How To Tighten Loose Skin After Weight Loss

Collagen and elastin are two proteins found in the skin that play a key role in skin tautness. “Collagen is the scaffolding of the skin providing structure and support. Elastin is the other major skin component leading to laxity; it’s responsible for the stretch and snap-back. Together, they give skin both the lift and the recoil,” says Brian Hibler, M.D., a board-certified dermatologist at Schweiger Dermatology Group in New York City, adding that recoil means the “bounciness” of the skin, or its ability to spring back after being pressed. “Youthful skin has high recoil, meaning it bounces back after pressure, but older skin that is looser and has lost its elastin is deflated and does not rebound in the same fashion,” he notes.

When we gain weight, our skin stretches to accommodate the increase in volume, says Dr. Hibler, but after losing weight our skin isn’t able to adequately recoil, or tighten—leaving behind loose skin, he explains.

What Other Factors Contribute to Loose Skin?

The skin’s structure changes after significant weight loss, resulting in thinner collagen fibers and altered elastic fibers, and these types of changes can be caused by other factors as well—not just weight loss, says Dr. Hibler.

“Collagen quality declines with age and is further damaged by sun exposure, smoking, diabetes, chronic inflammation and poor nutrition,” says Nicholas Jones, M.D., a double board-certified plastic surgeon at Nip & Tuck Plastic Surgery in Atlanta. “Those factors fray the fibers that give skin firmness, so even after fat is gone with weight loss, the ‘fabric’ is looser,” he explains.

What Are the Risks of Loose Skin?

For starters, many people may not like the appearance of loose skin. “Patients are bothered because they look older, despite feeling better physically,” says Dr. Hibler. There can be an emotional toll as well, notes Dr. Jones, saying, “Many patients feel their body doesn’t reflect their hard work.”

There are also physical repercussions. “Redundant skin can trap moisture and cause rashes, chafing and odor, and ultimately lead to infections,” explains Dr. Jones, adding that loose skin can also limit activities of daily living, including exercise, and make clothes fit poorly.

There are a variety of ways to address loose skin after weight loss, some more invasive than others. Treatment also typically depends on the severity and the cause of the loose skin. For example, loose skin related to aging and extensive sun damage may warrant a different type of treatment than loose skin resulting from significant weight loss, notes Dr. Hibler.

Lifestyle

“First, as you are losing weight, it should be gradual as skin remodeling takes time,” says Dr. Jones.

People typically lose muscle along with fat when losing weight, so strength training is also very important, notes Dr. Hibler, adding that strength training can give a more toned definition to the body after weight loss.

Diet can also support your body’s natural collagen production, says Mascha Davis, a Los Angeles-based registered dietitian nutritionist, Forbes Health Advisory Board member and author of Eat Your Vitamins, who says key nutrients for collagen formation include:

• Vitamin C, which is found in citrus fruits and all kinds of berries like strawberries, as well as many vegetables such as bell peppers and broccoli.
• Protein, which contains amino acids, the building blocks of all proteins including collagen (which, yes, is a type of protein itself). Sources include fish, poultry, eggs, beans and legumes.
• Copper and zinc are two minerals that help with the collagen-building process, with good sources of both found in nuts and whole grains.

Topicals

While there aren’t a lot of super-powerful topicals, retinoids and retinols may be helpful for mild laxity, says Dr. Hibler. The term “retinoid” refers to chemical compounds that are derived from vitamin A, and they’re often used for acne, fine lines and wrinkles, among other things. Retinol is a type of retinoid, and it’s commonly used to improve skin pigmentation, texture and tone. For example, some retinol lotions can be good, and gentle on skin, says Dr. Hibler, including areas like the neck, back of hands and arms.

Fillers

Research notes a phenomenon called “Ozempic face,” which is facial skin that can appear prematurely aged and fatigued as a result of rapid weight loss from the use of semaglutide medications like Ozempic—which is approved by the FDA for the treatment of type 2 diabetes, not weight loss, though it can lead to substantial weight loss.

Hyaluronic acid fillers can help restore lost volume and provide more structure to the face, including building cheekbones, enhancing jawline contour and lifting facial fat pads, says Dr. Hibler.

A biostimulator filler like Sculptra—an FDA-approved injectable designed to help stimulate your body’s own natural collagen production and improve skin tightness—is another option, notes Dr. Hibler.

Non-surgical Energy Devices

Radiofrequency and ultrasound tissue-tightening treatments, both of which use energy to heat the deeper layers of the skin and stimulate collagen production, are also effective, says Dr. Hibler, explaining that energy-based devices essentially introduce a controlled wound into the skin, and the body responds by building new collagen—a process that can take a few months. “These are some of the most popular treatments because they are completely non-invasive and there is no downtime,” says Dr. Hibler, noting that energy devices can be used on the face, chest, arms, legs and abdomen.

Radiofrequency microneedling is another option, adds Dr. Jones. This combines radiofrequency energy with traditional microneedling, which involves superficial and controlled puncturing of the skin by rolling it with very small, fine needles.

Surgery

Our experts agree that for those with significant weight loss and skin laxity, surgery is often the best treatment. When there’s true redundancy—meaning loose and sagging skin that has typically lost elasticity—surgery is the gold standard, says Dr. Jones, noting that options include the following procedures, which remove skin from various areas:

• Abdominoplasty or “tummy tuck” (abdomen)
• Panniculectomy (abdomen; involves the removal of excess skin and fat that hangs over the lower abdomen)
• Brachioplasty (upper arms)
• Rhytidectomy (face)
• Mastopexy (breasts)
• Circumferential body lift (abdomen, hips, lower back and buttocks)

These procedures are designed to remove the extra skin and reshape the contour in a single step, and for certain individuals, these procedures may be combined, notes Dr. Jones.

When using hyaluronic acid fillers, major risks include redness, bruising and swelling, says Dr. Hibler. Biostimulatory fillers, like Sculptra, can also lead to bruising and swelling, as well as infection and nodules (small growths or lumps).

Non-surgical treatments like radiofrequency and ultrasound treatments typically have short downtimes but can cause temporary swelling, bruising, burns or even pigmentation changes in rare cases, says Dr. Jones. “If you are considering any of these options, make sure your provider is experienced and has the appropriate credentials.”

Surgery is more definitive but carries inherent risks like scars, seroma, bleeding, infection, delayed healing—especially after significant weight loss—and blood clots, adds Dr. Jones, noting that safety can be greatly improved by choosing a board-certified plastic surgeon, optimizing nutrition, managing underlying medical conditions and not smoking.

“Anyone who is actively losing weight should pay attention to skin changes and consult a specialist if they are noticing increased laxity,” says Dr. Hibler, adding that it’s important to be proactive in addressing skin changes. “It is best to treat concurrently during the weight loss journey instead of waiting until there is extra, redundant skin and then trying to tighten it,” he explains.