Renuvion Skin Tightening in Seoul: What Helium Plasma Can and Cannot Do for Loose Skin

Why can the line stay the same after weight loss?

After weight gain and loss, or after pregnancy, the skin and the structures that support it can stay stretched. At Bonita Clinic, we see this as a problem of skin and structure rather than fat. In our view, stretched skin rarely shrinks back with exercise or diet alone. Reducing fat alone at this point can leave skin behind and make the line look even looser.

Skin that stays after weight loss

Replay

1. 1Weight gain or pregnancythe skin and the structures that support it stretch together
2. 2After weight lossthe fat is smaller, but skin that has stretched stays and sags
3. 3Reducing fat aloneleftover skin can make the line look even looser, as Bonita Clinic explains
4. 4Two things to assesshow much fat is left under the skin, and how much stretched skin remains

So a loose contour has two separate parts to assess:

• How much fat is left under the skin
• How much stretched skin there is

If there is a lot of fat, reducing it comes first. If there is a lot of excess skin, methods that only tighten from beneath have limits. Renuvion is aimed at the space in between: skin that is mildly to moderately loose.

Where loose skin often bothers people

Replay

1. 1Abdomenskin loosened after pregnancy
2. 2Inner upper armsskin that still sways after weight loss
3. 3Inner thighs · above the kneesthin, less elastic skin where change is easier to notice

What does Renuvion do under the skin?

Renuvion (formerly called J-Plasma) passes radiofrequency energy (energy that uses electric current to make heat) through helium gas. This creates a plasma, a gas that has been given so much energy that it carries an electric charge, which comes out of the tip of a thin probe.

On the body it is mostly used together with liposuction. The tip is inserted through the same small openings and delivers energy into the fat layer under the skin, where the heat makes the tissue firm up (coagulate).³⁴ It is not an operation that pulls skin from the outside and stitches it; it creates a heat reaction in the tissue beneath.

What Renuvion does under the skin

Replay

1. 1Through a small openinga thin tip goes into the fat under the skin through an opening used for liposuction
2. 2Helium + radiofrequencyradiofrequency energy passed through helium gas makes plasma at the tip
3. 3Heat firms the tissuewhere the tip passes, the tissue under the skin coagulates with heat
4. 4A safe distancetoo close to the dermis risks a burn; retained helium rarely causes gas under the skin

At Bonita Clinic, even with the same device, we adjust power, depth and combination to your skin condition and goal. In the end, what your current condition needs matters more than the device name.

What has the US FDA cleared, and what has it not?

Renuvion was first cleared as a general surgical tool for cutting and coagulating soft tissue during open and laparoscopic (keyhole) surgery. Aesthetic uses were added one at a time from 2022.¹ In March 2022, the FDA warned against using it for skin resurfacing or skin contraction, because its safety and effectiveness for those uses had not been established at the time.¹ The cleared uses then expanded as follows.

US FDA warnings and clearances

1. March 2022Warning against use for skin resurfacing or contraction
2. May 2022Dermal handpiece for wrinkles (skin types I–III)
3. July 2022Loose skin of the neck and under the chin
4. April 2023Coagulation of tissue under the skin after liposuction
5. May 2023Update: check the device and its cleared uses

A closer look at the wording

The wording matters. "Improve the appearance of lax (loose) skin" applies only to the neck and the submental (under-the-chin) region. For body contouring, the cleared use reads "coagulation of subcutaneous soft tissues following liposuction".²

The evidence behind each clearance also differs:²

• Neck and under the chin: a prospective study at several centers (one that followed a set group of patients forward in time). The people judging the results did not know who had been treated (evaluator-blinded).
• Body contouring: retrospective chart reviews, meaning a look back at existing medical records, from 6 studies covering 483 patients and 1,184 body areas. These were compared with the complication rates of liposuction alone and showed no new or increased risks.

In other words, the body data in the clearance summary focus on safety. They do not include data comparing how much the skin tightens against a comparison group (a control group).

The FDA advises patients to discuss the benefits and risks of aesthetic procedures with their provider and to ask which devices will be used.¹ The clearances described here are US FDA decisions; the scope of approval in Korea should be checked separately.

What can the research tell you, and what can it not?

