A weight-loss journey is exactly that — a journey. While it may come with its highs and lows, there is no better feeling than reaching your personal goals. As you achieve them, you will probably notice that your body has changed along the way. The fat may be gone, but loose and/or excess skin is often left in its place. One of the most common areas of concern? The abdomen. To better understand how to tone and tighten the stomach once you reach your weight loss goals, we spoke to a top dermatologist and plastic surgeon. Below, a guide to the best surgical and non-surgical treatments to treat loose stomach skin.
What Causes Loose Stomach Skin?
No matter the cause, weight gain and loss can have significant effects on the elasticity of the skin. “After rapid weight loss or postpartum, often skin does not shrink back easily,” says Dendy Engelman, MD, a board certified cosmetic dermatologist in New York City. “As a result, some people are left with loose skin.”
As it turns out, collagen and elastin aren’t just the culprits behind sagging skin on the face — they impact laxity from head to toe. “A cause for loose skin is the stretching of the dermis beyond the limits of its elasticity,” explains Cameron Francis, MD, a board eligible plastic and reconstructive surgeon in Del Mar, CA. “After the loss of the underlying fat or birth of the baby, in some individuals, the skin is unable to retract because it has lost its elasticity, like a rubber band that has been overstretched and no longer snaps back to its original length.” It’s worth noting that this process also leads to stretch marks. Stretch marks “actually represent fracture lines in the dermis,” he shares.
How to Treat Loose Stomach Skin
When it comes to achieving a toned and natural-looking abdomen, Dr. Francis says there are a few key factors that come into play:
- Tight internal muscular core
- Sculpted subcutaneous tissues
- Taut abdominal skin
- A youthful belly button
Depending on the severity of the skin laxity, there are both surgical and non-surgical skin tightening techniques that can achieve those results. While non-invasive procedures have little to no downtime, they may not be able to provide the same level of results as their more invasive counterparts. So, what are the pros and cons of each? We break it down:
Non-Surgical Skin Tightening
Non-invasive skin tightening and toning options have come a long way in recent years and “utilize radiofrequencies and/or temperature to deeply penetrate the skin and tissue, stimulating collagen production to tighten skin and reduce fat cells,” Dr. Engelman explains. For the right candidate, “non-surgical treatments are generally the most effective for treating mild skin laxity in select locations [of the body],” Dr. Francis adds.
Dr. Engelman recommends in-office radiofrequency (RF) procedures for patients looking to tone loose skin after weight loss. For example, NuEra Tight features five different frequencies that allow for a more customized treatment. “This device uses intense radiofrequency to upregulate the dermal components of skin — collagen, elastin, and glycosaminoglycans,” she explains. “Increasing the thickness and density of the structures allows for an improved texture of the skin and also leads to tightening of the treatment area.” It usually takes three or four 30-minute sessions (Dr. Engelman likens the sensation to a hot stone massage) to see results, and there is little to no downtime.
Other popular non-surgical radiofrequency procedures include Thermage® and BodyTite™, both of which use RF energy to contract both skin and fat tissue. Emsculpt Neo®, meanwhile, combines RF with high-intensity focused electromagnetic technology (HIFEM) to reduce fat, firm skin, and strengthen the underlying muscle(s).
Surgical Skin Tightening
On the surgical end of the spectrum, there are different types of procedures that can remove loose or excess skin and improve abdominal contour. The two most common are panniculectomy and abdominoplasty (a.k.a. tummy tuck).
For patients who have undergone bariatric surgery or an extreme weight loss, a panniculectomy may be needed to remove a remaining pannus (i.e. large flap of skin and fat that distends over the abdomen). The purpose of a panniculectomy is solely to address the excess skin and fat — not the underlying musculature.
Those who are experiencing less severe cases of loose skin, a tummy tuck tends to be the gold standard of surgical solutions. It removes excess skin, eliminates unwanted fat, and repairs the abdominal wall in one singular procedure.
“An abdominoplasty involves a two-layered approach to restoring a flat, toned abdomen,” Dr. Francis says. First, the internal structure must be addressed. In the case of pregnancy or a significant weight gain, it is not uncommon for the abdominal muscles to separate. This causes a gap known as rectus diastasis. “Fixing it is as simple as suturing the muscles back together into their pre-pregnancy [or weight gain] location,” Dr. Francis says. From there, liposuction may be performed to remove excess fat and skin will be resected as needed. “If significant skin laxity is present, liposuction alone can often make the problem worse and skin resection is usually necessary,” he notes.
Whether performed alone or as part of a larger mommy makeover or body lift procedure, recovering from a tummy tuck requires patience. As Dr. Francis explains, there is “serious downtime” (lasting about five days) before patients carefully return to “some normal activities.” Light cardio can usually resume around two-weeks post-op, but “heavy lifting needs to be avoided for at least four weeks,” he cautions. While swelling peaks in the first two weeks, it can linger for up to six months.
After a pregnancy or during your weight loss journey, loose skin can make an appearance — especially around your stomach. There are, however, an array of surgical and non-surgical procedures to firm and tone the skin. Consulting with a board certified dermatologist or plastic surgeon will help determine the best treatment plan for your anatomy and aesthetic goals.
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