What happens to my skin after liposuction?

Liposuction is so popular because it permanently gets rid of stubborn fat under your skin, but how does that affect the appearance of your skin afterwards?

April 29, 2021

8 min read

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Will you be left with saggy loose skin or bumps and wrinkles?

Anatomy

Let’s take a quick look at the anatomy of your skin and fat, so you have a better understanding of what exactly liposuction will do, and what will happen to your skin afterwards.

Skin

Your skin is the largest organ in your entire body. It’s most important job is to keep you protected from the outside world. That means it’s pretty resilient, but it can also work too hard and become damaged.

Your Skin is Elastic

Your skin is able to stretch to accommodate the changes that happen as you grow and move throughout your life. That’s because of specific proteins called elastin and collagen that are found in the deep layer of your skin. Elastin is what gives your skin the ability to stretch and “snap back,” like an elastic band or a balloon inflating and deflating. Collagen keeps your skin thick and strong, so it can maintain its shape.1

Over Time, You Lose Elasticity

You put your skin through a lot, just living in the world. Being active, weight gain, pregnancy and childbirth – these all cause your skin to stretch. There’s a point where your elastin just can’t bring your skin back to its original shape. This happens frequently with pregnancy and that is why many women have extra, saggy skin after childbirth. In addition, you lose your ability to form elastin as you grow older, and your collagen becomes less supple and more rigid2. These factors causes your skin to become droopier, and thinner. Smoking and sun exposure prematurely age your skin, so you might notice less elasticity if you spend a lot of time tanning or if you’ve been a smoker for a while.

Fat

This is probably the most complained about tissue you have on your body. It seems like it’s always where you want it least, and it just won’t go away no matter what you do.

You’ve Got Fat Everywhere

You actually have fat all over, including inside your body. Mostly, it’s under your skin, which is called subcutaneous fat, but you also have some inside your belly called “visceral fat”. Where you carry your fat is typically determined by your hormones. Women tend to carry more in their thighs and buttocks and men carry it more inside their belly (what is often called a “beer belly”).3

But What is Fat?

The technical term for fat cells is called “adipocytes”. Now, why do you need fat cells? Fat cells store energy for your body. They also cushion and insulate your organs. You create fat cells as an infant and right before puberty4. After puberty, the number of fat cells stays the same. But when you gain weight as an adult, those fat cells are doubling or tripling in size. When you lose weight, those cells shrink, but they don’t get destroyed. Instead, they’re just ready to fill up with more stored energy again.The more fat cells you have in a particular area, the easier it is for that area to appear to “get fat” since there’s more cells readily available to fill up.

Underlying Structures

You have other structures beneath your skin running through your deeper tissues that will also affect the way your skin looks after liposuction.

Connective Tissues

Connective tissues are special tissues that add structure or protection to other tissues in your body. Think of a piece of chicken. You’ll see cartilage, tendons, and fibers that attach the skin to the meat – those are all connective tissues. You have similar structures under your own skin.

The most important connective tissue fibers in fat are collagen fibers. They keep all the fat together and connect the skin and fat to the deeper fascia and muscle layers below.

Blood Vessels

Every cell in your body needs nearby blood vessels to live, and your fat is no exception. Blood vessels run through your fat providing oxygen and nutrients. Typically, the more fat cells you have in one area, the more blood vessels, which was a problem with older liposuction techniques. There was a lot of bleeding and patients would frequently require blood transfusions following their lipo.

What Does Liposuction Do?

Now, you know that with diet and exercise, your existing fat cells just empty and wait to fill up again, but there is a way to get rid of fat permanently – liposuction! Because it permanently gets rid of fat, liposuction is a very popular procedure.

The Liposuction Process

There are a few main components of liposuction that contribute to the destruction of fat cells.

Tumescent Fluid

One of the most important parts of the liposuction process is the injection of “tumescent” fluid into the fat. Tumescent fluid is a solution made of saline, lidocaine, and epinephrine. The fluid itself doesn’t destroy fat cells but it still serves a very important function. It helps protect the blood vessels in the area being liposuctioned.

In the past, blood vessels in areas being treated with liposuction would get destroyed. This caused a lot of bleeding. Some patients would even need blood transfusions after surgery.5

With tumescent fluid, the blood vessels in the targeted area gets smaller, which protects them from being as damaged. The fluid also engorges the tissue in the target area, which gives the surgeon more room to work.

Separation

After the tumescent fluid has had time to take effect, the surgeon can start inserting cannulas under the skin. If your surgeon uses the SAFElipo technique, they will start with a special cannula with a wide, open tip, to help separate fat globules from each other and the surrounding tissues6. This helps to manually break the bonds of the collagen fibers holding the fat together, as well as destroying some of the fat cells in the process. This makes the fat easier to suction out, since it’s already somewhat loosened under the skin.

Aspiration and Tunneling

After the fat has been separated, the fat can be suctioned out. This process is called “aspiration”. Another cannula is inserted and the suction is started. As the cannula is moved back and forth, fat is suctioned out of the body. The movement of the cannula, combined with the suction, removes fat from the target areas. This creates little tunnels throughout the fat. Once enough fat has been aspirated, the cannula is removed and the tunnels collapse, bringing the skin closer to the underlying tissues. If your surgeon is performing SAFElipo, after they aspirate, they’ll equalize the fat layer that is left beneath the skin, to create a smooth contour.

Effects of Liposuction on Your Skin

Since the fat under your skin has been removed and destroyed, what happens to the skin above that area? Does it tighten up against the deeper tissues, or does it become loose and saggy?

It Depends on Different Factors

Whether your skin tightens up or not depends mostly on two things – your skin quality, and how much fat is being taken out.

