Loose Skin After Weight Loss: What You Can Do
Key Takeaways
- Loose skin can develop after significant weight loss of any kind, including from GLP-1 medications, bariatric surgery, or diet and exercise.
- Your skin may tighten some over time, but it is unlikely to completely return to its original shape.
- Strength training, nutrition, hydration, and skin care can support your skin during weight loss. But preventing loose skin can still be difficult.
- You can see a dermatologist before, during, or after weight loss to help with loose facial skin and volume loss. For substantial hanging skin anywhere on your body, surgery is typically the most effective treatment.
After significant weight loss, your skin doesn’t always keep pace. You might notice sagging around your jawline, a more sunken look in your cheeks, or extra folds on your abdomen, arms, or thighs. Some changes affect how you look; others can leave you dealing with chafing, rashes, or discomfort.
GLP-1 medications have brought more attention to these changes, but loose skin can occur regardless of how you lose weight. And while skin care has its place, there’s a limit to what even a well-formulated cream can do.
University of Rochester Medicine cosmetic dermatologist Mara C. Weinstein Velez, MD, and plastic surgery experts William Bruce, MD, and Brielle Raine, MD, explain what can help, what won’t, and how to decide when you’re ready for treatment.
Why Does Loose Skin Happen After Weight Loss?
As you lose weight, the fat beneath your skin takes up less space—but your skin doesn’t always shrink along with it. It can stay stretched even as your body gets smaller, leaving loose skin or extra folds.
This can be especially noticeable when you lose weight quickly, though gradual weight loss can leave you with loose skin, too.
Will Loose Skin Tighten After Weight Loss?
Your skin can bounce back after weight loss, but it may not bounce back all the way. How much it tightens depends on its elasticity: the ability to stretch and spring back.
Think of a rubber band that's been stretched for a long time, Dr. Weinstein Velez explains. It can pull back, but it may never regain its original shape. The same goes for your skin.
The following factors influence how much your skin tightens:
- How quickly you lose weight
- Genetics
- Age
- Skin type
- Lifestyle
What Is “Ozempic Face”?
Despite the name, “Ozempic face” isn’t exclusive to people taking GLP-1 medications. The sunken cheeks or sagging skin you may notice after weight loss can happen regardless of how you lose weight, Dr. Weinstein Velez explains.
Do GLP-1 Medications Cause Loose Skin?
GLP-1 medications don't directly cause loose skin. It's a response to weight loss, whether you lose weight with medication, bariatric surgery, or diet and exercise.
Two changes can contribute to that look:
- Volume loss: Losing fat in your face can make it look more sunken.
- Skin laxity: Loose skin can leave your face looking less firm or more saggy.
You may have one or both. Your doctor will examine your skin and the fat beneath it to understand what’s changed and which treatments could help.
Can You Prevent Loose Skin During Weight Loss?
You can care for your skin from the start, but you can’t control everything about how it responds to weight loss. Age, genetics, and skin type all play a role, and even a consistent routine may not prevent loose skin.
Still, there are steps you can take to support your skin along the way. Dr. Weinstein Velez recommends:
- Lose weight gradually. A slower pace is her preferred approach, though loose skin can still develop.
- Start skin care early. Include your skin in your care plan before you begin noticing changes.
- Build strength. Strength training helps build strong muscles and tissue.
- Get enough protein. Your body needs it to support your cells and collagen.
- Stay hydrated. Hydration helps keep your skin supple.
- Choose skin-care ingredients carefully. Specific ingredients can help support skin strength and collagen.
Treatments for Loose Skin After Weight Loss
Treating loose skin on your face may call for a different approach than treating extra folds on your abdomen. Your care team will consider:
- Where you have loose skin
- How much loose skin you have
- What you want to change, such as improving firmness or removing excess skin
- Whether you’re still losing weight or have reached a stable weight
In-office Treatments
Laser skin rejuvenation and ultrasound treatments, including Sofwave and Ultherapy, can help strengthen skin, Dr. Weinstein Velez explains. How much improvement you’ll see depends on the amount of loose skin and when treatment begins.
