When is J Plasma necessary with liposuction?

Question

I'd like to know when you believe J Plasma is necessary in conjunction with liposuction. I went to a consultation, and my doctor advised to not spend money on j plasma, but other doctors suggest it's necessary. I'm unsure of what to do and would appreciate your advice.

Jason Emer, MD · Answer

In our practice, we always follow liposuction with Renuvion J Plasma. This is because whenever fat is removed, skin laxity is created which diminishes the otherwise excellent results our patients want to see. It is crucial that we tighten this skin so that our patients look tight and sculpted with no loose or sagging skin.

Arnold Almonte, DO · Answer

One of the main challenges in face or body contouring is how to manage loose skin after liposuction. Options after liposuction used to be just two: wearing compression garments until the skin shrank over time,  or undergoing surgical skin excision which required longer incisions. Renuvion emerged as a “middle-of-the-road” tool used to tighten skin after lipo without making longer incisions. Patient selection is the key. An experienced plastic surgeon can make that determination for you. In your case, if you’re young and have good skin tone, you may not need Renuvion as skin shrinkage alone would achieve your goal.

Connie Hiers, MD, FACS · Answer

I like to use technology like Renuvion and J plasma when there is or will be loose skin with or after liposuction. However, the amount of loose skin is not too excessive and does not need a tuck. You can always just do liposuction first. If after 6 months, you are concerned about your loose skin, then get it done.

Darryl J. Blinski, MD · Answer

This is a very interesting question in regards to the use of a technology that has very limited applications. The J plasma helps with some skin retraction, but is not a guarantee plus, it also has some major complications of causing severe internal fibrosis internal burning and scar deformities. I recommend J plasma if the patient has previous liposuction and very scarred down areas of fat or fibrosis on very low settings. I also use plasma for abdominal sketching. I also use it in revision liposuction or skin retraction of any kind is advisable. Since you did not post any photos, it’s very hard to advise best to post photos or do in virtual or in person consultation with only board-certified real plastic surgeons. 
Expect fees to increase by $1000-$3000 with use of Jay plasma since the device is quite expensive these days. Good luck.

