Rippling and loose skin after Laser Lipo

The delivery of laser energy to the skin was thought to be able to tighten the skin. Unfortunately it does very little to tighten the skin. Redundant skin will require surgical excision.

Unfortunately the problem you have can be difficult to treat, because the laser that was supposed to help the skin shrink can also cause scarring under the skin. I doubt that the cold therapy (Coolscul[pting, Zeltiq) would be helpful there but no one can give specific advice without seeing you. Revision lipo could be an option in some cases, but for the upper abdomen where there is scarring and skin laxity then a reverse tummy tuck is another useful option.

rippling and uneveness is very common after iposuction. sometimes it gets better on its own and other times it has to be corrected. as u had stated its been 5 yrs now, its unlikely to get better on its own. I  would not recommend fat freezing. Micro-liposuction to correct these defects would be my approach to correct these. in my practice I do a lot of these procedures and I see patients from all over the country. its possile to make it better but with caution.

              The upper fat roll you mention can be easily contoured with repeat liposuction as this a frequent area that goes unsuctioned or undersuctioned. Waviness or rippling is an extremely frustrating result for surgeon and patient alike.  It is an inevitable consequence for some patients, unfortunately.  As far as correction, tummy tuck improves this in some patients but not in a patient like you with taut skin.  The area can be reelevated with another liposuction type procedure to allow the flap to stick back down again, hopefully better.  If there are distinct areas that are full, these can be liposuctioned at this time.  Areas that may be a little thin can be fat grafted. 

Thank you for the question.  How much skin will "tighten" will depend on the quality of skin elasticity of the overlying skin.  Generally, younger patients and patients whose skin does not demonstrate loss of elasticity (physical findings of stretch marks, irregularities etc.), tend to do better with liposuction surgery.  Many patients who present for liposuction surgery are not good candidates for the procedure.  Ultimately, it is better not to undergo the liposuction procedure if the outcome leaves the patient with skin contour irregularities or other aesthetic problems that he/she is displeased with (and are very difficult to correct). This is one of the many reasons patients are better off seeking consultation with board-certified plastic surgeons who have the full "armamentarium" of procedures at their disposal.



Generally speaking, good candidates for liposuction surgery are patients who present with localized areas of diet and exercise resistant adipose tissue and an overlying skin “envelope” that demonstrates good skin elasticity. 



My best suggestion again: make sure that your selected surgeon is a board-certified plastic surgeon giving you good/ethical advice. Best wishes.