High Definition Liposuction Revision | SurgiSculpt
Author: Babak Moein, MD FACSBoard-certified,
Fellowship trained in Cosmetic Surgery

High Definition Liposuction Revision

Introduction To High Definition Liposuction Revision

High Definition Liposuction Revision Procedure describes the correction of an entire gamut of botched liposuction outcomes. Poor liposuction outcomes following cosmetic procedures can result from a variety of causes. Liposuction revision surgery in plastic surgery requires additional liposuction to correct. Skin excision surgeries such as tummy tucks may be necessary in more severe botched liposuction cases. Liposuction revision plastic surgery can be recommended for any of the following reasons that include:

  • Skin contour waviness or asymmetry; this complication occurs when the deeper fat layer is removed unevenly. The deep layer must be removed entirely and uniformly for optimal results following traditional liposuction. If the traditional liposuction provider lacks expertise, he/she may inadvertently leave patches of deep fat behind, creating wavy irregularities. This complication occurs most frequently when liposuction is performed under local anesthesia with an awake patient. This is because removing the last bit of fat requires the removal of the fat intimately adhered to the muscle tissues. Muscle tissues possess a higher density of pain fibers, making fat removal painful.  As a result, when patients attempt liposuction while awake, they will often ask their surgeon to stop liposuctioning prior to complete fat removal.
  • Skin contour divots; this complication occurs when the liposuction provider attempts to remove superficial fat. The superficial fat is universally composed of fat pads traversed by a web of collagen pillars, called retaining ligaments, that provide stability to the overlying skin. When attempts are made to pierce the superficial fat with a cannula, the cannula will get wedged and stuck. This makes uniform superficial fat removal not possible. It is not feasible to clear out superficial fat because of the high density of retaining ligaments; any attempts to remove fat from this region will frequently result in unsightly grooves and divots.
  • Paradoxical adipose hyperplasia(PAH); PAH has been coined to describe the overgrowth of deep fat following treatment with topical cryotherapy, branded as Coolsculpting. Coolsculpting results in the reduction of superficial fat and improved prominence. However, in a subset of patients, there is a paradoxical overgrowth of the deep fat directly underlying the treated superficial fat. It has been hypothesized that removing the superficial fat eliminates compression and physical hindrance of the deep fat cells for growth. Once the superficial layer has been compromised, and following moderate weight gain, this deeper fat grows unimpeded compared to other fat. This results in the deformity characterized as PAH.
  • Skin roll deformities; Skin roll deformities and/or skin redraping irregularities describe generalized deformity in skin contour observed when redundancy in the skin has been created and/or not addressed. Patients who observe skin redundancy following liposuction will be marred by random redraping of skin that settles unevenly and appears operated looking and deformed.

Today, these botched outcomes results can be improved with VASER liposuction. This is because VASER liposuction has several unique advantages compared to traditional liposuction. VASER liposuction has the unique features of being able to:

  • Removal of deep fat comprehensively and uniformly
  • Removal of the superficial fat selectively
  • Able to traverse through scar tissue
  • Redrape skin irregularities

Only with uniform removal of fat from the superficial and deep layers can you be assured that all the deformities enumerated above may be resolved. Resolution of deformities will include the elimination of divots in the superficial layer, eliminating asymmetry or wave-like deformities in the deep layer, and correcting PAH deformities. If skin redundancy is present, a combination of VASER and either Renuvion skin tightening or actual skin excision using a mini-tucking procedure is used to tighten the skin and strategically eliminate any skin roll deformities.

High Definition Liposuction Revision Description:

  • Procedure:  Correct any contour irregularities created by ineffective fat removal techniques and/or skin deformities arising from unmanaged skin redundancies.
  • Length: 3 to 5 hours, dependent on the number of areas needing correction; in general revision, liposuction requires 30 to 40 % more treatment time than areas that are previously untreated.
  • Anesthesia: General anesthesia.
  • Place of Treatment: Outpatient procedure in an Outpatient surgical suite.

