tx laser treatment because that is primarily caused by skin laxity. Removing fat from there may actually make the jowls worse. Please consult a plastic surgeon about your options.

Doctors Answer
April 1, 2015

Thanks for your question and I’m sorry that you are looking to have your SmartLipo re-done. Although there aren’t any pictures and you aren’t specific in what you are dissatisfied with, there are a few things to consider. If you don’t have any contour deformities (grooving, dents, etc.), the most common reason for a revision is that the fat removal is under-done. Fortunately, this is straightforward to do now that you’ve waited a reasonable amount of time for the final results and healing to be completed. However, gaining weight (even after your dissatisfaction) confuses things and it is advisable to get back to the same weight as you were the day of the operation to have an accurate reference point. For example, even though the fat cells that were killed or removed originally are gone forever, the remaining fat cells can enlarge with poor diet (one can ‘out-eat’ the operation). I am sure the original surgeon would do anything reasonably possible for you to get the result you want but if you are not going back to him or her, make sure the next plastic surgeon has experience with secondary liposuction. SmartLipo Centers of Excellence means that the doctor has a large number of cases done and teaches other physicians how to perform SmartLipo. Good luck

Doctors Answer
March 30, 2015

Three days after SmartLipo, much like in any surgery, there is the maximal amount of swelling to be expected which should begin to taper off over the first week or two. The final results take a few months to be seen but you will see the majority of the swelling subside in about 6 weeks. The fat that is removed is gone permanently but the body’s tendency to temporarily swell in the soft tissues is a normal and expected response. The good news is that this will go away and the fat this has been removed is gone forever. Please be patient with the process and you will soon see the results. 

heathersgo | Ontario, ON

I had smartlipo done on several areas and had the 3m reston pads attached to the areas treated and now absolutely can not get the pads off of my arms, I was able to finally remove from the other areas with a lot of pain and a lot of oil but can not remove from my arms. I feel like I am ripping my skin off. This is 5 days later. What can I do?

Doctors Answer: Reston foam after SmartLipo
March 30, 2015

Reston foam is a self-adherent foam manufactured by the 3M corporation that is sometimes used as a post surgical dressing. However, the company’s product description reads that it is contraindicated in its use as a dressing for post-surgical treatments such as liposuction and may result in blistering of the skin and other problems. If you cannot safely remove the foam yourself at this point, see your surgeon.

Doctors Answer
March 27, 2015

Congratulations on starting the next step in your life. Based on your information and photos, you are most likely a candidate for SmartLipo and fat transfer. While SmartLipo will destroy the fat cells, the fat can first be carefully harvested with liposuction, and then carefully prepared for injection elsewhere (such as the buttocks). Then, SmartLipo can be performed to ‘finish’ off the contouring or slimming portion of the procedure where the fat that is subsequently removed is discarded. Please consult a qualified plastic surgeon in person for all the SmartLipo, liposuction and Brazilian butt lift procedures to see if you are a candidate (which you appear to be). In many patients, we offer this procedure under local anesthesia as an option which often results in a faster recuperation as well as being more cost effective (no anesthesia fee, fewer personnel and equipment requirements). Good luck

Doctors Answer
March 17, 2015

The fullness of the abdomen is due to a contribution of several factors. These include 1. subcutaneous fat (fat under the skin and over the muscle) which can be treated with liposuction 2. muscle laxity (diastasis) that requires an operation such as a tummy tuck or abdominoplasty in order to tighten the looseness and 3. intra-abdominal or visceral fat that surrounds our internal organs where fat is gained preferentially for some people. Based on your photos, your skin elasticity looks satisfactory so that SmartLipo to remove the subcutaneous fat may be a good option. This may ‘jumpstart’ your already good exercise regimen to target the abdominal muscle in order to flatten your profile once the SQ fat is removed optimally. Factors such as having children or losing a lot of weight (50 pounds or more) will affect your candidacy. A trainer may be able to focus strengthening the abdominal muscles to enhance your outcome once the excess fat is removed. Additional weight loss will make the results even better. Good luck and consult a qualified plastic surgeon to see if you’re a candidate.

Doctors Answer
March 17, 2015

After three years, you certainly have the final shape after SmartLipo. I am glad you are happy with your abdomen but it appears that you are unhappy with the proportions following SmartLipo of the hips. Since there are no photos and you don’t mention any technical problems with the hip SmartLipo such as contour problems or grooving, you probably can have your own (autologous) fat taken from somewhere else and then carefully prepared and then injected into the hips where you want more volume. When this is done for increasing the buttocks, this is known as a Brazilian Butt Lift (BBL) but can be done in almost any part of the body where volume is needed or wanted. Please get a consult from a qualified plastic surgeon (or two) to see if you are a candidate and good luck. 

senitive | Saint Louis, MO

it has been two weeks since my smart lipo procedure and the skin around my navel is looking a little wrinkly and also looks like an orange peel. I called my PS and was told that it is part of the healing process. When I called I couldn’t exactly explain how it looked but they knew exactly what I was talking about, and that’d where I got the example of an orange peel

