Laser lipo vs regular lipo with J-Plasma? (Photo)

Hi, I want to first clarify some terminology. When you hear people talk about "laser lipo", they could be talking about non-invasive laser treatments that are supposed to shrink fat through your skin. There are devices such as Zerona® or iLipo® which cause the fat cells to shrink temporarily but does not destroy them. Other non-invasive laser liposuction treatments such as Sculpsure® do permanently destroy the fat but none of these come close to actual liposuction. There is "laser assisted liposuction" such as Smartlipo® which is real liposuction along with laser energy delivered under the skin to cause skin tightening. J-Plasma® aka Renuvion® works like the laser assisted liposuction except it uses radio frequency energy to energize helium gas to create plasma which tightens the skin from underneath as well. I find that the Renuvion works the best for skin tightening. The actual removal of the fat needs to be done with liposuction. A power assisted liposuction device such as Microaire® uses vibration to break up the fat as it is being sucked out. The power assisted vibration can also be used to create a smoother finish. To fix the bumps and irregularities, you need a skilled doctor who knows how to use a power assisted device to level out the unevenness. The energy device such as a laser or Renuvion can help tighten the skin but if used improperly, these devices can amplify any defects and make the irregularities worse. The bottom line is to do your due diligence in finding the right doctor rather than the type of device.

Thank you for your inquiry about the best liposuction approach for your needs, considering the condition of your abdominal skin.
Concern About Loose Skin: The primary consideration in your case is the laxity of your anterior abdominal wall. Traditional liposuction might exacerbate this issue, leading to increased skin looseness.
VASER Liposuction with J Plasma: This combination is often recommended for maximizing skin contraction while removing fat. VASER liposuction efficiently breaks down fat cells, and J Plasma can aid in skin tightening.
Regular Lipo vs. Lipo with J Plasma: While regular liposuction can effectively remove fat, adding J Plasma might offer the additional benefit of slight skin tightening. However, it's crucial to moderate the extent of fat removal. Over-aggressive liposuction could worsen the appearance of abdominal wrinkles.
In summary, VASER liposuction combined with J Plasma could potentially offer you the best results, considering the need to balance fat removal with skin tightening. It's important to have a detailed discussion with your plastic surgeon to tailor the procedure to your specific needs and expectations.
I hope this response provides clarity on your options for liposuction and assists you in making an informed decision.
Wishing you the best outcome for your procedure.
Sincerely,
Dr. Katzen

Hi Bee_2016,

This is a great question. Many patients are faced with these same decisions due to previous work they had. Half the work I do is revision/enhancements for patients like yourself. If you are not wanting a tummy tuck, the next best option is Vaser liposuction. Even better if adding the Renuvion j plasma. (Yes you can have both.)

You have a lot of scar tissue from the previous procedure that I can break up on your abdomen and do more body sculpting to your anterior waist and anterior flanks to complete the look.

It’s important to know although it is possible to remove more fat and retract the skin there is still possibilities of getting lumps, bumps, irregularities. The goal would be to break that up and correct the areas bothering you. Where ever you go, most doctors will recommend a tummy tuck. Whatever you decide, make sure you find a board certified plastic surgeon who specializes in revision liposuction.

If you would like to discuss this further I recommend scheduling a complimentary consultation. Good luck with your transformation journey. - VBMD.

Bee, Thank you for your question and posting the photos. I have a lot of experience with revision of previous liposuction and tummy tucks. The most important factor for correcting and smoothing your results is the skills and technique of the surgeon.
When it comes to technology, both Renuvion / Jplasma and Laser Assisted can add additional skin tightening to the liposuction procedure. I have both and prefer the Renuvion / Jplasma for multiple reasons. Renuvion plasma spreads more evenly and can deliver more tightening. Wishing you the best of health, Dr Wright

Neither! These questionable skin tightening options have very high failure rates and high %s of sub dermal fibrosis. Be careful out there.

