Featured Wednesday, 15 January , 2020Short Link:
The aftermath of weight loss is often expected and welcomed: higher energy levels, smaller pants, and a more defined body. But there is one unexpected challenge: keeping skin tight while losing weight.
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Well, in short, it’s usually linked with rapid weight loss, so it’s a common conundrum among people who undergo bariatric surgery for massive weight loss (more than 100 pounds), explains Jordan Jacobs, M.D., an assistant professor of plastic and reconstructive surgery at Mount Sinai Hospital in New York.
In fact, about 70 percent of people who undergo the procedure are left with excess skin, some studies find. “Losing weight rapidly doesn’t give our skin adequate time to gradually contract and this results in loose, hanging skin,” he says.
But loose skin post-weight loss is also a product of the weight gain itself. “Skin has a finite elasticity, and if pushed beyond the limit of that elasticity upon weight gain, the skin cannot fully contract back down upon subsequent weight loss,” explains Joshua Zuckerman, M.D., surgical director at New York City-based Zuckerman Plastic Surgery.
So who can expect loose skin after weight loss? While it varies, mild weight loss (think: 20 pounds or less) typically doesn’t lead to excess skin, Zuckerman says. Weight loss of 40 to 50 pounds can as can massive weight loss of 100+ pounds.
Also: It’s not just how much weight you lose, but your age and skin quality that determines whether or not you’ll experience loose skin after weight loss, he says. “Younger patients have a better chance at avoiding excess skin as do those with inherently high skin elasticity.” (As you age, the elastic fibers and collagen molecules that give your skin its firmness lose their strength.)
Men also tend to do better in their arms and legs than women do, notes Jeffrey M. Kenkel, M.D., a professor and chair of the Betty and Warren Woodward Chair in Plastic and Reconstructive Surgery at UT Southwestern Medical Center.
Loose skin from weight loss usually requires surgical removal to effectively contour the body, explains Jacobs.
“Typically speaking, after bariatric surgery or massive weight loss, plastic surgery is required to remove excess skin,” says Zuckerman. “These plastic surgery procedures are very effective and typically involve cutting away excess skin and lifting or reshaping the remaining tissue.”
On top of surgical excision, options include liposuction (which uses a suction technique to remove fat, and, for patients with mild skin (and fat) excess, non-invasive procedures usually in the form of ultrasound or radiofrequency procedures that heat up the skin and cause contraction by triggering collagen production, explains Jacobs.
You might have micro-needling with radio frequency energy done, for example, which makes thousands of tiny punctures in your skin and delivers radiofrequency energy during treatment, explains Zuckerman.
Patients can also turn to contouring procedures such as BodyTite and FaceTite (which can be used in conjunction with liposuction) to remove fat and tighten skin, but for all but mild cases of excess skin, these treatments may not fully address the problem, he notes.
In short, surgical excision (though it comes with a longer recovery) remains the gold standard, says Jacobs (and produces “profound” effects) and the results from the more minimally-invasive treatments are what you would expect: subtle, he says.
Besides the non-invasive and minimally-invasive options out there that are somewhat effective, (but, again, usually only for those with mild cases) there’s no magic cream or exercise that’s going to tighten loose skin after weight loss on its own. That’s what makes excess skin a difficult problem for those with more moderate cases, says Zuckerman.
While it’s not always an option (especially for those who have bariatric surgery done), gradual weight loss seems to be the best though for preventing loose skin in the first place, notes Jacobs.
Not really, docs say—though remember, how much excess skin you’re left with and how well your skin responds to weight loss in the first place depends on everything from age and genetics to how much weight you lost and your skin quality. So, depending on your circumstance, you might be able to expect some changes.
“Patients who may see improvement in their loose skin are those who do not have stretch marks and younger patients who still have reasonable skin quality despite weight gain,” says Kenkel. “The quality of the skin is the key to improvement.”
Jacobs also suggests that if you’ve lost weight gradually to give your skin a full year to contract once you’ve reached your goal weight. “After this time, you are not going to see any more noticeable tightening.”
Then, if you have loose skin you’re concerned about—or if you have loose skin after bariatric surgery—do your homework and get in touch with a plastic surgeon certified by the American Board of Plastic Surgery to learn about your options, suggests Jacobs.
“There are a lot of physicians that label themselves as ‘plastic surgeons’ and, as long as they have a valid medical license, they can legally perform any procedure,” he says. “But the American Board of Plastic Surgery denotes the proper training.”