Liposuction and Loose Skin: Will My Skin Tighten Back Up After Liposuction?
After liposuction, is there loose skin? When you have liposuction done, fat is removed from under the skin, but the skin stays the same size. It may hang loosely over the treated area. Liposuction was designed to remove fat, not tighten the skin. If only very small pockets of fat are being removeda couple of ounces perhapsthe looseness may not be noticeable and the skin still drapes smoothly. However, in most cases, the skin is loose over the treated area and it will take a bit of time for it to shrink down to your new size.
How fast your skin takes to tighten up depends on several factors, but for most people, the skin does tighten up and the looseness disappears. If you have a considerable amount of loose, hanging skin from significant weight loss, you will more than likely need to have a lift procedure, which removes excess skin, rather than liposuction.
However, small areas of loose skin may be successfully tightened with the use of "superficial liposuction.” Some surgeons may even rasp the underside of the skin and have their patients wear a compression garment so that the skin adheres to the tissue below after it heals. Other surgeons treat the underside of the skin with lasers to help it adhere better. Bear in mind that the last two procedures still give unpredictable results as yet, so superficial liposuction with minimal skin excision (if needed) is usually performed on those patients who have redundant skin. Some surgeons offer a combination of any of these procedures.
If you have a significant amount of fat to be lost, your surgeon may prepare you for liposuction by putting you on a weight-loss regimen including a new diet and exercise. The amount of fat that can be removed with liposuction is not large, perhaps only 6 or 7 pounds, total. The amount that is sucked out of you should not exceed 6,000 ml (6 liters or about12.5 lb), but that includes the liquid that is infused into you during the procedure. Remember that liposuction is not a weight-loss procedure.
Your skin should naturally tighten on its own in time after liposuction, but some people have skin that is naturally more elastic and better able to bounce back. The elasticity of your skin (or actually the lack of it) may be one reason a plastic surgeon may advise you against liposuction. Older people and smokers have skin with less elasticity and some people just have thin skin that does not do well after liposuction.
Submental (under chin) fat removal and skin tightening is very common. This is a small area to treat, so a bit of liposuction can work wonders, unless you need significant fat removal or have very slack skin. If you do have a lot of loose skin here or the muscles of your neck and throat have become lax, you might need a neck lift or a platysmaplasty.
Lax skin on the sides of the abdomen can sometimes be tightened with superficial liposuction. However, substantial, loose skin and stretched out abdominal muscles (as can result from obesity or pregnancy) will have to be surgically corrected with abdominoplasty (tummy tuck). If you would like to learn more about your options in abdominoplasty, please see our sister site, TuckThatTummy.com.
Buttock and Posterior Thigh Liposuction
If you have loose skin on your buttocks, either due to weight loss or as a result of liposuction, there is a surgical procedure called the buttock lift. A thigh liposuction with a lift can help with loose skin on the thighs after liposuction. For thigh laxity there is a procedure called a thigh lift. Superficial liposuction in these areas can cause a mottled appearance, so please check with your surgeon about liposuction here and your individual skin type.
The skin on the back of the arm usually does not tighten on it's own In older people or those who have had significant weight loss. Unfortunately, the only procedure to remedy this is brachioplasty, or an arm lift. Brachioplasty is usually performed by making a long incision down the underside of the arm, excising the redundant tissue, and resuturing the flaps together. With arm liposuction or brachioplasty there is an increased risk of lymphedema, or retention and swelling of the arm due to disruption and removal of the ductwork of the lymph system. The swelling in the arm can be cosmetically unappealing and can be debilitating.
Suction-assisted calf contouring is become more popular. Liposuction can be used to thin and shape the lower legs and even give the appearance of more muscle. As with liposuction in the arms, persistent swelling (edema) is an issue. You must elevate your legs several times day during the healing phase. Swelling can become quite pronounced for a while if you have a job where you'd stand up all day.
If lax skin on the lower legs is an issue, you can get a small calf lift with the incision placed in the crease at the back of the knee. If you cannot develop muscles in this area and the laxity is due to LACK of volume, you can also look into calf augmentation, where a silicone insert is used to add bulk to the calf.
Erwin J. Bulan, MD
Bulan Plastic Surgery
75 Main Street
Millburn, NJ 07041
Sanjay Lalla, MD
Sanjay Lalla, MD
383 Northfield Avenue
West Orange, NJ 07052
Joshua A. Greenwald, MD, FACS
Cosmetic Surgery Associates of New York
166 5th Avenue
New York, NY 10010