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When contemplating a cosmetic procedure, we spend so much time researching everything we can about the surgery – its benefits, [downtime](https://aedit.com/aedition/best-plastic-surgery-recovery-nurses-centers-products), side effects and [complications](https://aedit.com/aedition/guide-to-cosmetic-surgery-complications), and what we can realistically expect to achieve from it. In the case of surgical procedures, a piece of the puzzle that you may overlook is what kind of incision (or incisions) are involved. Any time there is an incision, there will be a scar. Other than genetics, one of the most important factors – especially in the first few days and weeks post-op – in determining what that scar will look like? Tension. 

While the skill of your board certified plastic surgeon will go a long way toward reducing tension and ensuring as inconspicuous a [scar](https://aedit.com/concern/scars) as possible, what you do in the aftermath of your surgery plays a large role in how incisions ultimately heal. If you’re considering a body cosmetic procedure or already have one scheduled, you’ve come to the right place. Read on to learn expert tips on what you can do post-op to ensure your incisions heal optimally and your scars are as minimal as possible. 

## **The Role of Tension in Scarring**
Late last year, we ran an article on the [kind of scarring you can expect from popular body procedures](https://aedit.com/aedition/scarring-after-body-plastic-surgery) (if you haven’t checked it out, you might want to read it first). One of the things that came up time and time again in our discussion with plastic surgeons was the idea of tension and how it impacts scarring. That gave us the idea to explore the topic further because, as it turns out, both the surgeon and the patient have control over how much ‘tension’ an incision site experiences.

In the healing sense, tension refers to any force that pulls the wound apart, says [Umbareen Mahmood, MD](https://aedit.com/provider/umbareen-mahmood-md-23), a board certified plastic and reconstructive surgeon in New York City. When there’s too much tension on an incision, “it is at risk of widening or completely separating,” warns [Lauren Chmielewski, MD](https://aedit.com/provider/lauren-chmielewski-md-143), a NYC-based board certified plastic and reconstructive surgeon. The former increases the likelihood of a wider scar, while the latter results in an open wound.

There are many ways to limit tension on post-surgical incision sites, and they start in the operating room. “As plastic surgeons, we do a thorough multi-layer closure, which means closing each layer of tissue to reduce stress on the top layer of skin (the final scar),” Dr. Mahmood explains. “We also work to leave a meticulous fine line final skin closure.”

And then there is what the patient can do at home. “The best way to care for a healing scar is to follow your surgeon’s after-care instructions and keep your post-operative visits,” Dr. Chmielewski shares. While the directions vary a bit by provider, they generally include:

- Keeping dressings in place
- Wearing protective or [compression garments](https://aedit.com/aedition/benefits-of-compression-garments-after-cosmetic-surgery)
- [Activity restrictions](https://aedit.com/aedition/when-to-start-exercising-again-after-cosmetic-surgery-procedures)
- Abstaining from [smoking](https://aedit.com/aedition/impact-of-cigarette-smoking-vaping-on-skin-hair-teeth-health)
- Limiting movement of the treatment area

“These are all directions that should be followed closely, as they can affect the ultimate outcome of the scar,” Dr. Chmielewski notes. It goes without saying, but don’t skip out on follow up appointments with your surgeon. They are a time for you to ask any questions and for your provider to monitor your recovery process. “Ultimately, having an experienced pair of eyes monitoring the healing is important, too,” she adds.

## **How to Reduce Tension & Minimize Scarring**
Now that you have a better sense of the role of tension in the scarring process, it’s time to talk about what it means for specific cosmetic surgeries. Below is a break down of expert tips for [minimizing tension and scarring](https://aedit.com/aedition/minimizing-scars-after-surgery) after some of the most popular body procedures:

### **Abdominoplasty (a.k.a Tummy Tuck)**
An [abdominoplasty](https://aedit.com/procedure/abdominoplasty), or tummy tuck, removes unwanted skin and fat and tightens the muscles of the abdomen. The scar, which is usually concealed below the bikini line, typically extends from hip to hip. “A tummy tuck, by definition, is going to be a somewhat tight closure,” Dr. Chmielewski says. To limit abdominal movement, any activities that use your core – including lifting, pushing, and pulling – should be avoided for at least two weeks. During that time period, you’ll also want to be mindful of your posture. She recommends maintaining a “beach chair” position, “as not to fully extend and stretch out the torso.”

Need a visual? When laying down, use [pillows](https://aedit.com/aedition/best-pillows-for-plastic-sugery-recovery-healing) to prop up the upper body and lower legs (similar to sitting in a beach chair), so that there is a gentle bend of 20 to 30 degrees at the hips. Sitting in a recliner has a similar effect. The goal is to take pressure off the abdomen and avoid laying flat. When standing, now is not the time to channel your inner ballerina. Hinge at your hips and refrain from standing up straight.

<BeforeAfterModule
  title={Before & Afters: Tummy Tuck}
  procedureId={840}
/>

### **Brachioplasty (a.k.a Arm Lift)**
A brachioplasty (a.k.a. [arm lift](https://aedit.com/procedure/arm-lift)) sculpts the upper arm by removing skin and fat. The incision generally extends from the axilla (armpit) to the elbow and, depending on the surgeon, can be placed on the back of the arm or the inner arm crease. In either case, minimizing tension is tough because of how much we use our arms. “It’s obviously impossible to tell a patient not to move their arms for one month after an arm lift,” Dr. Mahmood admits. “But there are certainly movements they can be mindful of.” 

For starters, keep hair styling (think: blow drying, ponytails, etc.) and other sweeping motions to a minimum because repetitive movements that involve extending the arms can cause the scar to widen. “Even small things – like wearing a bra that closes in the front – is helpful in the first month post-op, so that a patient doesn’t have to stretch their arms behind their back,” she explains. 

Her suggestion for optimal healing: Keep the arms at your side as much as possible and do any unavoidable tasks with your forearm and hand (instead of the whole arm). 

<BeforeAfterModule
  title={Before & Afters: Arm Lift}
  procedureId={787}
/>

### **Breast Surgery** 
There are (obviously) big differences between [breast augmentation](https://aedit.com/procedure/breast-augmentation-solutions), [breast lift](https://aedit.com/procedure/breast-lift-solutions), and [breast reduction](https://aedit.com/procedure/breast-reduction-and-revision-solutions) surgeries when it comes to the purpose of the procedure. They also all involve unique incisions. “The biggest scar burden is with a reduction,” Dr. Chmielewski says. “A lift usually has more of a ‘lollipop’ incision, and an augmentation has the smallest scar.” Breast augmentation incisions can be in the inframammary crease (i.e. under the breast), periareolar (read: around the areola), or in the armpit. 

Even so, the way in which you go about reducing tension in the area is similar for all three. “Generally, the patient is to avoid any heavy lifting, pushing, pulling or upper body workouts for two weeks,” she explains. Refrain from raising your arms above your head during this period, too. When it comes to the breasts themselves, wearing a supportive (non-underwire) bra that provides the right level of compression is key to keeping everything in place.

To minimize tension while laying down, breast surgery patients are usually encouraged to elevate the head and upper torso. A [wedge pillow](https://aedit.com/aedition/best-pillows-for-plastic-sugery-recovery-healing) can get you into this semi-fowler position (meaning your back is at a 45 degree angle), and it also helps improve drainage and swelling. Beyond that, many doctors recommend placing a pillow or bolster under the knees to take pressure off the low back.

<BeforeAfterModule
  title={Before & Afters: Breast Reduction}
  procedureId={801}
/>

### **Liposuction & Fat Transfer**
[Liposuction](https://aedit.com/procedure/liposuction) is the gold standard of fat reduction, and it tends to be minimally invasive as far as incisions are concerned. As Dr. Mahmood explains, they are usually small (approximately 3 millimeters) and well-hidden. In abdominal liposuction, for example, incisions are usually concealed low in the bikini line and in the umbilical hood. “They heal well with no issue,” she notes. It should be noted that heat-based lipo modalities (like [VASER](https://aedit.com/procedure/ultrasound-assisted-liposuction) or [SmartLipo](https://aedit.com/procedure/smartlipo)) carry a higher risk of scarring.

While tension is less of a concern after liposuction due to the size of the incisions, you may be encouraged to [sleep on your back](https://aedit.com/aedition/sleeping-better-after-cosmetic-surgery-aesthetic-procedures) to maintain an even distribution of weight. Creating bumpers around yourself with pillows can help you from turning over. If you have fat removed from your arms or legs, keep the limbs elevated to ensure proper blood flow and minimize swelling.

Depending on your aesthetic goals, the fat removed via liposuction can be purified and transferred to another part of the body via injections (à la a [Brazilian butt lift](https://aedit.com/procedure/brazilian-butt-lift)). The fine needles used to inject the fat rarely result in external scars, though there might be other aspects of recovery to keep in mind.

<BeforeAfterModule
  title={Before & Afters: Liposuction}
  procedureId={1021}
/>

### **Thigh Lift**
The purpose of a [thigh lift](https://aedit.com/procedure/thigh-lift) is to remove excess skin and fat and reposition underlying tissue to lessen the appearance of sagging. The incision usually runs along the inside of the leg and the groin crease, which can be problematic for healing for several reasons. “There is often a lot of tension after a thigh lift,” Dr. Chmielewski confirms. “Compression is absolutely critical to control [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) and prevent shear forces from pulling at the incisions.” 

Wound care is part of any recovery, but it’s especially important post-thigh lift due to the treatment region. “Good wound care is also important, as the incision can be in close proximity to the groin, a notoriously high-bacteria area,” she explains. “Infections prevent healing and can ultimately create a very bad scar.  

It can be nearly impossible to eliminate all tension after a thigh lift, but there are some steps you can take to relieve as much pressure as possible. “Everything that engages your legs, unfortunately, puts tension on a thigh lift scar,” Dr. Chmieleski shares. “While gentle activity – such as walking – is encouraged, there is no cardio heavy pushing, pulling, lifting for at least two weeks.” When standing, try to keep a slight bend at the hips for the first seven days or so.

<BeforeAfterModule
  title={Before & Afters: Thigh Lift}
  procedureId={823}
/>

## **The Takeaway**
Finding a board certified plastic and reconstructive surgeon who [specializes](https://aedit.com/aedition/finding-the-right-plastic-surgeon-dermatologist-or-cosmetic-dentist) in the body procedure you are interested in is critical to any successful cosmetic surgery outcome, but what you do (and don’t do) in the post-op period also has a lot to do with how you heal. To minimize scarring after any procedure, don’t forget to keep bandages in place and wear post-surgical garments as per your surgeon’s instructions, Dr. Chmielewski says. And, once you’re cleared to do so, invest in skincare. As she explains, “using a high-quality [scar cream or silicone tape](https://aedit.com/aedition/scar-minimizing-skincare-to-use-after-surgery) to optimize the scar is also helpful.”