Doctors Answer: 2 weeks after SmartLipo orange peel appearance
March 13, 2015

The orange peel appearance is due to swelling which thickens the skin and the stretching of the pores. This is not unusual following SmartLipo or any liposuction especially around the umbilicus because that is where the surgeon needs to be a bit more aggressive in removing the fat to get a flat result. The belly button has a stalk that is attached to the abdominal wall below. If fat is left behind encircling the stalk, it causes the ‘bagel’ or ‘doughnut’ bulge where the umbilicus is the hole of the ‘bagel’. More laser and more suctioning in the area causes more swelling of that area relative to other parts that are treated so this is a reflection of that extra effort and will go away over time (a few weeks). However, in rare circumstances, a fluid collection may cause this appearance and needs to be addressed by your surgeon so please make sure that isn’t the case. 

Doctors Answer
March 12, 2015

Many patients ask about arm contouring and I appreciate your question. The ‘gold standard’ for a patient like you is to liposuction the upper arm to debulk the size and then remove the skin with a brachioplasty. This will yield the most reduction in volume and deals with the excess skin that would occur after liposuction at the expense of an incision from the elbow to the axilla. SmartLipo of the arms with a modest amount of liposuction with skin that has enough elasticity might be all some patients are looking for. The surgeon, together with the patient, strikes a balance between fat removal and leaving enough to support the skin to look satisfactory. Seek a consult with a qualified surgeon (such as one who has a Center of Excellence, meaning he or she teaches SmartLipo to other doctors) to determine if you are a candidate. The arm is a three dimensional structure where good results can be obtained in the right patient but is more technically demanding. Good luck

Doctors Answer
March 11, 2015

In general, it takes up to four months to assess the final results of SmartLipo. In the neck, more background is needed to answer your question. Age, skin laxity, platysma (neck) muscle bands, access incisions will all affect your outcome. The most important factor is if you are a candidate for SmartLipo in the first place. In your case, the outcome will probably improve with time. The bands are likely secondary to the heat of the laser since no fat was removed. Schedule a follow up appointment at about two months after the procedure to discuss your progress with the surgeon.

Doctors Answer
March 11, 2015

Taller patients such as yourself are generally good candidates for body contouring procedures such as SmartLipo because there is more space in the midsection to get the results of an hourglass or ‘V’.

To address your question, swelling at two weeks is normal and you may feel bigger for several weeks (clothes tight, etc.) This is because the space occupied by the fat that is now removed is now taken up by edema or swelling of the skin and soft tissues. Think of it as a moist sponge that takes time to ‘wring out’. The good news is that it will eventually go away to show your results but the final result may take up to four months or more. The fat that is removed is gone permanently because we don’t make any more fat cells in number to any large degree after puberty is completed.

The firmness around the abdomen is common and reflects the inflammation that occurs after an operation and this will also go away (gentle massage for a few minutes a day may speed up the process).

Tenderness at two weeks is unusual since most patients don’t feel much discomfort after a day or two but may occur. Regarding the volume difference, talk to your surgeon about the number of cc’s removed so that your expectations can be managed. Please give it a few months to fully assess your result and good luck.

301Linda | Waldorf, MD

I had Smart Lipo on my arms two months ago at the age of 61 (female). Currently, my right arm has a lot of loose skin, and my left arm has loose skin and some lumps. I am afraid they will get no better in the next 4 months. My surgeon tells me it takes 6 months to see the final results of Smart Lipo. Do you think there could be a big change from my current condition in another 4 months?

Doctors Answer: 6 Months to Show Final Results of SmartLipo
August 24, 2018

The reasons surgeons tell patients it takes up to six months to see the final results following SmartLipo include: 1) the improvements seen where the  fat that is (permanently) removed is temporarily masked by swelling of the skin and soft tissues and 2) any skin contraction or tightening that will occur takes about that long. Of course, this is an ongoing process for up to a year or longer but most of the swelling goes away at about three or four months. Similarly, the skin tightening due to the mechanical process of liposuction and the heat of the laser is roughly about 75% done by then. If you have loose skin after this time, it is more likely a patient selection issue because some patients’ skin will not tighten enough and may actually look worse after this procedure. Lumps seen at two months probably will go away on their own and gentle massage may speed up the process. I would get a follow up appointment at about four months postop and discuss your concerns with him or her who will give you options. Good luck

Doctors Answer
March 7, 2015

Swelling after SmartLipo usually peaks at around 2-5 days after surgery and some numbness may persist for several weeks. Also, some bruising is to be expected and resolves after a week or so. The areas of swelling may appear slightly uneven but any lumpiness that is out of the ordinary or very marked may indicate a fluid collection such as a seroma or hematoma that needs to be aspirated (drained). Call your plastic surgeon so that he or she may diagnose you correctly. Most minor lumpiness is due to swelling and is affected by your posture, garment and other factors and is normal. 

sspotten | Los Angeles, CA

My legs are fairly muscular from good strength training and regular exercise but with time, the definition has been reduced. My upper inner thighs feel firm when I stand but they do touch at the very top. Is it a good idea to treat that area with a micro cannula? I thought that may give the PS more control than a standard size device.

