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Q: Excessive Fibrosis scarring after liposuction surgery ( Answered 5 out of 5 stars,   0 Comments )
Subject: Excessive Fibrosis scarring after liposuction surgery
Category: Health > Beauty
Asked by: marianella-ga
List Price: $45.00
Posted: 19 Aug 2004 08:33 PDT
Expires: 18 Sep 2004 08:33 PDT
Question ID: 389934
How can i get rid of excessive fibrosis scar tissue in my abdomen and
waist after liposuction surgery?
Subject: Re: Excessive Fibrosis scarring after liposuction surgery
Answered By: crabcakes-ga on 19 Aug 2004 11:34 PDT
Rated:5 out of 5 stars
Hi marianella,

  You didn?t mention how recently you had liposuction, but it appears
that some scar tissue problems may resolve on their own, after some
months. Adhesions, which most internal scar tissue is called, are
fibrous in nature, composed of fibrin, cells, fat and bits of left
over devascularized tissue, and are a result of an injury and/or
surgery. These are not common after liposuction, and indeed, the FDA
site below does not even mention scars/adhesions as a liposuction
complication (Although presence of a seroma could precipitate adhesion
formation). The majority of adhesions are harmless, though they can
cause pain and discomfort, but on occasion, can cause bowel and/or
Fallopian tube obstruction. Patients who have had multiple surgeries
can develop a web of scar tissue known as arachnoiditis.

   While not common, scar tissue/adhesions do occur, and according to
some of the sites I came across, can be, in part, due to the skill of
the surgeon, the elasticity of an individuals skin, age of the
patient, and the amount of liposuction performed at one time.

Scar tissue *can* be surgically removed, in a laparoscopic procedure.
However, often the doctor will advise against it, barring serious
medical complications, as the surgery to remove adhesions, can produce
yet more adhesions.

?Adhesions- scar tissue which forms as a result of injury or surgery 
(unlike adhesions which follow many other types of surgery, adhesions
following liposuction are beneficial, in that they tend to tighten the

?In fact, the definite etiology of pelvic adhesion formation is not
clearly well known, but the following risk factors have been
incriminated in this process:
·Intrabdominal infection. 
·Tissue hypoxia or ischemia. 
·Tissue drying. 
·Rough manipulations of tissues during surgery. 
·Presence of reactive foreign body. 
·Presence of intraperitoneal blood. 
·Dissection of prior adhesions. 
Ischemia of the tissues may result from excessive or rough tissue
handling, ligating, suturing, crushing, cauterizing or stripping of
the peritoneum. These may cause adhesion formation via inhibition of
the fibrinolytic activity (which resides in peritoneal tissue) and
stimulation of angiogenesis from a non-ischemic area to that devoid of
its adequate blood supply. In addition, desiccation of the peritoneal
tissue during prolonged surgical procedures may result in mesothelial
cell desquamation with a resultant raw basement membrane and fibrin

   A somewhat graphic picture of internal abdominal scar formation
?Adhesions occur in the majority of women who have pelvic surgery.
Even after adhesions have been removed, they form again about 80
percent of the time.?


   Neither I nor Google Answers  endorses any of the following scar
tissue therapies. The following information is presented as
educational material only, and is not to be considered of a diagnostic
nor therapeutic nature.

    ?Adhesiolysis is the removal or surgical separation of adhesions.
Ironically, the removal of adhesions can aggravate the healing
process, thereby leading to the formation of new adhesions.?
?Treatment may involve cutting and releasing the adhesions
(adhesiolysis) during a laparoscopy procedure or treating the
adhesions during a laparotomy.?

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the upper right hand corner of the site. (Most pop-up blockers do not
block this kind of ad)
?Adhesions in the abdomen are basically bands of scar tissue that form
after a surgical procedure is performed in the abdomen or pelvis. Most
commonly they form after gynecologic surgery or a procedure involving
the colon (such as colectomy or appendectomy). Factors that increase
the likelihood that adhesions will form include abdominal infection,
poor blood flow in the abdominal vessels and use of certain suture

 See what two doctors say on the Locate-a-doc website:

I have had two liposuctions of the abdomen areas, the first on Jan.31,
and most recent on Oct. 24. I have some scar tissue buildup from the
first surgery, and am battling it now from the second. Although I am
going for twice-weekly half-hour massages of the area and trying to
pinch it and break it up myself, is there anything else I can do? If
there is a "pad" of scar tissue left in the lower abdomen area, can it
be removed in any way? Are there any tools or massagers I could use to

Answer 1:
Oct. 24 is still quite recent, and the "pad" may still go away. If not
it can certainly be removed surgically. David M. Metzner, MD

Answer 2:
Dear Keli, The scarring from liposuction is usually very minimal.
Pressure and massage help but will not break it down completely. Are
you and your physician certain that there was no hematoma or blood
build-up at the time of the procedure? This should be handled in a
different way.

