Will I Have Loose Skin After Liposuction?

I am considering lipo on my upper and lower abdomen. I have a strange pocket of fat on my upper abs which does not completely go away with exercise although it does shrink depending on my weight.

I am not considerably overweight (just untoned) however my surgeon says I will probably be left with loose skin. Is he just saying this to cover himself or will I really be left with folds of loose skin? Should I lose weight first so that the skin doesn't need to shrink back too much?

Doctor Answers 16

Everyone's anatomy is different, and it's difficult to...

Everyone's anatomy is different, and it's difficult to know or predict what your results will be without examining you.

The factors that can increase your risk of having loose skin after liposuction include:

  • too much skin to begin with
  • poor quality skin
  • poor healing after the procedure

I will often use ultrasound during the liposuction procedure, as I find this will help the skin tighten after the procedure. Laser heat can also be used for this purpose, but if your surgeon is concerned about it, I would take him at his word and understand this as a risk before going forward with the procedure.

Seattle Plastic Surgeon
5.0 out of 5 stars 134 reviews

Definition of loose

When you remove fat, the skin almost alweays becomes more loose, if you are talking about tensile strength and elasticity unless you generate enough subdermal scar tissue. However, most patients are referring to their contour when they are concerned about looseness. Looseness from hanging, excess skin is not the same as looseness from loss of tensile strength and elasticity. You might have a flat abdomen with skin that is loose and pliable, sort of like a form-fitting silk shirt which is different from that same form-fitting shirt made out of rubbery wet suit material. Or, you can have a hanging abdomen from tight skin as many beer-drinkers have, like a heavy, over-stuffed winter coat. When you take the "stuffing" out, what happens to the skin depends on the intrinsic tensile strenth and elasticity. How much you take out will also affect the contour. Each situation is different. If your fat pocket is relatively "juicy" with a sense of firmness, then removing fat will allow the skin to "shrink". If it feels more soft, the skin might not shrink as much.

The other question of your history of the pocket of fat and when to do liposuction is even more important. You should be in a healthy, stable lifestyle as far as exercise, level of activity, habits, and diet is concerned. If you have gained weight which is why the pocket of fat is there, you should ask yourself why you have gained weight and what changes in your lifestyle are healthy and sustainable. You shouldn't lose weight just in order to get liposuction, you should improve your health as much as you can and then reassess your body's contour and then see what additional improvements you desire. that plastic surgery can offer.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 10 reviews

Loose Skin After Liposuction?

When liposuction is done properly the skin re-drapes and retracts to conform to the underlying tissue. Most times the skin becomes tighter because it has retracted (pulled back) and this tends to prevent further loosening of the skin. If the skin tone is already too loose then the patient may not be a good candidate for liposuction.

David Amron, MD
Beverly Hills Dermatologic Surgeon
4.5 out of 5 stars 56 reviews

Every Patient has the Potential to Develop Loose Skin Following Liposuction

Every patient has the potential to develop loose skin following liposuction surgery. It’s therefore important that this topic be part of the preoperative discussion and informed consent process.
The potential to develop loose skin varies from patient to patient. This determination is based on physical examination alone. Some patients have excellent skin tone with minimal laxity and aren’t likely to have difficulty with skin sag. These patients are often younger and are close to their ideal body weight. In this group, liposuction is an excellent treatment option with high satisfaction rates.
There are also patients who are clearly at risk for developing skin sag. This group is often older and their skin has more laxity. They have experienced greater fluctuations in their weight and frequently have had multiple pregnancies.
In many cases, they are not within 10% of their ideal body weight. They may also have associated weakness of their underlying abdominal muscles.
In this group, therapeutic decisions are often more difficult because of the potential for skin sag. For this reason, it’s not only important to understand the patient’s potential for skin sag, but their aesthetic goals as well. It’s important to know whether they want to look good in a swimsuit or look good in clothing.
Based on these considerations, liposuction may still be a good choice for some patients. They must understand their potential to develop skin sag. They must also understand that if skin sag develops following liposuction, an abdominoplasty will be required to correct this problem.
Facing the realities of this situation, many patients will elect to proceed directly with abdominoplasty.
The care of patients with abdominal fat deposits needs to be individualized. In this group, skin quality and aesthetic goals are important considerations. The best results are obtained when a proper analysis of the problem is combined with a board-certified plastic surgeon that has experience treating this problem.

Skin Laxity Following Liposuction

Redundant skin after liposuction is a concern when the skin elasticity is poor.  Stretch marks are a major contributor to poor skin elasticity and recoil.  Advanced age doesn't help either.  Your surgeon likely has concerns about your skin quality and should be able to state why he or she is so concerned.  Do you have loose, redundant skin in the upper abdomen now, in the "full" state?  Is the belly button readily visible?  Truly redundant skin with poor elasticity almost always needs to be removed and tightened.  Losing more weight first would be ideal because your surgeon can comment on the skin changes arising from that deflation.  Hope this helps.     

Brian M. Braithwaite, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 4 reviews

Skin should tighten after liposuction.


I think you should get another opinion.  Women with really loose skin (usually after childbirth) need a tummy tuck. Others can get a flat stomach with liposuction.  With good superrficial technique and subdermal tunnelling, the skin is tightened after liposuction, not made looser.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Loose skin and liposuction

A good question desrves a good answer. The quality of your skin can be hard to judge. Whether there will be any laxity depends on the area, the amount of change you are looking for and sometimes a little good fortune.

It is important to properly contour an area, leave the superficial fat intact and be on the conservative side so as to not create deformities. If you have pre-existing deformities or laxity, this will not be improved with any particular device - in this situation, grafting and skin tightening may be needed.

A good result takes time and careful assessment. If you understand your own goals and can relay them to the surgeon then you should be happy with the outcome!

Trevor M. Born, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 86 reviews

Skin Elasticity Is Important

Good skin elasticity is an important part of getting good liposuction results. Even though some laser liposuction techniques, such as Smartlipo, can help tighten skin, good skin tone is still necessary. Without seeing photos or having the chance to physically exam you, I am not in a position to comment on your surgeon's assessment. If your skin is lax, losing weight before getting liposuction won't help get the results you want, either. The key is finding a plastic surgeon you trust to provide an honest assessment of whether you are a good liposuction candidate. Then you can make a decision that will produce the best aesthetic results.

Arthur M. Cambeiro, MD
Las Vegas Plastic Surgeon
5.0 out of 5 stars 111 reviews

Loose skin

This all depends on your skin laxity. If you have stretchmarks and pre-existing loose skin, you'll most likely have more loose skin after your surgery if you just get liposuction. If you feel that your surgeon is trustworthy, then you should probably believe them when they say you'll have loose skin. 

You can always lose weight to see if that has any effect on your arm contour. Weight loss will reduce the amount of fat you have and give you a good idea of how your skin will be as well.

Ronald Levine, MD
Toronto Plastic Surgeon
4.5 out of 5 stars 16 reviews

Loose skin or not loose skin, that's the question!

You are describing the typical hard-to-loose fat product that lives in the mid upper abdominal wall just above the belly button. Although it's impossible for anyone to accurately answer your question without 'pinching' you and assessing skin laxity, it's safe to expect that skin when deflated by liposuction to settle on a 'hood' over the belly button, giving it more of a horizontal vs. circular appearance. 
That being said, I recommend you lie down on your back every time to put on your garment to allow the skin of the abdomen to redistribute evenly over the entire abdominal area before zipping up the compression garment. Everything looks better lying down, right?
This maneuver is more effective than anything else to smooth and tighten your skin.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.