What can I do for skin tightening after lipo of the stomach?

Question

Iv had liposuction done twice. A year later I noticed my skin got loose so I went in again for lipo. Now it's been 7 months and my skin seems like it's more loose when I'm standing up it looks a bit saggy and when I sit I have a big roll over my pants and it's just skin. What can I do to tighten up my skin. smart lipo ? Thermage? What's my best option

Gerald Minniti, MD, FACS · Answer

Hello,I don't understand why you would have a revision liposuction for loose skin.  Liposuction has no direct positive benefits on skin quality.  In fact, it potentially has some direct negative effects on skin that can and do occur, specifically the loss of critical skin attachments to underlying deep structures which can yield an irregular or wavy result.Despite the prolonged media blitz over high tech devices like laser lipo (e.g. Smartlipo), ultrasound lipo (e.g. Vaser), radiofrequency lipo, and a host of external/non-surgical gizmos like Thermage and Exilis, none of these have proven consistently or significantly effective at skin retraction/shrinkage.You will need to be evaluated by a real plastic surgeon that is capable of delivering all of the body contouring surgeries like tummy tucks, not just liposuction.  Certification by the ABPS and membership with the ASAPS are necessary credentials.Best of luck!

Emmanuel De La Cruz, MD · Answer

Hello Dgaribay, 
  
I appreciate your questions! I would recommend consulting with an experienced plastic surgeon to evaluate your candidacy for either VASER Liposuction with Renuvion (J-Plasma) or abdominoplasty (tummy tuck). VASER Liposuction is clinically proven to cause 53% more skin retraction and the risk for contour irregularities is significantly lower with the use of the VASER machine relative to other traditional liposuction methods. In some cases, liposuction by itself won’t be sufficient to achieve optimal results. Therefore, depending on the presence of skin laxity and stretch marks, plastic surgeons might suggest getting an abdominoplasty (tummy tuck). With a mini or full abdominoplasty patients can get rid of excess skin, stretch marks, fat around the abdomen and have their belly button fixed, all in one procedure. After surgery, they will have a firmer, and flatter abdomen. In the future, I’d recommend you sharing photos to better address your questions. Kind regards! Dr. De La Cruz.

Jerome Edelstein, MD · Answer

Tightening the skin cannot be done with liposuction. To achieve more predictable, dramatic results, you'll need to surgically remove the skin with a tummy tuck. You can try nonsurgical methods of skin tightening, but please note that these generally take longer and results aren't as predictable. However, you won't have a scar afterward.

Vincent N. Zubowicz, MD · Answer

Any significant surplus of excess skin require surgical excision. Don't waste your money on any so-called treatment this "tightens" skin.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Sometimes liposuction can create a little bit of looseness of the skin especially to skin is not of the best quality prior to the procedure. There all kinds of treatments that are nonsurgical to tighten skin. I rarely believe in any of those. The best way to tighten your skin or to get rid of the excess more specifically would be to surgically remove the excess.

Jason Emer, MD · Answer

Photos are necessary to see the extent of the problem.  Some people need tummy tucks and liposuction alone makes the skin laxity worse.  For some radiofrequency, ultrasound, or laser treatments of the skin post liposuction can be helpful.  I cannot give an accurate assement without photos or a formal consultation.  I wish you the best of luck, Dr. Emer.

Carmina Cardenas, MD · Answer

Sadly and honestly, there is NO procedure to tighten the skin. If your skin was saggy before liposuction you was candidate for Tummy Tuck, and liposuction is only removing the volume that was holding the skin, but now it is not there, the skin will naturally be sagging. Dr. Cardenas

Frederic H. Corbin, MD (license restricted) · Answer

Photos and a complete history and physical are really needed but from your description it sounds like you are a candidate for a Tummy TuckDr Corbin

Edward J. Domanskis, MD (in memoriam) · Answer

Unfortunately, liposuction does not tighten the skin as much as advertised. If a patient has a lot of excess skin before body contouring liposuction, they will still have looseness after. In order to correct that, you have several alternatives, either non surgical like we do with Thermage as well as Excilis or surgical, various variations of a tummy tuck from just a mini to full.

William J. Seare, MD (retired) · Answer

I respectfully and wholeheartedly disagree with Dr. Minniti. I have over thirty years of experience with lipo and have specialized just Lipo and fat transfer since 1987.  I came San Diego 4 years ago and acquired a military population who had to meet certain umbilical measurements to stay in their service.  In order to get 6-8" of umbilical improvement, we became more amd more aggressive about performing our liposuctions in San Diego.  By removing up to 90% of the fat and leaving less than 1/2" of pinch, we were able to get a single umbilical measurement improvement averaging 6-8" and many times even more.  We discovered when doing this aggressive lipo and removing the fat that prevented the skin contraction, combined with the natural contraction that happen after lipo,  we got skin tightening rivaling even Smartlipo® tightening, but over an immense area compared to the very small areas we can treat with Smartlpo®.  We do not see this is we remove even 40-50% of the fat.  It takes about a 90% reduction circumferentially to get these results.  It usually takes me up to 8 hours of lipo to do the entire 360 degree lipo from the breasts to the pubis circumderentially, but it is well worth the benefits.Dr. seare

What can I do for skin tightening after lipo of the stomach?

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