Any suggestions for loose facial skin after Weight Loss? (photos)

Thank you for your question and for sharing your photos.  Ultimately, a surgical face lift provides the best contouring for someone with moderate or severe laxity. This procedure could include tightening your underlying musculature to give you a better contour and also removing the excess skin laxity. Together this allows for a much better face and neck contour. In some instances, some liposuction is also beneficial to reduce the submental fullness.  However, given your history, age and photos, you may want to explore non-surgical options first.There are effective non-surgical options for you. I would recommend Ulthera if you are looking for something with no downtime, or Profound if you could tolerate some downtime. Ulthera is an ultrasound based energy that heats the underlying tissue and stimulates collagen in response. Profound is a radio frequency microneedling device that allows for the creation of Elastin, collagen and hyaluronic acid and hence restores some of the lost elasticity in the face. It has more visible downtime with the possibility of some swelling and bruising that diminishes in about a weeks time.Dermal fillers may also give you more cheek (mid face) definition and soften the jowls to a lesser degree than surgery, but create a nice contrast. I tend to recommend Sculptra for my patients who have lost a lot of weight as this provides a long lasting approach to address pan-facial volume loss.I would visit with a board certified plastic surgeon who has the portfolio of non-surgical options in your area who can help explain the treatment options for you and the limitations of each option, both surgical and non-surgical.

Patients
who experience skin laxity after weightloss, especially in very young patients
where hormonal change is not at play, are usually experiencing a loss of fat in
their faces, as well as their bodies, which causes skin to appear looser. It’s
very hard to tell from this photo, since I cannot gauge the overall contour of
your face, but I imagine you have lost some fat in the upper cheek
(“cheekbone”).

I
have treated many patients for fat loss in the face due to overall weightloss.
My go-to procedure for correcting this loss of fat in the cheeks is to use fat
transfer to replace the lost fat. Fat transfer re-inflates the cheeks, and
lifts the skin back to its previous location, recreating your natural, youthful
contours. Fat transfer is extremely long lasting, and because it is your own
fat, usually harvested from the love handles or stomach, it feels and looks
very natural.

In
the rare case that you have lost so much fat that there is not sufficient fat
to transfer, you could achieve the same look with dermal fillers.

There is no weight to significantly tighten skin. A true surplus would demand surgical excision. From the photograph it looks as though a modification of a facelift might indeed be indicated.