Skin tightening after any liposuction depends more on you
I agree with Dr. Di Sala- and would add that the degree of skin tightening that will occur after any liposuction procedure (whether it be tumescent liposuction, Smartlipo, or Vaser liposelection) depends most on the quality of the skin present, and less on the technique chosen by you and your surgeon.
Many claims of improved skin tightening have been made in the effort to attract patients and physicians to a particular technology, but most responsible practitioners agree that no evidence supporting a significant skin tightening benefit from one technique over another exists.
In other words, if you have excess, loose skin, liposuction (in any form) is probably not going to make you flat and tight and you should consider a tummy tuck. If you have tight, firm skin, then any liposuction modality is likely to give you a pleasing outcome, and which technique is used is mostly surgeon preference.
Skin tightening is often observed after Vaser LipoSelection.
I have been performing VASER® LipoSelection since the medical device was approved in 2001. This medical device employs low level of ultrasound that pulsates to gently break apart the fat cells with minimal collateral damage to other tissue, such as nerves, blood vessels, lymphatic, and skin. I have been extremely satisfied with my results. I have safely performed Vaser® LipoSelection in hundreds of patients in many different anatomical areas, including the abdomen, posterior trunk, inner and outer thighs, arms and even the face and neck. When comparing this technique to standard liposuction with or without ultrasound, it is my observation that I do see increased skin contraction and tightening. There is ongoing research in this area to study and verify this finding. Additionally, my patients seem to have less downtime and post-operative pain. Because I can use smaller instrumentation, with the probes and cannulas measuring between two and three millimeters, I have noticed smoother skin surface and body contour.
Laser Lipo or Ultrasonic Lipo - Neither contracts skin better than Conventional Lipo
Laser Lipo also called smartlipo, slimlipo or coolipo, uses laser light to liquify the fat. It is then suctioned by conventional liposuction.
Ultrasonic Liposuction, also called Vaser, uses soundwaves to liquify fat cells. It is then suctioned by conventional liposuction.
Both technologies create heat and collateral damage. Supporters feel that the heat will contract the skin. Both technologies have a higher risk of burns to the skin, as well as residual fluid collections under the skin, called seromas.
A study in Europe demonstrated that the less injury to the fascia (tissue that connects the skin, fat and muscle together) the better the chance for skin contraction after liposuction. In part two of the study, they compared Ultrasonic Lipo, Laser Lipo, Conventional lipo and Power-assisted Lipo (PAL) and found that PAL was the best technology for leaving the fascia attachments intact!
In second place was conventional lipo. Ultrasonic Lipo was a distant third and Laser Lipo was in last place. PAL is the use of a reciprocating (move in and out) handpiece that moves the cannula (liposuction tube) in and out of the body in very small rotations. This allows for less bruising and a more precise use of the cannula.
According to the scientific literature, NO.
Excellent question, and one that I put to the manufacturer of the Vaser directly. Their answer---no scientific papers have established skin tightening for Vaser liposuction.
Liposuction now comes in many types:
• Traditional Liposuction--where no energy source is applied internally
• Ultrasonic Liposuction (Vaser)--where internal ultrasonic energy is used
• Laser Liposuction (Smart Lipo, Cool Lipo)--where internal laser energy is used
All of these approaches utilize infiltration of fluid that decreases bruising and typically has local anesthetic. Traditional liposuction has stood the test of time and safety, and is the only one of the three that cannot cause a burn of the skin. Internal laser techniques are the newest.
Suffice it that there is considerable disagreement among surgeons about the differences in the relative benefits to each of these techniques. Despite the marketing hype, there is no one best liposuction technology or technique.
Bottom Line: Many claims are about Ultrasonic and Laser devices that are not supported in the scientific literature. I believe that the tool used by your surgeon is far less important than the skill with which the tool is used.
Hope this helps.
Tighter skin after Vaser is a "definite maybe"
I have used VASER liposelection as well as Smart Lipo over the last eight years or so and notice some skin tightening with each in some cases, but no reliable skin tightening that I would tell a patient he or she could count on.
Keep this in mind when going this route with skin tightening high on your list of priorities.
John Di Saia MD
VASER Can Tighten the Skin.....somewhat
VASER can stimulate collagen reorganization and cause skin tightening, but it is often less than we hoped to get.
VASER Liposuction / Liposelection and Skin Tightness
Liposuction, or SAL (suction assisted lipoplasty) is the removal and shaping of fat with high vacuum. Ultrasonic assisted lipoplasty (UAL) adds a preliminary shaking and breaking up of fat cells with sound waves before the resulting fat emulsion is vacuumed as it is with traditional tumescent SAL. Laser assisted Lipoplasty (LAL) such as SmartLipo cooks the fat with a laser beam and the remaining fluid needs to be suction evacuated.
Some areas Back / hips lower tummy appear to tighten much better than others such as the inner thighs. Owing to the mild irritation of sound waves there MAY be some shrinkage with VASER than there is with traditional tumescent SAL BUT I never count on it and tell my patient not to count on it.
At the most recent cosmetic surgery meeting in Miami in Feb 2010, a live transmission of an OR demonstration of the SmartLipo to hundreds of plastic surgeons was a major disappointment. The reported stated conclusion was that SmartLipo's marketing in skin shrinking was way ahead of its capabilities.
Anyone who promises you real, significant and predictable skin tightening only through the use of liposuction is either ignorant of the facts, not telling the truth OR using too much heat and energy close to the skin to in effect "shrink" the skin by thermally injuring (IE cooking) it. For your safety stay away from such physicians.
As a general rule, skin will not be tighter after liposuction. Skin has the ability to shrink wrap around the underlying tissues depending on its quality. The more superficial the liposuction, the more shrink wrapping that can occur.
If the main goal of the surgery is tighter skin, then liposuction in combination with a skin tightening (excisional) procedure will be necessary. This is not what most people want to hear, but its the truth. I feel more than qualified to comment on this, since I perform traditional lipo, smartlipo, vaser lipo and power lipo. If a doctor has never used a particular technology, than their commentary lacks credibilty.
Vaser liposuction and skin tightening
Althoughl Vaser liposuction is not a substitute for an abdominoplasty or neck lift, it can help to tighten and tone looser skin to some degree. If the skin is significantly sagging then excision of the excess skin should be considered.
VASER liposuction skin tightening
VASER Liposuction has recently been shown in a 2010 medical study to tighten skin. Vaser liposuction was performed on one leg in 20 female patients and traditional liposuction was performed on the other leg. There was a 53% improvement in skin tightening on the leg that had VASER liposuction compared to the other leg.
I routinely perform VASER and have done over 1,000 cases with this technique. I have personally seen more skin tightening with VASER than traditional liposuction. I feel that areas such as the arms, abdomen, and inner thighs can better be done with VASER even if the skin is a little loose. This is because the VASER will result in more skin tightening.