Loose skin after weight loss solutions, explained by experts

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I lost 85 pounds without bariatric surgery. Weight loss has been on my mind pretty much my entire life, especially since I started this journey in earnest in July 2019. And, as proud of myself as I certainly am for losing that weight and finally being healthier , it’s met to- on the feet with pervasive anxiety and a nagging question: what about the excess skin?

Due to the slower rate at which I am losing weight, I have yet to experience any loose skin, although I still have at least 50 more pounds to lose. I worry, maybe too much, if I will be able to reach my goal weight without needing to tighten the skin at the end of this trip.

It’s a pretty unsexy topic, which is why it’s rarely, if ever, discussed. But for those like me who are losing weight or whose body has changed dramatically during pregnancy, it’s a question that haunts us: will I have excess skin the more skin I lose? weight ? And if I do, what can I do?

Apparently, I’m not the only one with questions, according to Lara Devgan, New York plastic surgeon to the stars. “Skin tightening remains one of the elusive black boxes in the world of plastic surgery,” she says. That said, we are all always learning best practices – from me to medical professionals.

So I decided to investigate further. Bringing together five renowned dermatologists and plastic surgeons from across the country, I ask them all my questions. And here’s what they have to say.


If you want to try to reduce sagging skin due to significant weight loss, lose weight slowly.

“Losing weight gradually rather than quickly can prevent excess skin after significant weight loss,” says Los Angeles-based dermatologist Harold Lancer. “However, rapid large-scale weight loss will invariably result in excess skin.” Devgan supports this. “The best way to prevent sagging skin after weight loss is to do your best to lose weight at a slow, steady pace,” she says. “While it may sound appealing to reach the finish line fast, it’s actually the worst thing you can do in terms of sagging skin.” Losing weight slowly, she says, allows the skin to contract and shrink as the body shape shrinks.

While it may sound appealing to reach the finish line fast, it’s actually the worst thing you can do in terms of sagging skin.

If you’re having weight loss surgery, consider a surgical punch: weight loss surgery immediately followed by skin removal surgery.

Although I haven’t personally opted for weight loss surgery, many do – and there’s no shame in that. But due to the faster rate at which weight is lost after surgery, there is a greater likelihood of excess skin. Why do you have to worry about excess skin, especially after faster weight loss? This is “because collagen and elastin fibers are destroyed when the skin is stretched significantly and remains stretched for a long period of time,” says New York plastic surgeon David Shafer. “Patients should plan for step-by-step procedures if undergoing weight loss surgery followed by skin removal surgery.”

The elasticity of the skin depends on two main factors: age and genetics. But lifestyle choices matter too.

“Generally, younger patients with thicker, more sebaceous skin will have more skin contraction during weight loss due to better elasticity,” says Devgan. “From the 1920s, the elasticity of the tissues begins to decline. Even in the absence of weight fluctuation, loss of tissue turgidity and decreased firmness can be seen in mid-face descent in the late 20s, breast laxity in the 30s, laxity abdominal pain in the 40s and extremity laxity in the 50s.”

However, everyone’s body is different, says Devgan. “There is enormous variability in the human experience, such that some patients may lose 50 pounds with minimal change to their body, while others may lose as little as 10 and see tissue loosening.” If you’re genetically endowed with exceptionally superb tissue elasticity, Devgan says, it may be less dramatic. (And you’re in luck.)

Additionally, lifestyle choices can also be considered, says Boston-based dermatologist Ranella Hirsch. How long have you been at the weight you started losing? Are you a smoker? Do you spend a lot of time unprotected in the sun? All these factors affect the elasticity of the skin.

Keep the skin well hydrated.

“Using an emollient moisturizer rich in vitamin E will help improve the skin’s protective barrier and lock in moisture,” says Devgan. And the medical-grade topical ingredients you use on your face for skin firmness and tightness — like hyaluronic acid, peptides, niacin, squalene, vitamins C and B, retinol, and bakuchiol — can also work elsewhere, she says. “Most people focus on using them for the face and neck in their daily routines, but from a molecular perspective, their effectiveness is all over the body.”

But save your money on creams that promise you the world.

“Losing large amounts of weight quickly tends to leave skin behind,” says Hirsch. “Although creams with incredible claims abound, they don’t actually do much.”

Instead, consider non-invasive treatments and even strength training.

Building muscle through weight training may help reduce the appearance of sagging skin, says New York dermatologist Dendy Engelman. “It helps reduce appearance by replacing lost fat with muscle mass.” And there are non-surgical options for treating loose skin after weight loss, but they won’t help with skin folds or hanging skin.

“Non-invasive treatments such as laser and radiofrequency can help tighten the skin, but there’s a limit to what they can do,” adds Shafer. “Dangling skin usually needs to be surgically excised with procedures such as tummy tuck, body lift, and arm lift.” There is a difference between ample skin and suspended skin, says Shafer. “Patients may be able to manage and treat cases of excess skin without undergoing skin removal surgery, for example if the skin is loose but not hanging down.” He adds: “In this case, non-invasive treatments can be helpful, but the hanging skin most often requires surgical excision.

Non-invasive treatments such as laser and radiofrequency can help tighten the skin, but there’s a limit to what they can do.

If excess skin is interfering with your life, it’s time to consider plastic surgery, with input from several medical professionals.

“After significant weight loss, people can have skin that hangs off their body,” says Engelman. “These thick folds can cause health problems such as pain, inflammation and frequent infections due to the constant rubbing of the skin. This can happen during exercise or during daily activities. When a person has problems functional because of her excess skin, that should be a sign that this problem needs to be fixed.And, of course, everyone’s journey is different.

Lancer says some people will tolerate moderate laxity and be content with the weight loss accomplishment; others will seek to tighten skin for as little as a five pound weight loss (he’s based in Los Angeles after all). But, he says, if plastic surgery becomes the option on the table, “I would recommend getting at least three opinions from doctors who exclusively perform excess body skin reduction. Once you’ve selected a doctor, do a small area on your body so you can assess the procedure, how your body is healing, and your results.Then you can determine if you want to have a larger, full-fledged procedure.

He suggests seeing a dermatologist for non-surgical options, then asking that doctor to recommend plastic surgeons who deal with excessive body skin reduction if you think that’s the right path for you. This is a major decision that should not be taken lightly. Engage medical professionals throughout the weight loss journey (even if you’ve already started) and ask all the questions: Which specific procedure is best? How much will it cost? Will the insurance cover it? (Based on my research so far, no if it’s cosmetic, but maybe yes if it would help fix something that’s limiting functionality in your daily life.) No questions are off limits, and no don’t try to make these decisions alone.

Above all, and perhaps most important, be proud of yourself.

If this article applies to you, whether it’s because of the weight you’ve been carrying for a long time or weight loss you gained during pregnancy or anywhere in between, it means one thing: you’ve taken steps. important to better physical health, and that should be applauded. “Everyone’s weight loss story is different, and some days are harder than others,” says Engelman. “I say, try to be nice to yourself. You have just accomplished a huge accomplishment and you should be proud of it.

Devgan agrees. “Achieving a personal health goal like significant weight loss is an incredible achievement that everyone should be proud of,” she says. “While excess skin may seem like a burden or a source of self-consciousness, it’s also a metaphorical and literal reminder of the loss of weight from a previous version of yourself. You can’t have a seamless couture dress, and you can’t have surgery without a scar. Life has limits, but that doesn’t make it any less beautiful. It makes it more real.

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