Doctors Answer: SmartLipo and the inner thighs
March 9, 2015

Laser-assisted liposuction or SmartLipo is an excellent technique for the upper inner thighs in properly selected patients. Based on your photos, it appears that you have a small amount of fat and good skin which is crucial to a good outcome. Of course, a qualified plastic surgeon should make sure in person. The laser helps to emulsify or break up the fat so that smaller cannulas may be used. As you’ve suggested, this allows the surgeon greater accuracy in an area that is at higher risk for a contour deformity due to the inherent thinness of the skin there. The heat of the laser may also result in skin tightening in some patients which helps the overall result. Obtain a consult from someone who does a large volume of these procedures to see if this is the right operation for what you are looking for and good luck.

Yarab | Los Angeles, CA

I just had smart Lipo don’t today on my upper and lower abdomen as well as flanks. I was ok when I left the dr but now I am in the worst pain. I am unable to walk properly, sit up or even get up to use the bathroom. The pain is intense. I keep taking oxycodone to help with the pain but it’s not doing much. Should I go to the ER? Is this normal?

Doctors Answer: Pain After SmartLipo
March 6, 2015

Some discomfort a few hours after SmartLipo is to be expected once the local anesthetic wears off but the excruciating pain you are describing is not normal. You should be evaluated by the surgeon immediately; if this is not possible, you must be evaluated in the ER. 

Timeformeat50 | Ohio City, OH

I’m 49 A mother of 3. 12-14 I had smt lipo I still have quite a bit of fat on midsection. I’m sched for revise on 3-14 for my L- FL Larger, R thigh Lgr. I added my back. I don’t want to bend over in my jeans n have fat bulge. 1st surgery 6K now I’m at another 1500 for revision/ back. I want sm. waist, abs gone n back . Will I be happy w/ this revision w/ my skin tone? My skin has cellulite. I Kno I could use to lose about 10 or 15 pounds and exercise. I am willing to tone at the gym

Doctors Answer: Revision SmartLipo after 3 months
March 5, 2015

Although there is no substitute for an in-person evaluation, it appears from the photos and your description that it is reasonable to undergo a revision to gain more symmetry and perhaps a bit more fat removal. The surgeon, I believe, wants to have the best result possible for his or her patients so is agreeable to the revision. The skin overlying the sides of the body (mid back, flank, outer thighs, etc.) tends to respond to SmartLipo better than the abdominal skin and will likely improve with a touch up procedure. The abdominal skin (even after laser) is at risk of sagging afterwards because it lacks elasticity once the fat is removed. This is especially true if you have had children or weight gain and loss. If you have enough laxity of the skin together with abdominal muscle stretching (diastasis recti), a tummy tuck would be the most effective operation to get a flat and tighter abdomen. Please consult with a qualified plastic surgeon to be informed. 

Doctors Answer
March 3, 2015

SmartLipo of the chin is an excellent option for patients with good skin elasticity and specifically located fat that may run in the family. Seeking an opinion of a qualified plastic surgeon is important because he or she may address other issues that contribute to your overall profile such as possibly benefiting from a chin implant. SmartLipo of the chin is usually done under local anesthesia and aside from having an excellent safety profile, also has a short recovery time.

Chelly04 | Atlanta, GA

the compression garment provided just keep me in & smooths my body contour BUT it doesnt give me that “hour glass compression” that i am trying to acheive especially in my waist. So now i wear both(see pics) is it ok? When i showed my doc he said the latex vest would leave a mark but when i tried both at home (wearing the black latex vest over the beige compression garment) i dont see where it leaves a mark and i am really serious about getting a hour glass & not $5000 wasted. Help please?

Doctors Answer: Latex vest over garment following SmartLipo
March 3, 2015

Compression garments in general help the early swelling normally associated with the operation but the final result is not affected (that is determined in the operating room). While some compression is helpful, more is not necessarily better. Too much pressure with a fold in the garment may result in a (temporary) ridge which may take longer to smooth out. Please allow time to reveal the final result.

Nitaw | Francisco, IN

I am considering smart lipo in a couple of months, however, I am terrified !! I’ve been reading some reviews online and I ran into this horrific review about lumps and bumps not going away and turning out to be scar’d tissue. How safe is smart lipo ?

Doctors Answer: Is SmartLipo safe?
March 3, 2015

The first thing to realize is that SmartLipo is a minimally invasive surgical procedure and while having an excellent safety profile and satisfaction rate, has certain risks and benefits. It is very important that the surgeon has the appropriate credentials, performs the surgery in an accredited operating room and does a large number of these operations (look for Centers of Excellence where the doctors train other doctors). Also, this may be done under local anesthesia without the need for general anesthesia and the associated risks, costs, and longer recovery period. That being said, SmartLipo involves liposuction in order to permanently remove fat and the outcome is highly dependent on the surgeon. For example, lumps and contour deformities can occur anytime fat is suctioned. The good news is that the laser helps to emulsify or liquefy the fat, making its removal more easily done. Smaller cannulas can then be used to perform the lipo portion and that gives the surgeon greater accuracy. Finally, make sure that your desires are matched by the doc so that there is a realistic expectation. Good luck

