What is the newest skin tightening procedure?

If you can’t stop watching liposuction videos on social media, join the club. It seems as a culture, we can’t get enough of the gorgeous before and after photographs that epitomise next-level fitness ambitions, especially the razor-sharp six-pack abs and all-over enhanced muscle.

“The majority of men that I see, what they want is to have everything really well etched out,” says San Francisco-based plastic surgeon, David Sieber, MD, who adds that most of his female patients want “athletic definition, especially around the midline and sides” but “almost never” ask for a full six-pack.

And to get these next-level, fascinating results, standard liposuction, which Dr. Sieber defines as “uniformly eliminating fat from tough regions,” just isn’t going to cut it since “you’re not really doing anything to make that anatomy more obvious.” Yet, for the majority of patients seeking for an all-over slimdown, not superhuman status, standard liposuction is the tried-and-true alternative.

There are several ways a patient may go to acquire this sort of fitness model appearance, especially as liposuction procedures continue to advance. And between social media, marketing ploys and the era of misinformation, the world of liposuction has become rather complicated, even to those considering the treatment. To sort through what’s true and what to call baloney, we’ve asked four board-certified cosmetic surgeons and members of the American Society of Plastic Surgeons, for their ideas on how to properly reach their patients’ goals using different liposuction procedures and instruments.

“All the time, people come in thinking they’re a good candidate for liposuction and they’re disappointed to realise that they’re not,” says New York City-based cosmetic surgeon, David Shafer, MD, who adds that this is especially prevalent with patients who have lost a large amount of weight. “In these circumstances, liposuction would be the worst thing for them since you’re eliminating any remaining fat and would simply make their skin looser; what they need is a skin excision treatment, like a stomach tuck or body lift.”

What are the most popular forms of liposuction?

Recently, the lipo cavitation umbrella has expanded bigger to enable unique surgical procedures adapted to patient needs. Currently, there are three common techniques of liposuction — standard liposuction, high-definition liposuction and 360 liposuction.

Classic liposuction involves volume reduction, explains Philadelphia-based cosmetic surgeon, Christian Subbio, MD, but high-definition liposuction “is a more concentrated liposuction that sculpts out the underlying musculature” resulting in prominent muscle definition. And “muscle definition” is, of course, a matter of opinion, since many patients wanting high-definition liposuction aren’t necessarily aiming to equal the Hulk (although many do), but rather enhance their genuine, natural and underlying six-pack.

“High def may be producing a look that’s really light and athletic, where you only do a touch on the front and side, to be more muscular,” explains William Rahal, MD, who works in Beverly Hills, and cautions that not everyone is a fit for this sort. “And even within that, there’s a sliding scale of just how muscular or athletic a patient wants to look.”

To complete out the trio of popular forms, 360 liposuction is a more “comprehensive version” of lipo, adds Dr. Rahal, for which everyone is a candidate. As its name indicates, the operation eliminates fat circumferentially across the torso, but “excludes the arms and thighs.”

Why might liposuction outcomes be so much better with skin tightening?

Once the fat is eliminated during liposuction surgery, in many cases, the body “simply adjusts and then tightens up,” explains Dr. Shafer. “But with patients who may have loose or crepey skin, or who just might not fare well with liposuction alone, you additionally want to stimulate skin with some energy-based device” to help the skin elasticity with snapping back into shape.

What are my alternatives for skin tightening?

There are various viable choices for skin tightening in a range of energy modalities that may be done in combination with liposuction or at a future consultation. Dr. Shafer’s go-to is SmartLipo, which is driven by laser energy to tighten skin from below the surface, while dissolving fat, making it easier to suck out during lipo.

Other alternatives to tack onto liposuction operation day include Vaser, which is driven by ultrasound and is typically partnered with high-definition liposuction, BodyTite, which harnesses radiofrequency energy, and Renuvion, which creates plasma energy.

Post-operative skin tightening devices are less popular with patients, as they require numerous treatments due to the fact that external energy application employs less intense amounts of energy (otherwise, you’d burn the skin’s surface).


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