Vaser Lipo (stomach & mons pubis). How can I minimize the risk of loose skin?

Question

28F. I’m due for VaserLipo in 4 days. I am 5’4 weighing 13 stone. My stomach has a bad overhang. I am terrified of loose skin. I didn’t go for a tummy tuck as didn’t want the hip to hip scarring. What are the best non-surgical ways I can make sure I give myself the best chance at no/very minimal loose skin? My surgeon suggested I physically pull up the skin continually in my compression garment (?). Any other tips welcome (water, EMSculpt, collagen supplements, exothermic creams..?)

J. Timothy Katzen, MD, FACS · Answer

Hello Exuberant471979. Thank you for your question regarding how to minimize the risk of loose skin after VASER liposuction of your stomach and mons pubis. Thank you for your history. You mentioned in your history that your “stomach has a bad overhang”. To minimize loose skin after VASER liposuction,  I would suggest wearing the compression garment as much as possible--that means 24 hours a day. I would also suggest you were compression foam and an abdominal board for at least three weeks. I would suggest you wear your compression garment for at least eight weeks or more( if you have swelling) after the VASER liposuction procedure. Two weeks after your VASER liposuction,  I would suggest lymphatic massage. Lymphatic massage should be done  two to three times a week for three weeks.  Also, there are special compression vests made specifically for VASER liposuction, which are made to go over the compression garment to minimize skin laxcity. Your chosen plastic surgeon should be able to provide this vest. Water, EMsculpt, collagen, supplements, and exothermic creams will NOT significantly improve the laxity of your skin. None of these modalities have been shown in the medical literature to conclusively contract loose skin after VASER liposuction.  In the end, it boils down to your genetics, anatomy, contractility of your skin, your age, your plastic surgeon's skills, the way your skin reacts to the VASER, and your postoperative treatment of the liposuction areas. Good luck. I would’ve answered your question on ways to minimize the risk of loose skin after VASER liposuction of the stomach and mons pubis.  Good luck!

Emmanuel De La Cruz, MD · Answer

Vaser Liposuction, also known as Vaser Lipo, is a procedure used to remove excess fat from targeted areas of the body. While it can be effective in contouring the body, there's always a risk of loose skin, especially if a significant amount of fat is removed or if the skin has lost its elasticity. Here are some steps you can take to minimize the risk of loose skin after Vaser Lipo:

Consult with a Qualified Surgeon: Ensure that you consult with a board-certified plastic surgeon who has experience in performing Vaser Liposuction. A skilled surgeon can assess your individual situation and provide recommendations tailored to your needs.

Maintain a Stable Weight: Before undergoing Vaser Lipo, it's essential to achieve a stable weight. Fluctuations in weight can affect the elasticity of your skin. Aim to maintain a healthy lifestyle with a balanced diet and regular exercise both before and after the procedure.

Hydration and Nutrition: Stay hydrated and consume a diet rich in nutrients, particularly foods that promote skin health such as fruits, vegetables, and foods high in antioxidants. Proper hydration and nutrition can support skin elasticity.

Skin Tightening Treatments: Some individuals opt for skin tightening treatments in conjunction with Vaser Lipo to help improve skin elasticity and reduce the risk of loose skin. These treatments may include radiofrequency, ultrasound, or laser therapies, which stimulate collagen production and tighten the skin.

Compression Garments: Wearing compression garments as recommended by your surgeon can help support the skin during the healing process. These garments provide gentle compression, which can aid in contouring and minimizing the risk of loose skin.

Follow Post-Operative Instructions: Adhere to the post-operative instructions provided by your surgeon diligently. This may include proper wound care, wearing compression garments as directed, avoiding strenuous activities during the initial recovery period, and attending follow-up appointments.

Gradual Return to Exercise: While it's essential to stay active for overall health, avoid strenuous exercises immediately after Vaser Lipo. Gradually reintroduce physical activity as approved by your surgeon to prevent complications and support proper healing.

Be Realistic: Understand that while Vaser Lipo can remove excess fat and improve body contours, it may not completely eliminate loose skin, especially if you have significant skin laxity prior to the procedure. Managing expectations and discussing realistic outcomes with your surgeon is crucial.

Skin Care: Maintain a good skincare routine that includes moisturizing the skin regularly. Hydrated skin tends to be more elastic and can better adapt to changes in body contour.

Quit Smoking: If you smoke, consider quitting before undergoing Vaser Lipo. Smoking can impair circulation and decrease collagen production, which may negatively impact skin elasticity and healing.

By following these guidelines and working closely with your surgeon, you can minimize the risk of loose skin after Vaser Lipo. However, it's essential to remember that individual results may vary, and some degree of skin laxity may still occur depending on various factors such as age, genetics, and skin quality.

