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 – re 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.

The information provided will give you a basic understanding of this challenging procedure but it can't answer all of your questions, since a lot depends on your individual circumstances. For more information, view the "Frequently Asked Questions".

* American Board of Plastic Surgery

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.

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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.

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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.

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What happens the day of surgery?

Your secondary liposuction will be performed at either one of our specialty hospitals or an accredited outpatient surgery facility.

Prior to the procedure, medications are administered for your comfort and to lessen the anxiety if needed. General anesthesia is typically used for patients undergoing liposuction. The surgery usually takes 2 to 3 hours depending on the technique used and if you have any other procedures such as a tummy tuck. After surgery, you will awake in a recovery area where you will be closely monitored. Dr. Rohrich recommends his patients spend the night at the hospital after surgery in order in ensure your comfort and safety.

Be sure to arrange for someone to drive you home and stay with you to assist you the first couple of days while at home. The "Patient Care" section on this website provides instructions to prepare for surgery, including guidelines on eating, medications to avoid, drinking and smoking. If you are a smoker, you will be asked to stop smoking 4 to 6 weeks in advance of surgery. Smoking significantly increases the risk of postoperative complications. Read Dr. Rohrich's article "Why I Do Not Perform Cosmetic Surgery On Patients Who Smoke" to get more information about smoking and surgery.

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What is the recovery like?

You will have some discomfort and/or pain following surgery. While you are in the hospital your pain control is done intravenous for the extent of your stay. You will most likely feel tired and sore for 7 to 10 days following surgery. You will be able to return to work in approximately 7 to 10 days depending on your occupation and the extent of your liposulpting. The bruising usually resolves in 2 to 3 weeks as will most of the swelling but some swelling can remain for 3 to 6 months. You will wear a compression garment or binder for two weeks day and night following surgery and then during the night for the next two weeks. Your exercise regimen must not include any workouts or activities that increase your heart rate above 100 beats per minute for at least 3 weeks. You are encouraged to begin walking the day after surgery. This will help to speed up recovery. Dr. Rohrich will contact you the first 1 to 2 days after surgery to see how you are doing and ask if you have any questions.

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What should I know about my results?

You will see a noticeable difference in the shape of your body soon after surgery. However improvement will become even more apparent after 3-4 months when much of the swelling has resolved. Whenever surgery is performed on your body a scar will result. The scars for this procedure are small and inconspicuous. It is usually not visible in your swimsuit or underwear. Dr.Rohrich will discuss the placement of the small incision on your first visit.

Although liposuction does remove fat cells, this doesn't mean that you will not gain weight in these same areas, especially if you gain more than 15 to 20 pounds. Patients who have had liposuction and have gained weight have noted that is more evenly distributed and not as localized as before. Liposuction should not be used as a means for weight control. It is only used to reduce localized fat deposits. Dr. Rohrich can give you information about nutrition and exercise but ultimately it is up to you to retain your results.

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What does the surgery cost?

At the time of your initial consultation, you will be quoted a price that will include Dr.Rohrich's fee as well as hospital and anesthesia fees. Fees are due in full at least two weeks prior to your surgery. Checks, money orders, cash and credit cards may be used for payment. A $500.00 deposit will reserve a specific time and date for our surgery.

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