Aesthetics

We’ve got expert tips on how to sit, stand, and sleep in the aftermath of cosmetic surgery to optimize results.

How To Reduce Tension After Cosmetic Surgery To Minimize Scars

How To Reduce Tension And Scarring After Body Procedures

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Thinking about a [tummy tuck](https://aedit.com/aedition/tummy-tuck-recovery-healing-process) post-pregnancy or weight loss? Or perhaps a sculpting [liposuction](https://aedit.com/aedition/high-definition-liposuction-techniques-for-body-contouring) session? In your research, you may have come across something called a seroma. If you’ve had surgery, maybe you’ve even experienced it first hand. It can be likened to having a puddle inside of you. A seroma is “a build-up of tissue or healing fluid inside the body, which can happen after surgical procedures of any type,” says [Ryan Neinstein, MD](https://neinsteinplasticsurgery.com/), a board certified plastic and reconstructive surgeon in New York City. 

One of the most common [cosmetic surgery complications](https://aedit.com/aedition/guide-to-cosmetic-surgery-complications), a seroma is most likely to occur after [body contouring surgeries](https://aedit.com/procedure/body-contouring-solutions). Here, we’ll talk more about what a seroma is, why it happens, and what you can do to avoid it. 

## **What Causes a Seroma?**
“Seroma is a collection of normal body fluid that accumulates in dead spaces,” says [Elise Min, MD](https://www.drcassileth.com/surgeons/dr-elise-min.html), board certified plastic and reconstructive surgeon at Cassileth Plastic Surgery in Beverly Hills. The clear (i.e. serous) fluid pools under the skin and is usually found near incisions. It can happen soon after surgery or, in some cases, weeks later.

While it’s natural for some amount of body fluid to accumulate at a surgical site, it becomes problematic if it does not subside. “Generally, [the fluids] get reabsorbed by the body in the postoperative period and go away on its own,” Dr. Min explains. “Sometimes, too much fluid can accumulate and form a pocket of fluid collection.” This is most common, she adds, after operations “where a surgical space is created” due to tissue removal. In cosmetic surgery, this can include:

- [Abdominoplasty](https://aedit.com/procedure/abdominoplasty) (a.k.a. tummy tuck) 
- Breast surgery 
- Lifts (such as [arm lift](https://aedit.com/procedure/arm-lift), [butt lift](https://aedit.com/procedure/butt-lift), or [thigh lift](https://aedit.com/procedure/thigh-lift))
- [Liposuction](https://aedit.com/procedure/liposuction) 

As Dr. Neinstein explains, our bodies respond to the inflammation from surgery by creating fluid and scar tissue. “When the healing capacity is overwhelmed, the fluid becomes apparent and a seroma develops,” he shares. “This can happen because surgery was aggressive, too much energy – such as a laser – was applied, no drains were used, or improper garments or aftercare were applied.” Other times, he says, seromas can happen for no reason at all.

## **Symptoms of a Seroma After Cosmetic Surgery**
While they can usually be identified via a physical exam, an ultrasound may be needed to confirm a seroma diagnosis. Most seromas don’t pose a health risk to the patient. They usually look like a swollen lump and feel like a cyst that may or may not be tender to the touch. Clear discharge is common and changes in color may be indicative of an infection that requires medical attention. If the seroma becomes infected, it may look red and feel painful and/or warm to the touch. An infected seromas can lead to the formation of an abscess.

## **How to Treat a Sermona After Cosmetic Surgery** 
How a seroma is treated depends on its size. A small seroma usually goes away on its own with compression, but larger ones may need professional intervention. “Some may require aspiration in the clinic by the physician,” Dr. Mi says. Dr. Neinstein says that seromas can be dealt with in a minor office procedure where the fluid is drained and pressure is applied through dressings and garments to prevent re-accumulation.

If a large or infected seroma is left untreated, it may eventually require a full removal of the seroma and the fibrous [capsule](https://aedit.com/aedition/capsular-contracture-breast-implants) that comes to surround it, Dr. Min cautions. In very rare cases, calcification (read: hardening) of the fluid may occur. “Once in a while, the seroma can harden and form a scar ball inside that may need to be removed surgically,” Dr. Neinstein notes. “Luckily, these are rare.”

## **How to Prevent a Seroma After Cosmetic Surgery**
In the case of seroma, like so many things, the best treatment is prevention. That prevention begins in the operating room. In his textbook chapters and masterclasses on liposuction, Dr. Neinstein shares many strategies to reduce the occurrence of seroma. “It all starts with finesse surgical technique and gentle handling of tissues,” he says. “After this, I discuss an outlet for surgical fluid to get out.” Those outlets can include various forms of drains or leaving small liposuction sites open so that excess fluid can drain. 

Dr. Min adds that surgeons try to prevent seromas by either placing drains in the surgical space or by placing progressive tension sutures in the surgical site internally. “All of the techniques strive to minimize the dead space created during the surgery,” she says. 

After surgery, [lymphatic drainage massages](https://aedit.com/aedition/benefits-of-lymphatic-drainage-massages-after-cosmetic-surgery) can help reduce the risk of seroma by promoting healing, Dr. Neinstein says. Additionally, it’s important to follow your post-op instructions to a T. Beyond healthy eating and [proper rest](https://aedit.com/aedition/sleeping-better-after-cosmetic-surgery-aesthetic-procedures), they will likely include recommendations for elevating the treatment area and wearing compression garments and tell you when to return to your surgeon to have drains removed. If you need help assembling your post-op recovery kit, we’ve got guides to the best [meal plans](https://aedit.com/aedition/meal-plans-diet-before-after-cosmetic-surgery), [pillows](https://aedit.com/aedition/best-pillows-for-plastic-sugery-recovery-healing), and [compression garments](https://aedit.com/aedition/benefits-of-compression-garments-after-cosmetic-surgery) to consider after cosmetic surgery.

It should be noted that, in some cases, seroma is unavoidable – no matter your surgeon's or your own best efforts. If you think you might have a seroma, contact your provider. Early diagnosis and treatment can be key to preventing infection. 

There is much that can be done to prevent the common complication.

The Risk Of Seroma After Cosmetic Surgery

What To Know About The Risk Of Seroma After Cosmetic Surgery

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We often fall into the trap of forgetting that the face isn’t the only part of the body that has skin that needs care. As such, the face is not the only area that experiences [unwanted pigmentation](https://aedit.com/aedition/guide-to-hyperpigmentation-dark-spots-melasma). Truth be told, this unwanted side effect of excess melanin production can happen anywhere from head to toe. From the armpits to the inner thighs and even the stomach, discoloration likes to call these areas home, but the reason for its existence isn’t quite as simple as one may think. Struggling with hard-to-erase patches of pigmentation on the body that seem to appear out of nowhere? You’re not alone. Here’s what you need to know about treating discoloration on the skin below the neck.

## **Color Theory**
Every [skin tone](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types) contains melanin — it’s what gives pigment to the skin. Some of us naturally have more or less melanin than others, which is where darker and lighter skin tones come into play. An overproduction of melanin leads to hyperpigmentation anywhere on the face and body. Most of us are familiar with how [hyperpigmentation](https://aedit.com/concern/uneven-skin-tone) affects the face, but discoloration can occur from the neck down, too.

Simply put, hyperpigmentation is nothing more than an increase of melanin, the natural pigment in the skin, eyes, and hair. The overproduction produces patches and spots on the skin that are darker than the skin’s natural complexion. Hyperpigmentation on the face and body are similar in that they manifest as areas of discoloration on the skin. However, certain types of pigmentation are more likely to occur in certain areas, says [Dendy Engelman, MD](https://aedit.com/provider/dendy-engelman-md-312), a board certified dermatologist and Mohs surgeon in New York City. 

Generally speaking, there are three main types of hyperpigmentation on the skin: 

1. **Sun Spots**: Also known as ‘liver spots,’ or ‘lentigines,’ they arise due to [excessive sun exposure](https://aedit.com/aedition/cosmetic-procedures-treatments-to-correct-sun-damage). The face, hands, chest, and arms are commonly affected, and they are more likely to occur in lighter skin tones.
2. **Post-Inflammatory Hyperpigmentation (PIH)**: PIH can form as a result of any inflammation or irritation to the skin. It is most common in the areas where acne forms, like the face, back, and shoulders. “If you notice a new dark spot where you recently had a pimple, it is likely due to [post-inflammatory hyperpigmentation](https://aedit.com/aedition/how-to-treat-acne-induced-post-inflammatory-hyperpigmentation),” Dr. Engelman shares.
3. **Melasma**: The most ambiguous of the bunch, [melasma](https://aedit.com/concern/melasma) is believed to stem from genetics and hormonal changes (think: pregnancy, medication). It can occur anywhere on the body, though the face and stomach are typical locales for the brown blotches.

Especially as it relates to dark spots on the body, it’s important to talk about the difference between hyperpigmentation and [birthmarks or moles](https://aedit.com/concern/birthmarks-and-moles). “Birthmarks and moles may be raised, which can indicate that they are not another form of hyperpigmentation, although often they look identical,” Dr. Engelman admits. “If you notice a new dark spot that seems abnormal, visit your dermatologist to get it checked out since [skin cancer](https://aedit.com/aedition/bipoc-skin-cancer-awareness) can also look like a birthmark, mole, or hyperpigmentation but is extremely dangerous and can be fatal.”

The factors that cause discoloration on the face are the same as those that produce it on the body. With that said, facial skin generally produces more melanin than body skin does. But that's not all. Certain body parts have different melanin levels than others, says celebrity aesthetician [Natalie Aguilar](https://www.instagram.com/n4skincare/). Discoloration from one body part to the next can vary in color, even when exposing the body to the same trigger equally.

Furthermore, the face is also one of the areas most likely to be exposed to the sun. As a result, it can have more potential for damage and, in turn, hyperpigmentation. But, of course, that doesn't mean that the neck down is immune to unwanted discoloration — it's not. [Marisa Garshick, MD](https://aedit.com/provider/marisa-garshick-md-313), a board certified dermatologist in New York City, says that, because the skin on the body tends to be thicker, any of the hyperpigmentation involves the deeper layers of the skin. That means it can take longer to fade. 

