Skin Laxity after VASER

Many patients, in fact all patients, will during some stage of a consultation ask about skin laxity.  Most will mean they are concerned about skin wrinkling or having rolls of skin hanging from their torso.
In my experience it is fairly easy to assess whether a patient will react well to the VASER treatment and suffer from lax skin or not.  If there is any doubt that there is going to be wrinkly skin then the patient is not a candidate and I decline to treat them.
The term "Loose skin" applies to the mobility of the skin.  This occurs when the interface between the muscle and skin becomes less elastic and allows the skin to move freely over the muscle and connective tissue.  As we become older our elastic tissue becomes a little lax and thus allows for the skin to be a little more mobile.
This becomes especially noticeable when someone has lost a few stones.  Compare this to a ballon that deflates - the membrane becomes flaccid as the volume depletes.   Similarly the skin becomes a little "wobbly" over the muscle.  VASER does help a little with skin tightening, but there is a limit as to how much will take place.

I hope this explains and reassures you a little with regards to skin laxity.

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VASER Hi Def - before and after

I saw another VASER Hi Def patient yesterday.  The procedure was performed in June last year.
One of the important aspects of having this treatment is being willing and able to maintain the result.  Its not a quick fix at all.  Ideally prospective candidates should be relatively fit and already have a fair amount of contour.  The procedure is aimed at pronouncing the contour and definition.
I see many patients that see themselves as very fit, but are not suited for the procedure.  This can be due to a variety of reasons:
lax skin, too many stretch marks, musculofacial laxity (when the skin is very mobile), too much visceral fat (fat around the organs), clear inability or lack of motivation of not being able to maintain the result.


Understandably many patients are disappointed if I tell them that they are not suitable for the VASER Hi Def procedure.  It all boils down to being honest and realistic.  There is no point in trying to attempt to perform the procedure on a patient that is not suitable.  Firstly its unethical from a medical standpoint, secondly the patient will not be satisfied, and thirdly, one will be trying to correct what one cannot achieve.

There are many before and after pictures available on the net that are good examples of patients that were not suitable for the VASER Hi Def procedure.

The procedure needs to be tailored to the individual patient.  Thats where the 3D "vision" comes in.  Visualising the anatomical landmarks and underlying muscles is of paramount importance.  Hence its easier to treat patients that have a fair amount of muscular definition already.  It is although not impossible to visualise these under a thinnish fat layer.  Also important is input and feedback from the patient prior to the procedure. Some patients don't want specific types of the definition and its important to specify this at the marking stage.  I always get my patients to look at their marking and make sure they are in agreement with the style of definition.  Before pictures of the markings will then also confirm this.
Below is a picture of another content patient who has managed to maintain his result.......

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Click here to see a video on VASER, its indications, how it works and what it can achieve.
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MLD after VASER lipo

I thought I would you some insight into what is required in the post-operative period of VASER.
Besides wearing the compression garments it is also important to have manual lymphatic massage.
The duration that you will wear the garment depends on the practitioner.  Each will have their own preference.  My patients wear the first line garment for 2 weeks 24/7 (taking it off for washing etc), then for another 3-4 weeks about 10 hours a day.  Best is to wear it during the day as at night most of the oedema (swelling) will settle so its not as effective.
MLD has only really been introduced in the post-operative period in the past 2-3 years.  Many traditional, old school plastic surgeons still don't see the benefit in the treatment.
I have noticed a tremendous improvement in the speed of recovery, minimising swelling, softening of tissue, minimising bruising and general improvement in comfort.
The number of sessions that are required is variable.  My feel is that one cannot have enough MLD.  Obviously finances are a limiting factor.
Here is a rough guide as to the average number of session:
arms - 3
abdomen - 5-10
flanks - 5-10
outer + inner thighs - 3-5
chin/face - 3-5
In Hi Def patients this may rise to 15-20 sessions (remember that these are just guidelines and your Dr may recommend more or less)
As I said it is variable from patient to patient and also depends on your level of activity.  Most patients getting back into gym and exercise usually require less sessions.

MLD therapists can be found on the www.MLDUK.ORG.UK website.  Make sure they are registered or otherwise they may be using traditional massage techniques which are not appropriate.  The treatment is very gentle, almost like stroking.  It should not be uncomfortable - if it is then its being done incorrectly.
Try and see the therapist that the Dr recommends as they generally have a good relationship and give each other feedback on how the patients are doing.  Thereby concerns are flagged up early and can be dealt with immediately.  Many therapists have gotten to know me now due to the many referrals and anticipate the treatment regime I recommend. Some have even come to seek VASER treatment themselves after seeing the dramatic results and the snappy recovery of their patients.
The procedure kickstarts the lymphatic system back into action.  With all the fluid that is infiltrated for the local anaesthetic the tissue becomes a bit overwhelmed with the tissue load and struggles in reducing this.  Once the sustain is complete majority of the fluid has been aspirated out.  However, tissue swelling soon starts and results in a little swelling.  Occasionally some lumps and bumps appear too.  These again respond very well to MLD.

Hope that gives you a little more insight into MLD and VASER treatments.

Have a look at this video for more clarification......

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Bye for now.
Dr Dennis Wolf