Liposuction Combined with Thermage Shows Promising Results

Liposuction results often can be improved with the addition of thermage, a cosmetic treatment that smooths, contours, and tightens skin. The combination treatment was among the hot topics discussed at this year’s American Society of Plastic Surgeons annual meeting.

Liposuction is an excellent treatment to remove excess fat in various parts of the body when diet and exercise have failed to make an impact. But, liposuction alone can sometimes leave the skin looking slightly wrinkled, if the skin lacks the elasticity to spring back into place. Now, many doctors are using a new, non-invasive treatment called Thermage in conjunction with liposuction to help tighten the skin and improve the final result.

Plastic surgeon Dr. Richard Baxter, presented on the combination technique at one of the Hot Topics sessions at Plastic Surgery 2009, the annual meeting of the American Society of Plastic Surgery, held at the Washington State Convention & Trade Center in Seattle October 23 – 27. He noted that he is careful to categorize the patients who qualify for Thermage, which uses a wand-like radio frequency device to smooth, contour and tighten skin after liposuction. It is effective, he says, but not meant for everyone.

“It’s really a nice option for those patients who have a little bit of skin laxity,” notes Dr. Baxter. “Not so much that they need a tummy tuck or a face lift – but, enough that you’re concerned that the results of liposuction, alone, may not be quite ideal. I think most people know that liposuction is a good option for those who have localized areas of fat that are resistant to change from diet and exercise. But, the people who have a little bit of skin laxity are in a sort of special category.”

This is because liposuction by itself should often allow the skin, with its elastic tone, to naturally tighten itself. But, in minor or moderate cases where this doesn’t happen, a treatment like Thermage is ideal. Optimum treatment areas are the face and neck area. But, for those who have lots of loose extra skin in those places, a face lift is better.

Baxter cites a clinical test where a liposuction patient with loose skin underwent a Thermage treatment on one side of his body. The treatment results offered 30 percent more skin shrinkage.

“That’s what we call a ‘proof of concept’ study,” he says. “We know that there’s something real happening here. The skin is shrinking more when we apply the Thermage immediately after.”

New liposuction technologies, such as laser liposuction, promise similar results. The laser energy is meant to heat the collagen in the skin, leaving skin tighter after the liposuction procedure. Although the treatment works well in many cases, Dr. Baxter cautions that some patients are bound to be disappointed when they expect this procedure to fully replace something more invasive.

“[The manufacturers are] promoting it as an alternative to a tummy tuck or a face lift,” he says. “And I think the more you do that, the more likely you are to have disappointed patients. I’m seeing patients in my practice already who knew they should have had a tummy tuck. They were convinced that a laser liposuction would be a good alternative. And they’re coming in now with scarring and lumpiness. It’s a really difficult problem to try and go back to fix later.”

Dr. Baxter’s advice on avoiding this problem?  “Shop around a little bit,” he says. “Talk to a plastic surgeon who does tummy tucks; find out what that’s really about. Really have a good idea of what you can expect from these procedures before you make up your mind.”