Since no two bodies are the same, no two cases of body hyperpigmentation are either. Hyperpigmentation can occur in all skin tones but is more common in darker skin due to increased melanin. “When an injury occurs to the skin, it can stimulate melanin production, which leads to hyperpigmentation,” Dr. Garshick shares. “Additionally, some hormonal triggers can worsen or trigger hyperpigmentation, as seen in the setting of pregnancy and with some oral contraceptives.”  

## **How Well Do You Know Your Skin?**
There's no denying the importance of regular (read: at least annual) [in-office skin checks](https://aedit.com/aedition/dermatologist-skin-cancer-screenings-mole-checks) with a board certified dermatologist to identify and keep tabs on any skin changes. That goes for dark spots and patches, too. Anything from hyperpigmentation to [precancerous sites](https://aedit.com/aedition/guide-to-actinic-keratosis) can be discovered during these appointments and then appropriately treated. “If the discoloration is associated with thickening of the skin, it should be discussed with a doctor to ensure there are no other contributing factors,” Dr. Garshick advises.

As we’ve established, hyperpigmentation can occur anywhere on the body and is primarily due to injury or inflammation. Body parts with folds tend to contain more melanocytes, but the most common areas of the body that are home to hyperpigmentation include:

- **The Underarms**: Aguilar says that hyperpigmentation in the underarm area is usually genetic, although irritation from repeat shaving, plucking, and deodorant may stimulate it. To reduce friction when shaving, always use thick, moisturizing shaving cream (we like [Pacific Shaving Co. #ShaveWithPurpose](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.pacificshaving.com%2F)) and a fresh, clean razor blade.
- **The Inner Thighs**: Tight pants that cause friction and chaffing can lead to discoloration in the thighs and even stretch into the bikini line and groin area. Along with sun exposure, hormonal imbalances and changes and even some types of birth control can cause a darkening of the skin in these areas.
- **The Buttocks**: Darker skin tones tend to develop dark patches of skin and dark spots on the butt, which is a high-friction area that is prone to rubbing.
- **The Neck**: Normally found on the back of the neck, darkness can result from the sun or hormonal disorders. Marks on the front of the neck are usually more in line with what you experience on the face and décolleté.
- **The Stomach**: Technically known as the linea nigra, many pregnant women develop a vertical line running from as high as under the breast fold down towards the belly button and beyond. After childbirth, the linea nigra usually begins to lighten up around the four- or five-month mark. Melasma is also possible on the abdomen.
- **The Chest**: One of the most open and exposed areas to the sun is the chest, which is why sun spots like to take up residence here. On average, Dr. Engelman says people start to see body hyperpigmentation in the form of sun spots around age 40. “It can vary from person to person based on the amount of melanin present in the skin and how much sun exposure they have had,” she shares. 

Thanks to sun exposure alone, entirely preventing hyperpigmentation is hard (if not impossible). But there are steps you can take to minimize the risk. For starters, wear sunscreen every day on *all* exposed areas of skin (we’ve got a [roundup of dermatologist picks for face and body](https://aedit.com/aedition/dermatologist-approved-sunscreen-for-face-body)). Additionally, don't pick or scratch at the skin, as this can cause new discoloration or worsen existing spots. Finally, avoid using products on the skin that are irritating or photosensitizing (without protection), as they can trigger a reactive response.

## **Creating a Clear Slate**
As with any skin condition, the first step in [treating hyperpigmentation](https://aedit.com/aedition/what-its-like-to-treat-hyperpigmentation-with-skincare-cosmetic-treatments) is identifying the root cause of the problem. From there, it’s best to implement (with the help and recommendations of your dermatologist) a plan of attack over the course of at least three months, if not longer. Dr. Garshick says that the thickness of the skin on the body may make it harder for certain ingredients to work as well or as quickly as they do on the face. But, with patience, they can still be effective. “It is important not to be tempted to use too much of certain ingredients, like retinoids or [exfoliating acids](https://aedit.com/aedition/benefits-of-glycolic-acid-for-body), even though the skin may be thicker,” she cautions. The reason? More irritation means more chances to exacerbate pigmentation. 

While the length of time it takes for discoloration on the body to resolve varies from one person to the next, some find that it takes longer for post-inflammatory hyperpigmentation to fade from the body than the face. It is also important to remember to be as diligent about [sun protection](https://aedit.com/aedition/how-to-apply-sunscreen-and-not-miss-a-spot) when PIH involves the body as you are when it involves the face, Dr. Garshick says. “This is because the more sun exposure, the darker the area may become and the slower the healing time,” she shares. “Without sunscreen, the hyperpigmentation can worsen and take even longer to fade.” 

Aguilar says effective ingredients for treating body hyperpigmentation include topical [niacinamide](https://aedit.com/aedition/guide-to-topical-niacinamide-vitamin-b3-in-skincare) and [alpha hydroxy acids](https://aedit.com/aedition/guide-to-topical-alpha-hydroxy-acids-in-skincare) (think: glycolic and lactic). “Glycolic acid helps to expedite the shedding of dead skin cells and reveal brighter and newer cells,” she explains. “Lactic acid also helps exfoliate old, dull skin cells on the skin's surface by dissolving the bonds that hold them together.” Both AHAs can be used as part of a skin-brightening plan since they are some of the gentler ones available. Niacinamide (a.k.a. vitamin B3) helps fade existing hyperpigmentation by decreasing inflammation and the redness associated with discoloration while providing antioxidant protection, too.

Other proven skin brighteners include [vitamin C](https://aedit.com/aedition/guide-to-topical-vitamin-c-in-skincare) and [retinol](https://aedit.com/aedition/guide-to-vitamin-a-retinol-retinoids-in-skincare). “These ingredients – and niacinamide – work together also to fight other symptoms of aging skin and give the skin an overall healthier, younger appearance,” Dr. Engelman says. [Hydroquinone](https://aedit.com/aedition/giude-to-hydroquinone) is a more complicated brightening agent, while alpha arbutin is a less controversial alternative. Dr. Engelman's picks include the [Glo Skin Beauty Hydra-Bright Alpha Arbutin Drops](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.gloskinbeauty.com%2Fhydra-bright-alpha-arbutin-drops), which is made with lactic acid and alpha-arbutin to brighten and gently exfoliate, and the [SkinCeuticals Advanced Pigment Corrector](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwww.skinceuticals.com%2Fadvanced-pigment-corrector-883140023234.html), a lightweight lotion formulated with a non-toxic hydroquinone derivative called hydroxyphenoxy propionic acid. 

Body exfoliating washes and lotions are important to incorporate, too. Most contain exfoliating AHAs to help brighten the skin and fade unwanted discoloration. For a more intense exfoliation, Dr. Engelman suggests [chemical peels](https://aedit.com/aedition/guide-to-superficial-medium-deep-chemical-peels) and [chemical exfoliants](https://aedit.com/aedition/difference-between-medical-grade-chemical-peels-at-home-exfoliators) to remove the epidermis (the top layer of the skin) and hyperpigmentation over time. “This is not a quick fix, and it requires multiple treatments for best results,” she shares. “But hyperpigmentation will improve over time.”

*All products featured are independently selected by our editors, however, AEDIT may receive a commission on items purchased through our links.*

Wellness

How To Treat Hyperpigmentation And Discoloration On The Body

Everything You Need To Know About Pigmentation On The Body

shutterstock 170651342

If it works, it will stand the test of time – and there’s no truer example than the practices of Traditional Chinese Medicine (TCM). While we often look to modern innovations to solve ailments that come with having a body (think: headaches, sore muscles, low energy), it’s often because we’re seeking a quick fix. When it comes to TCM and, more specifically, acupuncture, however, the remedy isn’t a bandaid and it certainly isn’t one and done. The treatment doesn’t just focus on the pain point, but rather its root and how to treat it long-term. 

Now, the majority of us are no strangers to the overwhelming cycle of work, family, and life responsibilities. They can take a toll on not just the psyche but our physical wellbeing, too. It’s a hamster wheel of stress that we often wear on our face with dark circles, a dull complexion, or tired eyes and in our bodies with area tension and pain. 

To find another way of treating these symptoms *and* combating these stressors at their root, I had the chance to try acupuncture at one of New York’s most sought after wellness destinations, [WTHN](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwthn.com%2F), with its co-founder and chief healing officer, [Shari Auth, DACM](https://wthn.com/pages/acupuncture#healers). With some two decades of experience, Dr. Auth was able to explain exactly what the ancient treatment can offer, its lesser-known benefits, and why it’s never going out of style.

## **What Is Acupuncture?** 
“Acupuncture is 3,000 years old and is one of the oldest forms of medicine in the world as a part of TCM,” Dr. Auth says of the treatment. The practice of placing hair-thin needles across specific pain points is known to stimulate the nervous, immune, cardiovascular, endocrine, reproductive, and digestive systems (if the millennia of practice aren’t enough, perhaps the over 4,000 scientific studies espousing the efficacy of acupuncture for concerns ranging from [tennis elbow](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7870184/) to [PTSD](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328930/) to [skin health](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5653339/) will make you a believer). 

And while acupuncture seems to do it all, this painless healing treatment is capable of so much more. For Dr. Auth, acupuncture is part of a holistic approach to wellbeing. The mission for WTHN is “to make it more accessible and do the education necessary because it has proven benefits. We don’t want it to be intimidating – it’s a treatment that is incredibly healing,” she says. 

## **The Treatment** 
The image of acupuncture is very mainstream – tiny needles placed all over the body in a manner that seems simultaneously haphazard and methodical. There is a method to the placement of said needles to truly make an impact. “The needles are placed in acupuncture points, the meeting place of blood, nerve, and lymph,” Dr. Auth shares. Part of the training to become an acupuncturist requires an understanding of where those points are on the body and how they interact.

Prior to my appointment, I filled out an online form to dive into my specific concerns (chief among them: lower back pain, insomnia, and muscle fatigue) to give Dr. Auth a better understanding of what was troubling me. This information is especially crucial when making an appointment to safeguard your experience. 

Now, as somebody who is used to injections (be it Botox® or a vaccine), I was fully prepared to feel the needles. In my mind, it’s a surefire sign that something is happening. However, to say that the insertion was painless would be an understatement. Furthermore, the sensation once they were placed was nonexistent to the point where I was concerned if it would work or not. “Those who are afraid of needles will notice that, after that first needle goes in, it’s not noticeable and not a big deal,” Dr. Auth notes. 

