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The ideal candidate for liposuction is a person who is relatively young with good skin tone and localized fat deposits and who has good personal habits of nutrition and exercise.  In the less-than-ideal world in which we live, some patients who see me in consultation for liposuction are less than perfect in at least one of these areas.  As long as the patient is realistic in her goals I can often design a plan that will work reasonably well.

There is a persistent myth that I would like to dispel- that there is a way to significantly tighten loose skin involving a particular technique of liposuction.  The first version of this myth was promulgated in the mid 1990’s and involved a technique known as superficial liposuction.  The theory was that if the surgeon scraped the undersurface of the skin with the canula (the metal tube that is used to extract the fat), this would tighten loose skin.  Unfortunately, all this left was dimpling and irregularity.  All current claims of skin tightening are variations on this theme; the only difference is that the surgeon is supposed to use ultrasound or laser energy to irritate the undersurface of the skin.  Theoretically it all sounds appealing, but there are practical limitations that make it all but impossible to apply the energy in a uniform way.  Once again the result is often dimpling and irregularity.

What to do for the patient who has true localized fat excess and significantly diminished skin tone?  For some patients the goal of the surgery is simply to have clothes fit better and the tone of the skin truly is not an issue.  These patients will gladly trade more looseness of the skin for a better fit of clothes across a certain area or areas.  If the patient is realistic in her goals, it is possible to offer the patient a significant benefit with liposuction.

Another possibility is to combine liposuction with a procedure that removes excess skin.  This combination works best in the lower abdomen.  For the patient with significant fat excess in the hips, waist, and abdomen and loose skin in the lower abdomen (a very common pattern) a combination of vaser® lipoplasty with excision of lower abdominal skin can restore a pleasing balance to the body form.