Your Questions

Q: Hello, I have some severe lumps from a previous liposuction therapy on my upper and lower abdomen. I have since attempted corrective surgery, but it has actually made the issue worse. Is it possible to better the results?

A: Waviness or unevenness is the most significant risk in liposuction of the abdomen. While it is not a common postoperative problem, it is a particularly difficult one to improve once it occurs. It may develop for a variety of reasons including poor quality abdominal skin, an aggressive liposuction approach, and a liposuction technique that only uses a unidirectional point of access. This  results from an inconsistent fat layer that is left behind underneath the skin.

While not just unique to abdominal liposuction, contour irregularities are most commonly seen on the abdomen because it is the only truly flat surface of the body that is so treated.

Small abdominal irregularities can be rather easily improved by select or spot liposuction touch-ups. Severe or extensive lumpiness, however, is a much different story. Your efforts at corrective surgery, and the resultant lack of any improvement, reflect the difficulty of the problem.

If further invasive corrections have not worked, one last option would be to consider injection therapy. I have used a mixture of lipodissolve and steroid injections to treat the high spots of abdominal irregularities with some success. It usually takes several injection sessions spaced about 6 weeks apart to get the maximal improvement. This approach will never get the abdomen to be perfectly smooth again but it can help lessen the magnitude of a ‘cratered‘ abdominal wall.

Dr. Barry Eppley

Indianapolis Indiana

Q: I have some severe lumps from a previous liposuction therapy on my upper and lower abdomen. I have since attempted corrective surgery, but it has actually made the issue worse. Is it possible to better the results? I have attached some pictures of my abdomen so you can see how bad it is.

A: A very lumpy and irregular abdomen after liposuction is a difficult problem indeed. This is doubly so considering you have had two attempts to correct it. Lumpiness after abdominal liposuction is the result of uneven fat removal, leaving behind a surface of high and low spots. The most common reason this occurs in the abdomen is from the use of a non-cross tunneling technique. In an effort to eliminate any visible entry points, many inexperienced practitioners perform the liposuction exclusively from inside the centrally-located belly button in a 360 degree radiating pattern. This can result in unevenness in fat removal due to the radiating linear pattern. It is always better to use to two waistline entry points (one on each side of the waistline) in addition to the belly button location to ‘cross’ the linear liposuction strokes. This creates a cross-hatching pattern throughout the entire abdomen and helps lessen the risk of leaving flat surface irregularities.

Can your lumpy abdomen be secondarily improved by using this liposuction technique? That would depend on knowing how your original procedures and the subsequent revisions were performed. If no cross-tunneling has ever been performed, then this revisional liposuction approach may be considered. But the hope of having a perfectly smooth abdomen is not a realistic outcome when one has this liposuction complication. The best result at this point is some degree of less abdominal unevenness.

Dr. Barry Eppley

Indianapolis Indiana