Mats Hagstrom, MD (license on probation) · Answer

If you have money to burn and want to try experimental procedures, that can “theoretically” create an improvement then add Jay plasma to your procedure.
I purchased the device several years ago and used it for one year.
During that time, not a single one of my patients noticed any skin tightening.
I made objective measurements from skin markings, moles, incision lines, etc. and after six months we remeasured these markings and saw 0 inches in the skin tightening.
 in my personal opinion based on extensive firsthand experience, this device does nothing but potentially induce harm, create complications, and gives zero skin tightening.
The device is a complete sham.
I don’t own bodytite I can tell you whether fairly good amount of certainty that that device will also not deliver measurable or visible skin tightening.
I’ve yet to meet a patient who was thrilled by having either one of these treatments.
I think plastic surgeons are apprehensive to acknowledge the device. They spent over $100,000 purchasing actually doesn’t deliver and an ad desperate attempt to recoup their loss. They continue to promote the use of the device.
 I was myself in that situation, but as a true patient advocate, I took the loss, sold the machine and told the truth.
This has been particularly unpopular with the company that sells the device and some degree providers who are still trying to make money using it.
To date, I have not been followed by dark cars in tinted windows. Regardless, I’m going to continue to speak the truth and share what I believe to be the truth in the name of patient advocacy.
Now let’s talk about something that’s really important.
Delivering consistent quality. Liposuction results is far more difficult than most people realize.
The number of plastic surgeons have truly mastered this procedure is very small.
Most plastic surgeons. Think they’re good at Liposuction when, in fact, they have just begun to scratch the surface of what this procedure is actually capable of.
Likewise, the ability to distinguish individual patients candidacy for the procedure is equally difficult. The ability to master the procedure, including the ability to assess patient’s candidacy our critical in order to get consistent quantity results that are predictable.
I believe most plastic surgeons still have outcomes that baffle them in that sometimes results are good and sometimes they are not when it comes to Liposuction.
Recognize that Liposuction results are permanent, irreversible, and can’t potentially leave people permanently disfigured.
Being bored, certified in plastic surgery does not mean somebody has mastered any one single procedure especially not Liposuction.
Mastering Liposuction as a long steep learning curve.
Of all plastic surgery procedures, I believe Liposuction results have more variation, depending on who does the procedure than any other plastic surgery operation.
The importance of provider selection cannot be over emphasized.
It is also equally important that patient understand if they are a good candidate, average candidate, or not such a great candidate for this procedure.
Generally speaking young, slightly overweight, individuals with tight skin, and no pregnancy related changes tend to be the best candidates for Liposuction.
Older individuals with significant skin, laxity, excess visceral, fat, muscle, separation, or other variables, not related to excess subcutaneous fat tend to not be ideal candidates for Liposuction, and should not expect quality outcomes, regardless of who does the procedure.
 to find the right provider I suggest patients have multiple in person consultations with providers in their own community.
Look for those plastic surgeons who seem to do a lot of liposuction or work for Liposuction specialty clinics.
Board certification in plastic surgery is important, but does not mean somebody is talented at Liposuction.
 During each consultation, ask each provider to open up their portfolio and show you their entire collection of before and after pictures.
And provider should have no difficulty showing you the before and after pictures of at least 50 previous patients.
In fact, highly experienced providers should have access to hundreds or preferably thousands of before, and after pictures to show you.
Being shown only a handful of pre-selected images Representing the best results of providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider, how many of these procedures they’ve actually done or what your results are likely to look like.
When reviewing before, and after pictures in a multi provider, practice always insist on seeing before and after pictures of the actual provider who is going to do your procedure.
Seeing results from providers, other than who is going to do your procedure means nothing.
When working with large corporate Outfits recognize it’s not the company doing your procedure it is one specific individual, and it is the skill and experience of that individual provider who is going to determine your results, regardless of of the reputation of the organization.
Everyone has had their first day on the job.
Bring pictures of your own body, the same way plastic surgeons take before and after pictures and use these pictures as reference when reviewing before and after pictures.
Don’t go by memory when reviewing before and after pictures.
Have each provider explain your candidacy for the procedure.
Ask them to tell you what reasons make you a good candidate and what reasons are going to limit your potential outcome.
 The most typical variables that are going to influence Liposuction results are laxity from previous pregnancies or weight loss, increased age, excess, visceral, fat, muscle, separation from previous pregnancy, excessive cellulite, previous pregnancy.
When reviewing before, and after pictures, ask the provider to point out exactly what areas were treated and what areas were not treated.
Ask them to point out the transition zones between treated and untreated areas.
Look very closely and all transition zones between treated and untreated areas.
Take careful notes during the consultation, noting how much time the provider spent with you, the overall quality and quantity of before and after pictures, did they point out exactly what areas they recommend treating and why? Did they discuss with you anesthesia options and why they recommend the type of anesthesia they do? Recognize that Liposuction can be done with patients awake or asleep.
It could be done using general anesthesia, twilight sedation, light, sedation, or local anesthesia alone.
Regardless of the amount of sedation, local anesthesia is always used during liposuction.
Continue having consultations until you feel pretty comfortable. You found the best provider for your needs.
This may take having 4 to 6 consultations or more.
Unless you feel very certain someone has really mastered this procedure simply continue looking until you find the right provider.
 I cannot emphasize the importance of being thorough when it comes to provider selection.
For all those thousands of patients who’ve been disfigured from Liposuction, that outcome was completely preventable if those individuals had taken the time and effort and responsibility to vet providers properly and select Out providers who have a proven track record.
Never assume Somebody is good at Liposuction until they can show you evidence that they are.
Best,
Mats Hagstrom, MD

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