Research on Renuvion is growing quickly, but conclusions drawn from the same body of work differ sharply. First, the study types in the table:

• Meta-analysis: a study that pools the numbers from many studies and recalculates them
• Systematic review: a study that gathers all the relevant research using set rules and sums it up
• Randomized controlled trial: patients are assigned at random to receive the added treatment or not, and the two groups are compared

The meta-analysis authors themselves acknowledge that because most included studies were uncontrolled case series, the added benefit of Renuvion over liposuction alone could not be measured.⁴ The independent review concludes that no evidence supports tightening beyond what conventional or ultrasound-assisted liposuction can achieve.³ The blinded randomized trial found better patient-rated scores for loose skin when Renuvion was added to abdominoplasty (surgery that removes loose skin and fat from the lower abdomen). But it was used alongside skin removal, not instead of it.⁵

Complication rates (meta-analysis, 34 studies)

Replay

1. 1Alonecomplications 5%
2. 2With liposuctioncomplications 8%
3. 3With skin-removal surgerycomplications 15%
4. 4Read with carea manufacturer-funded meta-analysis of mostly uncontrolled studies, so the added effect cannot be calculated

Taken together, Renuvion is a device whose evidence is still being built. It is sensible to keep expectations narrow and realistic.

Which method fits your situation?

Which method fits depends on how much loose skin there is and how much fat lies beneath it. At Bonita Clinic, we likewise separate mild looseness, fat combined with sagging, and cases with a lot of excess skin, and set the direction before choosing a procedure.

By the amount of loose skin and fat

• 1More fat, skin with good elasticity

  Liposuction alone is considered; any loose skin may look more obvious afterwards

  Liposuction

• 2Mildly loose skin

  Renuvion alone is considered; there is less evidence for stand-alone use on the body

  Renuvion

• 3Fat and sagging together

  Liposuction with Renuvion is considered; the size of the added effect differs between studies

  Liposuction + Renuvion

• 4A lot of excess skin

  Skin-removal surgery is the main option; it leaves a scar but removes skin directly

  Skin-removal surgery

When a lot of skin remains, as after major weight loss, skin-removal surgery is the main option, and energy devices are being studied as an addition to it.⁵ Where the skin is only slightly loose, an approach through liposuction openings can be considered before surgery that leaves a long scar.

What are the procedure and recovery like, and what can go wrong?

At Bonita Clinic, we perform Renuvion line lifting as surgery under sedation combined with local anesthesia; you go home the same day, and stitches are used. A compression garment is worn to manage swelling and bruising, and light activity resumes while you keep wearing it. The length of recovery and the follow-up schedule depend on how much is treated and on your condition.

Known risks include:

• Common changes: swelling, bruising, temporary numbness, and a crackling feeling under the skin from gas have been reported in studies.³
• Fluid and wound problems: seromas (clear fluid collecting where surgery was done) in about 7% in studies combined with liposuction. In a study combined with abdominoplasty, seromas occurred in 15% and wound separation in 10%.³
• Burns: because heat energy is used, burns through the full thickness of the skin can occur. Burns were the most common type of event in US FDA adverse event reports.³
• Nerve problems: nerve weakness was reported in 6.2% of patients treated in the neck and under-chin area.³
• Rare but serious: case reports describe helium spreading where it should not. This caused gas under the skin (subcutaneous emphysema), air outside the lung (pneumothorax) or air in the middle of the chest (pneumomediastinum). FDA adverse event reports include 15 life-threatening events and 3 reported deaths.³

Adverse event reports are voluntary and cannot show how often problems occur, and for some of the reported deaths the cause was not determined.³ Even so, they make clear that the operator's experience and the conditions of use matter for safety. Shortness of breath, chest tightness, or swelling spreading to the neck or face after treatment needs urgent medical attention.

How we approach it at Bonita Clinic

Treatment options you can discuss in Seoul

Dr. Kwang-Seop Chung, a plastic surgeon trained and board-certified in Brazil, has seen patients himself at Bonita Clinic since it opened at its current location in 1995. For loose skin after weight loss or pregnancy, the options described on our treatment pages are:

• Renuvion alone for mildly loose skin
• Liposuction combined with Renuvion when fat and sagging occur together
• Area-by-area body redesign, or Renuvion with supporting procedures when sagging is advanced
• Liposuction revision when irregularities or sagging remain after earlier liposuction

Which of these fits, and whether another method such as skin removal should be considered, is decided only after an examination.