My session was paired with a guided meditation via headphones, so I was able to truly immerse myself in the ambient surroundings. The WTHN space is clean, inviting, relaxing – the antithesis of the busy New York streets. To say that I walked out a new (and more relaxed) woman would be an apt description. 

## **Benefits of Acupuncture** 
From migraines to physical strains and even anxiety, the treatment is beneficial for virtually anyone, and while we are all familiar with these pain points, here are a few more benefits of acupuncture to note. 

<a href="https://www.youtube.com/watch?v=WuJ_6Z2JHqI&feature=youtu.be" class="embedly-card" data-card-width="100%" data-card-controls="0">Embedded content: https://www.youtube.com/watch?v=WuJ_6Z2JHqI&feature=youtu.be</a>

### **1. Aesthetics**
Acupuncture is not just a mind-body treatment, it may offer aesthetic benefits, too. The tiny needles can be placed over the back of the body or the face, and, while it’s not going to sculpt your cheekbones or give you six-pack abs, it may be a part of your complexion-perfecting regimen. “It’s good for a host of skin ailments from [psoriasis](https://aedit.com/aedition/what-its-like-to-live-with-and-treat-psoriasis) to [eczema](https://aedit.com/aedition/best-skincare-products-to-treat-eczema-flare-ups-in-the-winter) and helps reduce wrinkles, as well as boosting collagen and elastin,” Dr. Auth says. Known as [cosmetic acupuncture](https://aedit.com/aedition/cosmetic-facial-acupuncture-for-aging-skin-rejuvenation), inserting needles into key areas of the face has been shown to stimulate collagen production (à la [microneedling](https://aedit.com/aedition/difference-between-professional-microneedling-at-home-dermarolling)) and the flow of energy.

Furthermore, Dr. Auth notes that it can address digestive issues (IBS, anyone?) and those that relate to gas or bloating, which can not only feel uncomfortable but impact the skin and over all self-image. 

### **2. Better Beauty Sleep** 
We know the importance of a [good night's sleep](https://aedit.com/aedition/impact-of-beauty-sleep-on-skin-health-nighttime-skincare-products) for our physical and mental wellbeing, and acupuncture can help induce sweet slumber. As Dr. Auth explains, it provides a boost of “natural melatonin and gamma-aminobutyric acid, which helps to relax the mind.” 

So, was a better night’s sleep in the cards for me? As someone who has a love-hate relationship with bedtime, post-acupuncture, I was treated to a level of rest I hadn’t experienced in months. To further relieve my sleep concerns, Dr. Auth recommended the [WTHN’s Dream On](https://go.skimresources.com?id=170670X1638612&xs=1&url=https%3A%2F%2Fwthn.com%2Fproducts%2Fdream-on) herbal supplements, which are formulated with organic ashwagandha, jujube, and valerian to promote deep sleep. They have helped combat my insomnia and done wonders for my circadian rhythm.  

### **3. Mood Elevation**  
Acupuncture can be an antidote to what Dr. Auth calls “the gambit of negative mental health complaints (i.e. [stress](https://aedit.com/aedition/impact-of-stress-on-skin-acne-wrinkles-dryness), anxiety, depression) because “it decreases your stress hormone and increases serotonin and dopamine levels.” A natural mood-booster, this therapeutic treatment also provides a much-needed break from overflowing schedules. Though your mood might not instantly change after one session, with continuous visits, it will become a fringe benefit of the treatment. 

Personally, it absolutely shifted the day that I was having. By taking away certain physical pain (more on that below), it allowed me to recenter my focus and be less irritable to the small inconveniences the day may bring. 

### **4. Improved Recovery** 
“Acupuncture is great for inflammation-based pain, as it increases circulation and is good for tight muscles,” says Dr. Auth. Post-procedure and during [recovery](https://aedit.com/aedition/best-plastic-surgery-recovery-nurses-centers-products), your nervous system is prioritizing healing, which can be a [painful experience](https://aedit.com/aedition/benefits-of-lymphatic-drainage-massages-after-cosmetic-surgery). While acupuncture is not necessarily recommended immediately after a procedure (hello, healing stitches and limited mobility), it may be beneficial in the months to come to promote healing and minimize pain. The treatment can be a part of a holistic approach to post-op care, as it offers immune-boosting benefits and muscle relief (among many other things).  

I haven’t had any aesthetic treatments lately, but I entered the appointment with sore muscles and lower back pain. The relief was almost immediate. One appointment certainly couldn’t solve my problems (nor did I expect it to), but there’s no doubt in my mind that my session with Dr. Auth provided much welcomed relief and made me seriously consider incorporating acupuncture into my overall health and wellness routine. 

### **5. Women’s Health** 
Dealing with an irregular [menstrual cycle](https://aedit.com/aedition/skincare-during-menstrual-cycle), painful periods, [polycystic ovary syndrome (PCOS)](https://aedit.com/aedition/pcos-related-skin-hair-concerns), PMS, or some combination of the above? Acupuncture can likely help. “This treatment is great for a host of women’s health complaints,” Dr. Auth says. “It’s a woman’s best friend all of her life.” 

Additionally, acupuncture can have a positive impact on family planning and pregnancy. “Both naturally as well as alongside IVF, it can be beneficial for fertility while also helping in prenatal care to combat morning sickness, acid reflux, and fatigue,” Dr. Auth notes. It may also prove effective for [treating postpartum depression](https://pubmed.ncbi.nlm.nih.gov/31259837/), [aiding lactation](https://www.ncbi.nlm.nih.gov/books/NBK501890/), and improving energy. 

## **The Takeaway** 
As tried-and-true as it comes, there is a reason acupuncture has been used to treat an array of health, wellness, and beauty concerns for centuries. As with any specialized treatment, expertise is key. In order to enjoy the benefits of acupuncture, it is important to find a highly skilled practitioner who can be realistic about what is achievable and develop a treatment protocol that will suit your needs.

*All products featured are independently selected by our editors, however, AEDIT may receive a commission on items purchased through our links.*

A staple of Traditional Chinese Medicine, acupuncture is known to alleviate pain and restore balance – but here’s what you may not know about this healing treatment. 

Beauty And Wellness Benefits Of Acupuncture

5 Benefits Of Acupuncture You May Not Know About 

shutterstock 612400328

If you’re thinking about undergoing a cosmetic procedure, you are probably wondering what you can realistically expect from the outcome. One aspect of the result that is easy to overlook is [scarring](https://aedit.com/concern/scars). The fact of the matter is: Any time there is an incision, there will be a scar. While there are some things you can’t control when it comes to the healing process (hi, genetics), there are some things you can do — from choosing a highly skilled surgeon to proper scar care — to ensure your incision(s) heal as optimally as possible.

To better understand what types of scars can result from body surgeries — and the best ways to treat them — we’ve asked the experts (and, if you're interested in a procedure above the neck, check out our [guide to facial plastic surgery scars](https://aedit.com/aedition/scarring-after-facial-plastic-surgery)).

## **Scarring After Body Procedures**
There are two main factors that determine how surgical incisions heal. One you can control, and the other you can't. “The most important factor in scarring is genetics,” says [Jacob Unger, MD](https://aedit.com/provider/jacob-unger-md-2649), a board certified plastic and reconstructive surgeon in Nashville, TN. “This, unfortunately, is not something any doctor or patient has control over, but it is the most prominent deciding issue when identifying how well someone scars.”

This is true regardless of the procedure, and your medical history should shed some light on how your plastic surgery recovery will go. “For all surgeries — abdominoplasty, brachioplasty, breast surgery, etc. — the primary factor that impacts how a scar heals is the patient’s own wound healing,” says [Umbareen Mahmood, MD](https://aedit.com/provider/umbareen-mahmood-md-23), a board certified plastic and reconstructive surgeon in New York City. “Some patients form [keloids or hypertrophic scars](https://aedit.com/aedition/how-to-treat-every-type-of-scar) with any trauma to the skin, whereas other patients heal with imperceptible scars.” 

The second part of the healing equation is the one you do have a say in. “Surgical technique is a key component to an optimal scar outcome, including types of suture use and how the tissue is handled,” Dr. Mahmood says. Choosing a [board certified plastic surgeon](https://aedit.com/aedition/finding-the-right-plastic-surgeon-dermatologist-or-cosmetic-dentist) who specializes in the procedure you are interested in will go a long way. “All scars heal best under less tension, but the problem, of course, is that patients want to be pulled tight for the best result,” explains [Michael Frederick, MD](https://aedit.com/provider/michael-frederick-md-643), a board certified plastic and reconstructive surgeon in Fort Lauderdale, FL. “It’s the good surgeon’s ability to be able to balance these factors to create the tightest result with the best scar.”

With all of this in mind, below is a break down of the incisions required of some of the most popular body procedures:

## **Abdominoplasty (a.k.a. Tummy Tuck)**
Also known as a tummy tuck, an [abdominoplasty](https://aedit.com/procedure/abdominoplasty) is a surgery that removes unwanted skin and fat and tightens the muscles of the abdomen. “The scar generally extends from hip to hip in order to remove the excess skin in these areas,” Dr. Mahmood says. “Multiple layers of stitches help take tension off the top layer of skin — which is where the scar is — to ensure a fine line scar.” While the length of the incision and subsequent scar is significant, it is strategically placed. “Abdominoplasty scars should be very low and well concealed below the bikini line,” she adds.

<BeforeAfterModule
  title={Before & Afters: Tummy Tuck}
  procedureId={840}
/>

## **Brachioplasty (a.k.a. Arm Lift)**
A brachioplasty, or [arm lift](https://aedit.com/procedure/arm-lift), is a surgery that contours the upper arm by removing skin and fat. As Dr. Mahmood explains, arm lift scars “tend to be one of the more difficult scars for some patients to accept because they can widen or become hyperpigmented.” This is because the arms are such an integral part of just about every motion we make. “Activities as simple as putting hair up in a ponytail or putting on a bra can cause tension on the scar,” she notes. 

<BeforeAfterModule
  title={Before & Afters: Arm Lift}
  procedureId={787}
/>

With that said, the incision generally extends from the axilla (armpit) to the elbow. “Some surgeons choose to place the incision at the back of the arm,” she says, noting that she likes to put it in the inner arm crease. “In this location, it is not visible when the patient's arms are at their side or in a relaxed communication position,” she shares.