Doctors Answer
February 28, 2015

SmartLipo has a wide range of prices that depend on 1. the qualifications of the surgeon 2. the area you are thinking of doing the procedure 3. the experience of the surgeon 4. what type of facility in which it is performed 5. the type of anesthesia used. For 1 and 3, please seek a qualified plastic surgeon who has body contouring as a significant part of his or her practice. For example, plastic surgeons and non-surgeons alike who perform SmartLipo have varying degrees of experience. Centers of Excellence are places where the doctors teach the technique to other doctors and have done a large volume of cases. For #2, sites such as this one are helpful in getting a ballpark figure for where you live because the costs of running a practice vary. Fourth, SmartLipo can be done in the office OR which has lower overhead and costs to the patient. Just make sure that it is an accredited facility so the safety standards are upheld like hospitals are. Lastly, this can be performed safely and effectively under local anesthesia (awake). There is also a much shorter recovery and doesn’t require an anesthesiologist and other nursing staff as in traditional liposuction under general anesthesia (please see link for a paper which we wrote about this subject).

Doctors Answer
February 28, 2015

Following laser-assisted liposuction, a few things can occur that may explain the hard lumps. Normal inflammation that happens after any type of surgery causes swelling but is usually diffusely spread out. As long as it is not a fluid collection such as a hematoma or seroma which needs to be addressed by your surgeon, other causes include fat necrosis where the fat is killed but not removed hardens. In almost all cases, these resolve on their own. To speed things up, gentle massage may help. Only a few minutes a day are required but the key is to do it consistently over several weeks. If you have symptoms such as pain, sudden enlarging of the lump, etc., check with your surgeon immediately to rule out other, very rare causes. Good luck

Doctors Answer
February 27, 2015

Based on the photos you’ve provided, it looks like you are a good candidate for SmartLipo for the following reasons: 1. your weight appears to be in normal range so the volume reduction won’t be so large that the skin is at high risk for sagging 2. you have excellent musculature underneath which will enhance your result afterwards (possibly HiDef) 3. your age is ideal in terms of skin elasticity. For the chest, the excess glandular tissue (which is very common) is more visible the more your pectoralis muscles are built up. The muscle acts as a ‘stage’ for the breast tissue and is more prominent. In both cases, SmartLipo will likely result in very satisfying profiles. Also, it can ideally be done under local anesthesia with a minimal amount of downtime as an option. Please seek a qualified surgeon who does high volume (such as those associated with Centers of Excellence). Of course, an in-person consultation is needed to confirm this and best of luck to you.

Doctors Answer
February 18, 2015

A fluid collection or seroma following liposuction is an uncommon but recognized event that happens to a small percentage of patients. Timely recognition of the seroma and aspiration of the fluid as in your case is appropriate therapy and the collection typically resolves after a few treatments. It is encouraging that the volume of the fluid has decreased each time and it may simply be too small to find the third time or it may be change with body position. Rarely, a drain may be inserted to take care of the seroma but most are fully resolved with aspiration.

Jaymilee | Manchester, CT

About 12 days after smart lipo of upper and lower abs an flanks I noticed a bulge like area to the right of my belly button that was soft to the touch and cause a wave like affect that rippled up my side when touched. Saw my PS, 1st time he drained 100ccs, the next day another 40ccs of blood from the pocket. It is filling up again although not as much as the first time. Is there a point where draining with a needle won’t help?

Doctors Answer: Fluid after SmartLipo in abdomen
February 17, 2015

It sounds like from your description that you have a fluid collection in the same space where the fat was removed. Occasionally, fluid accumulates in the space left behind following liposuction in a larger amount than the body can get rid of on its own and is known as a seroma. If the fluid is blood, it is called a hematoma. In either case, serial aspirations (removing the fluid by needle and syringe over a few days) and compression of the area usually takes care of it. In unusual cases where the fluid re-accummulates after many aspirations or when multiple office visits are not possible, placement of a temporary drain may help. In any case, this condition should be addressed in a timely fashion because, if left alone, there may be irreversible changes to the skin that may occur.

Doctors Answer
February 13, 2015

Although there is scar tissue with previous liposuction with or without laser under the skin, an experienced surgeon often is able to get a good result for revision if he or she finds you a candidate in an in person consultation. Eight months is a reasonable amount of time so that the swelling and fibrosis has subsided enough that an accurate touch up procedure can be done. Many of us who do body contouring as a large part of our practice often do revision lipo procedures on patients who may have had two, three or more operations done elsewhere and can give you an opinion if yet another operation is worth pursuing. Often, very good results may be achieved to get you where you want to be from a cosmetic standpoint.

Doctors Answer
February 13, 2015

This is a temporary swelling as a result of the tumescent fluid settling down in the lowest part of the operated area and the inflammation of the cannula crossing the area to get to the treatment area even though no liposuction was done there (as you perceptively noted). There is likely some scar tissue under the skin from your previous operation that is keeping more fluid or swelling in certain areas over others but this will most likely go away with time. Allow for a few weeks for it to resolve or have a follow up with the surgeon to make sure nothing else is responsible.

