Loose skin? Is this normal after lipo? (Photo)

Question

Hello I am 23 years old and this is my 2nd round of lipo. The first time around I also had loose skin afterwards. I noticed that the garment was pulling my skin towards each other as I tightened it up. I have been a lot more careful and made sure to have foam around me so the garment doesn’t sink into my skin. I am also getting massages everyday however I am scared that my skin will stay like this. Is there anything I can do? Is this normal after lipo?

Raffy Karamanoukian, MD, FACS · Answer

Our Hidef Liposuction protocol addresses skin tightness and laxity, contour irregularities, and body proportions to reestablish harmony in the body. Options include fat cavitation, fibrous release, RF multiplane tissue tightening, fat grafting, fat matrix, liposculpture, and liposuction. Cellulite can also be addressed with our exclusive Brazilian Cellulite Treatment. 
Best, 
Dr. Karamanoukian
Realself100 Surgeon

Farbod Esmailian, MD · Answer

Liposuction is a great procedure as it can produce big results with minimal scaring.  However, at times it is a bit over-utilized.  It is fairly early in your postoperative period to determine how much of the resulting loose skin you have would retract.  I would likely say some of it will but some will not.  You do have age on your side which will help, but if you have had previous pregnancies, that will weigh against you as the skin will be less likely to retract back.I would just be patient for now and see how things look like when you are 6 months out from your procedure.  In the meantime it sounds like you are doing everything that can be done in your postoperative regimen.Hope that helps.

Jason Emer, MD · Answer

It is too soon to tell what your final results will be. You have swelling, which can last 3-6 months after your procedure. I recommend adding hyperbaric oxygen and lymphatic massage along with your compression to help decrease swelling. To improve your final results, I also recommend adding vanquish for further fat removal, exilis/venus legacy for skin tightening, cellutone/z wave to make the skin smooth, remove scar tissue, and improve the skin’s appearance. However, depending on skin laxity, you may have been a candidate for a tummy tuck. See an expert. Best, Dr. Emer

Erik Miles, MD, FACS · Answer

One of the limitations of liposuction is that skin is not removed and the results are very dependent on the elasticity of your skin and how much skin laxity you had prior to the procedure.  Age, genetics, smoking history, sun damage, and nutrition can all play a part in how elastic your skin is.  In some cases liposuction will create loose skin.  In these situations a skin removal procedure such as a tummy tuck is indicated.  Repeated liposuction will not solve the problem. Best wishes.

Daniel Barrett, MD · Answer

Dear Missnewbooty_3,liposuction will only remove the extra fat and depending on the amount of removed fat, it can make your skin loose. Quality and elasticity of your skin will have a significant effect on whether your skin will become tighter after liposuction. Based on your photo before any surgery, it looks like you also had a problem with abdominal muscle separation which should be resolved in order to get the best results. I would suggest you to follow your surgeon's instructions and consult him in case of any concern. Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Raja Mohan, MD · Answer

There are a number of things you can do to help with loose skin after liposuction, including: ExerciseRegular exercise can help tone your body and increase collagen and elastin production. Weightlifting exercises that target specific areas can help tighten the skin. For example, squats and lunges can help with loose skin on the hips, thighs, and buttocks, while bicep curls and triceps dips can help tighten the skin around the arms. HydrationDrinking enough water can help replenish the skin's elastin. DietA healthy diet rich in vitamins, minerals, and lean protein can help keep your skin healthy and supple. SkincareCleanse and moisturize your skin regularly to prevent dead skin cells from building up. Non-surgical treatmentsRadiofrequency treatments and laser therapy can help tighten skin without surgery. These treatments work by heating the skin to promote collagen production. Compression garmentWearing a compression garment for at least six weeks after liposuction can help tighten the skin. Surgery should only be considered as a last option, and is typically only recommended for those who have lost a significant amount of fat. Surgical options include facelifts, neck lifts, or arm lifts.

John V. Williams, MD · Answer

The before photo shows significant bulging and laxity of the abdomen. the post op photos shows uneven excess skin and uneven skin re-draping. The uneven  and excess skin has to be re-draped with excision of the excess skin. Pre op photos also seem to show abdominal muscle laxity. 
Additional Liposuction procedures will more likely than not fix this problem. Most likely a "Tummy Tuck"  will be recommended.

Tim Sayed, MD, MBA, FACS · Answer

The degree of skin laxity (looseness) after liposuction depends on the elasticity/tone of your skin beforehand.Your before photo did not suggest a lot of loose skin but that can only really be assessed on exam, and even then there is no way to be certain the particular patient will have appropriate skin retraction as desired. The fact that you continue to have looseness suggests you had a reasonably aggressive liposuction procedure but your skin elasticity is not sufficient to tighten up to your liking. In these cases it is not unusual to require some skin removal. However, I can not tell from your photo if you are sitting upright, or flexing at the waist, as all patients will have some skin laxity when flexing (otherwise we would not be able to bend and stoop if our skin was fully rigid). See your surgeon in the office to discuss your observations.

Aaron Stone, MD · Answer

It's not clear to me how you went from that before photo to that after photo. The before photo doesn't look like you have that much excess skin. The after could like that if you are sitting in a partial crunch or if you developed a seroma in the affected areas. I doubt that would be just due to how you wear your compression garment. The best person to assess this is your surgeon who has seen you before, during and after surgery. If there is true skin excess you only option will be its removal via a tummy tuck.

Steven Wallach, MD · Answer

When one deflates a large pocket of fat, the ability for it to snap back is related to several factors including how much it was deflated, and what the quality of the skin is like.

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