What's it called & how is it treated when a 57 yo woman develops rolls of skin across her abdomen. They are not overweight.

Question

Over the last 4 years or so their stomach is no longer flat but there are 4-5 horizontal folds of skin that are more noticeable when sitting but still there when standing. Just not as predominant. What's the best treatment? Trying to stay away from a tummy tuck since it's a surgical procedure. Not sure about Coolsculpting because of the recent bad press.

Kristopher Hamwi, MD · Answer

The rolls usually develop as we age because the skin starts to shift downward. This is accentuated by sitting or bending at the waist because it pushes the skin together. When we stretch the skin, the rolls tend to go away. So what your noticing is likely due to the tissue becoming looser and/or less elastic. Excess fat can make the folds bulge more but are not the primary culprit, its the skin and/or the density of the tissue. Fixing loose tissue is not something plastic surgery has conquered. We primarily treat it with tucks. Non-surgical procedures can help a little bit but are most effective on the head and neck where small changes can make a big difference. On the body small changes don't do as much. Liposuction can treat fat and bulging areas but when the fat is removed it has essentially deflated the skin so it may become looser (this depends a lot on your natural elasticity.) Nothing is out there that will prevent your abdominal skin from bunching up and rolling when your sitting (this happens to 20 year old's and super skinny people too.)

J. Timothy Katzen, MD, FACS · Answer

Hi sempertyrannis,

Thank you for your question regarding the appearance of horizontal folds across the abdomen in a 57-year-old woman who is not overweight. Without seeing pictures, it's difficult to provide a precise diagnosis, but from your description, it sounds like these could be due to excess skin. Ageing, changes in weight, and natural changes in skin elasticity can lead to such skin folds, even in individuals who maintain a healthy weight.

If the issue is primarily excess skin, treatments like CoolSculpting, which targets fat reduction, may not be the most effective solution. CoolSculpting is designed to reduce fat cells in specific areas and might not adequately address skin laxity, which seems to be the main concern based on your description.

Given your hesitation towards surgical procedures, it's understandable that a tummy tuck might not be your first choice. However, a mini tummy tuck or even a full tummy tuck could be the most effective ways to remove excess skin and achieve a smoother, flatter abdomen. These procedures are specifically designed to address and remove excess skin, tightening the abdominal area for a more toned appearance.

There are non-surgical options that claim to improve skin tightness, such as radiofrequency treatments, ultrasound therapy, or laser treatments, which may offer some improvement in skin texture and firmness. However, the results from these non-surgical options are typically more subtle and may not fully correct the appearance of multiple horizontal folds.

Ultimately, the best treatment option depends on a detailed physical examination and discussion of your goals and expectations. Consulting with a board-certified plastic surgeon who specializes in body contouring can help you understand the potential outcomes and decide on the best course of action for your specific situation.

Sincerely,

Dr. J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

Chet Mays, MD · Answer

Thank you for your inquiry!  It could be laxity of the skin.  As a person ages, the skin does not retract like it once did.   We would love to sit down with you to discuss your concerns.  Schedule a consultation with a Board-Certified Plastic Surgeon to discuss your options.

Emmanuel Mallol Cotes, MD · Answer

Thank you for your inquiry.
 For me to offer a valid medical opinion, it's essential to review images of your body from various perspectives. I recommend seeking treatment from a board-certified plastic surgeon with expertise in this procedure to achieve optimal results. Respectfully, Dr. Emmanuel Mallol Cotes.

Gary M. Horndeski, MD · Answer

As people age their skin loses elasticity. Your skin was tighter before but now with the weight and the loss of skin tone you now have some horizontal wrinkles. Unfortunately, the best technique for you is skin excision which is a tummy tuck. Coolsculpting will not be effective as it does not remove excess skin. Liposuction will also not remove excess skin.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Steve Laverson, MD, FACS · Answer

Difficult to answer without more context than offered, i.e. age, weight, pregnancies, history of weight loss, photos, etc.  Generally however there is NO non-surgical treatment that comes close to the abdominal shaping, flattening, and removal of loose extra skin accomplished by well planned individualized expertly accomplished tummy tuck (abdominoplasty).  Procedures exist in service of results.  Choosing a treatment that doesn't offer the result you want will be disappointing, potentially scar the abdominal wall (internally) unnecessarily, and waste valuable resources.

Zoran Potparic, MD · Answer

It is very difficult to make diagnosis and give proper advise without any photos. However, as we age skin looses elasticity and deeper tissue also loose structural support which results in laxity of skin, fat tissue and muscles. Result is aging of the abdominal wall, breasts, neck, eyelids etc.; removal of redundant skin and associated tissues and tightening of loose deep structures is way to improve shape and tightness. That however requires surgery.

Connie Hiers, MD, FACS · Answer

Coolsculpting does not tighten skin. Some minimally invasive radiofrequency skin treatments like Renuvion can help tighten skin. However, the best look will be with a tummy tuck.  I presume your "they" and "her" are about you.  Photos would be helpful.

Camille Cash, MD · Answer

From your description the issue sounds like skin laxity.  This comes from many factors such as weight gain/loss pregnancy, and aging.  Typically the best way to address it is a tummy tuck since excess fat and skin are removed, resulting in a tighter flatter tummy.  I've included a video that I hope you find helpful.

Mats Hagstrom, MD (license on probation) · Answer

To make an assessment we generally need to see quality pictures.Take a look at how plastic surgeons take before and after pictures to get an idea of what we need.It sounds like skill laxity is your concern and for that at tummy tuck is really the only procedure that’s going to fix it.It would be helpful to know if you’ve had previous pregnancies.Consider having a few in person consultations with plastic surgeons in your communityBest,Mats Hagstrom, MD

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