Q: Dr. Eppley, I’m hoping you will be able to advise based on your article on conservative vs aggressive liposuction and the trade-off with skin contouring. Would you please tell me what my options are to correct the skin irregularities on my upper arms as a result of liposuction done severalyears ago? Would weight training or weight gain or massage help? What are the odds that a second liposuction procedure on the arms would correct vs worsen the skin irregularities? Thank you!
A: The number one complication after liposuction is contour irregularities, i.e., lack of perfectly smooth skin. Certain body areas are more prone to that problem than others. The arms is one of those potential areas and that has to do with how liposuction is performed in an axially-oriented extremity…usually from one direction. It is very difficult, from an access standpoint, to treat the back of the arms from different directions. The concept of cross-tunnelling, an old liposuction concept, still has merit even with today’s advanced liposuction technologies.
Massage therapy done early after liposuction surgery can help with working out any irregularities and uneven areas. However, months to years later when the tissues have healed, make such tissue manipulation unsuccessful. Weight training or arm toning would be unsuccessful as the contour problem does not lie at the muscular level.
The only option for improvement would be another liposuction surgery. The scarred and irregular subcutaneous tissues must be released for any better contour to be achieved. Since the old motto of ‘plan B should not be the same as plan A if you want a different result’ applies, how the liposuction was done and what was done afterwards should be different. In my Indianapolis plastic surgery practice, I would use laser liposuction (Smartlipo) as a different method, access the area from both at the elbow and from behind the arms, and institute massage therapy beginning two weeks after the liposuction surgery. While no guarantee can be made that it would be better, my experience is that it would. If the same technique was used as the last time, the odds are higher that it could be worse.
Dr. Barry Eppley