Side Effects OF High Definition Liposuction Revision

Prolonged operative times. Prolonged operative times should be expected since the removal of previously treated areas is associated with increased scar tissue buildup that requires increased VASER times. VASER ultrasonic energy must be administered over longer to break through scar tissue and emulsify residual retained fat patches before removal with liposuction cannulas.  Side effects of secondary liposuction include:

  • Partial loss of fat grafting volume. If you have undergone a prior liposuction procedure such as cool sculpting, Smart lipo, laser liposuction, or traditional liposuction, your fat quality will likely be compromised. Transfer of compromised fat following a BBL may result in loss of buttock volume within six months of surgery.
  • Skin compromise. Since increased VASER times and more aggressive liposuction must be employed to attempt uniform removal of scar and fat tissue,  the overlying skin can become compromised. Early detection is critical to avoid any permanent damage to the skin. When skin compromise is detected, further VASER and/or liposuction of that area should be avoided. In addition, the topical application of Nitro paste will allow compromised tissues to be reverted to viable skin.
  • Recovery: The recovery for revision high definition liposuction ranges longer than routine high definition liposuction procedures since longer operative times and more aggressive contouring must be accomplished. High definition liposuction revision cases will routinely require 2 weeks for recovery. This is in contrast to the original procedure involving liposuction requires only a week of recovery.


Duration of Results: Patients are universally pleased with the revision high definition liposuction results, as the corrections are definitive and permanent.

High Definition Liposuction Revision Frequently Asked Questions:

High definition liposuction revision entails the correction of any deformities created by ineffective fat removal during the initial liposuction procedure. By uniform and comprehensive removal of all fat layers using VASER technology, plastic surgeons may ensure definitive and permanent correction of all deformed areas. When minimal to moderate skin redundancy is present, Renuvion technology can tighten the skin without requiring more invasive surgical excisions. More minor tucking procedures may be strategically employed as part of your cosmetic surgery procedure to eliminate redundant skin and subsequent contour deformities when moderate to severe skin redundancy is present.

You are a good candidate for high definition liposuction revision if you are dissatisfied with the appearance of your body contour following a previously performed fat removal procedure. Whether your results appear operated-looking or there are contour irregularities such as divots, asymmetry, or skin rolls, all of these deformities can be corrected using high definition liposuction revision.

You must plan for your high definition liposuction revision in advance. First of all, you have to recognize that your surgery will require more aggressive fat removal and thus require you to have a more extended period for recovery. In contrast, routine high definition liposuction requires 1 week for recovery, high definition liposuction revision will require 2 weeks for a full recovery.

You can expect to achieve stunning results following high definition liposuction revision with eliminating all of your deformities if you choose a surgeon with extensive experience in revision liposuction. Your surgeon will determine your candidacy for liposuction revision during your initial consultation. Since uniform and comprehensive removal of all fat layers is accomplished, your outcomes will typically be permanent.

Your successful liposuction procedure will be typically performed in a surgical facility. Your liposuction surgeon will want to review your earlier liposuction procedure and to confirm that you are a good candidate for liposuction revision.  If you have access to your primary liposuction operations, bring them to your consultation with your expert at liposuction revision. Advanced liposuction technologies using VASER liposuction and Reunvion J plasma will improve any deformities from previous liposuction procedures. 

High Definition Liposuction Revision Patient-Specific Questions:

High definition liposuction revision utilizes Vaser technology that emits an ultrasound wave that cannot only emulsify fat from all layers of the body before removal but also able to break up any scar tissue that may have formed from prior surgery. Its effectiveness in removing scar tissue should not be surprising if you consider that Vaser alone can remove all of the glandular/discoid tissue underneath the nipple and areola in gynecomastia patients. Traditionally, gynecomastia surgery requires direct excision of this discoid tissue, but with the advent of ultrasound energy, this tissue can now be removed definitively with Vaser liposuction alone.

Vaser technology utilizes ultrasound energy to emulsify any residual fat cells left after a botched fat removal procedure. This energy allows all layers of fat, including the superficial and/or deep layers, to be removed comprehensively. Regardless of whether the deep fat was removed unevenly or the superficial fat was removed inappropriately, all superficial and deep fat is removed universally. In doing so, patients have ensured a smooth and permanent correction of their deformities.

Paradoxical adipose hyperplasia (PAH) involves an overgrowth of the deep fat layer following cryotherapy (Coolsculpting) and subsequent patient weight gain. Cryotherapy results in the removal of the superficial fat layer only in the treated areas. Unfortunately, this treatment then results in loss of pressure inhibition on the deeper fat if weight gain follows. Patients with PAH demonstrate localized areas of deep fat overgrowth and resulting skin growth that creates discrete mound deformities. Vaser technology allows for the definitive removal of this deep fat in the cryo-treated areas and uniform removal of superficial and deep from adjacent regions. As a result, the entire patient can be debulked of unwanted fat universally. In addition, Renuvion skin tightening is used to tighten any skin redundancy following fat removal to avoid a secondary contour deformity. To date, patients two years out from PAH correction using high definition liposuction revision have demonstrated the reoccurrence of their deformities.


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