Non-surgical Tightening Options After Smart Lipo?

Question

I had Smart Lipo done on my thighs 8 months ago. I was told approx. 8,000 cc's of fluid was removed; a lot I know, but my thighs were large and I have very dense muscle mass. The doctor used a laser, Vaser, and suction.

	I am 56, physically fit, work out regularly, watch what I eat, drink lots of water, massage my legs several times daily and moisturize twice daily. In an effort to assist my post-op results, my doctor also provided 8 LipoEx treatments on the front, interior, and exterior areas of my thighs, and 1 mesotherapy treatment on a fatty pocket outside my right thigh. The mesotherapy appears to have done the trick on the fatty pocket.

	I still have small lumps and wrinkly sagging skin on the front of my thighs, skin discoloration, three areas of scar tissue, an unnatural looking transition from my thighs to knees/calves, and consistent burning and tingling all over (particularly shortly after a workout and in the evenings).

	Would something non-surgical like Thermage help tighten the loose skin? I understand that at my age I can't expect to have thighs like a 20-year-old, but after having made such a large financial investment in them, I would really like to look decent in shorts.

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

Jason Emer, MD · Answer

You need a formal evaluation by an expert in body shaping and contouring to determine what is best. Nonsurgical options give only mild improvement as compared to surgical lifting. If there is a lot of skin laxity, a Thigh Lift procedure performed at the same time as a VASER Hi-Definition Liposuction procedure (with ThermiRF, Renuvion, and InMode BodyTite) would give the most improvement. Other options for skin tightening would be a combination approach with Vanquish, truSculpt iD, Venus Legacy, Exilis, and Cellutone / ZWave. I recommend getting a formal evaluation with a high-definition physique expert. Best, Dr. Emer

Peter A. Aldea, MD · Answer

There is a limit to the amount of skin tightening achievable by Laser Liposuction (SlimLipo, ProLipo, SmartLipo etc), Thermage etc. At some point further and complete tightening requires surgery - in your case a Thigh Lift.
Nonetheless, if you want to try another nonsurgical modality I would recommend the Sciton SKINTYTE (part of its IPL machine the BBL). Look it up on YouTube.
Good Luck.
Dr. P. Aldea

Edmond A. Zingaro, MD · Answer

Try Titan treatments. We have had excellent results at Rejuvenation Center using Titan on torso and limbs. Be sure the professional performing the treatments is very well skilled as experience means everything with something so technique dependent.

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