Which procedure would best address loose skin after weight loss? (photos)

Question

I will be 32 in 2 months, I recently lose 90 lbs and with that came a ton of lose skin. I already do Botox, have done fillers and considered morpheus8 but I don't want to make things worse or potentially spend a lot of money for no results. Are there other procedures I should try first? It does it look like a facelift may be most beneficial?

Michele A. Shermak, MD · Answer

Thank you for your question.
After significant weight loss the skin can loosen and fat in the face reduces. Both combine to advance aging changes in the face. One noninvasive option would be facial laser treatment with the Sciton. This is an impactful laser that really tightens. The other option is surgical facelift. This is a reasonable consideration in your case. Be sure to consult with a board certified plastic surgeon, preferably one who does both laser and surgery so you can have all options presented to you. Best of luck to you!

Gianfranco Frojo, MD · Answer

I would recommend a facelift/necklift to address the laxity of the tissues. After a 90 pound weight loss, there is only a few solutions for skin/muscle laxity. The most reliable options is to perform a surgery that provides direct visualization of the structures that need to be tightened/skin that needs to be removed. I would recommend seeing a surgeon certified by the American Board of Plastic Surgery (ideally with 6 years of integrated plastic surgery residency training and ALSO a 1 year aesthetic fellowship accredited by the Aesthetic Society).

Fadi Bakhos, MD · Answer

At age 32, I would consider non surgical options first before jumping into a facelift. Ellacor is something you can consider. It's a newer treatment that takes micro-cores of tissue out of your skin and your skin essentially tightens to fill those gaps left behind. You can get some more information and see some pictures on their website if you're interested.

Richard G. Schwartz, MD · Answer

Your photos show noticeable folds and creases presumably due to loose skin in the anterior cheeks and what appears to be loose skin and platysma muscle fibers in the neck.  Despite your young age, a facelift would address both these areas, tightening and smoothing your cheeks and neck contours.  Although it's possible the Morpheus and similar technologies might tighten the tissue somewhat, it all depends on the extent of your looseness seen on examination.  Occasionally, the degree of improvement from the non-surgical options is not enough to correct the extensive looseness.

Ajaya Kashyap, MD · Answer

Thank you for your query. The best option for you may be to have a facelift procedure along with some fillers/ autologous fat .Thermitight/ Face-tite or other non surgical skin tightening treatments may also help if you do not wish to have surgery at this time . Please find an experienced board certified Plastic surgeon who can examine you and help you with all your concerns. All the best.

Ronald J. Edelson, MD · Answer

There is some laxity of your face and neck so a facelift might be in your future several years from now. In the meantime I wouldn’t bother with any non surgical skin tightening. It simply doesn’t work

Zoran Potparic, MD · Answer

The amount of redundant skin in your neck can not be treated by any other means but skin excision/removal. In that case,  an extended posterior neck lift with scars underneath the chin and behind the ear or lower face/neck lift with additional  scar in front of the ear, should be considered. In person consultations or at least a teleconference with a board certified plastic surgeon with proven expertise in face lift procedures is recommended. Good luck.

Robert Singer, MD · Answer

Everyone ages at a different rate. Some patients at 32  have more aging than those much older. It depends on numerous factors including: heredity, history of smoking, lifestyle, sun exposure, excessive exercising, underlying medical health, and significant weight loss.

Today, some patients opt to undergo a facelift at a younger age. It really depends more on the extent of aging, desired outcome, realistic expectations, individual anatomy and if the aging process bothers you enough to do something about it. Since every patient is different, the approach to facial rejuvenation (fillers, micro-fat grafts, mini facelifts, facelifts, and combination of procedures) needs to be individualized in order to achieve a natural appearing improvement.

The benefits from a facelift last forever, in that you would always look younger and better than a twin if you had the procedure and the twin did not. However, the face will continue to age. Generally, a facelift will turn the appearance of the clock back 8-14 years.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. There are many excellent facelift surgeons across the country. I would suggest you find 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 with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

David Janssen, MD, FACS · Answer

Although you have an animation band on your neck when smiling, I do not think that you need a facelift yet. Morpheus is so painful that when people buy packages, they do not complete them due to pain. We use SylfirmX and it does a superb job of tightening facial skin. A limited neck procedure could be done as well.

Darryl J. Blinski, MD · Answer

Nicely posed photos. Might offer mini face/neck lift with SMAS plication + many syringes of fillers or bio stimulators. Expect fees in the $10,000 ranges. Best to virtual consult with....

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