?Liposuction does not tighten skin although sometimes the underlying
tissue seems pulled tighter by a thin layer of scar tissue

?The most common problem after liposuction is surface irregularity or
waviness. This is less common as the surgeon becomes more experienced
but may occur even with an experienced surgeon.

It is less common when multiple small incisions are used along with
small cannulae. Cross suctioning also reduces the risk as do
feathering the edges of the area and suctioning both superficially and

If contour irregularities develop no attempt is usually made to
correct them for at least six to twelve months. Massage alone helps
many patients.

If surgical correction is needed the surgeon can suction raised areas
around the depression and fill in the depression with fat grafts. If
the skin is loose then it can be surgically removed by excision.
Cellulite is not usually improved by traditional liposuction and the
appearance may even be made worse. Ultrasonic liposuction may be a
useful treatment for cellulite and may cause less irregularity.?

?Risks common to all surgical procedures such as bleeding, infection
and scar tissue formation occur in a very, very small percentage of

?Some fat, crossing blood vessels and nerves, and other soft tissue
elements remain, but what also remains within the surgery site is a
large amount of empty space within the tissue. The natural healing
processes would tend to fill this "empty space" first with body
fluids, and then as the natural healing process progressed, with scar

?Following surgery, patients are traditionally placed into a custom
fitted elastic garment which squeezes together those empty spaces
within the tissues. This mechanical compression of the operated
tissues tends to eliminate most of the body fluid from the area and
reduces the eventual amount of scar tissue beneath the skin, allowing
the skin to contour to its new, desired shape. The compression garment
is worn for several weeks following the surgical procedure.?

?Disfiguring skin irregularities and depressions are frequently the
result of the surgeon's inattention to detail. For example, if a
liposuction surgeon attempts to do too much on a single day, and
becomes fatigued, the result may be an inattention to detail, and
undesirable cosmetic results. A liposuction cannula is a stainless
steel tube inserted through an incision in the skin that is employed
to suction the fat. The size of the liposuction cannula can influence
the smoothness of the skin after liposuction. The use of large
cannulas tend to create irregularities more commonly than
microcannulas (outside diameter less than 3 millimeters). Surgeons who
do total-body liposuction tend to use larger cannulas.?

?This is not a scar-free surgery; in fact the scars may be quite
severe depending upon the amount of skin needed to be removed, your
body's ability to heal, if you scar well, the skill of the surgeon and
the technique utilized. ?

Other treatments include:


    ?Endermologie is thought to help release these constrictive bands
and prevent fibrous scar tissue formation post-operatively.?

Endermologie utilizes rollers and  controlled suction to massage and
break down scar fibers and remove excess fluids following liposuction.

You can see a photo of the machine here:

    The effectiveness of lypossage  can be debated. Some claim it can
help break down scar tissue (adhesions) following liposuction.

?The goal of this type of deep tissue massage is to remove stagnant,
stalled lymphatic fluid from the tissues that can create the lumps and
bulges referred to as cellulite. The deeper Lypossage strokes break up
adhesions under the skin that cause the dimpled, uneven skin surface.
Lypossage can also help tone the muscles, lifting and firming sagging
tissue. It is performed by hand and the technique can safely be
applied to the hips, thighs, and lower abdomen, as well as the upper
body, including the arms, the face, and neck in almost anybody. There
are few contraindications, such as fresh scar tissue, infected tissue
and certain skin and blood disorders.?

    Hyaluronidase, a mucolytic enzyme is being investigated, as a scar
tissue ?dissolver?. ?Even if scar tissue is not removed, if it can be
softened (made more elastic), there may be relief from its physical
manifestations such as bowel blockage, pain, and some cases of

?Lysis of epidural adhesions with epidural injections of hypertonic
saline, in conjunction with steroids, and analgesics or hyaluronidase
has been investigated as a treatment option. Theoretically, the use of
hypertonic saline results in a mechanical disruption of the adhesions.
Adhesions may also be disrupted by the manipulation of the catheter at
the time of the injection. The hypertonic saline may also function to
reduce edema within previously scarred and/or inflamed nerves.
Hyaluronidase may be added to the injectate to further the penetration
of the drugs into the scar tissue. The injections may be performed
with or without endoscopic guidance.?

Additional Information:

About skin elasticity and liposuction

While not pertinent to your type of scarring, this site can give you
some excellent information about types of scars and their treatment.

I hope this is the information you seek regarding your scar tissue. If
any part of my answer is unclear, or if I have duplicated information
you already had, please request an Answer Clarification, before
rating. This will enable me to assist you further, if possible.


Search Terms
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fibrous scar tissue post liposuction
liposuction risks abdominal
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