Why the method and cost differ from person to person

"Loose skin" covers a wide range. The extent and combination of the work, rather than the device name, shape the plan and the cost.

• Number and size of treated areas
• Whether liposuction is combined
• How much loose skin there is
• Anesthesia: sedation with local
• Previous surgery in the same area
• Whether other procedures are added

Final plan and quote after seeing you in person

A final estimate is given only after an in-person examination, once the areas, the combination and the anesthesia are clear. A photo review can point to a likely approach; it cannot settle the scope.

What photos can show, and what needs an in-person exam

Photos help show the shape of a fold or overhang, but they cannot tell fat from skin or measure elasticity.

Photos can show

• Folds, overhang and creases
• How the area looks standing and bending
• Stretch marks and old scars
• Differences between left and right

Needs an in-person exam

• How much is fat and how much is skin
• Skin thickness and elasticity
• Irregularities from earlier liposuction
• Abdominal muscle separation after pregnancy
• Health conditions affecting surgery

Helpful photos: the area from the front and side, standing upright and then bending slightly forward, in the same light and without filters. If you have had liposuction, lifting or radiofrequency treatment before, note when and what. Your photos and questions can be sent to us by message.

Planning your visit and recovery

What is confirmed in advance is limited to the treatment information above. Surgery is under sedation with local anesthesia, with same-day discharge and stitches. A compression garment is worn, and how long is explained before surgery. How long to stay in Seoul and when to return for checks depend on the areas treated and whether liposuction is combined, so these are planned with you at consultation.

Because swelling hides the line at first, results are judged after the swelling settles. Keeping dated photos in the same pose and light as your pre-treatment ones helps any later review, at our clinic or with a doctor at home. Contact a doctor promptly if pain, redness or swelling increases, or if blisters or dark patches appear on the skin. Do the same if you notice shortness of breath or swelling spreading to the neck or face.

Real treatment cases

These cases appear on Bonita Clinic's Renuvion line lifting page. The photos were taken against different backgrounds and lighting, and results vary from person to person.

Abdomen, front view: skin folding into horizontal creases around the navel

Abdomen, front view: fine creased skin above and below the navel

* Results vary from person to person. Side effects are possible, so please decide after a thorough consultation with a doctor.

Frequently asked questions

Can I have Renuvion alone, without liposuction?

Mildly loose skin is sometimes treated with Renuvion alone. When fat and sagging come together, it is often combined with liposuction, so the decision depends on your condition. Note that the US FDA's body contouring indication is worded for use after liposuction.

Can it replace skin-removal surgery?

It depends on how much skin is left. For slight looseness it can be considered before surgery, but when a lot of skin remains, as after major weight loss, skin-removal surgery may be needed. In the research, Renuvion was used in such cases as an addition to skin removal.

When will I see a result, and how long will it last?

The line appears as the swelling goes down, so it cannot be judged right away. In the meta-analysis, satisfaction was higher in studies with longer follow-up,⁴ but because most studies had no control group, how long the effect lasts cannot be stated with confidence. Weight changes and ageing will also keep changing the line.

Will there be a scar?

There is no extra incision. It goes through the same small openings as liposuction, which are cared for so they fade over time. Small marks can remain at the openings, and in the rare event of a burn, a scar can form.

How long do I wear the compression garment?

It varies with the area and extent; you will be told the period before surgery.

What to prepare before your consultation

• Your weight history: when and how much you gained and lost, and whether your weight is now stable
• Pregnancies and when they were, if the abdomen is the concern
• Previous liposuction, lifting or radiofrequency treatments, and when
• Medicines you take regularly, medical conditions, and whether you smoke

Bonita Clinic is on the 3rd floor of 565 Gangnam-daero, Seocho-gu, Seoul, about 100 m on foot from Exit 8 of Nonhyeon Station (Line 7). You can read more on our Renuvion Line Lifting page. If there is also a lot of fat, see our Liposuction page; if irregularities or sagging remain after earlier liposuction, see Liposuction Revision.