I have all my patients who are candidates do venus legacy or velashape treatments before liposuction if they are worried about skin elasticity... however, the best results are to start these treatments after surgery as they help decrease swelling and improve skin tightening. Best, Dr. Emer.
We have found Thermi-RF to shrink and tighten skin better than Ulthera or Vela-Shape or Skin-Tite (Sciton) or Coolsculpt, although this may be operator dependent as much or more than technology dependent. Other skin tightening and skin shrinking modalities are Smart Lipo and VASER. Of the two, I only have VASER experience and it is not as dramatic as one might expect from the marketing. Thermi-RF at time of liposuction cranked up to higher ranges (60 degrees) accomplishes mechanical and thermal fat dissolution and reversible controlled dermal injury from which the skin heals by contraction and tightening. Level of energy carefully controlled by internal thermistor with auto-shut off and by FLIR infra-red heat sensing camera that monitors temperature of treated skin. Results emerge 6-9 months after treatment, and I believe continue to improve for 12-18 months as dermal collagen continues to re-model and contract.