So Many Lipo Options, Which One is Best? (photo)

This year I have dropped from 250 to 185 unexpectedly. The loss has left me with folds of skin on my lower abdomen, inner thighs, lower buttocks, and arms; as well as lumps of “bra fat” on my back and fat above my buttocks. My bra size dropped from a 42DD to a 38D; my breasts are now shapeless, flat, and sagging. What is the best procedure to address the sagging and lumps? It’s NOT about weight loss.

Doctor Answers 13

Lipo may make you looser.

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Thank you for your question and congratulations on your weight loss.

Liposuction, like your weight loss, removes fat from under the skin. As the skin loses volume it actually gets looser not tighter in most patients with significant weight loss.  You would need to be examined by a board certified pastic surgeon to see if liposuction is the right choice for you, but from your description, you may be better off with skin tightening procedures such as a breast lift, thigh lift or tummy tuck.


Best wishes.

Washington DC Plastic Surgeon
5.0 out of 5 stars 115 reviews

Best Option after Weight Loss?

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Thank you for your question and photos.Congratulations on your weight loss.

In general, when there is significant weight loss (as in your case), the procedures that will assist the patient with the loose, excess skin would be tummy tuck / body lifting not liposuction.  Liposuction will not help with the "folds" that you are describing.

Visit with a well experienced plastic surgeon to discuss your goals and see what procedures would help you achieve those goals.

Best Wishes.

Liposuction doesn't remove excess skin

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Unfortunately liposuction does not address loose skin.  An abdominoplasty would be a better option to remove the excess skin and fat in the abdominal area. A brachioplasty and thighplasty are also good options to address your arms and inner thighs. You may also want to consider a breast lift with or without implants. Consult with a plastic surgeon who routinely performs surgery on patients who have had major weight loss.

Laxity correction different than liposuction

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Thank you for the question.  Fat reduction through one of the many liposuction techniques is different than laxity correction.  When the skin and soft tissue has lost it's elasticity the excess skin needs to be removed surgically through breast lift, tummy tuck, bra line back lift, etc.

All the best,

Dr Remus Repta 

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

Body Contouring

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Congrats on your amazing weight loss! It is very common to have loose skin after losing that much weight. Liposuction simply removes more fat but it does not tighten the skin and may make it more loose. Most likely you need some sort of skin tightening procedure: tummy tuck, breast lift, lower body lift, arm lift etc... You should see an experienced, reputable plastic surgeon for a consultation to learn all of your options. Good luck!

Daniel P. Markmann, MD
Baltimore Plastic Surgeon

Traditional Liposuction Is Best By Test!

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With that degree of weight loss, you will certainly have some need for skin resection and a breast lift, probably with implants.  As far as the areas to be liposuctioned, traditional liposuction has 30 years of experience behind it with minimal complications.  All the various vaser, laser, slim and smart lipo have a lot of hype but very little proof that they are better than the traditional liposuction. 
Choose a Board Certified plastic surgeon experienced in both liposuction and various types of skin resection.  It's the skill of the surgeon and not the technical equipment that will give you the best result.

Plastic Surgery after Weight Loss

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With your degree of weight loss and skin folds, it seems that a tummy tuck and breast lift (with or without implants) would be indicated.  Liposuction of some areas may also be appropriate as well, but for significant skin excess as you describe, a tummy tuck for example would address the problem better than any type of liposuction.  A consultation with a board certified plastic surgeon will help you determine which procedures are best for you.

Arnold S. Breitbart, MD, FACS
Long Island Plastic Surgeon
4.8 out of 5 stars 160 reviews

Massive weight loss

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From your description you have excess skin and may be residual persistant fat pockets. and empty breast

You may need a tummy tuck, possible lower body lift with or without liposuction of the fat pockets and a breast lift with or withour a breast implant depending on your choice.

Samir Shureih, MD
Baltimore Plastic Surgeon

Lipo won't tighten skin much after weight loss

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There are so many techniques hyped for liposuction that it is all but impossible to determine if any one is really better. In general the most important factor is the experience of the surgeon, not the technology. I would especially caution you to be wary of claims about skin tightening with laser lipo procedures (such s smart lipo). Although there may be some small degree of extra skin shrinkage as compared to lipo without the laser, it isn't anywhere near enough to deal with loose skin after larger weight loss such as you have had. See a plastic surgeon who can advise you about all options.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

For major weight loss, a combination of procedures including liposuction and lift procedures is usually most effective.

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Congrats on the weight loss, although something tells me it was due to a stressful event.  As you might have guessed, you are going to need (1) liposuction, (2) excisional procedures to deal with extra loose skin, such as a tummy tuck and maybe arm lift, and (3) a breast lift.  It is not uncommon to need multiple procedures after major weight loss.  You need surgery, not these types of external liposuction that are supposed to reduce fat without surgery.  I use ultrasonic liposuction, but traditional liposuction is just fine too.  The important part of the machine is the surgeon using it, as surgeons like to say.  You can learn more about your options by checking out these procedures on my website, if you like.  I've attached a link for breast lift.

Eric Swanson, MD
Kansas City Plastic Surgeon
4.7 out of 5 stars 62 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.