Doctors Answer
February 10, 2015

Based on your photographs, you appear to be a good candidate for either procedure although an in person consultation will determine that. While both standard lipo and SmartLipo can be performed with a variety of anesthesia options, SmartLipo is usually done with the patient awake with local anesthesia. The laser emulsifies or breaks up the fat so that its removal by suction can be performed through instruments and incisions typically smaller than with traditional lipo. Some patients also report some skin tightening with the laser. In any case, I recommend that you consult with a qualified surgeon and with a SmartLipo Center of Excellence (where the doctors train other doctors in the procedure) to be informed of your choices.

Doctors Answer
February 10, 2015

Congratulations on embarking on your exercise and diet regimen. As you and others have found out, arms are less responsive cosmetically to the efforts of adopting a healthier lifestyle and often are a source of frustration. Arms are very good areas to contour with liposuction in the appropriate individuals with satisfying results. However, it is important that the skin is not too loose so that the fat removal results in a smaller, yet sagging appearance of the arm which is worse than before. An in-person consultation is needed to see if you’re a candidate. Once you are determined to benefit, SmartLipo may be an excellent choice for you because it includes laser and liposuction of the arms for the contour benefit while often using smaller instrumentation through small incisions. We usually perform this under local anesthesia (with the patient awake) so that he or she can recuperate quickly (usually within a day of the procedure) with an excellent safety profile. In short, SmartLipo includes the fat removal of ‘traditional’ liposuction but with the addition of laser to break up the fat to allow smaller instruments while having the option to do it in the awake patient safely and comfortably. Both are considered minimally invasive types of surgery. It is often helpful for patients to get information from surgeons at a Certified Training Center where large numbers of patients are treated with this technology and where other physicians are trained in the operation.

Doctors Answer
February 7, 2015

The benefits of SmartLipo (or laser-assisted liposuction) is that a proportion of the fat cells in an area such as your abdomen are killed by the laser. Followed by liposuction, the cells that are destroyed and removed from your body are gone permanently. The number of fat cells that we have doesn’t change significantly after puberty because they don’t reproduce in number. The fat cells that you have get larger or smaller depending on weight gain and loss. For example, if you lose a lot of weight, the fat cells shrink down but are still alive and capable of expanding again if you eat too much. This contributes to the yo-yo effect. However, if you reduce the actual number of fat cells with the laser and liposuction, your ability to gain weight is reduced because you have fewer cells in the treated area to expand with weight gain. Both the surgeon and patient alike want to remove the right amount of fat to be done safely and effectively in order to get the results wanted. The short answer to your question is yes the fat cells that remain after SmartLipo can get bigger if you take in too many calories but there are much fewer of them. SmartLipo in conjunction with a healthy diet, sustainable and reasonable exercise regimen and good attitude to maintaining your commitment is  a winning combination for many patients to get the results they desire for the long term. 

Yily Doll Not

Updated: Tummy tuck & BBL. – My belly button was not on the right side. She was too busy to get off the phone when she marked me and marked my line off-center. Never was my belly button to the right of my center. She has avoided me from the first office visit after surgery when I asked about it. Beware of doctors that blame the patient. .

Doctors Answer: Belly Button Off to the Side after Tummy Tuck
May 21, 2025

Unfortunately, if the umbilicus is off line or anywhere except the midline following an abdominoplasty, it is unlikely to move/improve position on its own. The reason is that the belly button has a stalk that is attached to the abdominal wall or strength layer of the trunk and is set in position by the surgeon when a) the new opening for it is made in the skin flap and b) sutured into place. That is why the preoperative markings are a critical part of the overall operation because once the patient is placed supine (on her back) on the OR table and the skin flap is created, made and then “inset” or readied for suturing, the surgeon relies on the markings to accurately place all key anatomic elements such as the umbilicus. I would wait several months following surgery to assess how much it bothers you so that you may make an informed decision whether to correct it. That would require elevating the skin flap again, detaching the umbilicus either at the stalk (“floating” the belly button), or anchoring it in the middle without detaching it and adjusting the lower, horizontal scar in the direction toward the midline. In your case, it looks like the lower incision is uneven and that could be improved at the same time if choose to correct the belly button position.

Doctors Answer
January 4, 2017

Not all surgeons have the same protocol regarding postoperative care following an abdominoplasty, especially at two weeks. The general ideas are to limit heavy physical activity (not lifting over 10 pounds, for example) and limiting how much you bend over, etc. While general achiness following increased activity at 16 days postop is not unexpected with some mild swelling, if you notice an excessive amount of pain and/or swelling, it could be due reasons other than over-exertion. Schedule a follow up appointment with your plastic surgeon to make sure it isn’t anything that needs to be taken care of (which it probably won’t). 

