At 4 months post Tickle Lipo, can loose skin be tightened?

Question

Tickle Lipo 5/31, 31 y.o f. Noticed skin folds/rolls right away. Stomach was flat pre-op. About 3 mos in I developed loose skin. Of note, less than 1 liter of fat was removed from upper/lower abdomen/waistline. Standing up the skin is fine, but when sitting you can see Andrea grab “rolls” . Has been confirmed by board Certified PS it is loose skin. Is it possible my skin will tighten back up over the next 2-3 months?

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

Daniel Barrett, MD · Answer

Dear Flamingopink777,I understand your concern. However, without a proper assessment it would be difficult to determine what is wrong. It is best that you visit your plastic surgeon for further assessment. Only after thorough examination you can get proper recommendations and advice.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jason Emer, MD · Answer

It can take up to 6 months for your final results. Non surgical options give only mild improvement compared to surgical lifting, but this will depend on skin laxity. Skin tightening can be done with a combination of Vanquish, Venus Legacy, Exilis, Cellutone/Zwave. However for best results, a tummy tuck can be combined with a high definition procedure at the same time, depending on skin laxity. For best results, I recommend a hi definition procedure like VASER liposuction. I use VASER HI DEF with ThermiRF and Fat Grafting to get the most fat removal, skin tightening, contour and definition. This combination will give you the most toned result. I recommend getting a formal evaluation with a hi definition physique expert. Best, Dr. Emer

Anteneh Roba, MD · Answer

It’s hard to give good advice without photos, having said that a tummy tuck would help a lot. Non surgical options would be treatments like the J Plasma, RF, body tite and a few others

Edward M. Zimmerman, MD · Answer

Hi Ms PinkFlamingo!  Great questions.  Ain't no replacement for youth and that under 25, never been pregnant, eating right and working out, body!!
We don't know from your question,  what your initial weight/BMI/measurements were, your natural elasticity (ancestry), if there are stretch marks and if your torso was ever larger around previously due to weight or babies?  All those factors can make a difference on the route and manner we suggest to enhance your figure.
Let's assume you were average weight, average exercise, minimal stretch marks, no babies and you were never heavier.  The one liter (about a quart US) of fat that was removed from your mid-section left a deflated space that was initially filled by swelling and inflamed tissue that takes several months to resolve.  Collagen and elastin from any invasive procedure generally take 90-120 days to show visible smoothing and tightening.  At 4 months out, honestly, you are not likely to see a lot more tightening-some, perhaps, but not a lot and the swelling that was masking the deflation has resolved.  Bummer!!
In your ideal world, you might have been offered Laser (SmartLipo and others), Mono-polar Radio Frequency (ThermiRF or BTL) or Helium Plasma (Renuvion) to "shrink wrap" the skin and tissue an additional 10-20% after the fat was sucked/scraped/washed/ from the inside.  If there is a lot of extra skin expected, you might have considered surgically moving the belly button upwards to release the redundant skin and trim the extra-sometimes 3-10 inches tall by 20+ inches across!) from the inferior  abdomen.  That's called a skin excision with umbilical relocation.  If the underlying muscle is tightened at the same time, then we call it an abdominoplasty.  It generally leaves a scar somewhere in the underwear area.
What to do now?  If there is just a bit of extra skin, then external RadioFrequency micro-needling (Profound, Vivace, and others) may be enough to fulfill you skin tightening needs for at least a few years.  If you regain the weight around your middle, that will re-inflate the skin, but if you get thinner as you age, the appearance of extra skin when you sit, may return.
Surgery trades removal of extra skin and stretch marks for a while, but torso skin stretches, the spine looses height over years and abdominal muscles relax and lose volume.  The scar is now part of your wardrobe....so think long term happiness if that is a good trade.
A new technology called EmSculpt causes your abdominal muscles to enlarge without actually doing the exercise yourself.  What would your belly look like if you did 20,000 (yes, 20,000!!) crunches in 30 minutes twice a week for a few weeks?
Hope that gives you something to ponder constructively.  Either way, the fat is probably better gone for your long term health, so something to rejoice about!  Enjoy the journey!
Best, Z

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