Delivering consistent quality liposuction results it’s more difficult than most people believe it. This includes both patients and plastic surgeons who often think they are better at Liposuction than they in fact are. to deliver consistent quality results without contour irregularities with this procedure is simply not as easy as people think and requires doing thousands of cases with the dedication to mastering this procedure. unfortunately too many plastic surgeons don’t take Liposuction seriously enough.
Revision work is many times more difficult than primary Liposuction saw the need to find a talented experienced provider goes without saying.
When choosing a procedure the first and most important variable is having a clear understanding of what the underlying problem is. In other words making an accurate diagnosis.
In your case the question whether skin laxity or an uneven fat distribution is causing more of an issue is something that needs to be determined. I personally have no faith that laser liposuction does anything that is in patients best interest. I have the same belief of J plasma and bodytite. to put things in perspective I began focusing my career exclusively and Liposuction and fat transfer procedures over a decade ago. I’ve been a board-certified plastic surgeon for 22 years and I have performed over 8000 liposuction procedures. I have done several thousand laser assisted Liposuction in procedurs and have yet to see the laser give me any benefit. I bought the Renuvion a.k.a. J plasma device several years ago and used it for one year. I honestly did not see any noticeable skin tightening or changes that could not be explained by Liposuction alone. Neither did any of my patients. After one year abuse I simply could not honestly recommend using the device and despite losing an extraordinary amount of money I got rid of J plasma because it simply failed to deliver what it supposed to.
Revision work for poorly done Liposuction is very difficult because the primary problem is an uneven fat distribution. Primary Liposuction allows the surgeon to start with an even fat distribution and to deliver a quality outcome they simply need to maintain an even smooth fat distribution while doing the procedure. like I mentioned doing this is more difficult than most people believe. with revision work the surgeon has to begin with an uneven fat distribution and now make it even. and that is extremely difficult to do for a multitude of reasons. During liposuction the contour irregularities so easily seen on examination completely disappear once tumescent solution is added to the fat and this is a necessary first step in Liposuction.
If you’re gonna have revision liposuction then you need to make absolutely sure you’re in the hands of someone who has truly mastered this procedure.
Finding really talented plastic surgeons for Liposuction especially revision work is not the easiest thing in the world.
To properly vet plastic surgeons and find the most appropriate provider patients generally need to interview a substantial number of surgeons.I recommend patients do this exclusively within person consultations avoiding a virtual consultations whenever possible.
During in person consultations ask each provider to show their entire collection before and after pictures. Simply being shown a few preselected 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. an experience provider should have no difficulty showing you a minimum of 50 sets up before and after pictures for a common procedure like abdominal liposuction. highly experienced surgeons will have hundreds or thousands of before and after pictures for this procedure. Ask the provider to show examples of other patients with similar body characteristics to your own. You may also ask the provider to show you examples of excellent outcomes, average outcomes and less than outcomes. We all have them.
Revision work is not nearly as common as primary liposuction so it is unlikely you’ll find a provider who can show you 50 sets of before and after pictures of revision work.
Anytime fat transfer is involved after pictures should be taken a minimum of three months from the date of the procedure. Early postoperative results from fat transfer can look very impressive but do not represent final results.
It’s not clear from your pictures if a skin tightening operation is going to get you a better outcome than restoring a normal fat distribution.
If you opt for skin tightening as a solution than the appropriate procedure is a full tummy tuck despite all the negative sequelae of that procedure. there simply is no alternative that actually tightens the skin despite all the claims being made.
When assessing the outcome of a surgical procedure patients should always show proper before and after pictures. You’ve shown good pictures of yourself but unfortunately your arms are out to the sides and this significantly changes how the skin drapes your body and for patients who have even mild skin laxity putting your arms out by your side changes The contour of your torso significantly.
When getting second opinion consultations always bring proper copies of before and after pictures. If you don’t have those then ask your surgeon to forward the ones they took. You should also ask for a copy of your operative report while you’re at it. They are part of your medical records that you have a right to receive.
Finally in choosing providers 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.
Attempts at revision work can easily make things worse. It may seem tempting to rely on new technology devices with such great claims and it isn’t difficult to understand the apprehension most people have at the idea of having a full tummy tuck.
Nobody has to have Liposuction, nobody has to have a tummy tuck and revision surgery is way more difficult than people think.
I’m afraid your current plan of action may lead to further disappointments and I have committed a substantial part of my life towards protecting people from being disfigured in the name of cosmetic surgery especially from procedures like liposuction and fat transfer. I have answered over 10,000 questions on this website almost all relating to liposuction and fat transfer procedures.
Your post has a red flags written all over it.
I suggest slowing down the train and beginning the slow tedious process of properly vetting providers until you are quite certain you’re in the hands of the right provider for your needs.
Do not except having another operation on your torso unless someone can clearly prove the ability to walk the walk and not just talk the talk.
Good luck,
Mats Hagstrom MD

Hi and welcome to our forum!
From your photos, I note lax abdominal skin with moderate stretch marks extending upward from the pubis to the mid-epigastric area. There is only minimal fat present.
Stretch marks indicate the presence of permanently damaged overstretched skin usually occurring during pregnancy or significant weight fluctuation where when pregnant or overweight, the skin's dermal elastic fibers rupture, resulting in the loss of elasticity (like an old rubber band) and the development of streaks on the skin surface. The skin will stretch over a greater surface area and will predispose to further sagging. The skin laxity (in your photo) is noted to be accentuated when bending forward as you have lost skin elasticity.
Loose skin will not respond well to liposuction, no matter which instrument the surgeon utilizes. Non-surgical procedures (such as ultrasound, radio frequency energy or intense pulsed light) may offer a degree of improvement (Venus Versa, Velashape).
On March 14, 2022, the FDA issued a warning stating that the j-plasma device has not been cleared or approved by the FDA for tightening of the skin due to some significant complications. However, its use is quite widespread. Results are variable.
Best wishes...