Doctors Answer
December 6, 2016

Although it is not possible to give you a definitive answer from just a photo, it appears that the bruising on the left side of the abdomen is a residual one from the operation. Although 17 days is on the longer side of a bruise to resolve, it is not unusual especially if you had significant bruising from the get-go. Please make sure you are making the regularly scheduled follow up appointments so that your surgeon can gauge you progress and answer any questions you may have.

Doctors Answer
October 21, 2016

Your question regarding TT and weight is an excellent one because the results of the operation depend on how much you weigh before considering the TT. An important distinction is to determine if you need the muscle repaired (diastasis recti suturing) and that is impacted by intra-abdominal or visceral fat. This fat is inside the abdominal space and not directly affected by TT. If there is excessive amounts of visceral fat, a diastasis repair will likely fail over time and the overall contour result will be less than ideal. This is due to the ‘pooch’ in the lower abdomen resulting from excessive intra-abdominal contents pushing forward to create a fullness. 

Certainly, removal of the skin and will make a dramatic improvement of the skin laxity. For most patients, I do not do aggressive liposuction of the subcutaneous fat on the abdomen to preserve the blood supply to the skin flap and reduce risk during healing. Instead, a staged approach where the fat of the abdomen is maximally suctioned under local anesthesia and the patient waits about two months to have her TT. In that way, the skin flap is thinned optimally with almost no downtime and is fully healed with a reliable blood supply. Also, the TT result is much better as both sides of the incision are “matched” and usually more loose skin is removed than if the skin flap was as thick as before in a non-staged approach. Staging the liposuction under local (both the love handles and abdomen) also shortens the total anesthesia time for the TT which is also a distinct advantage.

Please consult a qualified plastic surgeon to answer all your questions and good luck.

Doctors Answer
October 6, 2016

From your photos, you look to be an excellent candidate for abdominoplasty with liposuction of the flanks. Weight loss of about 7 pounds will not significantly affect your outcome but a healthy exercise and diet regimen before and after your surgery will enhance your outcome. Patients who are overweight and plan to lose 25 pounds or more before surgery should lose that weight before their operation because it will affect the aesthetic outcome. For example, less skin and fat in heavier patients are generally removed than less heavy patients.

Most of the contouring will be from the removal of the excess skin and fat hanging from your lower abdomen and also from the flanks. This will most affect how your clothes fit. In short, continue your healthy daily schedule and if that results in a few pounds weight loss, that is ideal. Good luck with the operation.

Doctors Answer
August 2, 2016

While it is difficult to assess your clinical situation without photos and the actual amount of recorded drainage, it is normal to have swelling that extends beyond the binder. You sound like you are doing the right thing with your activity level and eating/hydration. The amount of drainage may vary for a few reasons: 1. the surgeon may have used ‘quilting’ type sutures under the skin flap that decreases or even removes the need for a drain 2. the amount of dissection was limited 3. your amount of drainage is on the low end of what’s normally expected 4. the drain(s) isn’t/aren’t working properly. If #4 isn’t the problem, check with your plastic surgeon or the nurse and mention the recorded output. They may wish to move up your follow up appointment to check to rule out a fluid collection which may occur if the drainage that normally builds up following a tummy tuck is not removed.

Doctors Answer
July 20, 2016

In a full abdominoplasty, the skin is lifted off the underlying muscle all the way from the incision up to the breastbone. This allows the surgeon access to the muscle to tighten it when needed as well as allowing the skin flap to be brought down to close the incision once the excess lower abdominal skin is removed. Please remember that this skin flap is still healing and making new connections to the tissues underneath and is still very sensitive. Complete coverage with clothing and a high SPF is recommended for our patients exposed to the sun for at least 4 months post TT because of the risk of permanent pigmentation changes and even burns.

Doctors Answer
July 7, 2016

It appears from your photos that the soft tissue around the belly you are referring to is excess skin that remains following a tummy tuck where the umbilicus is ‘floated’ or where the skin immediately around the belly button is not incised completely around. The umbilicus is simply cut from its connection to the abdominal wall and allowed to move with the skin flap without changing the surrounding skin. While this might not be the case for you, it is suggested because you were concerned of loose skin above the umbilicus and patients with four children or more generally need to have more aggressive skin removal that umbilical circumscription (relocating the belly button opening) gives. The hard and stringy nature of the area may be due to scar tissue that may improve over time but I would go back to your plastic surgeon so that he or she can answer your questions and give you options.

Doctors Answer
June 10, 2016

Although it is unusual to have a seroma five months after a tummy tuck, it is not impossible. The first thing to do is to diagnose it correctly because it should be drained reasonably soon, especially if there is blood in there (you described a discolored swelling which is suggestive of some blood). However, it could be something else such as the imbricating suture (the corset stitch) which tightened the muscle pulling through the tissue at some point. In any case, I recommend you make an appointment with a local qualified plastic surgeon during your trip since at least you will get peace of mind for the remainder of your vacation. Good luck.

