Aaron Jeng, MD, MPH

Congratulations on your weight-loss! You look great and I am glad that you are maintaining a healthy weight and lifestyle. There are laser and RF devices that can improve elasticity; I use the newest FDA approved technology that is safe and approved for skin tightening- Tempsure. I would pair it with non-ablative laser resurfacing to address scarring, discoloration, resurfacing/retexturizing. 

You can get great results with lasers; however, if there is too much excess skin a tummy tuck would yield better results. Given that you have not had any children, and that you prefer not to undergo surgical risks/downtime... you appear to be a good laser candidate as long as expectations are properly managed. 

Without knowing the method they used to apply, the chemicals they applied, how long they left the acid on before neutralizing, their method of neutralizing, along with not knowing post-treatment care, any underlying conditions etc., it is difficult to know exactly how these results were achieved. Either way, you need to let your skin continue to heal. The pink skin is the newer skin. Hypopigmentation is rare, but when it does happen it is a risk most commonly associated with deep peels. This is why it is imperative to have a physician assessment prior to every treatment, as well as to have a properly trained provider for every treatment. It is rare that a properly applied chemical peel will cause scarring. Please make sure you communicate your skin concerns with your care provider so that they can prescribe medications to help minimize the appearance of any abnormalities. Give your skin 5 weeks before trying any new treatments (whether that is chemical peels or lasers, etc.)     

With that said, Chemical Peels, when properly performed, are an effective treatment to exfoliate the top layers of skin and thereby minimizing the appearance of hyperpigmentation, scars, pores, fine lines, wrinkles. Also, because chemical peels accelerate cell turnover, they are also an effective treatment for acne.

from patients of mine that have had both procedures, they’ve all said Kybella was “painful during and after procedure” and that SculpSure is just “a little uncomfortable during the 25 minute treatment.” They have also said that they were not happy with the results of their Kybella treatment, hence why they got SculpSure.   

From a physician’s/provider’s perspective, since you are also concerned about skin laxity being created after the fat reduction, I would recommend SculpSure as the heating of the fat cells will also heat the subcutaneous tissue causing micro-injuries, which will promote collagen production; this will actually cause some skin tightening. 

Sculpsure heats up the fat to the point of destruction (42-47 degrees Celsius). TempSure Envi (skin tightening device) heats up an area to no more than 41 degrees Celsius (before the point of fat destruction) so that it only causes micro-injuries to promote collagen production and thus cause skin tightening without fat loss for areas such as the face. So, since SculpSure is similarly heating an area for a sustained period, a pleasant side affect of the fat destruction procedure is some improvement in skin laxity. 

I developed a combination of procedures that achieve a natural facelift appearance. 

(All devices are FDA approved)

1. Stimulate collagen production + skin tightening, under eye bags/discoloration

2. Address hyperpigmentation, discoloration (including rosacea), spider veins/capillaries 

3. Resurface, exfoliate multiple layers, minimize pores, promote collagen, tighten skin, wrinkle reduction/elimination

.

Repeat. 

No downtime. No scars. No needles. 

There are a number of devices that operate on a similar premise as Tempsure Envi - where an area is heated to a certain temperature to cause minor damage, which then induces the production of collagen, thus tightening the skin. The difference with Tempsure Envi is that there are multiple safety mechanisms built into the machine so that the device will not heat the tissue past  a certain point and cause undesired effects that has happened with other devices.

Other skin tightening options: chemical peels, lasers.  

Your scar is young (under 12 months), so you are picking the best time to address this. To revise scars, there’s a method that uses lasers to resurface the scar. Depending on the severity of the scar, which is best assessed in person, it may take 3 or don treatments. In My practice, I like to address scars’ pigment as well the depth or elevation. I cannot tell from this picture if there’s any pigmentation changes, but I can see it is indented a bit. I have a RF device that I would use in conjunction with the laser. The RF device would treat the subcutaneous layers of the scar to promote collagen production; this will elevate the depth of the scar to even out with the rest of the surface. With the techniques that I use, you would not have downtime. So, you wouldn’t need to miss work or any social events. My Medical spa Clinic is in the LA area if you would like to come by for a free consult. 116 E Broadway, Penthouse Suite, Glendale, CA 91205   

Using RF to destroy fat works similarly to a laser. It heats the area up to between 42-47 degrees celsius. The area must maintain this temperature for a set period of time (about 20min) in order to damage/destroy the fat cells in that area. The efficacy is similar to that of Sculpsure as this device also uses heat (via laser) to destroy fat. The heating aspect is a great method because it provides a feathering affect to the surrounding area, thereby creating a smooth and natural contour. I have a RF device that I use at my clinic for skin tightening and collagen production; it is capable of fat destruction if the settings are increased. However, I prefer to use Sculpsure Submental as it has the "cool blast" feature in order to limit any discomfort during the 20-25min long treatment.