What can be done to minimize the appearance of sagging, loose skin and cellulite on legs after weight loss? (photos)

Question

I'm 30 years old, 120 and DEVASTATED. After losing 20 lbs my legs have become horrible. They are saggy, loose and have cellulite. Lipo wouldn't be an option because I don't want to reduce the size I like the weight I've paid 3000 for avelli on one small section and it did NOTHING. I'm so afraid that I'll never be able to wear shorts again. I have no idea where to go from here and I don't know if it's even possible to fix them. I really need help. I really need something that will work.

J. Timothy Katzen, MD, FACS · Answer

Thank you for your question regarding the appearance of sagging, loose skin, and cellulite on your legs following your weight loss. I understand how frustrating and discouraging it can be to see these changes in your body, especially after working hard to achieve your weight loss goals.

The changes in your legs are likely due to a combination of factors, including your weight loss, genetics, and possibly sun damage. While liposuction is typically used to reduce fat, there are other options available that can help improve the appearance of your legs without further reducing their size.

First, building muscle mass through targeted exercises such as biking, swimming, leg presses, and using the stair master can help improve the tone and appearance of your legs. Strengthening the muscles in your legs, particularly the quads, can create a firmer and more lifted look, which may help reduce the appearance of sagging.

Second, non-surgical treatments like Renuvion or radiofrequency therapy may provide some improvement in skin tightness and texture. These minimally invasive treatments use energy to stimulate collagen production and tighten the skin, which can help reduce the appearance of loose skin and cellulite.

Lastly, if you’re looking for a more dramatic improvement, surgical options such as a thigh lift could be considered. Since you’re concerned about reducing size, a crescent inner thigh lift might be a suitable option, as it focuses on removing excess skin rather than fat. The incision for this procedure is hidden high in the groin, making it less visible. For more significant sagging, a spiral or vertical thigh lift could be considered, with the incision extending from the groin down the inner thigh.

I recommend consulting with a board-certified plastic surgeon who can assess your specific situation and recommend the best course of action tailored to your goals and concerns. With the right approach, it is possible to achieve a more toned and smooth appearance in your legs.

Sincerely,
Dr. Katzen

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

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

Ryan Rebowe, MD · Answer

It is important to note that this is a very difficult problem with no best answer. However, there are some options. The underlying problem is the loss of elasticity following weight loss. Your best option would be something like BodyTite or J plasma which are moderately invasive procedures that apply energy to the skin to tighten it somewhat. While this will not fix the problem completely, it will hopefully improve the issue enough to allow you to wear shorts.

Zoran Potparic, MD · Answer

Providing that you do not want liposuction of inner thighs and knees the only other option is a skin tightening with radio frequency and J plasma modalities. Both of these will tighten the skin by gradual buildup of collagen but nobody can promise that it will create as much of improvement as you desire. In person consultation with a board certified plastic surgeon with experience in these procedures would help. Good luck.

Camille Cash, MD · Answer

You may want to consider BodyTite.  This minimally invasive procedure uses RF technology to tighten skin.  The treatment requires no general anesthesia.  You can add Morpheus8 treatments as well to address skin tone and texture.  I've included a video I hope you find helpful.

Mats Hagstrom, MD (license on probation) · Answer

The truth is, we don’t have a good treatment for flabby thighs.
You should avoid Liposuction since it’ll make the skin laxity worse and it doesn’t treat cellulite.
Aveli can work really well, but patient selection is really key.
It’s very good at treating individual deep cellulite contour irregularities it’s not very good for diffuse overall cellulite.
Impressive treatments really don’t exist. Micro needling or energy based micro, needling, a.k.a. radiofrequency micro needling may give slight improvements and may be a worthwhile endeavor.
Thigh lift surgery is crude and should be reserved for those who have severe skin laxity.
At least you understand not to get Liposuction, which is a big plus.
 I suggest you learn to appreciate what you do have and recognize. You are much better off having lost the weight than being obese.
The aging process only goes in one direction so enjoy what you have while you have it. 
If you don’t like spending money on procedures that don’t deliver then it’s probably a good idea to stay away from the plastic surgeons offices for any legitimate treatment for your concern.
I did mention micro needling as a treatment option, and that may be worthwhile.
There’s a little downside and the treatments are a little bit more reasonable.
It takes doing the treatment quite a few times to get results and even then they’re still going to be subtle.
For some people as slight improvement in skin tightness is worthwhile for other people it’s not.
In my opinion, there is no one single definitive treatment that’s going to fix your thighs.
This response was dictated using Word recognition.
My apologies for potential grammatical errors, etc.Best,
Mats Hagstrom MD

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