What areas do NOT respond well to Liposuction?   The key to the Liposuction exam is to determine exactly what is causing the problem. Some problems can be treated with Liposuction while others require removal of excess skin. Sometimes a combination of the two is best. This section will help you decide what is best for you.  This information is designed to educate you so that your plastic surgery experience achieves your goals. Part of our responsibility is to make sure that your goals are realistic. With this in mind we will first outline which clients are not good candidates for Liposuction.  Not all areas respond well to Liposuction. Most people feel that if they have a fatty area it can just be sucked away and the problem will be solved. This is not the case. There are other issues that must be considered.   Redundant Skin Redundant skin usually is best treated with removal. This is especially true with medial thigh, and arms, and often abdomen. If Liposuction is done in these cases then a poor result is likely. When the fat is removed, the loose skin becomes even looser often with waviness because the skin does not have the ability to recoil. This elastic skin contraction is extremely important and is elaborated on throughout this section.   Poor Quality Skin The entire basis of Liposuction depends of skin contraction. Poor quality skin does not have this ability. Poor quality skin is identified by stretch marks, cellulite, scars, age, and a certain thin dermis feel that only your plastic surgeon can determine.   Stretch Marks Stretch marks show that the skin does not have much elastin, which is necessary for the skin to contract. Therefore, after the skin has been stretched (i.e. pregnancy or weight gain) it cannot recoil back. The skin essentially forms scars that are represented by stretch marks. These scars have no capacity to contract.   Cellulite Unfortunately, cellulite also responds poorly to Liposuction. Ironically, this is why some women want Liposuction in the first place. Cellulite is skin that has fat in the subcutaneous areas separated by fibrous septa. These septa break the fat into compartments. Sometimes, when this fat is removed the cellulite can become more prominent. Currently, there are no good answers to this problem but certainly muscle tone and proper diet help.   Scars Scar tissue is devoid of elastin. It has NO ability to contract. Areas with scars are often best revised. Since a scar is already there a good plastic surgeon can perform a scar revision that will result in a less conspicuous scar. As a bonus, a skin and fat removal can be done at the same time, thus, creating a win-win situation.   Aged Skin Notice how the title is Aged Skin and not a specific age. This is because different people's skin age differently. Amazingly, even skin on different areas of the same person age differently. The bottom line is that the older the client is, the more likely is he/she to benefit from skin excision than Liposuction. The good news is that older skin forms thinner, less visible scars than younger skin.   Thin Dermis Areas Once again, skin contraction depends on elastin within the dermis. Areas that have a thin dermis do not have much elastin. Areas that are notorious for thin dermis are the medial thigh, and the inner arms. Pinch these areas and feel for yourself. This is why a medial thigh lift or arm lift is usually a better choice. An exception to this is the young client with thick, elastic skin in these areas.   Beer Belly This is almost exclusively a male concern. The problem is that this fat is NOT subcutaneous fat that is amenable to Liposuction. This fat is under the muscle within the abdomen itself. It is hard, therefore, pinching it is difficult. Because it is intra-abdominal it is not accessible to Liposuction and can only be lost by diet and exercise.   Markedly Overweight Liposuction is not meant to be a weight loss procedure. In fact, most plastic surgeons will limit the amount of fat removed so that client safety is maintained. Many will not exceed 5000 cc's (a bit less than a stone) in one operation. The fact is, massive Liposuction often leads to skin waviness as well as skin sag. Skin excision is often a better way to go