J-Plasma for loose skin in banana roll area? (Photos)

Question

I had lipo done to my outer thighs to address large "hip dips" & saddle bags. He did lipo to my banana roll area which I didn't realize at the time would be an issue. Would J plasma help to tighten my skin in that area? I only have issues with my right side. My left side is good. I do feel like I look better overall, but that area in particular makes me feel very self conscious and I would like to have it fixed without having to do a posterior thigh lift, if possible.

Connie Hiers, MD, FACS · Answer

I think Renuvion could be helpful in that area or radiofrequency treatment like ThermiTight. That area is not very forgiving, and treatment should not be overly aggressive.

Mats Hagstrom, MD (license on probation) · Answer

I think treatment that work should always be based on understanding what the primary underlying problem is. Personally I don’t believe there is any skin tightening procedure that actually delivers actual results with the exception of cutting skin with long scars. I owned Jay plasma and used it for a year and literally saw absolutely no skin tightening in any of my patients and none of my patients appreciated any skin tightening either. After a year of using it I could not in good faith recommend using it because patients had increased pain during and after the procedure and I saw absolutely no benefit. i’ve since sold the device and wish I never bought it.
Your surgeons approach to treating hip dips is quite different than how I would do it. I typically try to reduce hip dips by doing pretty aggressive liposuction from the top of the hip dip reducing love handles and waist and this is usually sufficient. If needed conservative amounts of fat grafting also help significantly.
The banana roll should not be treated with Liposuction as a general statement. Doing so typically only leads to problems.
My best guess is that most of your problems stem from inappropriate fat removal and restoring the volume is your best option.
Without an examination no one can really give you a good recommendation and in your case expect different plastic surgeons to have different opinions in regards to how to correct this as well.
I’m a big believer in having a clear understanding of what the primary problem is or which tissue layer is causing the problem before recommending an operation. To differentiate subcutaneous fat versus skin laxity the easiest ways to put the skin under tension by pulling up with both hands above the area of concern. If putting the skin under tension fix is the problem the skin laxity is at least part of the problem. Putting the skin and attention also allows us to see the true fat distribution more accurately since bulging skin isn’t getting in the way.
Delivering consistent high-quality liposuction and or fat transfer results is more difficult than most people believe and this includes plastic surgeons.
These are easy procedures to do but some of the hardest to master to the point of delivering quality results every time.
For that reason I recommend patients should be highly selective before letting anyone do body contouring with Liposuction or fat transfer. Provider selection should entail having multiple in person consultations to find the best provider.
During consultations ask each provider to show their entire collection of before and after pictures for the procedure and area you’re interested in. And experience provider should have no difficulty showing you a minimum of 50 quality before and after pictures for common procedures like thigh or abdominal liposuction. Simply seeing a handful of pre-selected sample pictures which most likely represent the best results of the providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider.
This is why patients need to take responsibility and properly vet each plastic surgeon individually by asking them to open up their portfolio and show as many pictures as possible. For example ask the provider to show examples of excellent outcomes, average outcomes and less than outcomes. You can also ask the provider to show as many pictures as possible of patients with similar body characteristics to your own.
Finally I recommend reading all reviews on various physician review websites avoiding providers with any significant number of justified negative reviews.
The absence of justified negative reviews is more important and more telling than having an abundance of positive reviews.
Consider that revision work is many times more difficult than primary Liposuction it goes without saying that you need to be highly selective if someone is going to do a revision procedure.
Providers lacking sufficient skill and experience can easily make things worse when it’s tempting to do revision work because revision work is really technically difficult.
I don’t believe you need a thigh lift and I don’t think J plasma is the way to go either.
I believe volume restoration with appropriate revision liposuction and fat transfer is probably your best option but to say that with accuracy would for sure require an examination.
If you want to try to correct this then I suggest boating all your efforts into finding the best provider.
Do that like I mentioned above through having multiple in person consultations.
Avoid providers who are confident and I believe correcting previous Liposuction work is easy or that some magical technology device like jay plasma or VASER is all that’s needed.
And the end plastic surgeons have the equipment they need to do their job. What differentiates talented plastic surgeons from those who are not is not the equipment they use but simply inherent talent which in part is based on experience.
Find the right plastic surgeon and everything falls into place.
Best,
Mats Hagstrom MD

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