By Dr. Chris Patronella
When skillfully performed on an appropriate candidate, SmartLipo, like many other liposuction methods, is good technology that can be very useful in body contouring procedures. However, liposuction predictably has yielded less-than-ideal results for the patients I’ve seen who had mild to moderate skin looseness for a simple reason: when you remove fat from an area that has loose skin, the skin will not shrink back smoothly and evenly. Most of these patients eventually have opted for tummy tuck surgery to restore a smoother, more natural-looking youthful appearance to their abdomens.
One such patient, Kelly, consulted with me for revision surgery to improve the unsatisfactory results from a SmartLipo procedure she received elsewhere as part of a mommy makeover to rejuvenate the appearance of her abdomen after having two children. Though she was pleased with the results of her breast augmentation and breast lift procedure, her abdominal results were a stunning disappointment that left her with more noticeable aesthetic concerns than she had prior to surgery.
Like many women who’ve had children, Kelly had loose abdominal skin and weakness of the underlying muscle wall as a result of the stretching that takes place to accommodate the growing infant during pregnancy. These characteristics are best corrected through tummy tuck surgery. Because Kelly had good skin elasticity with skin looseness primarily beneath the belly button previous to having her initial surgery, I most likely would have chosen to perform a mini tummy tuck on her, a less extensive tummy tuck procedure that is appropriate for about 10 percent of my abdominoplasty patients.
In revision cases such as Kelly’s, it is often difficult to restore a fully smooth appearance to the abdomen because patients have a layer of scar tissue beneath the skin’s surface and little to no fat left as a result of the laser liposuction treatment they received. Fortunately, improvement often is possible through corrective surgery. For Kelly, I performed tummy tuck surgery in conjunction with liposuction to sculpt the slimmer hip proportions she desired.
Though it’s a poor substitute for tummy tuck surgery, liposuction often serves as an excellent complement to enhance abdominoplasty results. In about 80 percent of my tummy tuck patients, I incorporate liposuction to accentuate the waist and/or to improve lower body proportions to help the abdomen’s appearance blend with adjacent areas for the most natural look.
Kelly was thrilled with her new look. Like many of the the revision patients I see in consultations, she was greatly discouraged by the poor results she received from her original surgery and fearful of going through a secondary procedure. Though revision surgery presents unique challenges to both the patient and surgeon, the resulting aesthetic transformation and restoration in these patients’ confidence makes it one of the most rewarding procedures I perform.