• Skin does not always bounce back on its own.
  • Certain liposuction techniques help encourage skin to tighten back up.
  • Skin folds can lead to a variety of health problems.

Many people assume that after undergoing a liposuction procedure they will instantly emerge from their doctor’s office with bikini-ready bodies. However, the reality isn’t always that simple.

While it’s true liposuction can always be counted on to remove excess fat from a treated area, the skin that once housed that fat doesn’t just disappear on its own. It can linger and hang from your arms, or abdomen, or wherever the fat was removed from your body. This is where skin-tightening comes into the picture.

Loose skin after liposuction

Liposuction breaks up and drains whole fat cells from the body. It is intended as a body contouring procedure. In other words, it aims to give you an ideal shape by removing fat deposits in troublesome areas.

Liposuction is not intended for weight loss, though some weight is lost as a result of the procedure. That being said, some people do get a more substantial amount of fat removed during liposuction.

A 2015 study in Plastic and Reconstructive Surgery suggested using an individual patient’s BMI as a metric for determining how much fat can be safely removed. Basically, the heavier you are, the more fat you can reasonably part with.

Liposuction removes fat, not skin. So all of that skin that grew to accommodate your heavier frame will still be there when all is said and done. The more fat you have removed, the more excess skin you’ll likely have.

Why doesn’t skin bounce back?

Skin elasticity (how well your skin tightens back up) is affected by more than just the amount of fat removed. There are a number of factors that impact skin elasticity such as:

  • Length of time spent at a heavier weight. The longer your skin spends stretched out, the less likely it will bounce back.
  • Speed of weight loss. Losing weight gradually may give your skin time to react. However, if you lose a ton of weight in a short period of time, your skin will have trouble catching up.
  • Age. Put simply, the older you are the less elastic your skin.
  • Overall health. Healthy skin is more elastic.
  • Genetics. Sometimes these things are at least partly out of our control.

Researchers are on the task

Plastic surgeons are well aware of the impact skin elasticity has on overall results. Studies have been conducted in an effort to improve cosmetic procedures that now result in excess skin, and to perfect methods of treating excess skin.

Plastic surgeon Marco Gasparotti introduced what he called “superficial subdermal liposuction” in 1989. This technique involves removing not only deeper layers of fat, but also superficial fat (just beneath the skin) to promote skin contracture. In short, the skin hangs better and tightens more readily without the superficial fat in the way.

While this method is largely considered successful at preventing most excess skin, researchers like the late Dr. Yvez-Gerard Illouz warn against removing too much superficial fat as it can lead to irregularities on the skin’s surface.

Other liposuction technologies, like laser-assisted liposuction (LAL) and ultrasound assisted liposuction (UAL), promise tighter skin. However, both of these methods come with their own risks, including subdermal burns and contractures to the skin resulting in contour irregularities.

Your cosmetic doctor will be able to help you understand the new technology available, what’s safe, and what isn’t.

If you’re looking for some guidance in how best to avoid loose skin after fat removal, consult with one of our plastic surgeons online to see your options.

More than just an eyesore

Maybe you’ve made peace with your post-liposuction body and aren’t interested in additional procedures. While it’s great to feel satisfied with the results of your procedure, loose skin is not just a cosmetic issue.

No matter how thoroughly you shower, folded layers of loose skin can trap sweat and dirt. This irritation can lead to sores, rashes, and even infections.

Intertrigo is an inflammatory condition that afflicts skin folds. It most frequently crops up beneath breasts, in armpits, and under skin folds on the abdomen. This painful burning condition is brought on by trapped heat and moisture, as well as friction between patches of skin. Once it occurs, it is difficult to alleviate as these same factors aggravate the condition.

If left untreated, intertrigo can lead to infection. Usually, this takes the form of a yeast infection due to the warm and moist conditions. However, other types of infections could form, especially if the skin is broken by friction or scratching.

Skin folds can lead to other serious issues as well. Depending on the amount and location of the excess skin, you could suffer from muscle and joint pain.

A common issue for those with loose skin on the lower back is back pain serious enough to inhibit regular activities. This can happen with excess skin in other regions of the body as well.

» If you’re experiencing skin problems as a result of your folds, speak to a cosmetic doctor near you.

Non-surgical strategies for managing loose skin

Surgery can be hard on the body and you’ve, presumably, just had liposuction. So, you might not be looking to go back under the knife just yet.

There are some things you can do to encourage your skin to tighten up or, at least, make the appearance of loose skin less dramatic.

