Debating on liposuction (tumescent), will skin be flat after or have saggy skin everywhere and look worse?

Question

I have a few areas that I can not get rid of it tighten with normal daily exercise. I'm okay with my stretch marks staying, all I want is the bulges gone and a flat tummy. Afraid after lipo that my stomach with be filled with saggy skin and look worse than before the procedure. Doctor says skin will tighten after lip and be flat, but I would like a second opinion on if this is true.

Scott W. Vann, MD, FACS · Answer

I feel that most patients who have liposuction will have their skin loosen a bit due to volume loss, and tighten a bit due to healing and dermal contraction. This ends up with the skin being about the same tightness as pre op with the bulges gone. You could have a flat tummy after lipo, if you have flat muscles layer under your fat. Discuss with your surgeon.

Larry S. Nichter, MD, MS, FACS · Answer

An exam would be required to see how much loose skin you have, the amount of elasticity your skin has and how much fat will be removed to be able to answer your question. Most patients are near normal weight and desire permanent contour changes. Patients with average weight, localized fat collections, and healthy elastic skin are the best candidates for liposuction. Obesity, cellulite, or loose, sagging, and inelastic skin are several conditions which may tend towards less desirable results. In fact, these problems may be worsened by liposuction. Unfortunately, many individuals performing liposuction are not trained in other techniques of body contouring and may not have the experience to recognize that a different procedure (such as a tummy tuck) may provide a better result for the patient. Suction Assisted Lipectomy (SAL) may be used in conjunction with other body contouring procedures, such as breast reduction, tummy tuck, thigh lift, or facelift.

Kenneth Hughes, MD · Answer

You may be a good candidate for liposuction, but pictures or an exam would be necessary to evaluate you.  Your choice of surgeon will be the key factor in your result.  Kenneth Hughes, MDLos Angeles, CA

Shim Ching, MD · Answer

Without an examination, it is impossible to tell whether your skin will be loose after liposuction.  Some degree of tightening is possible after liposuction.  If you are seeking a second opinion, post some photos are consult with a board certified plastic surgeon.

Marwan R. Khalifeh, MD · Answer

traditional lipo in itself will not tighten the skin dramatically.  If your skin has stretch marks, it may have lost its elasticity and while lipo is possible, caution is needed.I find that plastic surgeons that do both tummy tucks and lipo will give you the best advice, as opposed to "lipo shops" that tell everyone their skin is going to tighten even when they may be better served with a tuck.get a few in-person consults, and go with the majority opinion.good luck.

David Finkle, MD · Answer

Liposuction is the suction removal of subcutaneous fat.  Subcutaneous fat is located just below the surface of the skin and above the muscles and bones.  It doesn't remove all of the fat, but it does remove the majority of the fat.  The perfect candidate is at or near their ideal body weight and has localized areas of fat that are out of proportion to the rest of the body.  It is not a weight reduction technique.  It can be used on any area of the body, but it relies on the skin redraping after the fat is removed.  So, if you have loose skin, you may end up with wrinkles or folds after the surgery.  Some areas respond better to liposuction than others, the lateral thighs always look nice, the inner thighs and arms, not so much.  The tummy depends on how loose the skin was to begin with.  It does not remove or improve stretch marks.  There are many different terms used for liposuction:Tumescent liposuctionPower liposuctionLaser liposuctionVaser liposuctionSmart liposuctionUltrasonic liposuctionAnd many, many more.  All these techniques vary a little, but the bottom line is that the fat is removed by high powered suction.  A small tube or cannula with multiple holes at the end is hooked to a suction device.  The cannula is moved rapidly back and forth to remove the fat through very small incisions in the skin.  All blood vessels, nerves, muscle, bone and skin is left alone, just the fat is removed.  Large amounts of fluid are placed in the subcutaneous fat before the suction begins to reduce bleeding and to numb the skin, this fluid is referred to as tumescent fluid and consists of a balanced salt solution mixed with adrenalin and a local anesthetic.  There are 3 choices of anesthesia:Local anesthesia (the patient is awake)Local with sedation (the patient is given a mild sedation)General anesthetic (the patient is asleep)The choice is based upon an agreement between the patient and the surgeon.  Make sure you consult with a Board Certified Plastic Surgeon who operates in a nationally accredited surgery center and offers board certified anesthesia.  If the price you are quoted seems abnormally low, please do your research and find out why, you do not want to be surprised the day of your surgery!Liposuction can be combined with many other procedures; tummy tuck, breast reduction, thigh lift, arm lift, neck lift and is an essential part of a Brazilian Butt lift (this is where the fat comes from!)  All of my patients are treated post operatively with a compression garment that is worn for 2 weeks and 5 Endermologie sessions that start 3-4 weeks after the procedure.  Endermologie is a non surgical massage technique that helps to smooth out the results of the surgery to help prevent wrinkling and rippling of the skin.Liposuction is not a very painful procedure and recovery is usually quick.  Most people are back to work in 3-5 days and back to vigorous exercise in 2 weeks.  Of course, if more areas are treated, there will be more pain post operatively and a longer recovery.  I was back to work 3 days after my abdominal liposuction and no one knew any better!The cost varies not only from city to city, but from patient to patient.  The more areas that are treated, the higher the cost.  In the midwest, typical liposuction prices varies from $3,000-6,000 total.

Bruce E. Katz, MD · Answer

It is hard to say what would be best for you without
seeing a photo. I recommend consulting about Smartlipo; this procedure will
remove unwanted fat deposits while tightening the skin. The skin will be left
tighter with Smartlipo than tumescent. Good luck!

Gregory L. Combs, MD · Answer

It is difficult to advise you without an in person consult to evaluate your individual needs.  If you have loose skin with stretch marks, your skin elasticity has been challenged.  With liposuction, you will decrease the bulges but skin looseness could still remail as in your  pre operative state.  I would recommend other consults with a board certified plastic surgeon that would discuss both liposuction and a tummy tuck and determine which would best meet your needs with the most optimal results.

J. Garrett Harper, MD · Answer

This is a very frequent question and one that's debated all the time.  My concern is that you mentioned that you have stretch marks which right off the bat tells me that skin has been under duress before and was unable to "bounce back" as you may have liked.  There are some therapies to help improve the quality of your skin, but it sounds like it's the contour of your tummy that you don't like.  I'd be hard-pressed to say that liposuction would achieve the results you are after, but it's impossible to tell without examining you. Definitely get several opinions and don't go in to your consultations directing the surgeon in a particular direction (liposuction vs tummy tuck)- they may just tell you what you want to hear. Best of luck- sounds like you've worked really hard getting your body to where it is already- you deserve a great result.

Steven Wallach, MD · Answer

Liposuction does not tighten the skin to any great extent.  Best to be evaluated in person to determine whether or not you are a candidate.

Debating on liposuction (tumescent), will skin be flat after or have saggy skin everywhere and look worse?

Answers (12)

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