38, male, 40 - 50 lb. weight loss. How can I tighten a small amount of loose skin on my abdomen? (Photos)

Thank you for your message and congratulations on your impressive weight loss and muscle gain—that’s a major achievement.

Based on your photos and history of liposuction combined with significant weight loss, it’s common to see some residual skin laxity, especially in the lower abdomen and flanks. For cases like yours, where the loose skin is relatively minimal and you are in excellent shape otherwise, here are several options to consider:

1. Radiofrequency-Assisted Skin Tightening (e.g., BodyTite, Morpheus8):
BodyTite is a minimally invasive procedure that uses radiofrequency energy to contract and tighten the skin. It’s a good option if you're looking for something effective with minimal downtime. Morpheus8 combines microneedling and RF and can be effective for skin texture and tightening as well.

2. Laser Skin Tightening (e.g., SmartLipo or Thermage):
Laser-based methods also use heat to stimulate collagen production and improve skin firmness. They’re non-surgical and tend to be better for mild-to-moderate skin laxity.

3. Surgical Options (Mini Tummy Tuck or Skin Excision):
If the skin laxity persists and is affecting your confidence or clothing fit, surgical intervention remains the most definitive solution. A mini abdominoplasty may be appropriate if the laxity is localized to the lower abdomen.

4. Topicals & Lifestyle Maintenance:
While topical treatments (like retinoids or firming creams) won’t dramatically tighten skin, they can support elasticity. Staying hydrated, maintaining your current weight, and continuing strength training also help the skin gradually remodel itself over time.

5. Ultrasound-Based Treatments (e.g., Ultherapy):
Ultrasound energy targets deeper skin layers and can tighten mild skin laxity, though results are usually subtle and take a few months to develop.

Since your skin laxity is mild and you're in excellent shape, non-surgical modalities like BodyTite or Morpheus8 could yield satisfying and natural-looking results without major downtime.

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon