Revision Liposuction

Revision or secondary liposuction can be one of the most difficult areas to correct in cosmetic surgery. There are several methods of secondary liposuction techniques. In patients with a secondary contour deformity from liposuction, Dr. Rohrich uses traditional liposuction, commonly referred to as suction-assisted liposuction (SAL), using a vacuum-like cannula to replace fat in these areas after it has been injected with saline. The most recent development in liposuction is the use of ultrasonic waves to melt unwanted fat. The technique, commonly referred to as ultrasound-assisted liposuction, (UAL), uses a cannula-like device to deliver the sound waves to specific areas of fat that have been injected with a saline solution. Once the fat has been melted, it is then suctioned from the body. Dr. Rohrich uses both of these techniques to restore the body contour: fat injection and fat removal.

Dr. Rohrich reminds his secondary body contouring deformity patients that it may take 2-3 operative sessions of fat contour/reinjection to restore 70-80% of the previous non-operated body contour. Dr. Rohrich is a *board-certified, world-renown, plastic surgeon with over 15 years specializing in body contouring surgery. He is an internationally recognized expert in liposuction and is co-editor of the first ultrasound liposuction textbook entitled “Ultrasound-Assisted Liposuction” and has taught this new technique to over 2000 plastic surgeons. He is also a nationally recognized expert in correction of secondary liposuction/body contour deformity. He has written extensively on how to prevent/minimize secondary body contouring problems and how to handle these different problems. He has written numerous articles for scientific journals as well as given presentations internationally on the subject. He has been on Prime Time Live, The Oprah Winfrey Show and Barbara Walter’s The View discussing body sculpting. He is Chairman of The Department of Plastic Surgery at UT Southwestern Medical Center at Dallas.

Am I a good candidate for the surgery?

Dr. Rohrich believes that secondary liposuction can truly provide you the “boost” you need to restore your self-image and confidence. Furthermore, he believes it is vitally important to have a proper diet and exercise regimen to obtain the maximal results for body contouring surgery. A frank discussion of your problems and concerns are key elements for Dr. Rohrich to determine if you are a secondary liposuction candidate. Your visit with Dr. Rohrich will determine if you are a good candidate. If you are within 15 to 20 pounds of your optimal body weight and in good physical and mental health with reasonable expectations you should be an appropriate candidate. Before you decide to have surgery, think carefully about your expectations and discuss them with Dr. Rohrich.

What should I expect from my consultation?

During your consultation, you will learn in depth how secondary liposuction surgery is completed differently from primary liposuction procedures, as well as its advantages and disadvantages, and discuss your particular needs and concerns. Dr. Rohrich first and foremost wants to hear specifically from you the areas of your body you feel need improvement. This will help him understand your expectations and determine whether they realistically can be achieved. He will examine you and consider such factors as the quality of your skin tone and the contour of your body. He will explain which surgical techniques are most appropriate for you to give you the best result within your specific secondary liposuction contour problem. Contour depressions are more difficult to cover than contour excess.

After your consultation a photographer will take photographs to be used for your medical record and surgical planning and you will meet with Dr. Rohrich’s patient coordinator to discuss the surgery fees and scheduling dates. It is important to also schedule an additional consultation to view computer imaging so that you can visualize the results of the surgical technique that Dr. Rohrich has specifically designed for you.

You should come to the consultation prepared to discuss past medical history and previous liposuction procedures. This will include information about any medical conditions, drug allergies, medical treatments you have received including previous surgeries and medications that you currently take. It is important for you to provide complete information.

How is the surgery performed?

General anesthesia is usually used for patients undergoing secondary liposuction surgery. Dr. Rohrich only uses board-certified anesthesiologists who are familiar with his technique and operative rhythm to maximize his patient’s safety and operative efficiency. You will meet your anesthesiologist before surgery so that he/she may get to know you better and answer any questions you may have. Prior to anesthesia, Dr. Rohrich will mark the areas to be treated on you with a surgical marker, both for fat reinjection and fat removal. Once you are under a general anesthesia, a salt-water solution containing local anesthesia and adrenaline is injected into the areas to be treated and small, inconspicuous incisions are made for the insertion of the cannula. The procedure is initially done by SAL to maximize removal of fat for fat reinjection in the contour depression. Then a cannula that is connected to an ultrasound generator, is inserted beneath the skin and the ultrasound application causes the walls of the fat cells to break down and melt. This melted fat combined with the injected fluid creates an emulsion that is removed from the body by low vacuum pressure. After the procedure, the incisions are minimally closed and you are dressed into a compression garment that helps to reduce swelling.