The Question
Sometimes, cosmetic surgery procedures do not turn out quite as expected, or yield disappointing results. While there is no rubric which can predict the outcome of any given procedure with perfect accuracy, there are some indicators which a patient may want to look for and some possible ways to correct deficiencies or problems caused by issues with an initial procedure. This was the situation with the subject of Atlantic Coast Aesthetics’ Ask Dr. Pane segment this week. A viewer from Miami asks, “Will an outer thigh implant correct damage caused by a liposuction procedure?”
The Case
Dr. Pane evaluated the history and photographs of the area under consideration, as reported by the patient. His response to this question is based upon the information provided and should not be taken as a substitute for in-person clinical evaluation of the case.
The Answer
Dr. Pane notes he is not a fan of outer thigh liposuction unless the thighs display significant outward bulging. With that said, there are ways to perform this procedure safely and effectively. Typically, a small-bore cannula, which has a thin profile, would be employed to remove excess subcutaneous fat from the area. However, if the skin is damaged by using a cannula which is too large, if the cannula is applied incorrectly or if excessive fat is removed, it could leave the area with a depressed, concave appearance, unnecessary scarring or other issues.
In this patient’s situation, Dr. Pane says there are three ways to correct the issue. The first is to release the scar and graft it. In this procedure, the scar is physically excised from the area and the remaining skin is sutured together to deemphasize the damaged area, in a similar manner to the way a face or body lift is performed. While this is perhaps the most direct method to address the problem, it may not be wholly desirable depending upon the patient’s skin type and elasticity, physical condition, healing capabilities and other practical factors.
The second option would be a prosthetic, or implant. The benefit to this procedure is that it may offer more predictable symmetry with the offset side. However, this option’s major drawbacks are that an outer thigh prosthetic may have to be custom manufactured, and will require a larger incision and thus a larger scar. In addition, implants always carry some risk of rejection by the body. For some patients, these downsides may be countered by the assurance of symmetry, especially in the absence of other limiting factors such as a compromised or hyperactive immune system. For others, these considerations may knock the idea right off the table.
The third option is dermal fat grafting. While in this patient’s case, this is perhaps the least desirable option due to personal preference, it is the way which in Dr. Pane’s opinion will offer the greatest range of benefits with the least drawbacks. This is because it is by far the least invasive option, because rejection of material harvested from the patient’s own body is very seldom rejected and because the fat harvested elsewhere can be placed in a targeted manner to achieve the optimal silhouette while minimizing scarring.
As with any other cosmetic procedure, identifying the best way forward is something best accomplished through a direct clinical evaluation of the target area and the patient’s overall medical history. In addition, the patient should be prepared to advocate for themselves by asking about the surgeon’s experience, skill set and outcomes of similar procedures the surgeon has performed in the past. Finally, it is absolutely crucial that the patient trust and feel comfortable with the surgeon and vice versa. An adversarial or uncomfortable therapeutic relationship is less likely to achieve ideal results and may lead to unnecessary complications. Regardless of the type of procedure a patient is planning, a bond of confidence, trust and open communication can empower both the patient and surgeon to select the best possible option together.
The first step to knowledge is the willingness to ask questions. Everyone at Atlantic Coast Aesthetics, from our founder and Chief Medical Officer to the clinical staff, is committed to empowering patients through education and communication. That’s why we welcome you to follow us on Facebook and Twitter, contact us through our website at https://acplasticsurg.com or call us at (561) 422-4116. Your question may even be featured as the focus of ACA’s next Ask Dr. Pane segment, where Dr. Pane answers patient questions live in a Google Hangout. Remember, at ACA we believe the only bad question is the one you don’t ask!