Can Skin Rippling and Cellulite Post-Liposuction Be Eliminated?

I had Liposuction done 12 weeks ago. I'm 35, 5'8 and pre-op I weighed 141.7lbs. Fat was removed from my outer and inner thighs, lovehandles and knees. I must admit that looking at my body (fully clothed) in a mirror right after surgery and before the appearance of the swelling the results were impressive beyond imagination.

Now, my feelings are rather mixed about having the liposuction. My appearance has improved greatly, and I get very encouraging feedback from my friends, but I'm not happy with my body when I see me naked. My cellulite now seems more pronounced and there still are bulging areas, not as bulging as they used to be, but my body contour is not completely trimmed either. Apart from that my hips seem to have dropped, and the skin, when pinched, seems to be loosely connected to the underlying muscle. It feels as if I have the body of a woman 10 years younger and the skin of a woman 15 years older.

Are all these problems to be expected after liposuction? I'd also like to know if there's anything I can do to help treat those problem areas? Will any additional treatments (like mesotherapy, lipomassages) help, and up to what extent?

Doctor Answers 9

New Laser Liposuction Technology Can Smooth Skin and Tighten Skin after Old Style Liposuction

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Dear C_Pan,

Your experience is very common following traditional liposuction. Most patients who have had liposuction are very happy with the fat removal and the improvement in body contour. However, as many as 20% of people who have had a successful liposuction report skin irregularities, lumps, bumps, and uneven areas called contour deformities and loose skin.

First, I would recommend massaging the skin and the areas that are swollen or lumpy-this will help. Also, exercising to firm and bulk the muscles beneath the skin can help fill and firm your skin.You are only 12 weeks, you still have swelling, and you will improve with time. You will not know your final appearance for at least 6 months to a year.

When fat is removed from beneath the skin by suction, the skin must shrink or tighten back to the body contour. With large volume liposuction and with patients who do not have good skin tone, often the skin does not shrink enough and loose skin is left behind.

Irregularities and uneven areas occur because of uneven or non-uniform fat removal during the suction procedure.

New laser liposuction techniques have radically changed the occurrance of these problems in my clinical experience.

In laser liposuction, a small laser fiber is inserted beneath the skin to liquefy the fat before it is removed by suction. Melting the fat makes removal much easier, and smaller cannulas (the tubes that suck the fat out) are used. The heat from the laser also tightens the skin as the treatment is done.

In my experience with laser liposuction, in over a year, so far my patients have had uniformly smooth skin and firm skin after their laser liposuction procedure. See before and after photo.

In addition I have had success in correcting skin irregularities in patients who have lumps, bumps and contour deformities after old style liposuction.

The laser fiber is re-inserted and the irregular areas are treated with the laser. Thus treatment has had a smoothing and firming effect on the areas treated. See photo below. On the left I have marked with a purple circle irregularities on the abdominal skin which were left behind after a standard liposuction done two years before.

Before and after laser liposuction to correct the contour deformities on the skin

Laser liposuction is new and not widely available yet. However I am sure the popularity of this technique will rapidy increase because of the smoothing and skin tigfhtening benefits.

As I said in the beginning, you will get better. I would not think about any revision until at least a year after your original liposuction, and by then you may not need it.

Cellulite can be treated by multimodal therapy in experienced hands

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n my practice I have found that the only way to improve cellulite is to attack it with several different noninvasive technologies to contract and smooth at different depths. I call it Maercks Multimodal Therapy or MMT. I have never seen any one technology have an impressive effect on its own. Remember for most interventions, who performs the procedure and how they do it is more important than a brand name!

All the best,

Rian A. Maercks M.D.

Cellulaze Best for Cellulite Reduction

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Thank you for your question. I would suggest Cellulaze to reduce your cellulite. Cellulaze is the only minimally invasive laser procedure designed to attack the structure of cellulite beneath your skin. Cellulaze is backed by many years of clinical research. Studies have shown it increases the thickness of your skin by 25% and the elasticity of your skin by 29%—significant claims that haven't been made by any other treatments. Thicker and more elastic skin can help flatten and smooth the skin surface to improve the appearance of cellulite. In addition, 93% of patients surveyed were satisfied or very satisfied with their results at one year post their procedure, and all would recommend the Cellulaze cellulite laser treatment to a friend.

Skin rippling after liposuction

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Liposuction is a safe, popular, and effective way to contour the body. For a successful outcome it is essential that patients use a tight compression garment specifically designed to add even pressure to the area that has been treated. Patients experience long-term swelling after liposuction himself we recommend that are wear their compression garment and waits for 6 to 8 months to see the final result. At this time, you should be evaluated by a board-certified plastic surgeon will be able to assess your results and the quality of your tissue and determine the best course of action. They may recommend that you continue to wear the garment or may recommend treatment such as massage or even external ultrasound.

Choose options carefully

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Unfortunately some people experience what you have when the skin lacks enough elasticity to shrink evenly after lipo. Your options are fairly limited because in general cellulite treatment is not yet a perfect science. You may wish to see someone who has experience with Thermage cellulite treatment, or the Accent laser. I have not been impressed with what I have seen presented for mesotherapy.

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

Liposuction and Cellulite - one solution

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Cellulite After Liposuction

Obesity, cellulite, stretch marks, a history of back and forth weight loss, or loose, sagging, inelastic skin are problems which would tend toward poor results during a liposuction. In fact, these problems may be worsened by this procedure and may be best addressed by other surgeries such as a leg or body lift (e.g. tummy tuck) to improve your appearance if appropriate (loose skin). Lymphatic massage may also be of benefit within the first year following liposuction.

For treatments that helps to treat your cellulite, there is a laser treatment called Cellulaze that was recently approved by the FDA last year. This procedure is proven to show better results after one session. The outcome lasts one year or longer, but you may need followup sessions depending on the results.


Appearance after liposuction

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Right now you are only 3 months after liposuction. Although the majority of swelling is probably gone, there is still some time to heal. Cellulite can be improved sometimes by local fat injection release of the fibrous attachments, and some laser procedures.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Be patient!

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Most people are pretty stable in their recovery from liposuction at three months. Some take longer. Final results from liposuction require healthy contraction of the scar produced under the skin. This can take a long time to finalize. If you have questions go see your surgeon and voice your concerns.

I have found that massage and endermologie have helped some patients after liposuction. Going back to the gym and increasing muscle mass will improve the look of tightness in the legs and buttocks area.

Good luck.

Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.8 out of 5 stars 69 reviews

Thermage can tighten the skin of the thighs.

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To C_Pan,

Hi! I am glad that you stress the positive. You have a good attitude and will do well. Here are some facts:

1) It takes 4 months to see the final result of liposuction. So don't contemplate anything for at least another month.

2) Liposuction should not cause your skin to become looser.

3) In fact, when done together with superficial, subdermal tunnelling, liposuction can tighten the skin and improve cellulite.

4) If you have residual bulges, you may need touch up liposuction.

5) Of the non invasive treatments, we have had the most success with Thermage to tighten the skin of the thighs and improve cellulite. High energy settings need to be used with multiple passes. Almost everyone gets improvement, but the degree of improvement varies from subtle to quite dramatic. TECHNIQUE is very important with Thermage.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

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.