## **Breast Surgery**
While augmentation mammaplasty (read: [breast augmentation](https://aedit.com/procedure/breast-augmentation-solutions)) remains one of the most popular cosmetic procedures in the United States, it’s not the only type of breast surgery. Below is what you can expect from the most common breast procedures:

### **Breast Augmentation**
[Breast augmentation with implants](https://aedit.com/procedure/breast-augmentation-with-implants) is a procedure that allows for quite a bit of customization. [Patients choose](https://aedit.com/aedition/how-to-choose-the-right-breast-implants) the type and general size of the implant they are interested in, and the surgeon will insert the implants using their preferred technique. “This surgery typically has a very small scar — one to two inches — along the undersurface of the breast along the fold or possibly in the areola or under the arm,” Dr. Unger explains. He personally prefers the “under breast approach” because, with “proper positioning, delicate tissue handling, and meticulous closure technique,” the scars “can commonly be made to be nearly invisible once healed.”

<BeforeAfterModule
  title={Before & Afters: Breast Implants}
  procedureId={1013}
/>

### **Breast Lift**
Unlike a breast augmentation, a mastopexy (a.k.a. [breast lift](https://aedit.com/procedure/breast-lift)) requires a more prominent incision. There are an [array of techniques](https://aedit.com/aedition/mastopexy-breast-lift-after-pregnancy-breastfeeding) depending on the degree of ptosis (read: drooping), but it can often involve a vertical incision from the nipple to the lower border of the breast fold. In Dr. Unger’s estimation, this scar tends to be “concerning” for patients because “it is visible along the lower pole of the breast.” 

<BeforeAfterModule
  title={Before & Afters: Breast Lift}
  procedureId={800}
/>

With the right care, however, it can be greatly minimized. “At least in my experience, this scar almost always heals incredibly well, and is usually imperceptible for most patients after a healing period,” Dr. Unger says. “For some this means it's almost invisible by three months; for some it's more like one to two years.” Regardless of which camp you fall into, “it almost always fades away to a level that is difficult to identify it at all,” he adds.

### **Breast Reduction**
For Dr. Frederick, the pivotal component that makes scars better in a reduction mammoplasty (a.k.a. [breast reduction](https://aedit.com/procedure/breast-reduction)) is the technique. As he explains, in a “classic, old-school” inferior pedicle breast reduction, flaps are raised and closed “under tension over the top of the pedicle.” With a superior or superior-medial pedicle, meanwhile, “no flaps are raised” and “the pillars are closed together so there’s minimal tension on the skin,” he shares.

<BeforeAfterModule
  title={Before & Afters: Breast Reduction}
  procedureId={801}
/>

### **Gynecomastia Surgery**
[Male breast reduction](https://aedit.com/procedure/male-breast-reduction), or gynecomastia surgery, is one of the most popular cosmetic procedures for men in the U.S. Like a female breast reduction, patients may need fat removal, skin excision, or a combination of the two depending on the grade of gynecomastia. Unlike female breast reduction, the majority of patients do not need significant incisions. “Most gynecomastia is done with liposuction through a small opening,” Dr. Frederick says. “This external scarring is typically not an issue.”

<BeforeAfterModule
  title={Before & Afters: Male Breast Reduction}
  procedureId={1022}
/>

## **Liposuction & Fat Transfer**
Speaking of liposuction, the gold standard of fat reduction tends to be minimally invasive as far as incisions are concerned. “Liposuction scars are small — approximately 3 millimeters — and placed in well-hidden areas of the body,” Dr. Mahmood explains. For example, in abdominal liposuction, incisions are usually made low in the bikini line and in the umbilical hood for concealment purposes. “Incisions are minimal and tend to heal well,” she says. It should be noted, however, that if you opt for a type of lipo that is heat-based (like [VASER](https://aedit.com/procedure/ultrasound-assisted-liposuction) or [Smartlipo](https://aedit.com/procedure/smartlipo)), “there is a higher risk of scarring at the liposuction cannula site,” Dr. Mahmood cautions.

<BeforeAfterModule
  title={Before & Afters: Liposuction}
  procedureId={1021}
/>

Depending on your aesthetic goals, the fat removed via liposuction may be purified and injected into another part of the face or body. Known as fat grafting or fat transfer, the combination procedure is the basis for the [Brazilian Butt Lift (BBL)](https://aedit.com/procedure/brazilian-butt-lift) and [breast augmentation with fat transfer](https://aedit.com/procedure/breast-augmentation-with-fat-transfer), in addition to serving as an alternative to synthetic filler when [contouring the face](https://aedit.com/procedure/facial-fat-grafting) and [rejuvenating the hands](https://aedit.com/procedure/hand-rejuvenation-with-fat-transfer).

As for injecting the fat from the donor site, Dr. Frederick uses an 18 gauge needle and “small pokes” so there are no external scars. “The important thing is to fan out the fat evenly and quickly because it swells almost instantaneously and that will distort the [treatment area] and prevent you from seeing where you injected the fat if you do it too slowly,” he shares.

## **Thigh Lift**
The purpose of a [thigh lift surgery](https://aedit.com/procedure/thigh-lift) is to remove excess skin and fat and reposition underlying tissue to lessen the appearance of sagging. According to Dr. Frederick, the incision “almost always” runs along the inside of the leg and the groin crease, which can be problematic for healing. “The problem with the groin crease scar is that it’s fighting gravity, as the weight of the leg pulls down on it,” he explains. There are steps a surgeon can take while operating to lessen the burden. Ultimately, “it’s important to anchor the thigh to the more sturdy aspects of the pelvis so that it doesn’t drop back down with gravity,” Dr. Frederick shares.

<BeforeAfterModule
  title={Before & Afters: Thigh Lift}
  procedureId={823}
/>

## **How to Care for Scars After Plastic Surgery**
As we’ve alluded throughout the article, [well-healed scars](https://aedit.com/aedition/minimizing-scars-after-surgery) start in the operating room. “As plastic surgeons, we are very familiar with scarring and various techniques to help minimize the visibility and size of scars,” Dr. Unger shares. “There are methods and materials we can use to help improve scar tone and texture and quality.” This includes specific closure techniques and sutures that yield a ‘tension free’ result. “We use multiple layers of stitches commonly and try to make sure there is no ‘pulling’ on the final incision line,” he explains. “Tension or stress across an incision is a major determinant in how wide or thick a scar may end up.”

Once you’re home, you too can work to keep tension to a minimum. “Significant tension on the scar either at the time of surgery or by the patient’s increased activity early in the post-op period, affects how the scar heals,” Dr. Mahmood cautions. [Compression garments](https://aedit.com/aedition/benefits-of-compression-garments-after-cosmetic-surgery) (worn in accordance with your surgeon’s post-op instructions) are one way to decrease [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) and, in turn, minimize undo tension, as is being [mindful of your movement](https://aedit.com/aedition/when-to-start-exercising-again-after-cosmetic-surgery-procedures). “For example, stay hunched over after a tummy tuck,” Dr. Frederick notes. 

Topical treatments, like [silicone gels and strips](https://aedit.com/aedition/scar-minimizing-skincare-to-use-after-surgery), can be a helpful part of the recovery process — but consistency is key. “Silicone sheeting can help, but it’s like putting a tomato in a greenhouse,” Dr. Frederick says. “It needs to be there everyday for six months to get a 10 to 15 percent better yield.” 

It’s important to remember that scars can take a year or more to fully heal and fade. If you are unhappy about the appearance of your surgical scars, talk to your surgeon. As Dr. Unger shares, there are “a range of minimally invasive skin-remodeling techniques such as [dermabrasion](https://aedit.com/aedition/dermabrasion-might-be-the-scar-treatment-youve-been-looking-for) and lasers that can help place the body into optimal position for the best possible healing.”

In a perfect world, cosmetic surgery would be incision-free. We’re not quite there yet, but, in the hands of a skilled surgeon, scarring after body procedures can be minimal.

What Kind Of Scarring You Can Expect From Plastic Surgery On The Body

What Kind Of Scarring You Can Expect From Popular Body Procedures

jason-yoder-4g8SDwRbKnk-unsplash

What your [belly button](https://aedit.com/procedure/belly-button-correction-solutions) (a.k.a. navel) looks like is a bit of a wild card. For starters, it can cave inward (hi, ‘innies’) or protrude outward (here’s looking at you, ‘outies’), and there are different degrees of each. When it comes to shape, the navel can be round or oblong. If yours isn’t a perfect circle, it may be more horizontal or vertical in nature. The more time you spend inspecting your belly button, the more odd it is likely to look. 

While there is no ‘ideal’ navel, you may have strong feelings about yours. Additionally, pregnancy, weight changes, or injury can change the [appearance of the belly button](https://aedit.com/aedition/everything-you-need-to-know-about-navel-surgery). So, whether it’s a major life event or simply the return of ‘90s-inspired crop tops that has you navel-gazing in the literal sense, we’re breaking down everything you need to know about the cosmetic procedures that can alter the shape and size of the belly button. 

## **Why Consider a Belly Button Surgery**
The navel is the remnant of the umbilical cord that connected you to your mother’s placenta during pregnancy. In case you don’t remember from your grade-school biology class, the cord delivers vital nourishment during gestation but is not needed after birth. As a result, it is clamped and cut and the remaining stump falls off a couple weeks later. What’s left in its place is your navel. “Although the belly button is only a scar from the placenta, as humans, we attach a high value to it,” says [Melissa Doft, MD](https://doftplasticsurgery.com/), a double board certified plastic and reconstructive surgeon in New York City.