Doctors Answer
May 12, 2016

This is a common situation that many patients face. Based on your pictures and the fact that you have had two children, it is important to 1) check if the abdominal muscles have been stretched and 2) if the skin of the abdomen has been damaged so that they will not retract. Tightening of the muscles is important when the muscles are loose so that the internal organs and intra-abdominal fat make up the majority of the fullness you wish to correct. Only addressing the muscle will effectively flatten the stomach. Second, if the overlying skin is loose and has stretch marks, removing the subcutaneous fat will risk that damaged skin to hang even more loosely. In both these cases, a tummy tuck is needed to get the best possible result: tighten the muscle and surgically remove the excess skin to flatten the contour and have the skin “redraping” improved. 

Please obtain a consultation with a qualified plastic surgeon and thanks for your question.

Doctors Answer
March 11, 2016

Thanks for your question. Judging from your photos, you appear to be a good candidate for liposuction because there aren’t significant stretch marks or skin laxity seen and the amount of fat to be removed is moderate. Also, liposuction of the flanks will greatly enhance your profile and both can be performed safely and effectively under local anesthesia. With liposuction, the fat that is removed is permanently gone (we do not increase the actual number of fat cells significantly once puberty is completed). Check with a qualified plastic surgeon because those with a lot of experience offer both local and traditional anesthesia options and can give you a good opinion of the available technology (such as laser, VASER, bodyTITE, etc.) for body contouring and good luck. 

Doctors Answer
February 3, 2016

In healthy individuals who are not obese, tummy tuck with BBL is an option. Please make sure you obtain an in-person consultation with a plastic surgeon who is experienced with both these procedures so that you are in the best position to achieve the results in a realistic way together. 

Doctors Answer
January 5, 2016

Best of luck to starting to regain the result following a TT and subsequent weight gain. As you have described, the bulge is related to the longevity of the muscle repair and also is affected by the overlying fat gained since the procedure. A healthy approach to losing the weight is an excellent start to assess which part contributes most to the overall bulge. In some patients, liposuction (often done awake under local anesthesia) is helpful to thin the overlying skin flap of the TT to increase definition. If the bulge persists, it may be due to the gradual relaxation that occurs over time after the muscle repair. Almost all patients have some degree of relaxation but it varies from person to person. I would schedule a follow up with your plastic surgeon to assess your outcome over the long term and make a plan to optimize things as they are now. Good luck.

Doctors Answer
November 12, 2015

Tummy tucks can be performed safely after SmartLipo if enough time has passed for healing and if the SmartLipo was performed without complications (burns, dense scarring, etc.). In fact, I have staged many patients by ‘debulking’ larger abdomens that may have excess fat with SmartLipo or Vaser under local anesthesia first to thin the abdominal soft tissue. After healing, the patient undergoes the abdominoplasty with a better contour match between the abdominal skin above and below the incision. It is generally safer than aggressive liposuction of the abdominal skin flap done at the same time as the tummy tuck because the blood supply is less at risk. 

Please consult with a qualified plastic surgeon so that you are informed of all your options and good luck.

Doctors Answer
November 4, 2015

There is still significant swelling at three weeks after surgery and lumps or firm areas are not uncommon following liposuction in the short term. The lumps are areas of fibrosis or thickening in the soft tissues due to the normal inflammation that occurs after any surgery, in this case lipo. In this case, the tummy tuck portion of the operation will contribute to the swelling in that not only is skin and fat removed, there is undermining or releasing of the skin and soft tissues that are tightened and closed that also undergoes inflammation during the healing process. 

The short answer is that it is not abnormal and will usually subside on its own over time, possibly helped by gentle massage. These are questions that your plastic surgeon will be happy to answer at your follow up appointments.

Doctors Answer
June 16, 2015

While tummy tuck or abdominoplasty surgery can be done at the same time for small, asymptomatic hernias of the umbilicus, there are two reasons why I would not recommend it for you at this time. First, your hernia is symptomatic, or gives you pain with physical activity. This should be evaluated as soon as possible by a general surgeon who can determine how complex it is (or isn’t), whether it requires a mesh repair, etc. Second, I would recommend that you lose weight first to maximize the likelihood for success and minimize the risks. I believe that you would be a good candidate for it once you address these issues and good luck.

eve_2002 | Menifee, CA

My mom had tummy tuck a few years ago and called me that she was scared because her tummy tuck surgery had a grey string coming out from her tummy tuck and had a lil bit of puss n blood come out from a red bump she had is this normal

Doctors Answer
March 28th, 2015

It seems that from your description that a suture has gradually worked its way through the skin at the incision line many years after a tummy tuck or abdominoplasty. Permanent sutures remain there for the life of the patient whereas dissolvable sutures are gone in a few months (digested by the patient). Over time, permanent sutures may change position and work themselves through the incision where the coverage may be thin. There may also be a localized (limited) infection at the site because there is an open wound where the stitch is visible. By now, the incision is fully healed and the suture is no longer needed and may be removed by the surgeon without a problem. With cleaning and taking care of the wound and removal of the stitch, it should close in a few days to weeks without difficulty.

JJhernandez | Las Vegas, NV

What would yal recommend besides losing weight. I do plan to lose 70 lbs before getting anything done.

