What is the best procedure for tightening loose lower abdomen and lower back skin after weight loss? (Photos)

Question

I am a 38 year old male, I weighed about 220lbs and have had liposuction in the past. My lifestyle at the time did not sustain further weight loss. I finally started dieting and going to the gym 6 days a week as of January 2024. I now weigh 165lbs and am 6’0 tall, my weight has been stable and does not fluctuate. I have a small amount of loose sagging skin on my lower abdomen above my belly button and on my lower back/love handles. I have heard of Bodytite and other less invasive options but would like something that will eliminate or make my loose skin much less noticeable and preferably something that isn’t a short lived/temporary solution.

Anna Chacon, MD, FAAD · Answer

Thank you for your detailed background, and congratulations on your incredible transformation and commitment to a healthier lifestyle. At 38, with significant weight loss and stable maintenance, the concerns you're experiencing—mild to moderate skin laxity in the lower abdomen and love handle area—are common and very treatable.

Best Options for Long-Lasting Skin Tightening:
1. Mini Tummy Tuck or Full Abdominoplasty (if skin redundancy is moderate to severe)
Effectiveness: Gold standard for eliminating excess skin and tightening underlying muscles, particularly in the lower abdomen.

Longevity: Permanent results with proper weight maintenance.

Consideration: Comes with a scar (usually low and hidden under clothing) and downtime (about 2–4 weeks).

2. BodyTite (Radiofrequency-Assisted Lipolysis)
Effectiveness: Very effective for mild to moderate skin laxity, especially in patients who don’t have excess fat but are dealing with sagging.

Longevity: Longer-lasting than other non-invasive options (1–5 years), especially when combined with liposuction.

Recovery: Less invasive than surgery, with shorter downtime (a few days to a week).

Best Candidate: Skin that is loose but not excessive in volume.

3. Renuvion (J-Plasma)
Effectiveness: Delivers helium plasma and RF energy to tighten the underside of the skin with great precision.

Longevity: Durable results when performed properly.

Good For: Hard-to-reach areas like love handles and flanks.

Can be done as a stand-alone or after lipo for enhanced tightening.

4. Excisional Lower Back Lift (For love handles with sagging)
Effectiveness: If the sagging skin is more prominent in the love handle/flank area, a posterior body lift or lateral thigh/buttock lift may help.

Longevity: Permanent, but usually reserved for more pronounced laxity.

Procedures Less Likely to Provide Long-Term Results on Their Own:
CoolSculpting, Emsculpt, or Morpheus8: While these can be helpful adjuncts, they are best for fine-tuning and may not significantly address loose skin that has lost elasticity after weight loss.

Topicals and Creams: These can slightly improve skin quality but won’t reverse laxity significantly.

My Recommendation:
Given your age, skin quality, and goal for a long-lasting solution, I recommend a BodyTite + liposuction combo or Renuvion if your skin laxity is mild to moderate. For more pronounced sagging—particularly if the skin folds—it may be worthwhile to consult with a plastic surgeon about a mini or full tummy tuck and posterior lift options.

Non-surgical options can help, but tend to be maintenance-oriented rather than definitive. Based on your description and commitment, a minimally invasive procedure with skin-tightening energy plus selective fat sculpting may strike the ideal balance between outcome and downtime.

Raffy Karamanoukian, MD, FACS · Answer

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

Kishen Nara, MBBS, FACCSM(Surg) · Answer

Dear Ace,
Thank you for your question. I am sure you want to have this fixed soon but please consider all your options carefully before deciding on what is the best option for you. First of all, well done on making the effort to look after yourself through health living! Let's understand what happens when a person has massive weight loss. The body goes through a lot of changes especially with regards to losing soft tissue elasticity. This translates into the tissues being unable to retract back favourably when there is moderate to large changes of volume. The soft tissues of the upper or lower abdomen in the body is sensitive to these drastic changes which result in excess skin. It is important to get examined by a doctor trained in aesthetic surgery to give you the best options available for any cosmetic procedure. If, on examination, you have moderate skin excess, there may be an option to consider surgical removal of excess skin. Of course, this leaves a permanent scar, but with the realisation of removing redundant skin. You need to also have the underlying structures beneath the skin assessed to ensure you do not have any herniation of the deeper soft tissues. There is certainly a lot more to the examination. Whilst it's tempting to think that energy based devices may assist the situation, sometimes there are advantages and disadvantages that need to be openly discussed to help you make an informed decision. Don't rush, get a second opinion from a qualified medical professional before proceeding. All cosmetic non-surgical or surgical procedures carry potential risks and complications. To learn more about skin excision procedures such as mini abdominoplasty coupled with liposuction feel free to click the link below. Thank you for your question and I hope it gives you someinsight into important factors to consider for your presentation.

What is the best procedure for tightening loose lower abdomen and lower back skin after weight loss? (Photos)

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What is the best procedure for tightening loose lower abdomen and lower back skin after weight loss? (Photos)

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Everything you need to know about Skin Tightening

Our mission is to create a world where every investment in modern beauty is Worth It.