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Solutions for Extremely Loose Facial Skin?

I have very loose skin that doesn't seem to stay on my facial bone. It's like mush, has no structure at all. Could it have something to do with my facial muscles? I've had this problem since I was 21, and I'm now 30. I've tried everything, but nothing has worked for me. What could this be, and can something be done about it?

Doctor Answers (17)

Skin Laxity At 21 Years Old

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It’s unusual to have severe skin laxity in someone who’s only 21 years old.  There are several possible explanations for this phenomenon.   Possible explanations include loss of subcutaneous tissue following weight loss, inadequate support of the underlying bones and genetic connective disorders such as Ehlers Danlos syndrome.

It’s virtually impossible to make any type of recommendation without pictures or a physical examination.  In addition, it’s important to investigate the cause of this premature skin sag before a treatment plan can be formulated.

Depending on the cause of the skin sag, a variety of treatment options may be possible.  These may include procedures to augment the underlying boney skeleton or increase the volume of the subcutaneous tissue.  In other cases excess skin can be removed and tightened with standard facelift techniques.  If genetic conditions are identified, surgery may not be an option.

Under these circumstances consultation with a board certified plastic surgeon is appropriate.  This surgeon should be able to help formulate an appropriate treatment plan.


Omaha Plastic Surgeon
5.0 out of 5 stars 75 reviews

Prematurely Loose Facial Skin?

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There are multiple factors than can cause very loose facial skin at a young age: lack of development of the underlying bony framework, extensive sun exposure, excessive exercising producing low body fat, smoking, or a genetic basis for a connective tissue disorder like Ehllers Danlos Syndrome.

The options to improve the cosmetic appearance include surgical procedures, non-surgical treatments, or a combination of both. The optimal approach would depend on your anatomy, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure.

I would suggest that you have consultation with a plastic surgeon certified
by the American Board of Plastic Surgery and ideally a member of the American Society
for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns and options with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.5 out of 5 stars 14 reviews

Premature Loose Facial Skin

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One would have to really see and examine a person if they feel that their facial skin structure is loose as the plastic surgeon needs to confirm how much fat you have or have not lost in your facial fat compartments. Especially if you’re younger you may need deep layer fat compartment augmentation restoration only and if you indeed have facial skin laxity we need a combination fat augmentation and a Lift and Fill facelift. This would require an evaluation to fully evaluate what type of specific facial rejuvenation procedure would optimally fit your needs to provide you with a natural looking, youthful face.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 17 reviews

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Extremely loose skin

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Ani,

I agree that having extremely loose skin at age 21 is unusual and you may have an underlying connective tissue disorder.  However, it's hard to tell without examining you or seeing a photo. The best thing to do would be to see a Plastic surgeon in consultation to assess your individual anatomy and give you realistic expectations of what surgery can fix. If there is any question that you have an underlying CT disorder, you may need to have this worked up prior to proceeding with any surgery.  Regardless, your surgeon can discuss your options and help you have a better understanding of any procedures.

Dr. Cat Begovic M.D.

Catherine Huang-Begovic, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 5 reviews

Extremely loose skin at an early age

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What you describe give your age makes me concerned that you may have a congenital collagen disorder known as Ehlers Danlos.  My question to you would be do you have "stetchy" skin elsewhere?   Before you consider any elective cosmetic surgery, please seek the evaluation of a dermatologist or plastic surgeon to evaluate your skin.  After this assessment, you may be a candidate for treatments to add volume to areas that look hollow (fat injections or fillers) or skin tightening procedures.

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.5 out of 5 stars 117 reviews

Some treatments for Extremely Loose Facial Skin

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Extremely loose facial skin in youthful patients can be from genetic predisposition, significant sun-exposure, less than optimal facial bone prominence, and low body fat.  I am in Scottsdale Arizona and have a large facial plastic surgical practice, and it is not uncommon for me to see early facial aging in patients mostly due to sun exposure and the fact that patients like to stay quite thin.  I would say you are a bit young to be seeing this, but I have seen patients like you on occasion.  First, the lax skin needs to be addressed, and in some fashion the underlying supporting structures such as the skeleton of fat needs to be augmented.  Most commonly I will achieve this by performing a facelift with some deeper tissue manipulation (the SMAS) to build up facial fat along the cheekbones to provide youthful contours and projection.  This will provide support to the skin and remove any excess.  Further fullness in the cheeks and cheekbone areas (which will make you look more youthful and help slow the development skin excess) can be provided with actual cheek implants or by fat injections should you have fat to harvest.  These procedures can be performed at the time of your facelift surgery or at a later date.  Finally, further skin tightening can be achieved with laser skin resurfacing which will enhance collagen production and improve the quality of your skin.  I would perform this after your facelift surgery.  All of these suggested procedures can be performed alone, or in combination and it is best to get the opinion of a Board Certified Plastic Surgeon to decide what your particular options are.

Best of luck.

Daniel Shapiro, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 94 reviews

Extremely loose facial skin

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My best recommendation would be to have your skin, skin structure and overall appearance evaluated by a plastic surgeon or dermatologist. This is one of those questions that requires an exam of your skin specifically, especially because of your age.

Deason Dunagan, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 4 reviews

Extremely loose facial skin at age 30

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Extremely loose skin at age 30 could be related to collagen disorders such as Ehlers Danlos. You should be evaluated by a dermatologist to determine whether this is the case, before pursuing cosmetic surgery. Extremely loose skin can be tightened up with a tuck facelift. The facial muscles themselves are not loose at all and are attached to the bone; they are not what you are feeling. The excess loose skin is unrelated to the muscles.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 56 reviews

Poor facial structure can cause sagging skin

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Many people with poor facial skeletal structure have the appearance of saggy skin and poorly defined faces. This may all be related to your bone structure which can be easily and effectively corrected with many different options. But without seeing you or seeing photos there is no way to be sure.

Jason B. Diamond, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 2 reviews

Procedure for extremely loose facial skin

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Without photos extremely difficult to determine the reason you think you have loose facial skin. Let alone to classify you as a Cutis Laxa Facialis due to Ehles Danlos Syndrome (a paper I co-published over 30 tears ago as a chief resident). Go see 3 boarded plastic surgeons in your area. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.