The potential to develop loose skin varies from patient to patient. This determination is based on physical examination alone. Some patients have excellent skin tone with minimal laxity and aren’t likely to have difficulty with skin sag. These patients are often younger and are close to their ideal body weight. In this group, liposuction is an excellent treatment option with high satisfaction rates.There are also patients who are clearly at risk for developing skin sag. This group is often older and their skin has more laxity. They have experienced greater fluctuations in their weight and have had multiple pregnancies. In many cases, they are not within 10% of their ideal body weight. They may also have associated weakness of their underlying abdominal muscles.
In this group, therapeutic decisions are often more difficult because of the potential for skin sag. For this reason, it’s not only important to understand the patient’s potential for skin sag, but their aesthetic goals as well. It’s important to know whether they want to look good in a swimsuit or look good in clothing.
Based on these considerations, liposuction may still be a good choice for some patients. They must understand their potential to develop skin sag. They must also understand that if skin sag develops following liposuction, an abdominoplasty will be required to correct this problem.
Facing the realities of this situation, many patients will elect to proceed directly with abdominoplasty. The care of patients with abdominal fat deposits needs to be individualized. In this group, skin quality and aesthetic goals are important considerations. The best results are obtained when a proper analysis of the problem is combined with a board-certified plastic surgeon that has experience treating this problem.
