July 13, 2026 | Liposuction
A patient sat down across from me last month, lifted the hem of her shirt, and pinched the skin below her navel between two fingers.
“I do not want a scar,” she said. “Everybody tells me I need a tummy tuck. I want you to tell me the truth.”
Sometimes the truth is that yes, she does. Much more often than ten years ago, the truth is that she does not, and the reason the answer changed is a device I have been using since 2019.
The Problem Liposuction Never Solved
I started using Renuvion J-Plasma in 2019. I was one of the very early adopters, and I saw a missing need after liposuction, which was skin tightening. We were able to perform liposuction effectively, but after deflating the subcutaneous tissue layer, many patients were left with loose skin, which required surgical excision. When we began using Renuvion, we noticed that the tissues would contract, and oftentimes the surgical excision of excess skin was not necessary anymore.
Surgical excision is the clinical phrase for cutting the loose skin off. On the abdomen, that operation is a tummy tuck. On the upper arm, it is a brachioplasty, better known as an arm lift. Both are good operations and I perform both. Both leave a scar you keep for life. Anything that gets a patient the same result without one deserves my attention.
What Renuvion J-Plasma Is
Renuvion J-Plasma activates helium plasma and radiofrequency in the subcutaneous layers, making the connective tissue underneath shrink and contract, resulting in skin tightening and a smoother result. The helium plasma is important because it keeps the temperatures cool, which avoids burning.
The connective tissue I am describing is the fibrous webbing that ties your skin down to what lies beneath it. Tighten that webbing and the skin above comes with it, the way taking a hem in from the inside lifts a garment without anyone seeing the stitching. The helium is the safety half of the design, because it lets the energy arrive and leave almost immediately. That is the difference between a treatment that tightens tissue and one that burns it.
It goes in through the same small openings the liposuction cannula already used. Nothing additional is cut.
How Often I Use It
We use Renuvion J-Plasma almost every day, performing more than ten to twenty Renuvion cases per week. I am among the ten highest users in the world, according to Apyx, the company that manufactures the device.
I tell patients that for one reason, and it is not the reason you would expect. It is why I can also tell you where the device fails. A surgeon who has done a dozen cases has only met the good version of it.
What the 2026 Study Found
In March 2026, Huber and colleagues published a study in Plastic and Reconstructive Surgery Global Open. They reviewed 113 patients from one surgeon’s practice, treated between October 2021 and October 2023. Seventy-three had power-assisted liposuction by itself, and forty had power-assisted liposuction plus Renuvion J-Plasma. More than a year later, they went back and asked the patients themselves how they felt about the result, using BODY-Q, a questionnaire validated for exactly this purpose.
| Result at more than 12 months | Liposuction alone | Liposuction plus Renuvion J-Plasma |
|---|---|---|
| Satisfaction with excess skin | 73.8 | 87.8 |
| Satisfaction with the abdomen (no tummy tuck) | 45.0 | 68.8 |
| Needed a revision surgery | 37.5 percent | 12 percent |
| Ended up needing an abdominoplasty | 67.1 percent | 30 percent |
| Complication rate | 2.7 percent | 2.5 percent |
For the woman pinching her skin in my office, two of those rows matter. The Renuvion J-Plasma patients came back for a second operation far less often, and they needed a tummy tuck less than half as often. The complication rate did not move, and no complication was attributed to the device.
The caveat, which I would rather give you myself. This study looked backward at cases already done, nobody was randomized, and every patient came from a single surgeon. That makes it a strong signal, not a final verdict. The authors say so, and they are right to.
Who Is Actually a Candidate
Read this part closely, because the internet has been sloppy with it and I spend a lot of consultations undoing that.
In the right patient, one who does not have a lot of skin laxity or stretch marks and no rectus diastasis, the Renuvion J-Plasma can help keep patients away from an abdominoplasty and let them have just liposuction.
Three conditions, and you need all three of them.
Skin laxity mild to moderate, not severe. If a fold of skin hangs when you stand up, energy is not going to lift it.
No significant stretch marks. A stretch mark is a tear in the dermis, the deeper of the two layers of your skin. Tightening the tissue beneath a tear does not repair the tear.
No rectus diastasis. That is the separation of the two vertical abdominal muscles, and it happens most often with pregnancy. If your abdomen pushes forward because the muscle wall has come apart down the middle, tightening skin accomplishes nothing, because the skin was never the problem. The wall behind it is. That patient needs a tummy tuck, sometimes as part of a mommy makeover, and I would rather say so at the first visit than disappoint her six months after surgery.
There is one more situation where I put the handpiece down. I prefer not to use it in overly thin skin. If I encounter overly thin skin, I transition to BodyTite.
Where on the Body It Works
I prefer to use Renuvion J-Plasma in the abdomen, the flanks, the upper back, the lateral chest, and around the knees. We also use it on the arms and thighs.
There is a sweet spot in using J-Plasma, where more passes and more energy are not going to give you any further results. So being accurate in the number of passes and the energy for each area is extremely important to get the most benefit with the least risk.
More is not better with this device. More is just more, and eventually more is worse.
What It Will Not Do
The most important thing is really knowing the limitations, and knowing that J-Plasma will not tighten extremely loose skin after pregnancy or massive weight loss. It is very powerful in contracting the skin, and it often keeps patients away from needing a brachioplasty or excision of back rolls.
Both halves of that are true at the same time. It is strong enough to spare a patient an arm lift or a back-roll excision, which are not small scars to avoid. It is not a replacement for a tummy tuck in a patient who needs one, and I will tell you so on the first visit.
Recovery Is the Same
It is important to know that Renuvion J-Plasma is not going to increase recovery times. The recovery itself and the protocol are the same with or without Renuvion J-Plasma when you have liposuction. We still use the garments, and we still use lymphatic massages.
Same compression garment, same lymphatic massage schedule, same return to work. The skin keeps contracting for months afterward, so what you see at six weeks is not what you will have at six months.
Why Choose Dr. Agullo
I am double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, and I completed my plastic surgery fellowship at Mayo Clinic. I have taught as a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine since 2011, and Castle Connolly has named me a Top Doctor for thirteen consecutive years.
I have used Renuvion J-Plasma since the technology came out, at a volume very few surgeons anywhere match. That is why I can tell you honestly when it is the answer, and just as honestly when it is not.
#StayBeautiful
Ready To Talk?
If you have been told you need a tummy tuck and you want a second opinion on whether liposuction with Renuvion J-Plasma could get you there without the scar, come in and let me look. Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com/appointments.
For my candid, surgeon-to-surgeon version of this same subject, read Seven Years of Renuvion J-Plasma on drworldwide.com.
Follow along at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
