Episode 11: Will I Have Loose Skin After Liposuction?
Will I have loose skin after liposuction? That's one of the most common questions we get during a consultation for liposuction, which is a procedure that we perform a great deal and have had wonderful experience with.
The balloon analogy
So the best way to think about this is with a bit of an unflattering analogy, and this applies really to any body area, but here we'll use the abdomen as an example. You can think of the abdomen as a balloon, and in this analogy, the skin is like the outer coating of the balloon and the fat that we're addressing with liposuction is like the air in the balloon.
If you have a balloon and you remove just a little bit of air, the entire thing will get smaller and in general you won't notice much of a change in the tension or tightness of the shell of the balloon. But if you remove most or all of the air from that balloon, the shell of the balloon is going to look deflated and wrinkled and it's going to hang from the string. When we take this analogy and apply it to liposuction, the fat in the abdomen is like the air in the balloon and the skin is like that shell of the balloon, and removing the fat in liposuction is like removing air from the balloon.
Now, the response of the skin to liposuction really depends on how stretchy or how much elasticity the skin has. So in a young, healthy person that has nice tight skin or excellent skin elasticity, we can remove a great deal of fat without worrying about rippling or sagging of the skin. On the other hand, in an older person, perhaps who smokes and has loose skin for any number of reasons, including genetics, we can expect that if we remove a significant amount of fat, there will be skin laxity and looseness and rippling and maybe hanging.
So the answer to this question really is “it depends” — and that's where the expertise of a board certified plastic surgeon comes in. And they'll be able to examine you and determine how elastic your skin is or how much fat they'll be able to remove without having issues like excess skin laxity and that rippling and sagging that we're trying to avoid. So, in that example of a young fit, healthy person, you can have your liposuction and your skin will contract and essentially shrink wrap itself to your new shape. However, in an individual with looser skin, it probably won't shrink back as effectively to hug the new form that we've achieved with liposuction.
What can you learn from a liposuction consultation?
With the initial consultation, we can predict within a reasonable degree how an individual will respond. And if we think there's going to be skin laxity or looseness after liposuction, there are several things we can do about it. If there is minor skin laxity, we can combine a procedure with liposuction to tighten the skin at the time of the procedure. And what we like best for this is radiofrequency skin tightening and this works by heating the skin in a very controlled manner, leading to collagen and elastin production, which helps the skin contract to the new shape after fat is removed with the liposuction procedure. For people with more severe skin laxity, liposuction may not be the best option, and in the case of abdominal fat, a procedure that removes excess skin might be a better choice, like an abdominoplasty or tummy tuck. In the case of the arms that have too much excess skin for radiofrequency energy to adequately address, we would think about a procedure like a brachioplasty or arm lift. And similarly for the thighs. If there is too much skin laxity to get a nice result with liposuction alone, we would talk about a thigh lift procedure, which again, actually excises or removes the extra skin.
So to summarize and address the question “will I have loose skin after liposuction?”: it really depends on the shape your skin is in before liposuction. In those with relatively good skin elasticity, it will snap back and this really shouldn't be a concern at all. For those with moderate skin laxity or looseness, you may want to think about combining your liposuction with a procedure like radiofrequency skin tightening. For individuals with severe skin laxity, liposuction may not be the best choice and you might want to go with what we call an excisional procedure, where skin is actually removed. For the abdomen, this would be a tummy tuck, for the arms, it would be a brachioplasty or arm lift, and for the thighs, it would be a thigh lift.
So getting a great result after liposuction really comes down to having a consultation with a body contouring expert so that he or she can examine you and help you decide on the best procedure for your individual situation.