Doctors Answer
March 27th, 2015

Congratulations on your journey to losing weight and I hope you enjoy the many benefits of a more healthful lifestyle. Judging from your photographs and intention to lose 70 pounds, it appears that a tummy tuck or abdominoplasty will be needed to get the results you are looking for. This is because the excess skin will only become looser with weight loss and the muscle of the abdominal wall is likely stretched and loose as well. Removing the extra skin and tightening the muscle wall will give you the best chance for an improvement of the silhouette. Getting an in person consultation now with a qualified plastic surgeon will provide an opportunity to plan your course for the best possible outcome. This includes smart dieting, a sustainable exercise regimen, surgery for some and a positive outlook which all culminate to give you the best odds for long term success. Good luck

california99 | San Diego, CA

Is it normal for my skin to look like this my scar is so thick and bumpy and I just feel worried my doctor said it was fine along with my breast scars but I don’t know I need opinions I had surgery on my scars [revisions] on March 5

Doctors Answer
March 13th, 2015

It is too early at one week following a tummy tuck to make any comments on the final appearance of the scar. The abdominoplasty scars are closed in several layers and some surgeons use a technique to evert the skin layers or close the upper layer in a way that the edges are raised slightly. This helps to counteract any forces that would work against a fine scar from forming. Using absorbable sutures, the closure eventually flattens to leave a fine line. The temporary look you noticed is normal.

nicolemcreynolds | Mount Carmel, TN

I have had 2 children and not having any more. I ended up at one point weighing 230’ish back in 2011. I am now around 165-170 it varies month to month. I’m very uncomfortable with myself and would love to get a boost of confidence. I hate seeing myself naked and am wanting to change that. My eyes go straight to my belly. Me and my husband go to the gym and lift weights 4 days a week also I just can’t seem to get any further with my tummy. What is the best option for me?

Doctors Answer
March 9, 2015

From your photos and history, you have skin laxity and stretch marks mostly concentrated to the lower abdomen. Congratulations on losing the weight. Tummy tuck or abdominoplasty is an ideal procedure where the excess skin is removed, the muscle laxity (if present) is addressed and tightened, and a more youthful appearing umbilicus opening can be created. Liposuction of the midsection done before, during or after (this can be easily done under local anesthesia) will further enhance your results. I encourage you to get a consultation with a qualified plastic surgeon to find out your options and good luck.

SAHM 922 | San Antonio, TX

4 Months Post op extended tummy tuck, muscle repair and Lipo of the flanks. Would you say I need a revision or could this be swelling? I’m afraid my doctor did not remove enough skin.

Doctors Answer
March 9th, 2015

Unfortunately, good views aren’t seen in the photos and your surgeon will be able to address your situation best in follow up. In general, four months after a tummy tuck is not enough time to fully evaluate how things will look when everything is fully healed (which takes about a year). The good news is that abdominoplasty has a high satisfaction rate and rarely requires revision.

pinklady1984 | San Diego, CA

I had a full tummy tuck, muscle repair with lipo of the flanks and lower back 3 wks ago. I have been extremely swollen since day 1. I have not yet seen signs of a flat tummy whatsoever. I’m very concern that my tt didn’t work 🙁 Also, my incision started oozing yesterday from where the steri tape has fallen off. It seems to be clear/yellowish fluid. And my incision is very itchy and red and it hurts a lot. I see my PS in a few days but I would like opinions from other Drs. Thank you!

Doctors Answer
February 23rd, 2015

Although information regarding your condition 3 weeks after TT is limited through photographs, your concerns will be addressed as soon as you are seen by your plastic surgeon. I would encourage you to call his or her office today to be seen earlier than your scheduled visit so that the redness, drainage, fluid and overall fullness is assessed to be either in line with what is expected at this time after surgery or something else that needs to be taken care of. Abdominoplasty is an effective technique in achieving body contouring by removing skin and other tissues as well as targeting the muscle for tightening but some of the benefits may be masked in the short term by swelling and other factors. Good luck and I hope your goals with the procedure are eventually achieved.

lovely1983 | Colorado, CO

I started at 400pds so i have lost 180 and have been stuck at my current weight of 220 for 5 months I work out 5 times a week and I am losing inches but I see no difference because of the skin. I would like to know if a tummy tuck is ok at this stage, im 5’7 220 and I will eventually need skin removed on my legs and arms as well. I have been looking into getting a tummy tuck but would like a doctor’s opinion I have attached a picture the whole front of my stomach is skin sides as well thanks in advance.

Doctors Answer
February 16th, 2015

Congratulations on your significant weight loss and I hope that you are enjoying all the positives that go along with it. Please consult with a qualified plastic surgeon to determine if a tummy tuck or abdominoplasty is right for you. The things you would talk about include: 1. whether you want to lose more weight 2. if your abdominal muscle needs to be tightened 3. if the skin laxity (looseness) extends to the back which requires a longer incision and a modified operation (extended abdominoplasty) 4. if your outside thighs and buttocks can benefit from a lift (which usually requires an operation that goes around the waist such as a body lift). If you are a candidate, you may realize the aesthetic benefits of all the loose skin around the midsection removed to fit better into clothes, gain confidence and increase your physical activity, among other benefits. Good luck