The removal of quantities of fat from under the skin allows the elastic skin to potentially retract after suction-assisted liposuction (SAL) . Examples of this effect are seen after liposuction to the arms, stomach areas and breasts. The level of skin retraction following liposuction depends on the age of the patient, quality of skin, presence of underlying disease or smoking and the presence of previous skin damage caused by childbirth and surgery.
Liposuction techniques such as subdermal undermining using fine cannulas can stimulate further skin retraction but are more frequently associated with contour irregularity. While subdermal undermining may help the skin contract, patients with severe elasticity loss and heavy stretch marks prior to liposculpture may require removal of redundant skin by surgical means after liposculpture. Usually this can be performed after 6 months.
Surgical lifts such as a rhytidectomy (facelift), mastopexy (breast lift), abdominoplasty (tummy tuck), or lower body lift, thigh lift, or buttock lift can be utilized when sagging skin alone is the issue or after massive weight loss when the combination of large amounts of skin and shrunken fat cause significant skin droop.
Large volume Liposuction (SAL) in combination with other surgery is common, but may have higher complication rates. When done simultaneously, SAL is done minimally in the areas of the undermined tissues to minimize further harm to the blood supply.