The best thing to do is what I call, in my practice, MMT - Maerck's Multi-Modal Therapy. The name doesn't matter. I just combine a bunch of sound technologies in a safe efficacious manner. The abdominal wall is great because non-invasive skin tightening is not very effective. Maybe you get 10-15% tightening if you're really lucky.

To get the abdominal wall tightening or abdominal skin tightening, you're blessed with the circumference of the abdomen. When I treat, I treat circumferentially to try to get the most contraction I can. Again, for the superficial skin, I use a combination of infrared light. I use a specially tuned NDA laser superficially as well. I use several different kinds of radio frequency and ultrasound altogether.

The downside is it's expensive. It's not cheap to have me do this; it takes you about an hour and a half or two hours to do the procedure. For the money you spend, you could go with some liposculpting, a mini-tuck or something would be indicated; you're almost spending the money for a formal surgery that I know is going to give an amazing result.

With the skin tightening, I always tell patients there are no promises. I tell patients that if you look at the before and after pictures, we're going to see a reduction in cellulite and we're going to see some tightening and things are going to look better. I know in my opinion the improvement is going to be very underwhelming. I try to manage patients' expectations that way. I do have patients that are addicted to it, that come back every year and think it's the greatest thing in the world but I really can't tell patients that I can replace surgery with non-invasive technologies. In fact, no one can.

The danger is when people say "I have this device made by this manufacturer that promises X," and they really don't have the experience in surgical or non-surgical techniques. They burn patients, cause fat contour irregularities and all kinds of messes that need surgical reconstruction.

Unfortunately most people trying to avoid surgery end up getting surgery under a less than ideal situation.

Cosmetically Sculpted Abs

Dr. Rian Maercks discusses cosmetically sculpted abs.