Why does high definition liposuction create extra skin?

Because it removes a maximum amount of fat. The skin that covered that fat has less volume under it and can wrinkle, like a deflated balloon. Planning the skin at the same time is how that wrinkle is avoided.

When is VASER enough?

When the redundancy is minimal. Removing superficial fat lets the fibroseptal collagen cables shorten, and the skin retracts. A roll that is already too long will not shorten from that step alone.

When is Renuvion used instead of a tuck?

For moderate redundancy, after the fat is removed. Heat contracts the collagen. It does not excise a fold. Moderate to severe redundancy is treated by cutting the extra skin out.

How is the amount of skin to excise chosen?

On the exam, by distracting the skin that would be removed and seeing how much must go for the closure to lie flat. The photographs do not replace that pull test.

How To Avoid Skin Redundancy during High Definition Body Contouring Surgery

How to avoid skin redundancy during high definition body contouring surgery starts with the fat that is about to come out. High definition liposuction removes a maximum amount of fat. When that fat is gone, the skin that covered it has less to sit on. The shell wrinkles, the way a piece of fruit wrinkles when it is depulped, or a balloon wrinkles when it is deflated. A wrinkled, cellulitic surface after that removal can be a botched liposuction result. It is what happens when the skin was never part of the plan. The photographs above are the cases on this page. They do not, by themselves, name which of the three skin steps was used.

Waist Contouring — #SS110 — Photo legend
43-year-old female tolerated a full transformation by undergoing full tummy tuck with muscle plication, lateral thigh and buttock tuck, and VASER liposuction of the upper back, middle back, lower back, and flanks with fat transfer for her BBL.

Three measures are used to counter that extra skin, during the operation and after it. Skin retraction from VASER liposuction is for minimal redundancy. Collagen contraction from Renuvion subdermal coagulation is for moderate redundancy. Skin excision, a tuck, is for moderate to severe redundancy. The exam picks the step. Maximum fat removal does not pick it.

VASER Retraction for Minimal Redundancy

Skin retraction with VASER liposuction is an intraoperative way to avoid skin redundancy during the fat removal itself. Collagen cables run from the skin down to the muscle. Those cables are the fibroseptal network. Fat cells sit around them like sponges and keep the cables from shortening. When liposuction removes the fat, the cables can contract, and the skin retracts with them. That retraction is the first defense against a loose shell.

Waistline Narrowing — Photo legend
The service designations for this patient include Buttock Tuck. 43-year-old female tolerated a full transformation by undergoing full tummy tuck with muscle plication, lateral thigh and buttock tuck, and VASER liposuction of the upper back, middle back, lower back, and flanks with fat transfer for her BBL.

The superficial soft tissue has a higher density of those cables than the deeper fat. VASER is the method this page uses to remove that superficial fat, which is why it produces more retraction than suction that stays deep. When the same retraction is done as 360 degree body contouring, the skin can redrape around the trunk rather than in one patch. Skin tightening from VASER is indicated for minimal skin redundancy. It is not the treatment for a roll that is already too long to shorten.

Renuvion for Moderate Redundancy

Renuvion subdermal coagulation goes further than removing the spongy fat from around the cables. Heat makes the collagen molecules in those cables contract, the way shrink wrap tightens. With the fat already gone, that contraction pulls the skin in more than fat removal alone. This page indicates Renuvion for moderate skin redundancy. It is still a tightening step. It does not cut the extra skin away.

The order matters. VASER takes the fat, including the superficial fat that was holding the cables open. Renuvion then heats the collagen that is left. Doing the heat step on a field that is still full of fat does not give the cables room to shorten. Doing either step on severe laxity, where the skin is already a fold, leaves the fold. Moderate redundancy is the band where contraction is enough. Past that band, the plan changes to excision.

