Q: I had a liposuction operatoion to get rid of the fat in my saddle bag areas. It was done over aggressively as now I am left with indentations where the sasddle bags used to be. It looks like I have traded off one problem for another. I am looking for a plastic surgeon who has experience in fat grafting to correct these overly aggressive liposuction results in the saddlebags. I no longer have saddlebags, now I just have big dents!
A: The saddle bag or lateral thigh is not an uncommon area where irregularities and indentations can occur. Unlile surface contour problems in other liposuction-treated areas, the cause of such saddlebag problems is usually not the quality of the skin. It more often than not is the position in which the procedure is performed. It is usually done with the patient in the side or decubitus position. This is a good position to do the procedure but one has to be careful that the leg is lifted when liposuction is performed. In the side position, part of the saddlebag prominence is the greater trochanter process of the femur of the hip joint. When the leg is down, this bony prominence makes the saddle bag area look bigger than it is. Liposuction is then done to make the area flat (removing too much fat over the bony prominence), which looks good laying down and one one’s side, only to reveal an indentation from over-resection later when one is standing. This is why the leg is elevated as the liposuction procedure is done to havge a better idea what is fat and what is bone.
That issue aside, fat injections is the only method available for treatment of liposuction irregularities. It works best for specific defects, such as indentations, and less successfully for more generalized skin rippling and irregularities. It would be beneficial to see some pictures of the saddlebag area to determine if this would be beneficial for your thigh contour problems.
Dr. Barry Eppley