Doctors review what works best after dropping pounds.
The aftermath of weight loss is often expected and welcomed: higher energy levels, smaller pants, and a more defined body, not to mention what it can do for your self-image and confidence. But there is one often-unexpected challenge: tightening your skin after losing weight. Lots of loose skin can be uncomfortable, frustrating, and leave you confused about what to do next. It’s often not as easy as changing your lifestyle and using at-home remedies.
Discover how to tighten your skin while losing weight, as well as how to keep it tight, and find out what causes skin to stretch in the first place.
Why does loose skin after weight loss happen?
According to Jordan Jacobs, M.D., an assistant professor of plastic and reconstructive surgery at Mount Sinai Hospital in New York, loose skin is usually caused by the following:
Rapid weight loss
Loose skin due to rapid weight loss is usually seen in people who undergo bariatric surgery for large amounts of weight loss (more than 100 pounds). About 70 percent of people who undergo this procedure are left with excess skin. “Losing weight rapidly doesn’t give our skin adequate time to gradually contract and this results in loose, hanging skin,” says Dr. Jacobs.
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, explains Joshua Zuckerman, M.D., surgical director at New York City-based Zuckerman Plastic Surgery. When it comes to problems with loose skin, a weight loss of 40 to 50 pounds can seem as big as a weight loss of 100+ pounds.
Gradual weight gain
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,” Dr. Zuckerman says.
Aging skin
With age, one loses the elasticity needed for loose skin to “snap” back after most weight loss. This leads to loose, wrinkled, and sagging skin, says Jaimie DeRosa, M.D., a double board-certified facial plastic surgeon and founder and lead facial plastic surgeon of DeRosa Center Plastic Surgery & Med Spa in Boston and Palm Beach.
That’s why loose skin isn’t just about how much weight you lose. Your age and skin quality also determine whether or not you’ll experience loose skin after weight loss, he says. Younger people have a better chance at avoiding excess skin than older ones; so do people 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.
How can you get rid of loose skin after weight loss?
According to Dr. Jacobs, here are some options for tightening your skin after weight loss:
Surgical removal
For significant weight loss (usually around 70 to 100 pounds), the amount of loose skin will be really hard to remove non-surgically, Dr. DeRosa says. But there are tightening procedures that work and remove excess skin in a way that the scars are in inconspicuous places, such as the pant line or underarms.
Body contouring
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. Just be aware that these treatments may not fully address the problem unless you have a mile case of excess skin, Dr. Zuckerman notes.
Slower weight loss
While it’s not always an option (especially for those who have had bariatric surgery), gradual weight loss seems to be the best for preventing loose skin in the first place, notes Dr. Jacobs.
Exercise
Building muscle—by way of a solid exercise regimen with strength training work—is always a good idea. Plus, it can make your skin look more taut, says Holly Wyatt, M.D., professor of medicine at the University of Colorado.
In short, surgical excision (though it comes with a longer recovery) remains the gold standard, says Dr. Jacobs (and produces “profound” effects) and the results from the more minimally-invasive treatments are what you would expect: subtle, he says.
Can loose skin after weight loss go away on its own?
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 Dr. Kenkel. “The quality of the skin is the key to improvement.”
Dr. 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 Dr. 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.”
What is the best home remedy to tighten your skin?
There’s no magic skin tightening cream or exercise that’s going to really noticeably 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 Dr. Zuckerman. “If one has lost a moderate amount of weight, you may find that treatments to add collagen and elastin back into the loose skin may help tighten it,” adds Dr. DeRosa. “This can include some skin care products as well as ultrasound and/or radiofrequency-based treatments.” OTC products like cocoa-butter sound like a good idea, but tend to have subtle results, at best.
The best home remedy, then? “Taking care of your skin,” says Dr. Jacobs. “This includes sun protection, avoiding smoking, limiting alcohol consumption, and eating a diet rich in fruits and vegetables and low in sugar and saturated fats.”