Excision for Moderate to Severe Redundancy

Skin excision is the gold standard on this page for eliminating skin redundancy during body contouring when tightening will not take the extra skin away. The skin is cut out. That is a tuck. It can be planned for the abdomen, the arms, the upper back, the lower back, the buttocks, and the medial thighs. The operations that match those sites include a mini tummy tuck, a reverse tummy tuck, a brachioplasty, an upper body lift, a lower body lift, a lateral thigh and buttock tuck, and a medial thigh tuck.

How much skin to remove is judged on the exam, not from a photograph alone. The skin that would be excised is distracted, pulled, so the surgeon can see how much has to go for the closure to lie flat. In general, excision is indicated for moderate to severe skin redundancy. A patient can need excision in one area and only VASER retraction in another. The abdomen may hold a roll that a tuck has to remove, while a nearby area still has enough recoil for Renuvion after the fat is gone.

How to Avoid Skin Redundancy during the Operation

How to avoid skin redundancy during the operation is the choice made before the fat is taken, not a repair invented after the skin has wrinkled. The exam sorts the skin into minimal, moderate, or moderate to severe. Minimal redundancy is assigned to VASER retraction and the fibroseptal shortening that follows superficial fat removal. Moderate redundancy is assigned to Renuvion once that fat is out. Moderate to severe redundancy is assigned to excision. Skipping that sort, and removing the maximum fat everywhere, is how the fruit-shell wrinkle appears.

Waistline Narrowing Is More Than Removing Fat — Photo legend
Another view from the series, still reflecting Buttock Tuck as named for this case. 43-year-old female tolerated a full transformation by undergoing full tummy tuck with muscle plication, lateral thigh and buttock tuck, and VASER liposuction of the upper back, middle back, lower back, and flanks with fat transfer for her BBL.

Body contouring of a whole trunk makes the sort more important, because one circle of skin has to redrape together. A 360 plan can retract skin that is only minimally redundant. It cannot redrape a fold that needs to be cut out. The clothed photograph and the clinical frames show contour results. They are not a substitute for distracting the skin in the room and naming which tier it belongs to.

The fee follows the step. High definition liposuction cost covers the fat removal and the VASER retraction that comes with it. Renuvion is an added coagulation step. A tuck is an excision with its own incision and its own recovery. Those are not one line on a plan. Patients are seen in Newport Beach for the Renuvion exam and at the other liposuction locations, and the skin tier is named there before surgery.

What the Exam Is Sorting

Minimal redundancy still recoils. The skin wrinkles when the fat is pressed out of it, then settles back when the pressure is released. That is the skin VASER retraction is meant to help, because the cables are still able to shorten once the superficial fat is gone. Moderate redundancy recoils only part of the way. The surface stays loose after the fat is flattened, but it is not yet a roll that has to be thrown away. Heat on the collagen, after the fat is out, is the Renuvion step for that middle band. Severe redundancy is a fold. Pulling it shows extra skin that will still be there after any amount of contraction. That extra skin is excised.

The same person can sit in more than one band. The lower abdomen may be a fold that a mini tummy tuck has to remove, while the flank may only be lax enough for Renuvion after VASER. The arm may need a brachioplasty, and the medial thigh may need its own tuck, while the back still redrapes with a 360 retraction. Naming one operation for the whole body is how one area is corrected and another is left wrinkled. Each area is distracted on its own.

Postoperative care does not change the tier that was chosen. A compression garment supports the skin that was tightened or closed. It does not turn a severe fold into minimal redundancy, and it does not replace an excision that was skipped. The wrinkled shell this page warns about is created in the operating room, when maximum fat is removed from skin that needed a tuck. The garment is for the result that was planned, not a later substitute for the plan. Cellulite-like wrinkling after the fat is gone is the finding this page treats as a planning miss. The skin was asked to cover a smaller body without a step matched to how much extra skin was already there. Matching that step, area by area, is the whole of the avoidance.

Frequently Asked Questions

Continue with guides on this topic, or jump to a procedure, cost, or location page.

Source: /how-to-avoid-skin-redundancy-during-high-definition-body-contouring-surgery/