If you’ve noticed changes in your face, treatment may also involve replacing lost volume. Drs. Bruce and Raine describe combining topical skin treatments with injectable fillers to build support beneath the skin.
Can At-Home Products Help?
Be cautious about the promises on a jar. Dr. Weinstein Velez cautions that products marketed as “collagen creams” or “cellulite creams” usually don’t live up to their claims. Instead, she recommends proven ingredients that help support collagen:
- Retinol
- Peptides
- Ceramides
But improving your skin’s quality isn’t the same as getting rid of extra skin. Drs. Bruce and Raine put it simply: Therapies like topical medicine or laser primarily help improve the quality of the skin, but they are not able to remove extra skin.
When Should You Consider Skin-Removal Surgery?
Extra skin can be uncomfortable and get in the way. Extra folds may be difficult to keep clean and can develop recurring rashes, infections, or wounds. It can be painful, affect your posture, and even make running and other activities harder.Before you schedule surgery, your plastic surgery team will make sure you’re ready to heal. That means:
- Maintaining a stable weight. Bruce and Raine generally recommend six months at a stable weight before skin-removal surgery.
- Avoiding nicotine products.
- Getting medical conditions under control. Work with your primary care or bariatric surgery team to manage existing conditions.
- Addressing nutritional deficiencies. Your body needs adequate nutrition to heal, so any vitamin or nutrient deficiencies should be addressed before surgery.
The pace of weight loss is less important overall than how long you have been stable at the new weight and if you have adequate nutrition to heal after surgery.
Timing also matters for your results: Losing a substantial amount of weight after surgery can leave you with more hanging skin.
When to See a Dermatologist During Your Weight-Loss Journey
You don’t have to wait for loose skin to show up before seeing a dermatologist. If you’re preparing to lose weight, Dr. Weinstein Velez recommends establishing a relationship with a dermatologist as early as possible to discuss products and, when appropriate, in-office treatments to help care for your skin as your body changes.
Already noticing changes in your face or neck? You can get help along the way. To assess how much your skin has tightened after weight loss, she recommends waiting until you’ve maintained your goal weight for six months to a year.
Your dermatologist can help you sort through all your options and determine whether a plastic surgery consultation makes sense.
How Does Skin-Removal Surgery Work?
Depending on your needs, surgery might mean an arm, thigh, breast, or lower body lift, or a face or neck lift.
For your abdomen, a panniculectomy removes hanging belly skin. A tummy tuck removes excess skin and tightens the abdomen, which may include tightening the supporting tissue underneath. Some facial procedures also address those deeper tissues.
The amount of extra skin, the fat beneath it, and where they sit all help determine which procedure will best meet your goals.
Keep in mind: Scars are part of skin-removal surgery, but their placement is carefully planned. Your surgeon will work to make them less noticeable by placing incisions along natural lines or in areas where shadows help conceal them.
Does Insurance Cover Skin-Removal Surgery?
Your surgeon may say you’re a good candidate, but your insurance company has its own checklist. Coverage can depend on how much weight you’ve lost, how excess skin affects your daily life, and what you’ve tried already to manage symptoms.
Before scheduling a consultation, check your plan’s requirements online or call your insurer. Common criteria include:
- A weight-loss target: A certain number of pounds lost, a target BMI, or a percentage of excess weight lost.
- Symptoms that affect your health or daily activities: Recurring rashes in skin folds, pain, or difficulty doing certain activities.
- Prescription treatments that haven’t helped: Your plan may require a documented course of treatment from your primary care doctor or dermatologist. If treatment clears up your symptoms, or you haven’t tried it for long enough, surgery may not be covered.
- Photographs documenting the concern: Your insurer may need photos showing rashes and the amount or position of hanging skin.
Starting a Weight-Loss Journey? Don’t Forget Your Skin.
Whether you’re beginning weight-loss treatment or already noticing skin changes, URochester Medicine dermatologists and plastic surgeons can help you understand your options, from everyday skin care to treatments for loose skin and lost facial volume.
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