After any liposuction procedure the volume of the fat layer under the skin is reduced – sometimes dramatically. Regardless of the amount removed, there is always a question about how well the skin will retract and redrape over the treated area. Thicker, more elastic skin typically retracts better than thinner older skin. Factors that affect the skin’s elasticity include the patient’s age, gender, and skin pigmentation type.
From an aesthetic perspective, there is always a trade-off between the amount of body-contour remodeling that can be achieved through the removal of subdermal fat and the post-surgical appearance of the skin as it conforms to its new shape. Poor skin retraction will result in wrinkles or folds. Post surgical appearance will also be affected by pre-existing skin issues such as laxity, atrophy, and stretch marks.
The quality of skin retraction can be estimated for each individual patient by measuring skin thickness and elasticity. Then by reviewing before and after photos for past patients of similar age, gender, morphology, and skin type, the current patient can decide the balance they wish to achieve. Treatment strategies can also be discussed to improve skin elasticity prior to surgery as well as residual skin laxity after (for example, with the use of HIFU treatments).
Factors influencing skin retraction following body contouring
Post surgical skin remodeling and redraping will be affected by a variety of factors, including the patient’s:
- Area treated
- Pre-existing skin conditions
As we age, there is a reduction in the levels of our skin’s elastin, collagen, and connective tissue. Moreover, having had greater cumulative exposure to UV radiation, the skin will have undergone more oxidative cellular damage. Consequently, there will be a proportional reduction in the speed of post-surgical healing, and skin remodeling of the tissues will be less effective.
Gender and race factors
Men typically have thicker skin and a more robust matrix of connective tissue between the skin and its subcutaneous layers than do women. Because of this men typically have better skin retraction than women.
Certain racial groups, such as Afro-Caribbean and Asians generally have more robust skin than Europeans, and so typically have better skin retraction. On the other hand, darker skin can sometimes suffer pigmentation mottling after a liposuction.
Skin quality will vary over the body. Its thickness and elasticity will be subject to environmental factors, such as sun exposure, as well as the patient’s life history.
Skin on the inner side of the upper arms and on the inner thighs is usually thinner than in other areas of the body for most people. This explains why skin displays more laxity in these areas as we age.
Mechanical stress of skin can also diminish its elasticity. This can be seen in women who have had repeated pregnancies. For active people, it can also be apparent above the knees and around the elbows.
Skin that has been more exposed to the sun will have lost some of its elasticity, and be more prone to sagging with age.
Other issues that will affect skin retraction after a liposuction include connective tissue disorders, skin stretched by massive weight loss, a deficiency in collagen or elastin fibers, smoking damage, and chronic dehydration.
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