Frank Soto Leon, MD

Hi there! I understand why you’d want to avoid a tummy tuck if possible, and based on what you’ve shared, there may still be a good middle ground. From your photos, it looks like there’s some skin laxity along with a moderate amount of fat.

In situations like yours, I often recommend Renuvion as an alternative to a tummy tuck when patients want to avoid larger scars and more invasive surgery. Renuvion uses a tiny cannula to deliver helium plasma and radiofrequency energy beneath the skin, tightening the tissue from the inside. It can be combined with liposuction to remove any stubborn fat pockets while also improving the skin’s overall appearance and contour.

Morpheus8 can also help with tightening, but it generally works best for mild to moderate laxity. Given the amount of looseness I see in your photos, you might get a better overall result with Renuvion, especially if your goal is a flatter, smoother abdomen without going the full tummy tuck route.

A consultation with a surgeon experienced in both approaches can help you understand what kind of results are realistic for you.

Wishing you the best,
Frank Soto León, MD
Imagen Body Sculpting & Cosmetic Center
Omaha, NE

Hi there Reliable213! In my experience, injecting PRP superficially into the dermis, closer to the level of the hair follicles, tends to produce better results than deeper, subcutaneous injections. I have not seen issues with shock loss when using this approach, even when small blebs form under the surface.

For optimal results, I recommend a series of monthly PRP treatments during the initial growth phase, then moving to quarterly sessions for maintenance.

It’s also worth considering combination therapies. Treatments like exosomes, nanofat, smooth threads, and even Keravive can enhance results by improving follicle health, boosting collagen, and optimizing the scalp environment for regrowth.

Best wishes,
Frank Soto León, MD
Imagen Body Sculpting & Cosmetic Center
Omaha, NE

Hi sarahloveley! From your photos, your chin appears nicely balanced with the rest of your facial features. The profile line we often use in analysis (drawn from the upper to lower vermillion borders) is very close to ideal in your case, and your heart-shaped face creates a beautiful contour naturally.

The area that stands out most is a bit of submental fullness under the chin, which is softening your jawline definition. I believe you’d see the most impact from liposuction of the chin and neck. This would help create a cleaner jawline and more defined profile without the need for implants or major surgery.

A consultation with an experienced facial surgeon can give you a more detailed assessment, but I’d expect liposuction alone to deliver a lovely, natural enhancement.

Best wishes,
Frank Soto León, MD
Imagen Body Sculpting & Cosmetic Center
Omaha, NE

Hi there! From your description and photos, it sounds like you may be experiencing paradoxical adipose hyperplasia (PAH)—a rare but known side effect of CoolSculpting. The good news is that liposuction is considered the best treatment for this, and options like VASER or SmartLipo could work well for you.

At your age, your skin’s natural elasticity is a big advantage. Energy-based lipo techniques like VASER and SmartLipo also encourage collagen production, which often helps the skin tighten nicely without needing any skin removal (ie no big incisions).

For recovery, most patients are back to normal daily activities within 2–3 days, with just a few exercise restrictions. Since your job as a helicopter mechanic may be physically demanding, you might want to plan for about 5–7 days before returning to full-duty work, just to be safe.

It would be worth scheduling a consultation with a board-certified surgeon who can evaluate whether the fullness is subcutaneous (which responds well to lipo) or visceral (deeper fat that isn’t surgically treatable). They can help you decide on the best approach to get the results you’re hoping for.

Wishing you the best,
Frank Soto Leon, MD
Imagen Body Sculpting & Cosmetic Center
Omaha, NE

Hi there! First of all, I’m so glad you’re seeing some new growth starting—that’s a great sign your scalp is responding. But I completely understand how stressful ongoing shedding can feel.

I like to remind my patients that it’s normal to lose about 50–100 hairs a day, and shedding doesn’t necessarily mean treatment isn’t working. In fact, any stimulatory treatment (like PRP) often takes several months to show its full effect, and it’s not unusual to need 6–8 monthly sessions for the best results.

That said, it’s also worth taking a closer look at what might be contributing to your hair loss. Hormonal changes, stress, nutritional deficiencies, or even infections can all play a role. Your PRP doctor should be able to help you explore these possibilities.

In my practice, I sometimes add other therapies to support regrowth and reduce shedding, like:
✨ Scalp Hydrafacial (Keravive) – cleanses away impurities and balances the scalp.
✨ Exosomes, smooth threads, or nanofat – all of which stimulate collagen and hair follicle activity.

It sounds like you’re on the right track, but a combination approach and some detective work into underlying causes could help you get even better results.

Dr Frank Soto Leon, MD
Imagen Body Sculpting & Cosmetic Center
Omaha, NE

When deciding between SmartLipo and Traditional Lipo, it's important to keep in mind that all procedures have their limitations.  That being said, based on your photos, you appear to have good skin integrity (no stretch marks, no wrinkly skin now) with an appropriate amount of subcutaneous fat.  You are likely a good candidate for liposuction (in-person consultation is the only way to know for sure).

Your biggest risk for "wrinkled appearance" will be from over suction (removing too much fat).  

One of the benefits of the SmartLipo is that it stimulates collagen production.  That means that the skin may tighten some because of the addition of the laser.  We use the SmartLipo Triplex in almost all of our liposuction cases because of the added benefits.

Best of Luck!

Hi Cherishher!  There are several skin tightening procedures that can help!  Based on your photos, something like Cellulaze might be a big help, since it will not only tighten the skin, but also help to smooth it out.  Microneedling with Radiofrequency (we use Profound RF) is another one of my favorites for tightening loose skin.  Best of Luck!

Hi Boxinglilly!  Collagen Supplements alone will not likely help much.  That being said, we often recommend that our patients who are having skin tightening procedures (energy based) start on an oral collagen supplement.  I recommend that they look for the ingredient "Verisol" which has good clinical data to support its use ("Oral intake of specific bioactive collagen peptides reduces skin wrinkles and increases dermal matrix synthesis" by E Proksch, can be found on PubMed/NIH #24401291).  This gives your body the building blocks to make the collagen when the treatment stimulates its production.  Diet alone will have no effect on your skin laxity (though dehydration will make it worse).  If you have a lot of loose skin, a tummy tuck may be your best option.  It's best to have an in person consultation so that the physician can evaluate your skin integrity and give you advice on which treatments will get you the best outcome.  Best of luck!