Lipo with Skin Tightening - What are the most effective lipo-skin tightening procedures out there?

Question

I am getting married in August and I wanted to have liposuction on my abs and love handles. I am5-10 and 165, but I’ve struggled with love handles most of my adult life. I have lost weight in the past, but my skin looks normal when I am standing. It doesn’t look loose or crepy. However, if I bend over, it does hang a little. My concern is that, if I have liposuction, it might hang more. I have heard of procedures that combine liposuction with non-surgical skin tightening. I am aware that results could be impressive for the liposuction, but modest - at best - for the skin tightening. I am willing to accept this, as I will not consider any type of tummy tuck or skin removal. What are the most effective lipo-skin tightening procedures out there, understanding that they won’t be as effective as a tuck or skin removal? I am in the Cherry Hill NJ area and would like to do soon, as I know that healing takes time. I forgot to add that I am male.

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Moises Salama, MD · Answer

Thanks for your question. At my practice, we offer liposuction and j-plasma for skin tightening. I recommend scheduling a consult for a proper evaluation. Please always consult with a board certified plastic surgeon. Take care, Dr. Moises Salama, board certified plastic surgeon.

Michelle Zweifler, MD · Answer

Liposuction removes the excess subcutaneous fat.  This can be combined with Renuvion skin tightening.  Postoperative garments and lymphatic massage helps the skin redrape.  Additionally, Sofwave may help with skin tightening postoperatively.  
Skin excision with abdominoplasty removes the excess skin with tightening the abdominal wall.

David Hansen, MD · Answer

Be sure to get the micro canula liposculpting under local with a little iv sedation for complete comfort. Your doc can stand you up and fine tune the results right then and there.  Also make sure he/she does Morpheus and Quantum/bodytite RF for the most skin tightening possible.  It is worth traveling to see a doc who specializes in this. The micro canulas alone will really help the skin tighten up on its own anyway since you can rough up the underside of the skin so it contracts nicely.

Ricardo L. Rodriguez, MD · Answer

hello,

Congrats on your upcoming wedding.  It is great that you are planning for this procedure now, so you can be completely recovered by August.

In my practice in Baltimore, I use thin cannulas to extract the fat which results in smooth, even results.  I can get the most amount of fat using the thin cannulas as I can get into tight tissue spaces.  There are no drains with my procedure, as is often required for surgeons who use thick cannulas. You are back to work in 1 week. I have been performing this procedure with excellent results for 30 years!

I do not use laser with my liposuction . IMO, results either do not last, or some patients get unfavorable results . Furthermore, I believe that many of these lasers do harm to the adipose stem cells  . For more than 15 years I have been active in an organization  (IFATS) that studies the properties of adipose tissue.  Many patients (from other practices) have consulted with me to repair the damage done by laser lipo.  It can work, but it is hit or miss.  You want tried and true results!

Liposuction to the flanks and abdomen is often called Lipo 360, as the fat extraction is all the way around the mid section. The results can be dramatic!  Your plastic surgeon should be able to tell you if your skin will retract or get any looser following the liposuction.

I explain more about my technique in the link below.  If you have any more questions let me know via the contact form.  Take care and good luck!

Ricardo L Rodriguez MD
Board Certified Plastic Surgeon

Robert M. Tornambe, MD · Answer

I appreciate your concerns however it sounds like liposuction alone should suit your needs nicely. All of the so-called non-invasive skin tightening machines sound sexy but reality don’t work very well. Also, any results or slight improvement after the procedure takes months to attain.Younger and middle aged patient’s skin contracts nicely after liposuction. Come see me or another board certified plastic surgeon in our area to explore the best options for you. Good luck.

Camille Cash, MD · Answer

There are a couple of options for you to consider.  The first is BodyTite.  This procedure uses RF technology both on top of and just below the surface to tighten skin.  It can be combined with liposuction and does not require general anesthesia.  Morpheus8 treatments can also be added to optimize results.  For more traditional liposuction you can add J Plasma.  This too can tighten skin but is often performed under general anesthesia for the patient's safety and comfort.  Visit with a board certified plastic surgeon near you to learn more.

Asu Deniz Burhanoglu, MD · Answer

Nowadays, with the tools used for liposuction in today's technology, tightening can be achieved in the area. This will be very beneficial for you, don't worry, there will be no sagging in the area. However, if you don't consider an invasive procedure, treatments are also possible with fat shredder / firming devices for such problems. These are applications where you can see a lot of changes in a few sessions and you can become thinner and reduce your fat mass. Many treatments can be considered for your complaints and wishes

Christopher T. Chia, MD · Answer

You are accurate in your assessment in that liposuction can be impressive while the skin tightening procedure is moderate in results but still can be significant to the patient. The key is to make sure the patient is a candidate for the procedure. Too much laxity or looseness of the skin and soft tissue will exceed the capability of operation and be unsatisfactory no matter which type is used. Lots of stretch marks and thin skin are hallmarks of damaged skin which has lost the ability to retract which can be due to massive weight loss, multiple pregnancies and the like. No minimally invasive operation will be effective and liposuction with these patients will result in worse hanging skin in most cases since the removal of fat will also remove support of the overlying skin. People with minimal stretch marks, thick enough dermis and moderate fat to be removed have the best chance of good results and contracting soft tissue.

Once a patient is deemed a candidate for liposuction and skin tightening, what are his or her options? The principle of skin and soft tissue tightening lies in the production of collagen and elastin, naturally occurring compounds that contribute to the thickness, structural support and hydration of the skin and soft tissues. Like many things, the body makes less of these materials as we age resulting in thinner and less structurally sound skin. Controlled inflammation is key to induce the body to make more of these and other compounds following energy application. The types of energy used are varied and of differing efficacy starting with the most basic: mechanical inflammation. The act of passing a cannula under the skin imparts mechanical energy to the tissues which in itself stimulates production of these compounds when liposuction is performed. Other types of energy include laser (focused light energy such as SmartLipo), ultrasound (high frequency sound waves tradename VASER), radiofrequency (a type of electromagentic energy such as microwaves, fluorescence, etc. as in BodyTite), and noble gas carrying electrons or plasma energy (such as helium in Renuvion) all of which which heat the tissues to achieve stimulation of the cells to produce collagen and elastin.

However, not all modalities are equally effective in achieving these results and may have different risk profiles. In my opinion having used all of the above machines in our practice, radiofrequency has the most consistent and significant results in contraction compared to all the others and also has the strongest peer-reviewed body of literature demonstrating its efficacy. I also am able to perform liposuction with radiofrequency (as well as the others) under local anesthesia so the patient does not have the additional risk, expense and excess recovery time of general anesthesia if he or she chooses that technique.

All of these modalities are limited in that if there is too much laxity as mentioned above, the only effective procedure is to cut and saw in a traditional surgery such as a tummy tuck or abdominoplasty so choosing a qualified plastic surgeon with lots of experience is important. I have performed over 5,000 of these surgeries on 12 different anatomic areas over my 21 years in practice so have strong opinions on choosing the right one for each patient. Thanks for the question and good luck with your search.

Connie Hiers, MD, FACS · Answer

You did not post photos, which would have been helpful, but liposuction with radiofrequency skin tightening like Renuvion does a good job for most people.  Congratulations on your upcoming wedding!