  • Give it time. We know you didn’t want to hear this one, but there it is. It takes time for skin to bounce back.
  • Wear your compression garment. Your surgeon recommended it to you for a reason. It does more than just help reduce bleeding and inflammation. It can also help with skin retraction.
  • Intense pulsed light. Intense pulsed light (IPL) involves the use of light waves to treat various skin concerns. It has more recently been used to encourage skin contracture by heating up collagen in the skin.
  • Radiofrequency. RF therapy refers to the use of radio waves to tighten skin. In theory, it work in much the same way as IPL, by heating up the skin to induce collagen growth.
  • Strength training. To be clear, this will not tighten your skin. However, it will help give you a more filled out appearance by filling some of that empty space with muscle.
  • Water. Drinking water will also not directly tighten loose skin, but it will keep your skin healthy. Healthier skin is stronger making it more likely to bounce back.

Note that all of the above are widely recognized methods for dealing with loose skin, but they are not all necessarily proven to be successful. RF skin tightening in particular has had mixed results, according to this 2015 study.

Surgical methods for managing loose skin

Now it’s time for a hard truth. The only 100% sure fire way to get rid of that extra skin is to literally cut it off. That means going back to your plastic surgeon and undergoing additional procedures.

Body contouring surgery is an umbrella term for a variety of plastic surgery procedures, all of which involve cutting away excess skin and pulling the remaining skin taut. You’ve likely heard of many of these procedures already:

  • Tummy tuck
  • Facelift
  • Upper arm lift
  • Thigh lift
  • Back lift

In short, where there is loose skin, there is likely a “lift” you can do.

Body contouring is serious surgery. Doctors will want to know that you’re committed to keeping the weight off. If you need multiple areas treated, your surgeon will also likely schedule multiple sessions.

Serious surgery also means serious recovery. Expect to be in recovery for as much as six weeks for a single surgery, depending on what you have done. If you’re looking at multiple sessions, then you could be in for a long haul.

Going in with your eyes open

Understand that no cosmetic procedure can promise you a perfect body. Liposuction will help put you on the path to a healthier looking figure, but it’s not without its own downsides and complications.

If you are adamant about getting liposuction, consider preparing your body by getting closer to your ideal weight the old-fashioned way. You can also start a skin-healthy diet to promote elasticity prior to any procedure.

If you’ve already had it and want to address your skin concerns, start by making a plan to tone your muscles. The more muscle that you build, the less drastic any surgical skin removal will have to be.

» Need more information before making up your mind? Ask a cosmetic doctor about loose skin treatments and prevention on our forum.

References

  • Chow, I., BA, Khavanin, N., BS, Alghoul, M. S., MD, Hanwright, P. J., BA, Gutowski, K. A., MD, Hume, K. M., MA, . . . Kim, J. Y., MD. (2015). Body Contouring in Plastic Surgery A Risk Assessment Model of Liposuction Volume as a Function of Body Mass Index [Abstract]. Plastic and Reconstructive Surgery,135(4), 1186. journals.lww.com/plasreconsurg/Citation/2015/04000/Abstract_17___Body_Contouring_in_Plastic_Surgery__.82.aspx
  • Yvorchuk, W. A. (1995). Modified Gasparotti Superficial Liposuction [Abstract]. The American Journal of Cosmetic Surgery, 12(4), 301-311. doi.org/10.1177/074880689501200405
  • Jackson R.F. (2006) Superficial Liposculpture: Rationale and Technique. In: Liposuction. Springer, Berlin, Heidelberg.
  • Dixit, V., & Wagh, M. (2013). Unfavourable outcomes of liposuction and their management. Indian Journal of Plastic Surgery, 46(2), 377. doi.org/10.4103/0970-0358.118617
  • Blum, C. A., Sasser, C. G., & Kaplan, J. L. (2013). Complications from Laser-Assisted Liposuction Performed by Noncore Practitioners [Abstract]. Aesthetic Plastic Surgery, 37(5), 869-875. doi.org/10.1007/s00266-013-0153-x
  • Goldberg, D. J., MD. (2012). Current Trends in Intense Pulsed Light. The Journal of Clinical and Aesthetic Dermatology, 5(6), 45-53. Retrieved November 12, 2017, from ncbi.nlm.nih.gov/pmc/articles/PMC3390232
  • Araújo, A. R., Soares, V. P., Silva, F. S., & Moreira, T. D. (2015). Radiofrequency for the treatment of skin laxity: mith or truth. Anais Brasileiros de Dermatologia, 90(5), 707-721. doi.org/10.1590/abd1806-4841.20153605
  • Smith, L. F., & Smith, L. F., Jr. (2015). Safely Combining Abdominoplasty with Aggressive Abdominal Liposuction Based on Perforator Vessels [Abstract]. Plastic and Reconstructive Surgery, 135(5), 1357-1366. doi.org/10.1097/prs.0000000000001200

About The Author

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I am a former teacher, current resident of Colorado, and new mom. When I’m not writing and chilling with my son, I’m gaming, watching movies, doing yoga, eating out, taking pictures, and harassing my cats. I love words.

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