Can Skin Rippling and Cellulite Post-Liposuction Be Eliminated?

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.

Thank you for sharing your concerns about the changes in your body's appearance following liposuction. It's great to hear that you initially saw impressive results, but I understand your concerns about the current state of your skin and body contour.

From your description, it sounds like what you are experiencing may not be cellulite, but rather fibrosis, which is a common side effect of liposuction. Fibrosis is the formation of hard, fibrous lumps of scar tissue that can occur as the body heals from the surgery. This can create a texture that may resemble cellulite and cause the skin to appear uneven or dimpled.

Additionally, the loose skin you are noticing and describing as "loosely connected to the underlying muscle" suggests that while the volume of fat was reduced, the skin's elasticity might not have fully retracted to the new contour of your body. Given your situation, a mini tummy tuck might be an option to consider. This procedure can help tighten the abdominal skin and potentially address some of the loose skin around your hips if it extends into that area.

Here are some steps you can take:

Consult with a Plastic Surgeon: Since these issues can be complex, I recommend consulting with a board-certified plastic surgeon who can assess the areas of concern in person. They can determine if the unevenness is due to fibrosis and discuss options for addressing both the fibrous tissue and the loose skin.

Consider Additional Treatments: Treatments such as radiofrequency therapy, laser skin tightening, or ultrasound may help improve skin texture and firmness to some extent. However, the effectiveness of these treatments will depend on the degree of skin laxity and fibrosis.

Manage Expectations: It's important to have realistic expectations about what non-surgical treatments can achieve. While they may improve the appearance of the skin to some degree, they are often less transformative than surgical options.

Supportive Therapies: Engaging in regular moisturizing routines, maintaining hydration, and continuing a balanced diet rich in vitamins and minerals can support skin health and overall tissue recovery.

I'm sorry you're experiencing these side effects, and I hope you find a solution that helps you feel better about your body. The journey to feeling completely satisfied with surgical results can sometimes be longer than anticipated, but with the right interventions, significant improvements can be made.

I hope you get the results you desire and feel more comfortable and confident in your skin.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic Surgeon

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.

 

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.

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

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.

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.
 

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.

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.

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.