Is Loose Skin a Problem After Lipo or Liposonix?

A common concern voiced by patients in consultation for body contouring procedures at Celebrity Laser Spa is whether the procedure could lead to loose or hanging skin.  I would like to use this post to dispel some misconceptions and provide a better understanding about outcomes of these procedures.

In fat reduction procedures, there are basically four types of patients in regards to skin outcomes. Type 1 has a small to modest amount of fat and good skin tone with no or minimal stretch marks.  This group is a good candidate for Liposonix or Tickle Lipo and is expected to have great outcomes.  There is no reason to expect skin looseness since the amount of fat being removed is not extreme and skin elasticity is good.

Type 2’s have good skin tone but a large volume of fat to be removed.  In my experience, such patients also do very well with Tickle Lipo.  Provided that the compression garment is worn after surgery for at least 3 weeks and the patient is a non-smoker and healthy, such patients uniformly have had excellent outcomes without loose skin after the procedure.  Liposonix is not useful when larger volumes of fat need to be removed.

Type 3’s have primarily loose skin and a minimal amount of fat.  Such patients are generally not good candidates for either Tickle Lipo or Liposonix since removal of the small remaining amount of fat is not expected to significantly improve their appearance.  They are better candidates for skin tightening procedures, such as the Alma Accent or, if they have a more extreme problem, then surgical excision, such as tummy tuck.

Type 4 patients have both a large volume of fat to be removed and poor skin quality.  Detailed discussion of the options with such patients is key.  If a moderate amount of fat is removed with Tickle Lipo and a compression garment is worn, in most cases, a significant improvement in body contour without the creation of hanging folds of skin can be expected.  The healing process resulting from liposuction surgery stimulates contraction of the skin, drawing in redundant skin and improving body shape.  On the other hand, severe cases, such as patients that have a large pannus that hangs by more than a couple of inches, are not good candidates for liposuction, as they would be expected to have excessive hanging skin after the procedure.  Such patients are best served by weight loss, followed by excision of redundant skin at a later date.

- Alex Kaplan MD

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