For some, the benefits of belly button surgery are purely cosmetic. For others, it offers improved form *and* function. Below are some of the most common reasons people consider belly button surgery:

- **Aesthetics**: Not liking the way the navel looks is one reason to consider surgery. “Someone might be interested in an umbilicoplasty if their native belly button has always bothered them,” explains [Asaf Yalif, MD](https://aedit.com/provider/asaf-yalif-md-1893), a board certified plastic and reconstructive surgeon in Alpharetta, GA. “Whether that means an outie rather than an innie or just that they feel that it is not aesthetically pleasing, [surgery] can address those concerns.” When it comes to what constitutes “aesthetically pleasing,” Dr. Doft finds that “most people wish to have a belly button that is narrow and taller than it is wide.” 
- **Correction**: While aesthetics is the driving force here, too, some patients seek corrective belly button surgery after undergoing a previous procedure. “Most people seeking an umbilicoplasty have had a procedure before — whether it be laparoscopic, a tummy tuck, or even prior procedures like liposuction — that may have altered the appearance of their belly button,” shares [Mark G. Albert, MD](https://aedit.com/provider/mark-albert-md-77), a board certified plastic and reconstructive surgeon and [umbilicoplasty expert in NYC](https://www.albertplasticsurgery.com/). Such revision can improve the overall shape, size, and appearance of the navel.
- **Umbilical Hernia**: While not all people with ‘outies’ have an umbilical hernia, many do. As Dr. Doft explains, the belly button comes to protrude outward due to “a small hole in the fascia (the strength layer of the abdomen)” that “fat or intestine is pushing through.” In some cases, the hernia may cause pain or lead to functional concerns.
- **Piercings**: If that belly button [piercing](https://aedit.com/aedition/how-to-fix-old-and-sagging-piercings) you got in high school or college hasn’t aged well, belly button surgery can help. The cosmetic procedure will remove any hangover or sagging skin left behind.
- **Pregnancy**: Needless to say, the body undergoes a host of changes [during pregnancy](https://aedit.com/aedition/how-pregnancy-affects-cosmetic-surgery-results), and the appearance of the belly button may be one of them. As the uterus expands and pushes the abdomen forward, the navel may ‘pop’ as well. This protrusion is normal and usually subsides within a few months of delivery, though your belly button may not look exactly like it once did. If your ‘outie’ lingers longer, it may be a sign of an umbilical hernia. 
- **Weight Fluctuations**: As with most other parts of the body, [significant weight changes](https://aedit.com/aedition/what-its-like-to-get-plastic-surgery-after-bariatric-surgery-weight-loss) may lead to extra skin around the belly button. Depending on your aesthetic goals, an umbilicoplasty or abdominoplasty can be performed to address this change in the shape and appearance (more on that below).

Since there may be medical reasons for why you are unhappy with the shape of your belly button, it is important to consult with a board certified plastic surgeon who will be able to evaluate the cause for the concern and recommend the appropriate treatment.

## **Types of Belly Button Surgery**
Generally speaking, there are three types of belly button surgery that range from purely aesthetic in nature to medically necessary. Here is what you need to know about each:

### **1. Umbilicoplasty**
“[Umbilicoplasty](https://aedit.com/procedure/umbilicoplasty) refers to creating or changing the appearance of the belly button,” Dr. Albert says. It is a catch-all term of sorts, since, depending on the aesthetic goals of the patient, the surgery can involve reshaping and/or resizing the navel for an improved appearance. This procedure can be performed to address the look of a natural belly button or to revise the work of a previous procedure, the damage of a piercing, or the result of pregnancy or weight change (assuming a tummy tuck is not preferred). 

Patients generally only experience a few days of acute recovery following an umbilicoplasty, although [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) can persist for up to a month depending on the person. Most candidates can return to work after a day or two and exercise can resume after two to three weeks. It should also be noted that, because it’s a relatively quick procedure, it can often be [added on to other surgeries](https://aedit.com/aedition/best-surgical-and-non-surgical-cosmetic-procedures-to-combine). “It is very easy and makes a lot of sense to combine umbilicoplasty with pretty much any other plastic surgery procedure,” Dr. Albert says.

### **2. Umbilical Hernia Repair**
While you may have discovered you have an umbilical hernia because your innie became an outie, the reparative surgery is not about aesthetics. “In hernia surgery, we are repairing a defect in the fascia that allows tissue to escape through and ‘balloon’ out,” Dr. Yalif shares. “In repairing the defect, we are concerned mainly with ensuring no internal fat or organ can come out through the abdominal wall.” There is a functional benefit to the procedure. “Another way to say it is that, with hernia surgery, we are trying to functionally improve the abdominal wall, while in umbilicoplasty we are trying to make the belly button look better,” he adds.

Performed alone or as part of a tummy tuck, the procedure itself takes about 45 minutes, but there are greater post-op restrictions than umbilicoplasty patients face. If you have a desk job, you’ll probably be able to return to work after a couple of days, but you will need to avoid movement and activity that puts undue pressure on the weakened area as it heals. The biggest risk is that the hernia returns. Since there is a medical component to the surgery, it may be [covered by insurance](https://aedit.com/aedition/insurance-coverage-for-plastic-surgery-cosmetic-procedures).

### **3. Abdominoplasty**
If you are consulting with a board certified plastic surgeon about an [abdominoplasty](https://aedit.com/procedure/abdominoplasty) (a.k.a. tummy tuck), don’t be surprised when your belly button comes up. Similarly, if you are in the office to talk about your belly button, the surgeon will likely look at the abdomen in its entirety. “By definition in a tummy tuck, the umbilicus must be addressed,” Dr. Yalif explains. “We can choose from a myriad of techniques to make the belly button look smaller, bigger, higher, lower — they are all essentially at our disposal.”

<BeforeAfterModule
  title={Before & Afters: Abdominoplasty}
  procedureId={1044}
/>

Addressing the belly button during a tummy tuck is often a good option for [women after pregnancy](https://aedit.com/concern/mommy-makeover) or those who have experienced a significant weight loss, as the surgery addresses excess skin and fat, tightens the abdominal muscles, and reshapes the belly button. “We make sure to discuss this prior to surgery so we make sure we give you the belly button you want,” Dr. Yalif says. If a patient has an umbilical hernia, that can be corrected as well. 

The most involved of the belly button surgeries discussed here, expect to refrain from strenuous activity for about six weeks after abdominoplasty.

## **The Results of Belly Button Surgery**
The most common request of patients seeking belly button surgery? A natural result. In the hands of a skilled plastic surgeon, the work should barely be perceptible. “When performed correctly, an umbilicoplasty result should look exactly like a normal belly button with no visible scarring,” Dr. Albert shares. “The scarring can be hidden inside the belly button.”

Speaking of [scarring](https://aedit.com/aedition/minimizing-scars-after-surgery), it should come as no surprise that Dr. Doft says patients “seek to have a belly button where the incisions are hidden.” While a scar is inevitable, you won’t necessarily be able to see it. “Any time I cut you with a knife, it will leave a scar,” Dr. Yalif notes. “That being said, the belly button is the first scar we ever make, so, hopefully, the incision within that scar will not be frankly visible.” Due to the anatomy of the area, incisions and, in time, scars are more easily concealed. “In the end, we try to camouflage scars and hide them in natural creases so that they are less visible,” he adds.

## **The Takeaway**
While the results of umbilicoplasty, umbilical hernia repair, and abdominoplasty are immediate (save for the post-op swelling subsiding) and permanent, they will be affected by pregnancy, weight changes, and age. Whether you have a medical concern, don’t like the aesthetic of the navel, or are interested in addressing the abdomen as a whole, consulting with a board certified plastic surgeon will ensure you get the best treatment for your anatomy and aesthetic goals.

If you are navel-gazing in the most literal sense, here’s how to change that.

Types Of Belly Button Surgery: Umbilicoplasty, Umbilical Hernia Repair, Tummy Tuck

6 Reasons You Might Consider Belly Button Surgery

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Even though [cellulite](https://aedit.com/concern/cellulite) is incredibly common in female bodies (nine in 10, to be specific), I have never been able to accept it as a natural part of mine. The rippling appearance of cellulite generally begins during puberty, and I was no exception to the rule. First noticing it at the age of 13, it continued to be a bother into my early twenties. By the time I hit 30, I was seriously looking into [possible solutions](https://aedit.com/procedure/cellulite-removal-solutions). After having exhausted every at-home avenue to smooth my skin to no avail, I started to think the dimpling was something I would have to live with. That’s when [Qwo™](https://aedit.com/procedure/qwo) came into the picture.  

## **Why I Chose Qwo**
Anyone who has sought out ‘solutions’ for [cellulite](https://aedit.com/aedition/the-complete-guide-to-cellulite) will agree that no amount of dry brushing, foam rolling, coffee scrubs, firming creams, or lifestyle changes will truly change its appearance. Sitting at a size four and standing at 5'5”, I am someone who works out consistently and can attest that your weight, size, and diet can’t naturally change what is in the cards genetically. And, as someone who exercises to feel strong and does not mind having a little jiggle, I knew that my options were limited if I truly wanted the dimples to disappear. 

In-office procedures never interested me due to their inconclusive results, which left me in this limbo waiting for a concern-specific fix that does not require extensive downtime. I first found out about Qwo™ through [an article we published](https://aedit.com/aedition/qwo-cellulite-injectable-treatment-fda-approved) a year ago when it first received approval by the United States Food and Drug Administration (FDA). It appeared to be a miracle cure for one of my biggest insecurities. The [breakthrough injectable](https://aedit.com/aedition/new-injectables-neurotoxins-fillers-for-face-body) is approved by the FDA for use on the buttocks in moderate and more severe cases of cellulite. 

I was excited enough just knowing that a solution was approved and within reach. But, when I was offered the chance to get Qwo™ injections administered by [Bruce E. Katz, MD](https://www.juvaskin.com/about/our-staff/dr-bruce-katz/), a board certified dermatologist and the founder of JUVA Skin and Laser Clinic in New York City who had been a part of the clinical trials for the treatment, I knew the time to tackle my cellulite had arrived. According to Dr. Katz, Qwo™ has been “tested on moderate to severe cellulite” and “can treat all forms of cellulite.” 

<a href="https://youtu.be/yOLeojEnKWM" class="embedly-card" data-card-width="100%" data-card-controls="0">Embedded content: https://youtu.be/yOLeojEnKWM</a>

Because the process requires three sets of injections spaced 21 days apart, I cleared my calendar and hurried to see Dr. Katz for my shot at smoother skin. 

## **Qwo Treatment & Recovery**  
During my first appointment with Dr. Katz, I was assessed and told that I was indeed a candidate for Qwo™ (cue the sigh of relief). He had been a part of the clinical trials for Qwo™ and had glowing reviews from his patients, who, two years post-treatment, were still happy with their results. After getting marked up and having my ‘before’ pictures taken (see below), I laid down for the first set of injections. 

As somebody unphased by needles, the process was seamless, and Dr. Katz went above and beyond to make me feel comfortable. Unlike [Botox®](https://aedit.com/aedition/everything-you-need-to-know-before-getting-botox-for-the-first-time), which is injected into the muscle, Qwo™ requires a different technique. When the needle is inserted, collagenases (the enzyme that breaks down peptide bonds in collagen) are released as the needle is moved around to dissolve the collagen bond. While, from the outside, it appears as though the needle is being moved around, Dr. Katz explained that this is the necessary method to ensure the bands dissolve and release, thereby reducing the dimpling appearance. The overall pain level was no more than that of other injections, and the entire process was done in under 10 minutes. I was instructed to stay on my stomach for another 10 minutes to allow for the injectable to get to work on the fibrous septae. 

