Expert: Alan M. Engler, MD, FACS - 10/5/2006

Question
Dear Dr. Engler,

I received lipo of my u/l abs in Jan,2006.  I've been extremely concerned about hard lumps across my mid-section (above belly button) and one hard lump on my left side slightly above pubic area. I've seen my PS 3 times so far, each time being assured that it was swelling and would dissipate in time.  I went to the PS again yesterday, and he now informed me that it was scar tissue and I would remain this was permanently.  He did, however, offer to do a revision in the Spring with only a 10% improvement at best.  Can you help me? Is there anything that can be done to reduce the severity of my scar tissue? I am only and 1 1/2 drive from NYC, and am willing to see you if you feel you can help me.  Thank you for your time.

Answer
Dear Kathy,

Thanks for writing to me.  There's lots more info about plastic surgery at my site, www.bodysculpture.com.

First of all, I am sorry that you're having a problem after lipo.  Things such as these can, of coure, occur with surgery, but it's much better all around when they don't.

In general, when there are lumps that persist after a lipo it is usually worth trying at least one revisional procedure to get them to flatten out.  Some of that depends on when the lumps appeared.  If there were there pretty early on, then it suggests that the fat may not have been removed perfectly evenly (which can happen more easily than it sounds like it should).  Those cases, in particular, are likely to be improved by a revisional, or secondary, lipo, since they were, at least originally, mostly fat.   If the lumps appeared later (ie, it was flat initially, but then they appeared) they they may, in fact, be due to scar tissue formation.  This is harder to remove with lipo, but is still worth at least one try to get a better result.  Such lumps may also appear due to persistent fluid after the procedure which is why I almost always use drains of some kind, particularly on the abdomen.  Scar tissue is, obviously, better avoided in the first place.  But I think that in  most cases you can get better than a 10% result, depending on how extensive the problem is.

I would be happy to see you for a consultation, at which point we can decide what makes the most sense.  Feel free to call my office at 212-308-7000, tell them that you and I corresponded online, and they'll be happy to set something up.  Whether or not it makes sense to do the surgery is something we can talk about at that time.

You can also see a few plastic surgeons closer to you to get another opinion.  If you go to the About This Site page of my website, www.bodysculpture.com, you'll find links to several national plastic surgery sites that can help you find someone closer to you.  If you'd prefer, I would be comfortable seeing you, and giving you an opinion.  

I hope that this helps,

Dr. E
www.bodysculpture.com