The short answer is it has effects on even larger patients. It depends upon your expectation. Taking you from a BMI of 42, it will not make you a 26! Heavier patients can get a real jump-start on the body contouring effects of dieting and exercise. Their worst areas can often be responsive to Vaser Shape treatments and encourage them because their clothes fit better on their way out of the office visit with no surgery or anesthesia, or downtime. Of course, we counsel patients who are not at ideal body weight to put their efforts and financial commitments into lifestyle choices that will best serve them in the long term.
The short answer is that Vaser Shape can make a difference and it is a matter for you to have a frank conversation with your plastic surgeon as to what your goals are so they are met and not underachieved.
The skin you describe is a very common dilemma for optimum outcome. Obviously, the skin inelasticity on a 50-something even at ideal weight is less tone and skin thickness than a 30-something at exactly the same weight.
For you, I would tell you that indeed there is a setting called continuous mode that can heat your skin and provide over time and serial treatment the most optimum skin tightening available in a non-surgical treatment. Patients who are in your circumstances often consider a lipo-abdominoplasty because it will optimize the thinning of the abdominal fat layer with Vaser technique and then with a tummy tuck tighten the fascia as well as re-drape the skin and make it the tightest outcome possible.
For visual assistance in seeing this, I recommend you go to my gallery at paulvanekmd.com and take a look at panniculectomy Vaser patients. Given your desire to avoid surgery, I would say that Vaser Shape is the most likely modality to make a significant improvement for you. The body contouring improvement with thinning the “quilt” of the subcutaneous fat layer using the modulated mode is excellent and then using continuous mode and the lymphatic drainage the patient will have the most optimum amount of skin tightening of any non-operative body contouring treatment on the market thus far. Good Luck!