Skin Quality

If you have good skin quality with good elasticity and thickness, your skin has a better chance of tightening or adhering to the underlying tissue after liposuction. If you have poor skin quality due to loss of elasticity and aging, you probably won’t see much skin tightening, if any. Also, your skin quality can be different in different areas of your body. For example if you’ve gone through pregnancy and childbirth, the skin of your abdomen might have lost elasticity, but the skin on your thighs might still be elastic. In general, you probably have less elasticity now, compared to twenty years ago, when you were younger.

How Much Liposuction Is Done

If you’re removing a small amount of fat, your skin might easily tighten up. If you’re removing a large volume of fat, you might still have noticeably loose skin even if you have good skin quality with lots of elasticity.

What Can Help Your Skin Tighten?

There are a few things that can factor into whether your skin tightens after liposuction or not. Some things can be controlled by you or your surgeon, and some things can’t.

Correct Liposuction Technique

If you want a lot of fat suctioned out, you should be aware that you may have some loose skin afterwards. Your surgeon will help you think about how much fat should be removed. There are techniques that your surgeon can use to minimize visible depressions or grooves. Ask what techniques he or she uses. Also, look at before and after photos of liposuction patients that started out with your body type. This may give you a good idea of what your results will be like.

Part of the Body Being Liposuctioned

Some parts of the body naturally have thinner, poorly elastic skin. This means that the skin is less able to tighten after liposuction. One example is the inner thighs. If you pinch the skin of your inner thighs, you will notice that the skin is very thin here. Now, pinch the skin of your waist. You will notice that the skin of your waist is quite a bit thicker. That makes the inner thighs more prone to having loose skin after liposuction.

Compression Garments

Wearing compression garments after your liposuction is important for two reasons. First, it helps you heal by preventing fluid from collecting in the space left after your fat has been removed.7

Secondly, it helps to keep your skin bind tightly to underlying tissues to improve your skin contour. Keeping your skin compressed to the deeper tissues is important to make sure that it heals in the correct position.

Genetics

Some people are genetically predisposed to thinner skin or conditions that might cause them to lose their elasticity sooner than others. It’s one of those things that can’t be helped. If that’s something you’re concerned about, make sure to discuss that with your plastic surgeon at your consultation appointment.

BMI

Your BMI, or body mass index, is determined by your weight and your height. People with a high BMI typically have skin that is more stretched out. If you have a high BMI, your surgeon may recommend you lose weight before undergoing liposuction surgery in order to maximize your results.

Age

As mentioned earlier, your skin loses elasticity and collagen as you get older. Younger patients typically have skin that tightens up more easily.

Skin Damage

How much your skin has been stretched and damaged in your life is a huge factor in how your skin will behave after liposuction. If you were a dedicated sunbather or a long-term smoker, your skin will be more damaged and less elastic.8

If your skin has been stretched out from pregnancy or weight gain and loss, it probably won’t be able to tighten up.

Surgery

After liposuction, you may be left with skin that just can’t tighten. If that’s the case, you might be interested in some surgical options. Surgery is the most effective way to eliminate extra skin. For example, a tummy tuck can remove extra skin and tighten up your abdominal muscles in the process. An arm lift can remove the extra hanging skin from your arms. It’s important to remember these options if your skin doesn’t have the elasticity necessary for your skin to tighten on its own or if you want a significant amount of fat to be removed during liposuction.

Let Us Answer Your Questions

If you’re worried about what your skin will look like after liposuction, schedule a consultation with your plastic surgeon. They will be able to determine whether you are a good candidate, based on your skin quality, age, BMI and other factors. They will also tell you if you’d get a better result if you do liposuction in combination with another procedure like a tummy tuck. When you take these steps, your results can be amazing.

  1. Fisher, Gary J., Sewon Kang, James Varani, Zsuzsanna Bata-Csorgo, Yinsheng Wan, Subhash Datta, and John J. Voorhees. “Mechanisms of photoaging and chronological skin aging.” Archives of dermatology 138, no. 11 (2002): 1462-1470.
  2. Aziz, Jazli, Hafiz Shezali, Zamri Radzi, Noor Azlin Yahya, Noor Hayaty Abu Kassim, Jan Czernuszka, and Mohammad Tariqur Rahman. “Molecular mechanisms of stress-responsive changes in collagen and elastin networks in skin.” Skin pharmacology and physiology 29, no. 4 (2016): 190-203.
  3. Spalding, Kirsty L., Erik Arner, Pål O. Westermark, Samuel Bernard, Bruce A. Buchholz, Olaf Bergmann, Lennart Blomqvist et al. “Dynamics of fat cell turnover in humans.” Nature 453, no. 7196 (2008): 783.
  4. Spalding, Kirsty L., Erik Arner, Pål O. Westermark, Samuel Bernard, Bruce A. Buchholz, Olaf Bergmann, Lennart Blomqvist et al. “Dynamics of fat cell turnover in humans.” Nature 453, no. 7196 (2008): 783.
  5. Coleman III, W. P. (1999). The history of liposuction and fat transplantation in America. Dermatologic clinics, 17(4), 723-727.
  6. “The SAFElipo Difference.” Body Contouring & Liposuction Surgery. https://www.safelipo.com/safelipo/difference.cfm (accessed September 21, 2018).
  7. Shiffman, M. A. (2006). Prevention and treatment of liposuction complications. In Liposuction (pp. 333-341). Springer, Berlin, Heidelberg.
  8. Fisher, Gary J., Sewon Kang, James Varani, Zsuzsanna Bata-Csorgo, Yinsheng Wan, Subhash Datta, and John J. Voorhees. “Mechanisms of photoaging and chronological skin aging.” Archives of dermatology 138, no. 11 (2002): 1462-1470.

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