If liposuction has left you with poor results, contact Century Aesthetics® to learn more about how corrective or secondary liposuction can help you regain your confidence.






Century Aesthetics®
Peter B. Fodor, M.D., F.A.C.S.
2080 Century Park East,
Suite 710
Los Angeles, CA 90067

P. 866-370-9042
F. 310-203-9798

Visit our sister site,
Century Aesthetics® - centurycitycosmeticsurgery

Corrective (Secondary, Also Known As Re-do) Liposuction

As a highly experienced body contouring surgeon, Dr. Peter Fodor is often called upon to improve on less than satisfactory results of liposuction attained by other surgeons. Nearly half of the liposuction consultations at Century Aesthetics® involve patients who are seeking corrective or secondary liposuction.

As with any surgical procedure, liposuction poses certain risks to the patient. Inferior liposuction procedures can yield an asymmetrical, unnatural, or otherwise disappointing result. While this page details the ways in which Dr. Fodor can give you a body you can be proud of following a poor liposuction result, patients are urged to maintain realistic expectations when considering corrective liposuction. Re-do surgery is far more complicated than performing the procedure the first time, even in the hands of an expert such as Dr. Fodor. Though Dr. Fodor can obtain a major improvement in most secondary liposuction patients, a good result would have been easier to obtain if Dr. Fodor had been the primary surgeon.

" Many board-certified plastic surgeons routinely see patients in need of secondary or re-do operations. In my own practice, at least 50 percent of the patients consulting with me about lipoplasty are seeking corrective surgery. Many, but unfortunately not all, such patients can be helped and their results can be improved. However, it is important for these patients to have realistic expectations; an outstanding outcome from a re-do is less likely, even in experienced hands, than if the procedure were being performed for the first time."

— Dr. Peter Fodor
Medical Editor, Be Your Best: A Comprehensive Guide to Aesthetic Plastic Surgery (Insight International Press)

Corrective (Secondary) Liposuction – Repairing Poor Results

When liposuction is performed without discretion, artistic sense, or technical skill, the results can be unattractive and very discouraging to patients. Most commonly, secondary liposuction is performed to treat asymmetry, surface irregularities, and/or contour problems caused by excessive fat removal. Treatment of poor liposuction results often includes strategic suctioning to correct asymmetries and areas that were insufficiently reduced by the primary procedure. In other instances, areas over-reduced by the primary procedure are treated by autologous fat transfer. Very commonly, a combination of these two techniques is used to improve on less-than-satisfactory results obtained by another surgeon.

The Importance of Patient Selection

Just as careful patient selection is a necessary component of successful primary liposuction, patient selection is doubly important for secondary liposuction procedures. Unfortunately some of the re-do patients cannot be significantly enough improved to justify undergoing another procedure, which can be quite complicated and costly. Others may present with less than realistic expectations for what can be accomplished. These types of patients are not considered good candidates for corrective liposuction. “In my experience,” Dr. Fodor writes in Be Your Best: A Comprehensive Guide to Aesthetic Plastic Surgery, “only 1 in 4 patients who seek secondary lipoplasty eventually undergo the procedure. Careful patient selection differentiates those who would benefit from additional treatment from those with unrealistic expectations.”

In any event, when you consult with Dr. Fodor, you can depend on receiving a candid opinion about your chances of improvement from a secondary or re-do surgery. He routinely expresses in percentages the degree of improvement that you can expect from the secondary procedure. While no honest surgeon can give you a guarantee for results of any aesthetic surgery, Dr. Fodor evaluates your condition very thoroughly in order to assist you in determining to what degree is justifiable for you to undergo a secondary procedure.

back to top

What causes disappointing liposuction results?

A myriad of factors can cause a disappointing aesthetic result, as well as major mishaps like surface irregularities, pigmentary and sensory changes, and skin sloughing. Improper patient selection, inferior surgical technique, and insufficient surgical training are common causes of unsatisfactory liposuction results.

In addition, disappointing liposuction results are often attained by surgeons who lack the aesthetic sense to sculpt a beautiful result. Dr. Fodor elaborates:

"Aesthetic sense is hard to define and is more innate than learned … Overresections performed in an attempt to comply with a patient’s preoperative wishes for a ‘flat stomach’ or ‘skinny straight thighs’ may not be in proportion to the aesthetically natural curves of the body, which should be known and respected … Judging when to stop if one of the most difficult aspects of the [liposuction] procedure. What remains, not what is extracted, determines the ultimate aesthetic quality of the result.”

"Insufficient training, a casual or cavalier attitude toward this seemingly simple procedure, and limitations in technical ability or aesthetic judgment can all contribute to suboptimal [liposuction] results."

