Skin quality can have an effect on results

Elasticity of the skin is an important predictor for outcomes.  The thinner and less elastic the skin, the less it is able to contract and tighten in response to various laser procedures and the less it supports in response to surgical lifting procedures.

In general, younger skin has more elasticity (although this can be patient dependent), genetics, smoking, nutrition, sun damage are also factors in healthy skin quality.

In certain cases, poor skin quality or elasticity can be partially reversed through the use of laser resurfacing techniques. Resurfacing can eliminate damaged collagen and elastin, remove old sun damage and stimulate your body to make newer healthier collagens.  So there is hope for SOME reversal and some patients should consider some of these procedures ( CO2 laser, fractional lasers) prior to having a major lifting procedure.

It is important to perform the procedure that fits the anatomy and the expectations, not the other way around. Too often a "standard" procedure is performed without customizing it ,or modifying it or the patient's expectations, to accompany the anatomical realities. Skin quality is variable for sure, but if a patient's skin is "bad", the procedure should take some of that into consideration.  Skin might be "thick", or "thin", have lost elasticity, or is prone to hyperpigmentation or hypertrophic scars, but it does not usually cause lumpiness, pulled-down ear lobe, or residual sagging skin. You might ask your surgeon what he means exactly by "bad".

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