Dear Ludmila, Thank you for your question concerning the management of sagging skin after liposuction, especially in the upper back area. It's understandable to have concerns about skin elasticity and contour post-procedure. Here are some strategies that may help improve the appearance of the skin and support your recovery process. 1. Continued Use of Compression Garments: You're already wearing your compression garments, which is excellent. These garments play a crucial role in supporting the healing tissue, reducing swelling, and encouraging the skin to retract and conform to your new contour. Continuing to wear these as recommended by your surgeon is vital. 2. Lymphatic Massage: Starting lymphatic massage can be beneficial for improving skin texture and elasticity. Lymphatic massage helps to reduce swelling more efficiently and can encourage better circulation, which in turn supports skin tightening and healing. Usually, you can begin lymphatic massage as soon as your surgeon gives you the go-ahead, often a few weeks post-surgery, once the initial healing has occurred. 3. Hydration and Nutrition: Proper hydration and a balanced diet rich in vitamins and minerals can support skin elasticity. Foods high in vitamins C and E, for example, can help in collagen formation, which is essential for skin health. 4. Skin Tightening Treatments: There are various non-surgical skin tightening treatments available, such as radiofrequency, ultrasound, or laser therapies, that can improve skin elasticity. These treatments work by stimulating collagen production in the dermis, leading to tighter, more youthful-looking skin. Discussing these options with a dermatologist or your plastic surgeon can provide insights into what might work best for your situation. 5. Exercise: Once you're fully healed and your surgeon has given you the green light, incorporating exercises that target the upper back could help improve muscle tone beneath the skin, potentially improving the area's overall appearance. Regarding the timeline for skin retraction, it varies from person to person depending on factors like age, skin quality before surgery, and how well the post-operative care instructions are followed. While significant improvement in skin tightness can occur within the first 6 months, it may take up to a year to see the full extent of skin retraction and healing. It's essential to maintain open communication with your surgeon throughout your recovery process. They can offer personalized advice, assess your progress, and recommend additional interventions if necessary. While some degree of skin laxity might remain, especially in areas with inherently looser skin, the measures mentioned can help maximize the aesthetic outcome of your procedure. Sincerely, J. Timothy Katzen, MD, FASMBS, FICS Plastic and Aesthetic Surgeon