— Dr. Peter Fodor
Medical Editor, Be Your Best: A Comprehensive Guide to Aesthetic Plastic Surgery (Insight International Press)

back to top

Contraindications for Secondary Liposuction

While Dr. Fodor’s liposuction expertise, and particular experience in corrective liposuction procedures, allows him to successfully treat a wide variety of patients, there are certain cases where the deformities created by the initial operation are so extensive that nothing can be offered to improve the condition significantly enough to justify additional surgery. Such contraindications include:

Unfortunately, these contraindications are often present in combination

back to top

How is corrective liposuction performed?

Corrective liposuction most often involves additional, judicious liposuction; autologous fat transfer; skin excision techniques such as abdominoplasty; and implants to correct areas where overresection took place. The technique, or combination of techniques, employed varies widely, depending on each patient’s particular condition. However, most patients, in general terms, can be classified into four groups, each with their own type of treatment.

back to top

Classifying Secondary Liposuction Patients

Over his years of performing secondary liposuction procedures, Dr. Fodor has developed a classification system for secondary lipoplasty patients consisting of four groups. “From group I to group IV,” Dr. Fodor writes, “the complexity of their care, from the first consultation through the surgery itself, progresses exponentially.” However, he stresses that “in properly selected patients with realistic expectations, the satisfaction rate is high.” Excerpted from Secondary Lipoplasty by Dr. Peter Fodor. Originally published in Aesthetic Surgery Journal, July/August 2002.

Group I

Fortunately, most patients fall into this group. “Group 1 comprises patients with residual lipodystrophy and asymmetries who do not need autologous fat transfer,” Dr. Fodor writes. “They are treated with additional lipoplasty, and it is relatively easy to obtain a satisfactory result.”

Group II

Group II includes patients who had too much fat removed from some areas — areas that can be treated with fat transfer — and not enough fat removed from others. Dr. Fodor writes, “Group II includes patients who require additional lipoplasty combined with Autologous Fat Transfer (AFT) for areas of excessive resection. Treatment is more demanding but equally gratifying in properly selected patients … The unpredictable prognosis of transferred fat cannot be overemphasized during consultations with this group of patients.”

Group III

Group III is a group of patients who suffered from poor patient selection. In other words, they underwent liposuction when another procedure, such as abdominoplasty, would have been more appropriate. Dr. Fodor writes, “Group III patients are treated with skin resection procedures such as brachioplasty [arm lift], abdominoplasty, medial thighplasty, and circumferential body lift in addition to the treatment modalities described previously … In these patients, superficial lipoplasty was often performed as the initial procedure when a skin resection might have been more appropriate. Some of these patients did well initially with lipoplasty alone but noticed unaesthetic skin redundancy later as postoperative edema dissipated or aging progressed. Patients must first understand the difference in magnitude between skin resection operations and lipoplasty with regard to the surgical intervention, recovery, and scarring.”

Group IV

Few patients fall into group IV, and this group requires the most complicated care. “The patients in group IV,” Dr, Fodor writes, “are overresected to a point where residual donor sites for the purpose of autologous fat transfer are insufficient and skin resection procedures are inappropriate or unacceptable. Some of these patients may benefit from implants.”

Patient groups and approaches for secondary (corrective) liposuction

Patient Group

Approach

Group I. Residual lipodystrophy with or without asymmetry

Additional lipoplasty (appropriate for many patients)

Group II. Residual lipodystrophy and surface irregularities with or without asymmetry

Additional lipoplasty plus autologous fat transfer

Group III. Residual lipodystrophy, surface irregularities, and skin redundancy with or without asymmetry

Additional lipoplasty plus autologous fat transfer and skin resection (arm lift, abdominoplasty, etc.)

Group IV. Overresected patients without donor sites for autologous fat transfer

Skin resection and implants

Table excerpted from Secondary Lipoplasty by Dr. Peter Fodor. Originally published in Aesthetic Surgery Journal, July/August 2002. Reproduced with permission.

back to top

How to Minimize Liposuction Risks

As a patient, the best way you can minimize liposuction risks is to ensure that you have chosen a surgeon with appropriate surgical training, sufficient aesthetic sense, and technical knowledge specific to liposuction. In addition, the patient should learn as much as possible about all the details of the procedure. Here are some guidelines that will help patients select the best surgeon to perform their procedure and minimize liposuction risks:

Following these guidelines will help patients avoid liposuction complications and the need for a corrective, secondary liposuction procedure. Though it is impossible to completely eliminate the element of risk from any surgical procedure, knowing as much as possible about your surgeon and the procedure is one of the keys to a safe and effective liposuction experience.

back to top

Contact Century Aesthetics®

If you are living with the results of poorly executed body contouring surgery, contact Dr. Fodor to schedule an in person consultation for corrective (secondary) liposuction or body sculpting surgery. A significant portion of Dr. Fodor’s practice is dedicated to performing such procedures. Patients outside of the Los Angeles area, if they elect to do so, can begin with an online consultation.

back to top