Almost every week I hear from another company that has a new great machine to get rid of excess skin without surgery. Of course there machine is touted as being better than all of the others out there. I lost faith in these companies years ago.
According to present day plastic surgery lore, there are 5 types of abdomens:
1. requires no surgical treatment
2. is best treated with liposuction only
3. is best treated with a combination of liposuction & a mini abdominoplasty/tummy tuck
4. is best treated with a combination of liposuction & a modified abdominoplasty/tummy tuck
5. is best treated with a combination of liposuction & a standard abdominoplasty.
In relatively few cases there is little or no liposuction needed in a specific patient who lies in one of these categories.
Which category you are in depends on the relative amounts of excess skin/fat vs. abdominal muscle laxity you have above vs. below the navel. There are some good plastic surgeons who believe 4 should not exist. Also, there are probably naturalists, trainers, etc. out there who believe none of these should exist except 1. My experience & training lead me to believe that all 5 are valid & that diet & exercise can be combined with any of the 5. Only 2 or 3 may be amenable to non-surgical skin shrinkage if the machine works. I am not sure that machine currently exists.
There are a significant number of people out there with a condition know as diastasis recti (separation of the 2 central abdominal muscles) which is never amenable to diet or exercise. It is more common after the inherent stretching of pregnancy especially if the muscle is cut during C-section. These people need surgical tightening of the displaced abdominal muscles. Excess fat can be lost to some degree with diet & exercise depending on age, metabolism, etc.. Resistant fat may be amenable to liposuction.
The end result of liposuction or weight loss in turn is dependent on the ability of the skin left behind to shrink. Excess skin is more of a problem. Its ability to shrink after liposuction, pregnancy, large weight loss (decrease in the amount of fat under the skin) or decrease in underlying muscle mass is dependent on age, genetic makeup & how much shrinkage is required to get the desired result. If you need a lot of shrinkage, especially if you are older, it just doesn't happen. Not even exercise can shrink this skin. The result is flabby wrinkled skin that may have stretch marks.
These people require surgical removal of the excess skin because once the skin has been stretched beyond a certain limit it will not shrink much like an overstretched rubber band that has lost its elasticity. Not even ultrasonic liposuction can shrink this skin. If you are planning to or are in the process of losing weight, at any age, it is better to go ahead with the weight loss for health reasons. Once the weight is lost you can then continue an exercise program to tone the muscles. If the skin doesn't shrink it can be excised at a later date. There is no form of exercise that can shrink excess skin. Mild excesses, however, may appear less so after increasing the bulk of the underlying muscle. If the skin does not shrink sufficiently within 6 to 10 months it is unlikely it will ever do so. The presence of stretchmarks means the skin is even less likely to shrink.
The amount of excess skin can be assessed by standing in front of the mirror and pinching the skin above the his on the sides. If the belly button is then covered by skin or if it is covered on standing without the pinch you are a candidate for regular abdominoplasty. In this case you have so much excess skin that no non-surgical machine could get rid of it.