If you ask a plastic surgeon which part of liposuction is the hard part, and he answers you honestly, he will not tell you it is the fat.
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.
Read that last part again, because it is the whole reason I am writing this. Not that the skin looked somewhat better. The excision was not necessary anymore. A second operation, and a permanent scar, came off the table.
What It Is Doing Under There
This is the explanation I give in clinic, and I have never seen a reason to keep a simpler version for patients and a smarter one for colleagues.
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.
That last sentence is where the engineering lives. Radiofrequency by itself will contract tissue. Radiofrequency by itself, at the wrong settings, will also cook it, and our literature has documented what that looks like. The helium is what lets the energy arrive hot and get out fast. The handpiece goes in through the same access sites the liposuction cannula already made, so nothing new is cut and nothing new is closed.
How Much 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 put that near the top rather than the bottom for a reason. When a surgeon speaks well of a device, you are entitled to know how far into it he already is before you weigh anything else he tells you. I am very far into this one.
The Huber Paper
Apyx circulated a study through its clinical newsletter this spring. I read manufacturer mailings the way most of us do, with a raised eyebrow, because the company sending the envelope has an obvious interest in what I conclude. This one held up.
Huber, Bittencourt, Koteski and colleagues published it in Plastic and Reconstructive Surgery Global Open in March 2026. They reviewed 113 consecutive patients from one surgeon’s practice, treated between October 2021 and October 2023. Seventy-three had power-assisted liposuction alone, and forty had power-assisted liposuction followed by Renuvion J-Plasma. Past the twelve-month mark, they went back and asked the patients themselves, using BODY-Q, a validated instrument rather than a satisfaction form somebody drew up in a marketing meeting.
| Outcome (greater than 12 months) | Liposuction alone | Liposuction plus Renuvion J-Plasma |
|---|---|---|
| BODY-Q appraisal of excess skin | 73.8 | 87.8 |
| Same score, liposuction-only subgroup | 64.0 | 92.8 |
| BODY-Q abdominal appearance, no abdominoplasty | 45.0 | 68.8 |
| Surgical revision rate | 37.5 percent | 12 percent |
| Abdominoplasty rate | 67.1 percent | 30 percent |
| Complication rate | 2.7 percent | 2.5 percent |
The revision row is the one that stopped me. Thirty-seven and a half percent down to twelve. Any surgeon who has had to bring a patient back for a skin excision that neither of them wanted knows that the distance between those two numbers is not measured in questionnaire points.
The complication row matters too, more quietly. Adding energy under the skin did not add risk here, 2.5 percent against 2.7 percent, and no complication was attributed to the device.
The caveat, which the newsletter was not built to emphasize, so I will. Retrospective, not randomized, one surgeon. The authors say so themselves. It is a strong signal that happens to match what I watch happen in my operating room every week, and a strong signal is not proof. I would rather hand you that limitation myself than have you find it in the discussion section and wonder why I skipped it.
Where I Use It, and Where I Stop
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. I prefer not to use it in overly thin skin. If I encounter overly thin skin, I transition to BodyTite.
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.
That is the sentence I would put on the wall of every practice that just bought one of these. The dose does not scale in a straight line. Past a point you are collecting risk and buying nothing with it, and the device will happily let you keep going, because it has no way of telling you that what you have already done is enough. That judgment belongs to the surgeon.
The Unpopular Part
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 once, and the industry has a habit of quoting whichever half suits it that quarter. It really is strong enough to spare somebody an arm lift or an excision of the back rolls, and those are not small scars to spare a person. It is also nowhere near strong enough to replace a tummy tuck in a patient who needs one. Stretch marks it does nothing for at all, because a stretch mark is a tear in the dermis, and contracting the tissue under a tear does not repair the tear.
So here is the candidate, exactly as I describe him or her in the room.
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 all three are required. If the rectus muscles have separated, the abdomen is pushing forward because the wall came apart, and energy delivered into the fat layer above that wall does nothing about it.
Recovery Does Not Change
I lead with this now, because patients assume the opposite.
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.
You are not buying downtime here. You are buying a better envelope at the end of the downtime you had already agreed to. The skin also keeps contracting for months after you go home, which is why judging an abdomen at six weeks is a mistake, and why I spend part of nearly every week talking somebody down off that ledge.
Why I Am the One Saying This
I am double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, I completed my plastic surgery fellowship at Mayo Clinic, and 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. Castle Connolly has named me a Top Doctor for thirteen consecutive years.
None of that is why I trust this device. Seven years of using it almost daily is why. The credentials are why I am comfortable telling you where it fails.
#StayBeautiful
Ready To Talk?
If someone has told you that you will need a tummy tuck no matter what, it is worth a second opinion before you accept a scar you cannot undo. Call the office at (915) 590-7900, text 1-866-814-0038, or book a consultation at agulloplasticsurgery.com/appointments. You can also read more about liposuction at Southwest Plastic Surgery.
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