Will Vaser lipo, thread lifts and skin tightening help my stretched skin and deformities after 2 lipo procedures? (photos)

Question

Will vaser, thread lifts and skin tightening going to help. Had 2 regular lipo procedures which lead to stretch skin and deformities . I'm 29 and have no kids I just want to go back to the way I was before. I had no extra skin and I had a tight abdominal.

Gerald Minniti, MD, FACS · Answer

Your irregularities are not due to sagging or poorly elastic skin. You've had suboptimal liposuction, and  your result is extremely difficult to correct. Vaser liposuction has had a resurgence since Alfredo Hoyos, M.D. introduced the concept of 'hi def lipo'. This single surgeon brought the company back to life and this device occupies the operating rooms of hundreds of surgeons around the country. What you don't know is that Vaser, or any energy based system, can lead to significant unpredictable deformities due to heat formation (it's intended purpose, ironically). Threads are also popular for the face, and there is only one word that describes threads and any of its purported usage: Fraud. As for any purpose built device that 'tightens' skin: won't help you. You're only hope is SAFElipo, developed by Simeon Wall, Jr. He has spent the last decade teaching surgeons around the world this very important technique. This is a technique base system (as opposed to a machine based system like Vaser) devised specifically for revision liposuction using standard liposuction canulas with a variety of tips to produce a smoothing effect. Important aspects of your revision are internal scar rupture, further fat reduction, auto-grafting, and possibly true fat grafting.

Jason Emer, MD · Answer

you will get many opinions but liposuction + internal heating will IMPROVE this but not completely and you will still have looseness when you bend. to really improve this you need fat grafting and a tummy tuck. you can still have kids after. I suggest seeing a revision expert which is 60% + of my practice now.
You need a formal evaluation by an expert in body shaping and contouring to determine what is best.  Traditional liposuction awake and smart liposuction are old methods and do very poorly for tightening skin or significant skin tightening or contouring.  Small problem areas can be improved slightly by these methods.  The best in body contouring not only removes fat with energy devices like VASER ultrasound but also internally heat the skin with radio-frequency devices such as J PLASMA/RENUVION, InMode BodyTite, ThermiRF to heat the under surface of the skin and tighten it at the same time as fat removal. These combinations are called 4D HIDEF VASER contouring and can only be done by a well . trained body contouring specialist. At the same time fat should be harvested, PRP and stem cells added and injected into muscles or indentations/cellulite to get body shaping and contouring.  This is known as a Brazilian butt lift when you inject the fat to the buttock for contouring and lifting, but fat can also be used in areas such as the chest/breast, arms/shoulders, calves and face.  Cellulite should also be treated with cellfina, sculptra, subcision and/or fillers such as bellafill, renuva synthetic fat, or sculptra.  If skin is very loose before surgery then it will need to be removed such as lower abdominal skin (tummy tuck/abdominoplasty), breast skin (breast lift), arm skin (brachioplasty).  Overall you need a full assessment, but simple liposuction alone will not tighten skin and needs a combination of various methods -- fat removal, skin tightening, defining, fat grafting, skin removal -- to get the best in body contouring and body sculpting.  Dr. Emer.

Pedy Ganchi, MD · Answer

Hello,Contour irregularities and skin laxity are potential sequelae of liposuction surgery. Proper patient selection and meticulous technique can help minimize the occurrence of these side effects.Your images show some skin laxity and contour deformities that may be improved modestly via non-invasive laser and RF modalities.  Alternatively a combination of mini tummy tuck and fat grafting can help improve your contours, although this is an advanced revision procedure that requires experience and skill.  I would advise consulting with your surgeon first as to their recommendations.Warm regards,Dr. Pedy Ganchi                                                                                                                                     Village Plastic Surgery

Daniel Barrett, MD · Answer

Dear DGZ27,
I would have to examine you, but it appears that this is a contour irregularity after liposuction.  This happens often when areas the undergo liposuction are not feathered appropriately.
The good news is that it can be fixed and I have done so with good results before. While there is always a chance for contour irregularities with liposuction, someone who takes their time and uses the appropriate sized cannulas should give you a superb result. I have all my patients wear compression garments and I use multiple sized cannulas to feather out the result.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

James E. Chappell, MD · Answer

It would be nice to see your pre-treatment photos to better comment. However, your current appearance is consistent with someone who had a fair amount of fatty lipodystrophy (extra fat) and loose skin, and now just has the loose skin remaining. The contour irregularities are always possible if not expected (to some extent) and are something I discuss pre-operatively. I suspect nothing short of a skin tightening procedure, if only a skin only abdominoplasty, would give you satisfaction. Many doctors advertise that radio frequency or laser-assisted liposuction will fix these issues, but I would be very skeptical of that. Even with skin tightening, some of the contour irregularities may not ever completely go away.

Arian Mowlavi, MD, FACS (license on probation) · Answer

It is difficult to answer your question from just photos. You should consider a virtual or in person consultation with a board certified plastic surgeon. That being said, The definitive correction for liposuction deformities requires the advanced technology of ultrasound assisted VASER liposuction. As an official trainer of VASER liposuction, I encounter suboptimal liposuction outcome referrals weekly. VASER liposuction has been the only modality that has consistently corrected liposuction caused deformities. VASER liposuction ensures a smooth contour regardless of severity of contour irregularities by virtue of being able to remove any and all remaining fat comprehensively and uniformly. Finally, when skin redundancy irregularities are observed, Renuvion technology can be simultaneously applied to tighten your skin to optimize your overall contour outcome. A Skype or FaceTime consultation with a VASER specialist will help you get an accurate recommendation and pricing. 
Respectfully, 
Arian Mowlavi MD, FACS
Realself 100 Hall of Fame Inductee

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