Revision Liposuction FAQ

1. Is revision liposuction surgery more difficult than the initial surgery?
In virtually every aspect of cosmetic surgery, a revision surgery is more challenging and takes even a greater degree of good judgment and technical experience. However, in the vast majority of cases a significant improvement can be made.

2. Is healing and postoperative discomfort longer for revision liposuction?
I have not noticed that patients have any more discomfort and are usually up and about within an hour of the revision liposuction procedure.

3. Are there advantages to purely local anesthesia for revision cases?
I personally feel local anesthesia as opposed to general has huge advantages for liposuction surgery in general. But specifically the local tumescent fluid prior to starting the sculpting greatly helps to loosen up the scar tissue (hydro dissection) from the previous surgery.

4. Are costs any higher for revision liposuction?
While it is a technically more difficult surgery and most revision liposuction work does tend to cost more, I charge based on how long the procedure takes and do not have a surcharge for revision cases. I try to keep my fees reasonable and understand that the patient has already invested money with a previous surgeon.

5. What is the most difficult kind of liposuction surgery?
As I have outlined previously when an area with reduced elasticity has been done too aggressively or with disrespect for the skin and there are numerous irregularities of the skin surface with not much fat left it can be the most difficult to make perfect. Usually in these cases if the patient is a candidate I may use a combination of smoothing with a spatula cannula, fat transfer and skin tightening procedures with radiofrequency.

6. What are the simplest or most straightforward revision liposuction procedures?
While very little about well done liposuction is straightforward usually correcting asymmetry, areas that have been too conservatively done or blending shelves are generally not as complicated.

7. Does fat transfer last in revision liposuction cases?
Fat can be a finicky material. It is a grafting of tissue and its long term survival depends on it receiving a good blood supply. Well done fat transfer to the face almost always has a permanent take. But with some indentations from liposuction surgery there is scar tissue which can reduce the long term survival of the grafted fat. In most cases there is a long term survival of the fat but in some cases the fat may not survive after six months. It is for this reason that I like to combine fat transfer when I am going into the operating room for smoothing with liposuction and rarely for only fat transfer alone. There are today a number of excellent long term fillers that can be done for the patient who may only need subtle filling for far less cost.

8. Why is revision rate for liposuction so high?
There are a number of reasons. To begin with, it may seem like a deceptively easy procedure. But it is actually very difficult to consistently achieve outstanding results. It takes perfect judgment and perfect technique. Many times it is done by a surgeon who may excel at other cosmetic procedures but not at liposuction. Revision liposuction is truly a very difficult kind of surgery to any other. Next, I feel there is too much marketing or reliance on the machine rather than on the skills and artistry of the surgeon today. Lastly, I strongly feel that liposuction specifically being done under general anesthesia or on an unconscious patient puts the surgeon at a great technical disadvantage and greatly increases the chances for a poor outcome, whether it be by creating an improper shape, not being complete or causing surface contour irregularities.