Kyle Summers, DO · Answer

Great question. A lot of this depends on just how much extra skin you have. With extra skin there are really three ways that we can treat it. First is to cut it out. But, as you just said, you would like to try to avoid the scarring, which is understandable. However, if there is enough skin laxity or extra skin then sometimes this is the only option. Secondly, is to fill it up. What I mean by that is if someone has extra skin, you can sometimes inject fat or filler into the area to help fill out that skin envelope. However, obviously this is the opposite of what you want done. Thirdly you can heat or burn the skin. What I mean by that is we have multiple devices available that help to stimulate skin contraction using various modes of heat. Examples include radio frequency in micro-needling, Bodytite, Renuvion, etc. In our practice we have devices that can heat the skin both from the outside (radio frequency micro-needling) as well as from the inside (Bodytite, Renuvion). These modalities will certainly provide you with more skin contraction. However, again, it does depend on how much extra skin already have. Like I said, before, if you have a significant amount of skin laxity, or if you have a large amount of fat removed via liposuction. Then the best option may actually end up being to remove that skin. Hope this helps.

Anuj Purbey, MBBS · Answer

It's completely normal to have concerns about loose skin, and it's great that you're taking proactive steps to minimize this possibility. Here are some tips that may help:
Compression Garment: Following your surgeon's advice to wear a compression garment is crucial. It helps support the healing process and can potentially minimize swelling, promoting better skin retraction.
Hydration: Staying well-hydrated is essential for overall skin health. Ensure you're drinking an adequate amount of water each day to support your body's natural healing processes.
Healthy Diet: A balanced and nutritious diet can contribute to skin health. Include foods rich in vitamins and minerals, particularly those that support collagen production, such as vitamin C.
Collagen Supplements: Collagen supplements may help improve skin elasticity. Consult with your surgeon or a healthcare professional to determine if they are suitable for you.
Skin Massage: Gently massaging the treated areas can promote blood circulation and help with the even distribution of fluids, potentially aiding in skin tightening.
Topical Treatments: Consult with your surgeon before using any creams or treatments, but some individuals find benefit from products containing ingredients like vitamin E or hyaluronic acid for skin hydration.
EMSculpt: While EMSculpt is primarily designed for muscle toning, some individuals report improvements in skin tightness as a secondary effect. Discuss its suitability with your surgeon.
Remember, individual responses to these methods can vary, and it's essential to follow your surgeon's recommendations. If you have any concerns or questions, don't hesitate to discuss them during your pre-operative consultation or follow-up appointments.
Wishing you a successful Vaser Lipo procedure and a smooth recovery.

Navjot Singh, MD, FACG · Answer

"Thank you for your question. To optimize your results and minimize the risk of loose skin after Vaser Lipo, consider integrating Renuvion with your procedure, as it's known for aiding skin tightening. Consistent use of your compression garment is essential for skin retraction and shaping. Additionally, treatments like EMSculpt can offer added support by toning underlying muscles. Maintaining a stable weight is key; significant weight fluctuations can affect your outcome. Lastly, adopting a healthy lifestyle with a balanced diet and abstaining from smoking can further bolster skin health. Always keep open communication with your surgeon for the best advice tailored to your situation.

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Mats Hagstrom, MD (license on probation) · Answer

Without including pictures, we can’t make an assessment. Individuals who have skin laxity, especially related to previous pregnancies should consider skin tightening operations. The choice of surgery should be based on having a clear understanding of what the underlying problem or ideology is. In other words, the first step in the decision making process is to make an accurate diagnosis, followed by Prescribing the correct procedure. There are four tissue variables to determine what the abdomen looks like. Each of these variables is treated in a different way understanding which tissue variables are causing the problem helps determine what is the best procedure. The . Four tissue variables to determine what looks like our abdominal skin laxity due to previous pregnancy or significant weight loss, excess subcutaneous fat, muscle separation from previous pregnancy, and exes, visceral or intra-abdominal fat. 
A tummy tuck primarily treats, abdominal skin laxity, and muscle separation. Liposuction reduces subcutaneous fat. Excess visceral fat can only be reduced to weight loss.
Previous pregnancies do not change fat distribution, and generally speaking pregnancy related changes are best peters with a full tummy tuck.
There are no effective nonsurgical treatment for significant skin laxity. The best treatment is direct excision of the excess skin with procedures like a full tummy tuck. You cannot reduce your own skin, laxity with exercise, compression, garments, or any other treatment.
Nobody wants to have a full tummy tuck, but some people choose the procedure because it is the most effective operation at restoring pregnancy related changes.
Patients should be comfortable with their decision making before having cosmetic seizures. It’s normal to have anxiety before the operation but the time to question what procedure to choose. Should be done well in advance of scheduling surgery.
Do not expect Liposuction to deliver tummy tuck results.
Skin laxity is the most common reason. Patience fail to get quality outcomes from Liposuction.
Skin damage is unlikely from Liposuction, but the risk is slightly higher with the use of ultrasound assisted Liposuction a.k.a. VAS ER
Follow up with your provider if you have questions before your procedure.
Best,
Mats Hagstrom, MD

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