Accent Laser for Tightening Post-pregnancy Belly?

Question

I've had 2 Accent Laser treatments on my stomach (done by an esthetician; I've read here that a med specialist should be doing it), and so far I've seen no results at all. I'm not after losing the inches, what I'm looking for is the skin tightening for my post-pregnancy belly. Does Accent Laser really work for this goal? If not, what are my other options?

Michael A. Persky, MD · Answer

Hi Savi,
I my practice, Dana Krammer, RN administers Accent XL.  She is an expert with the technology and is an instructor for the company.  I can vouch for the effectiveness of Accent XL in her hands as our patients have a very high satisfaction rate.  I have asked Dana to answer your question as she truly is the expert with Accent XL.  Here is what she said:
"Well, in regards to the question as to whether or not an esthetician should be using the Alma Accent, it remains a gray area and the judgment call of the medical practice. However, as a training Nurse for Alma Lasers, We do not train or certify estheticians, therefore, the quality of the training and the use of technique may me an issue. Asolutely, the Accent works for skin tightening on post pregnancy abdomens. Please see my before and after photos. It is also important that at the time of consultation you are informed of how the technology works , and what your individual expectations should be.  I would be happy to provide a consultation to elaborate further on your individual situation.
Dana Kramer RN
I hope that this helpful for you.  Enjoy your baby!
Dr. P

Brent Moelleken, MD · Answer

Many patients experience looseness of the skin or fascia (the deep layer lining the muscles) after childbirth.  There is an unfortunate push to market lasers or radiofrequency devices to tighten large amounts of post-pregnancy skin.  These devices are useful to attain small degrees of tightening, i.e. in the face.  These devices will unfortunately not significantly tighten the abdominal skin or the loose fascia.
The reason for this limitation lies in the biology of skin.  Too much energy applied to the skin causes death of the skin due to coagulation of the vessels of the subdermal plexus, the area below the skin.  That is why by nature the energy of these devices must be very limited.  Many treatments cause an improvement in the appearance of the skin on a temporary basis.  This is usualy due to the heat of the treatments causing swelling in the tissues, or evaporation of water on a temporary basis, obscuring temporarily the looseness of the skin.
If there is extra skin that needs to be removed, or fascia that needs to be tightened, there an array of procedures available.
Liposculpture alone can reduce fat but does not tighten skin, and does not tighten fascia.  From the results I have seen, and I would include laser liposuction techniques in this category, I've yet to see a study showing that skin tightens on a permanent basis from energy applied to the very delicate subdermal plexus (same biologic limitations as above).  Often laser energy applied to the skin (above or below the surface) results in rapid evaporation (vaporization) of water, temporarily contracting the skin.  This should not be confused with long term meaningful tightening.
For women with a small amount of extra skin, a mini tuck may be just the right thing.  This is especially popular with women who have already had a C-section and have noted irregularities in their incisions.
For women who have only a small amount of skin to be removed but need the deep layer (fascia) tightened, there is the hybrid abdominoplasty (hybrid tummy tuck) or endoscopic tummy tuck.
For women requiring a large amount of skin and fat removed, a full tummy tuck may be appropriate.
So don't be fooled by a lunchtime device administered by an asthetician promising to tighten the skin after childbirth.

Richard P. Rand, MD, FACS (retired) · Answer

Whether you will be satisfied with this treatment depends on how stretched out your skin is and what your expectations are of the treatment. 
If you only have a minor degree of stretching and expect minimal changes, you might be very happy.  You might even have a placebo effect.  If, conversely, you have a significant amout of loose skin and expect a dramatic improvement, you will for sure be disappointed and will probably need a tummy tuck. 
Unfortunately, they won't give you back the money if you aren't satisfied with the Accent treatments.  So take an honest evaluation of your skin and your goals and expectations.

Accent Laser for Tightening Post-pregnancy Belly?

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Accent Laser for Tightening Post-pregnancy Belly?

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