The Question
It’s an unfortunate reality that sometimes, cosmetic surgery doesn’t deliver the results patients want or expect. There are a number of reasons for this, such as unrealistic patient expectations, problems which aren’t readily apparent during consultation, erroneous or inaccurate medical history reporting and surgeons attempting procedures they may not be as familiar with as they need to be to achieve the optimal results. It is sometimes difficult to pinpoint one thing as the cause of the patient’s dissatisfaction, but regardless of the reason, it does need to be addressed. The subject of this week’s Ask Dr. Pane segment is a good example of this. The viewer, from Palm Beach Gardens, asks, “I just got liposuction fat transfer of the buttocks and I am not happy with the results. What are my options? Can I do liposuction of the buttocks without compromising their appearance?”
The Case
In this case, the patient did not provide photographs or any other background. Therefore, Dr. Pane’s answer is limited to a general consideration of the possibilities. An in-person clinical consultation would be far more illuminating and provide a lot more actionable information which applies directly to the patient’s case.
The Answer
Many cosmetic surgeons would say liposuction of the buttocks cannot generally be done. It is a very tricky area to do properly, and many surgeons lack the experience to sculpt the area to the patient’s base specifications. This does not mean they are bad, wrong or incompetent by any means! It simply means they might be more reluctant to attempt lipo in the buttock region because of the relative difficulty associated with that area.
However, Dr. Pane says while this is a common response, it is by no means universal. He has done many of these procedures in the past, and is familiar with the difficulty and the potential complicating factors which may cause other surgeons to decline to attempt such procedures. Other high-volume practices, by which he means number of cases, not volume of the buttock region, would also be able to do this in certain cases, although it is not a common procedure in the parlance of cosmetic surgery by any means.
The biggest question Dr. Pane has is what the actual issue is. If the patient absorbed transferred fat in one area but not another, leading to an asymmetrical appearance of the butt, this is a different problem than if the appearance is too large or there is a skin problem. Based on the patient’s description, it is difficult to ascertain whether one, none or all these issues are in play. Therefore, the first step would be a clinical evaluation to examine the area up close and check the skin and underlying tissue.
RealSelf Patient Reviews of Thomas A. Pane, MD
Another factor is the base skin quality. If the patient has problematic skin, this could amplify problems with the initial procedure or even make problems appear to be present when they are actually not. However, if the skin looks good and there is no indication of issues in that realm, there is no reason why careful, judiciously executed liposuction of the buttock area should not correct any issues the patient may currently be experiencing. This procedure would require special handling, largely due to the difficulty of operating on an area which has already been operated on once, but assuming sufficient time has passed since the initial fat transfer, the patient should expect a good outcome with a minimal risk of complications.
Secondary and revision procedures always carry a higher risk of postoperative complications than the original. Any scar tissue in the area must be worked around, and some areas do not recover as readily from revision procedures. This is especially true of patients with slow healing or medical issues which may make them more prone to infection. Following surgical and support staff instructions before, during and after surgery to the letter can help moderate, if not wholly eliminate, any risks arising from revision procedures.
If you have a question concerning any facet of cosmetic surgery, the staff of Atlantic Coast Aesthetics are always happy to discuss your interests and needs. Simply follow us on Facebook, Twitter, LinkedIn and Instagram; call us at (561) 422-4116; or email us through the Contact page on our website. Your question may even become the focus of an upcoming Ask Dr. Pane segment, helping us educate and inform others who have the same interests you do while giving you the honest information you need to make a good decision about your cosmetic surgery. Remember, at ACA we believe the only bad question is the one you don’t ask!