<CaptionImg url={https://images.ctfassets.net/zw35sfestf1t/3oq3bwUvuZkYPpWPI1a5rN/08bdfb2c2ec24aab5397df212bce4673/QwoBA-2.jpeg}>
  The writer before (*left*) and seven weeks after (*right*) her last Qwo™ treatment.
</CaptionImg>

Now, although I did my [research on the treatment](https://aedit.com/aedition/what-its-like-to-get-qwo-for-cellulite) — reading up on aesthetics is, after all, my job — I was unaware of the dramatic impact the first round of injectables would have on me. During my initial appointment with Dr. Katz, I was reassured that [bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox) and [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) were to be expected. In fact, they’re a sign that the treatment is working. “That is indicating that the fibrous bands have been dissolved by the Qwo™,” he explained. I am prone to bruising, so I thought I had a pretty good idea of what the bruises would look like on me. However, I wasn't prepared for what happened a mere 11 hours post-injection. 

As the first day progressed, I started to experience a feeling of soreness as though I’d done a glute-heavy workout, and my skin felt raw as if I had a sunburn. Not knowing what I would experience that day, I wore jeans and soon found myself feeling irritated by the denim fabric. By the end of day one (and after constant inspection of my derriere), the small injection sites had blossomed into deep purple, baseball-sized circles. Nothing could have fully prepared me for the shock factor of the bruising, but having the forewarning from Dr. Katz allowed me to sleep easy — albeit somewhat uncomfortably — the next few nights. By my second set of injections three weeks later, the bruising had disappeared and I was ready to do it all again.    

The following two treatments mirrored my first experience — sans the significant bruising. I went in, got marked up, took progress photos, and felt the same sore-raw hybrid of sensations with limited bruising (compared to what I had come to expect from round one). The entire process, from consultation to completion, lasted less than three months, and I was excited to see a vast improvement. 

## **Qwo Results & Recommendations**
Once the swelling and bruising from the first set of injections went down, I noticed a slight improvement in the appearance of my skin. The real change, however, came at the three-month mark. After the third set of injections, the bruising was barely there — though it did linger for a few weeks (Dr. Katz assured me that this was perfectly normal).  

While my case of cellulite may fall in the ‘moderate’ category, in unflattering light or under constrictive clothing, I still found myself concerned about its appearance. Now that enough time has passed, I find that my skin is much smoother, the thought process behind choosing what to wear is less complicated, and my self-confidence has been restored. 

<CaptionImg url={https://images.ctfassets.net/zw35sfestf1t/2aY5KXamhCqPipbEWWyqdg/ed4445c77d1b9348805da3503a5ddd58/QwoBA-1.jpeg}>
  The writer before (*left*) and seven weeks after (*right*) her last Qwo™ treatment.
</CaptionImg>

As far as the timeline for how long the results should last, there’s no specific answer. Dr. Katz has patients who participated in the trials two and a half years ago and are still happy with their appearance. Even if there is a shelf life to my results, I would gladly go back and do it all again as needed. I would also recommend it to anybody who wants a minimally invasive solution that produces visible results. 

For those considering this treatment option for cellulite, here are a few things I think you should keep in mind when scheduling your Qwo™ injections: 

### **Do**: 
- Schedule treatment for a time when you’re less likely to wear revealing bottoms
- Consider what you will wear the day of injection
- Wear underwear that doesn’t dig into the injection site
- Plan your days following the injections to be light and know that sitting or physical activity may cause discomfort
- Expect bruising, especially if you are prone to it 

### **Don’t**: 
- Schedule any physically demanding activities post-treatment 
- Push yourself physically in the days following 
- Wear anything too compressive or with a rough texture for the first few days
- Feel discouraged by the bruising, swelling, or soreness (trust the process!) 

## **The Takeaway** 
Cellulite is not a reflection of your health, diet, or fitness capabilities — it's a genetically determined structure under your skin that creates a rippled appearance. While it is currently only FDA-approved for use on the buttocks, Qwo™ is being tested for use on the back of the thighs and has shown realistic improvement to a concern that previously was hard to treat. Despite the deep bruising and discomfort for a few days, the process is quick and the results are real!

Patient Perspective

After years of being self-conscious about my cellulite, I was able to treat it with Qwo™, an FDA-approved injectable that promises smoother skin in three sessions. 

What I Look Like Before And After Getting Qwo Injections For Cellulite

I Got Rid Of My Cellulite With Qwo Injections — Here’s Proof

alexander-krivitskiy-v3jlOMgK6V8-unsplash

Linda Evangelista made headlines on social media this week when she candidly opened up about her experience with paradoxical adipose hyperplasia (PAH), which she says she developed after a series of cryolipolysis treatments five years ago. In an emotional [Instagram post](https://www.instagram.com/p/CUJZa40tWXC/), the supermodel alleges the CoolSculpting® procedures “increased, not decreased” her fat cells and left her “permanently deformed even after two painful, unsuccessful, corrective surgeries.”

<CaptionImg url={https://images.contentful.com/zw35sfestf1t/5tUYfh7YSiYd0xHs77qCwi/eb88a5821865ba0aef90405f401b176c/LindaEnvangelistaIG.png}>
  Linda Evangelista's Instagram post about her experience with PAH. (@lindaevangelista/ Instagram)
</CaptionImg>

By sharing her story, Evangelista (who filed a lawsuit against the device’s manufacturer, Zeltiq Aesthetics, which is a subsidiary of Allergan) has paved the way for a renewed conversation around one of the lesser known adverse effects of the popular [fat-freezing procedure](https://aedit.com/aedition/comparing-fat-melting-sculpsure-and-fat-freezing-coolsculpting). So, what is paradoxical adipose hyperplasia and how common is it? Here, a top dermatologist and plastic surgeon break down everything you need to know about PAH — including how to treat it.

## **What Is Paradoxical Adipose Hyperplasia?**
To understand paradoxical adipose hyperplasia (PAH), it’s first important to understand cryolipolysis. Also known as ‘fat freezing’ or by its brand name, [CoolSculpting®](https://aedit.com/procedure/cool-sculpting), the non-invasive body contouring procedure is a controlled cooling technique that works by freezing fat cells at negative 11 degrees Celsius to permanently destroy them. “Cryolipolysis uses cooling to damage and destroy subcutaneous fat cells without damaging the skin to reduce the amount of fat in the treated area,” says [Paul Jarrod Frank, MD](https://pfrankmd.com/), a board certified dermatologist in New York City. 

Most patients experience a 20 to 25 percent reduction of fat in the treatment area, and CoolSculpting® is approved by the United States Food and Drug Administration (FDA) to address visible fat bulges on the back, buttocks, thighs, upper arms, flanks, and abdomen and under the chin and jawline. According to the [CoolSculpting® website](https://www.coolsculpting.com/index.html), post-treatment side effects include “temporary redness, swelling, blanching, bruising, firmness, tingling, stinging, tenderness, cramping, aching, itching, or skin sensitivity, and sensation of fullness in the back of the throat after submental or submandibular area treatment.” 

The site also notes that “rare side effects” may occur: “CoolSculpting® and CoolSculpting® Elite may cause a visible enlargement in the treated area, which may develop [two] to [five] months after treatment and requires surgical intervention for correction.” The paradoxical adipose hyperplasia Evangelista describes was [first reported in 2014](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171727/). “It is a rare, previously unreported adverse effect of cryolipolysis,” Dr. Frank notes.

PAH refers to hardened areas of localized fat that develop after cryolipolysis. “PAH is the unintentional growth of adipose, or fat, after cryolipolysis,” explains [Melissa Doft, MD](https://doftplasticsurgery.com/), a double board certified plastic and reconstructive surgeon in NYC. “Patients complain of a thick layer of hard fat in a similar shape to the applicator used for CoolSculpting®, and it has been described as looking like a stick of butter.”

[Studies show](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171727/) that less than one percent of patients (about 0.05 percent to 0.39 percent) experience the condition after cryolipolysis, though [more recent data](https://www.sciencedaily.com/releases/2018/06/180629182037.htm) indicates the figure may be as high as 0.72 percent. “It is unclear why some patients have the growth of fat cells instead of reduction, but what is known is that the incidence is higher than was previously expected,” Dr. Doft says. “Researchers estimated that it affects one in 138 patients who undergo cryolipolysis and is more common in male patients.”

As such, providers increasingly believe PAH does not get enough attention. “This complication is more common than we think, along the spectrum of mild to severe,” Dr. Frank shares. In her IG post, Evangelista laments that she was “not made aware” of the risk prior to undergoing treatment. 

While it is not life threatening, PAH can be physically and emotionally distressing — and it will not go away without treatment. “I do not have a CoolSculpting® machine, but I have seen several complications unfortunately,” Dr. Doft shares. “It is devastating to the patients.”

## **What Causes Paradoxical Adipose Hyperplasia?**
The tricky thing about paradoxical adipose hyperplasia? We don’t really know exactly what causes it. “We assume the cooling effect has some sort of stimulatory stem cell activation which causes multiplication of fat cells,” Dr. Frank explains, adding that it is “typically a localized phenomenon.” That means most patients who experience PAH do so in the area where the cryolipolysis applicator was placed, and it can happen anywhere on the body. 
 
Additionally, it can happen to anyone. “There is no data on why someone is more susceptible than others,” Dr. Frank says. “That makes it such a problem because it's unpredictable.” One potential factor? “People who get too many repetitive treatments in the same area may be more inclined to have PAH,” he adds. 

For example, there could be situations in which a patient is misdiagnosed after CoolSculpting®. “The most common cause is when a patient says they have a CoolSculpting® cycle, and they start noticing growth in the area,” Dr. Frank explains. Rather than recognize the growth as PAH, an untrained provider may blame it on weight gain and have the patient undergo another session. “It usually happens when you have too many CoolSculpting® treatments in a short period of time to the same area,” he says.

## **How to Treat Paradoxical Adipose Hyperplasia**
The most important thing to know about treating paradoxical adipose hyperplasia is that additional cryolipolysis treatments are not the answer. Instead, [liposuction](https://aedit.com/procedure/tumescent-liposuction) or, in more severe cases, [abdominoplasty](https://aedit.com/procedure/abdominoplasty) (read: tummy tuck) are the most effective ways to improve or completely correct PAH. Be aware that multiple surgeries may be needed.
 
The coldness of cryolipolysis creates inflammation that destroys fat cells, but it can also cause panniculitis, or the inflammation of fat. “That causes a rebound and exacerbation of scar tissue that comes from the inflammation,” Dr. Frank explains. As such, “it is necessary for patients to wait six to nine months after the [cryolipolysis] procedure to confirm that the inflammation and growth has plateaued,” Dr. Doft adds. During that time, “people who are experiencing the active stage of growth soon after CoolSculpting® treatment require systemic steroids,” Dr. Frank notes. 
 
At Dr. Frank’s practice, [vaser liposuction](https://pfrankmd.com/lipo/) is the “gold standard” of treating fat adipose hyperplasia. “[Most patients](https://www.instagram.com/p/CMUeHjRFm46/?utm_medium=copy_link) get enormous improvement after one treatment,” he explains, but many patients “will require two rounds of surgical intervention to really reduce the irregularities.” 
 
Dr. Doft agrees that liposuction often “works well to remove the excess fat tissue,” though it is not always enough. “Some patients not only have excess fat but also significant scar tissue and will need an abdominoplasty to correct the problem,” she says.
 
## **The Takeaway**
Even non-invasive treatments that are generally considered safe and effective, like CoolSculpting®, can have negative outcomes that require costly revision. “[PAH] is a more common than discussed complication, particularly in the hands of unlicensed professionals and med spas,” Dr. Frank cautions. While all aesthetic procedures carry the possibility of side effects and complications, visiting a [board certified provider](https://aedit.com/aedition/medical-board-certification-in-plastic-surgery-cosmetic-dermatology) who specializes in the treatment you are interested in can help mitigate risk and ensure you are in qualified hands should something go wrong.

Cryolipolysis is generally considered a safe and effective form of body contouring, but adverse effects (however rare) are possible. Here’s what you need to know about PAH.

What To Know About Paradoxical Adipose Hyperplasia (PAH) After Cryolipolysis, CoolSculpting

What You Need To Know About Paradoxical Adipose Hyperplasia

dmitry-osipenko-RTAsKw1c8cc-unsplash

Last summer, the United States Food and Drug Administration (FDA) approved Endo Aesthetics’ Qwo™, a first-of-its-kind injectable that improves the appearance of [cellulite](https://aedit.com/concern/cellulite), much to the delight of those dealing with dimpling. Statistically speaking, nine out of 10 women have cellulite they can’t shake, which makes sense when you consider it has nothing to do with diet or exercise.

There are plenty of topical treatments (think: lotions and scrubs) that claim to temporarily reduce the appearance of cellulite, and there are a few surgical procedures (hi, [Cellfina®](https://aedit.com/procedure/cellfina) and [Cellulaze®](https://aedit.com/procedure/cellulaze)) that address the bands under the skin’s surface that can lead to dimpling. But, with the approval of Qwo™, there is now  a minimally invasive [cosmetic solution](https://aedit.com/procedure/cellulite-removal-solutions) that addresses the cause of cellulite. Read on to learn more about how Qwo™ works and hear from patients about what their experience was like.

## **What is Qwo?**
[Qwo™](https://aedit.com/aedition/qwo-cellulite-injectable-treatment-fda-approved) (a.k.a. collagenase clostridium histolyticum-aaes) is the first-ever minimally invasive injectable procedure that releases fibrous septae enzymatically by specifically targeting types 1 and 3 collagen. Basically, Qwo™ targets the bands beneath the skin surface directly, which results in the surface-level smoothing effect. The enzymatic component is what differentiates the injectable from surgical procedures Cellfina® and Cellulaze®. While those two treatments also target the subcutaneous bands, they do so by severing the septae mechanically with either a knife or laser energy. 

## **Ideal Candidate for Qwo** 
Qwo™ is FDA-approved to treat moderate to severe [cellulite](https://aedit.com/aedition/the-complete-guide-to-cellulite) of the buttocks in adult women. During the clinical trial process, investigators needed to ensure they were reporting a two-point improvement in cellulite severity, which means participants went from having a lot of noticeable cellulite to a noticeably smoother rear. Additionally, Endo included women of all [Fitzpatrick skin types](https://aedit.com/aedition/guide-to-fitzpatrick-skin-types) in the trials, with nearly 30 percent of those treated with Qwo™ being Fitzpatrick IV, V, and VI. The treatment is considered safe and effective for women of all skin tones. It’s worth noting, however, that there are some groups of people who may not be candidates, including women who are [pregnant or breastfeeding](https://aedit.com/aedition/safety-of-cosmetic-procedures-during-pregnancy-breastfeeding) and those who have conditions that cause excess bleeding. 

## **Qwo Treatment Protocol**
Qwo™ requires two or three sessions, spaced 21 days apart. Each appointment takes about 30 minutes, and patients do not need anesthesia. Instead, they are marked up in the affected areas (i.e. where you have dimpling), and the provider injects into the markings. As with any injectable treatment, there is a strong likelihood of [swelling](https://aedit.com/aedition/how-to-treat-minimize-swelling-after-cosmetic-surgery) and [bruising](https://aedit.com/aedition/how-to-treat-prevent-bruising-after-lasers-filler-botox) at the injection site, which usually subsides in about two weeks. Post-Qwo™ bruising tends to be significant, so you will probably want to avoid scheduling your treatments around a vacation or warm-weather months. Results are known to last a year or more. 

## **Patient Perspective**
At this point, you’ve likely heard first-hand accounts of [Botox®](https://aedit.com/aedition/everything-you-need-to-know-before-getting-botox-for-the-first-time) and [filler](https://aedit.com/aedition/what-to-know-before-getting-lip-filler-for-the-first-time), but all injectables are unique and come with their own unique experiences. To get a better sense of what to expect from Qwo™, we talked to two patients about what it’s really like to get the cellulite-minimizing injections.

### **Frankie, 29, Boston, MA**
*Frankie has felt insecure about the cellulite on her upper thighs and buttocks since her late teens. She went out of her way to avoid swimwear and clothing that exposed the areas, which impacted her quality of life. Qwo™ is the first professional cellulite treatment she has tried, and she is pleased with her results.*

<Dialogue>
  <Question party={The AEDITION}>
    How did you find out about Qwo?
  </Question>
  <Response party={Frankie}>
    I read an article about the treatment last summer. I guess it found me just at the right time. I had gotten back from a trip with friends, and I’d felt pretty down about my body a lot of the time. I’d looked into treatment for cellulite before I heard about Qwo™, but I never pursued it because it would’ve needed a decent amount of downtime to recover. I left the article open on my phone’s browser for a few weeks and eventually decided to see if anyone near me was already offering the treatment. I found a doctor who I got on with, who understood the results I was looking for, and who was able to be honest with me with what was realistic in terms of achieving those results.
  </Response>
  <Question party={The AEDITION}>
    Talk us through the procedure. Was there any discomfort?
  </Question>
  <Response party={Frankie}>
    My doctor told me I wouldn’t need any numbing treatment beforehand and she was right. It’s so painless. Maybe butt skin is tougher than face skin — it hurts a lot less than getting fillers! Before my first session, I had a consultation, so we had already discussed which areas were a priority for me. Each treatment session took around 15 minutes, and we were super relaxed, chatting throughout. I had some bruising a couple of days after each time, but it wasn’t enough to make me reconsider going back for my second and third appointments. My doctor told me to expect to see results around 10 days after the first injections. I would say I saw noticeable differences closer to the two-week post-injection mark, but the changes were showing before my second session for sure.
  </Response>
  <Question party={The AEDITION}>
    How do you feel about the results?
  </Question>
  <Response party={Frankie}>
    I’ll be honest, I had some very high hopes for the treatment. You know how you see all these perfect butts all over Instagram? I was hoping this would take me to that level. But my doctor was an absolute gem at explaining what could be done realistically. Although I was gutted that I wouldn’t get the model butt of my dreams from such a straightforward procedure, I understood why and decided it was still the best option for me. In all reality though, now that I’ve completed my course of injections, the results are so good. Add in some self tanner, and I’m decently close to my dream butt, which is a big win in my books.
  </Response>
</Dialogue>

### **Flossie, 28, Boca Raton, FL**
*Despite being a professional swimmer and exercising six days a week for as long as she can remember, Flossie deals with stubborn cellulite. After hearing from a fellow swimmer about Qwo™, she decided to look into it and is currently waiting to receive her second round of treatment.*

<Dialogue>
  <Question party={The AEDITION}>
    Why did you decide to get Qwo?
  </Question>
  <Response party={Flossie}>
    It all came down to recovery time. I’m an athlete and have taken time out from regular training over the past year because of a pandemic and an injury. I couldn’t justify taking more time out for anything more invasive. I hadn’t ever considered getting any cosmetic procedure before. It wasn’t on my radar until a friend of mine was speaking about how she’d had it done. She’s an athlete too, so I was able to ask her about whether it affected her training or not. Once my friend cleared that up, I’d more or less made up my mind that I was going to go for it.
  </Response>
  <Question party={The AEDITION}>
    Was your first procedure in line with what you expected?
  </Question>
  <Response party={Flossie}>
    I have a pretty decent fear of needles, which getting my COVID-19 shot helped with. I was anxious, but not as worried as I could have been going into the appointment. My doctor offered to numb the area before injecting, which I was super grateful for. I was able to bring a friend with me too, so I held onto her hand pretty tightly throughout! There was very little pain during the procedure. It felt like little bug bites, nothing more than that. I didn’t get any noticeable swelling or bruising after, and just carried on with my routine. It was more or less precisely what I’d expected having spoken to someone who had already had the procedure.
  </Response>
  <Question party={The AEDITION}>
    How are you feeling ahead of your next session?
  </Question>
  <Response party={Flossie}>
    I’m so ready for it! I’m treating it as therapy against my needle phobia, too. I’m feeling a bit invincible because I’m proving to myself that I can do something scary without freaking out. I’m starting to see results from my first session now. I could see changes around a week after my first injections, but I plan to track my progress with photos after my next round. All around, it’s been a positive experience, and I’m looking forward to seeing the final results in time.
  </Response>
</Dialogue>

## **The Takeaway**
For women dealing with moderate to severe cellulite and looking for a minimally invasive way to smooth it, Qwo™ is a promising treatment option. Aside from some post-prick swelling and bruising, the procedure has little to no downtime. Consulting with a board certified dermatologist or plastic surgeon will determine if you are a candidate for Qwo™.

A year after it received FDA approval, two women share what it’s like to treat cellulite with the first-of-its-kind injectable.