The skin is a very elastic organ that has to stretch as one moves and grows. Different layers of the skin have different types of cells. Though the skin cells on the outer part of the skin – the epidermis are constantly being sloughed off and replaced with new cells, the skin cells under the epidermis are more permanent. These layers of the skin, called the dermis and epidermis, are constituted of elastic connective tissues, fibers, blood vessels and different components that can stretch or contract depending on how they are treated.

Overview

A lot of people who have successfully completed their weight loss journey or after having a baby, still struggle with the sagging skin. Whether one has lost a lot of weight or inch loss, it is common for the skin to sag in certain areas. Gaining a significant amount of weight causes your skin to stretch. The longer one remains overweight, the harder it is for the skin to retract after a significant weight loss. This loose skin, especially on the arms, abdomen or thighs could be challenging and frustrating to manage or get rid of. The older one is, the less collagen the person has, which means it is more likely to have loose skin following weight loss in older adults.

As science and technology has advanced, there are some medically – approved methods that are safe and effective for some people, apart from the conventional method of going under the knife – surgery!

Is loosening of skin preventable ? 

Before we get into steps on how to help the body deal with loose skin, let’s talk about how one can avoid this in the first place. Crash diets and severely restrictive diets, with excessive strenuous exercise can rapidly shed both muscle and fat, resulting in a double-whammy on your skin, which means that the supportive underlying muscular structure that holds the skin against the body is lost along with the fatty tissue that keeps the skin stretched tight.

Surgery vs Non-surgical methods 

Not every person is a good candidate for non-surgical skin tightening procedures. In some cases, opting the surgical method may turn out to work for the best. If the amount of loose skin is minimal, it is likely to retract by itself. However, if one has loose skin on stomach from multiple pregnancies or years of weight loss and weight gain, lifestyle factors alone may not be sufficient to tighten the skin.

Experts in this field are of the opinion that ideal candidates for non-surgical methods are people who have skin that is not sagging or drooping. People who have folds of skin are better suited for surgery, although it is very important that a full examination by a board-certified physician is carried out to determine which method is the best. Experts are also of the opinion that abdominoplasty or liposiction, which is a procedure that removes extra fat and skin and tightens the muscles in the abdominal area, it should be the last resort to get rid of loose abdominal skin.

It is also believed that people who have healthy skin are more likely to get the desired results as opposed to sun-damaged skin, which is hard to work on. Skin that is in good health responds better to treatment.

Some physicians recommend waiting at least six months after a significant weight loss before considering surgery.

In mini-tummy tuck the excess skin over the lower abdomen is removed. It is good for people with just a little loose skin whose abdominal muscles are still tight.

Non-surgical methods of skin tightening 

There are several non-invasive or minimally invasive options to choose from the non-surgical methods of skin tightening. These include :

  • Exercise : Building muscle mass through weight training exercises aids in reducing the appearance of loose skin
  • Tightening products : The effects of tightening creams are mild, but they can improve and help in firming loose folds of skin. Firming creams that contain retinoids are a good choice for skin tightening. Retinoids prevent free radical damage in the skin and help in collage formation. Other options for a good firming cream should include collagen, as it reduces the appearance of wrinkles and strengthens the skin, restoring and maintaining skin’s elasticity
  • Non-surgical procedures : These include some cosmetic procedures that can help in tightening loose skin. The basic principle of this procedure is to facilitate collagen production. They are :
  • Synthetic peels : In this, the outer layer of the loosened skin is removed and this helps in reducing the sagging and pendulous skin. After the skin peels off, the new inner layer of the skin is firmer and smoother
  • Laser peeling : It is similar to a chemical peel as it also sheds of the outer layer of the old skin. The laser also heats the skin layers below the topmost layer, resulting in production of collagen
  • Ultrasound skin firming : This method makes use of heat energy which triggers collagen production. Targeted energy is disseminated through skin’s surface to warm inner layers
  • Radiofrequency procedure : This focuses on skin’s outer layer. This is another type of energy conduction that warms the skin to stimulate collagen production
  • IPL/RF treatments : This method combines intense pulsed light (IPL) and radiofrequency (RF). In this process, the outer and inner layers of the skin are heated to induce collagen production
  • Botox : The substance botulinum can ease out the wrinkles. It is injected into the skin. The recovery time is the least and it minimizes loose skin appearance

Lifestyle modifications to tighten the skin 

Nutrition and exercise have a huge influence on skin elasticity. Lifestyle modification is the safest and the healthiest option but requires a lot of motivation and commitment. A combination of resistance training, aerobic exercise and a healthy diet can help one lose body fat, which will firm the abdominal area. Once the lost weight is maintained, sticking to a healthy diet and lifestyle is the key to keeping the weight off, since poor choices in the diet and sedentary lifestyle can lead to increase in fat mass; which has the potential to stretch out the skin again.

When it comes to particular exercises to strengthen the abdominal areas, exercise needs to be impactful enough to increase the muscle tone. Methods like adding weights, bands, and resistance tools along with working with the body weight can be more helpful. Some of the most recommended exercises for core muscle activation are : variations in planks and crunches, and involving flexion, extension and rotational movements.

Ways to address loose skin after weight loss 

  • Stay hydrated : Water is a very essential and important nutrient in maintaining skin elasticity. The skin is made up of hundreds of cells. Skin cells, all cells in the body are made up of water. Without water, the largest organ will not function at its best. If one stays well hydrated, the skin will be more resilient and elastic
  • Healthy diet : A well balanced diet containing protein rich foods, essential vitamins and minerals help in maintaining good skin health. This is important as protein rich food contains collagen and elastic forming components which is required for a good skin
  • Skin care : A good skin care routine can help in enhancing the skin quality. Skin tightening creams with plant based formulas and ingredients like aloe vera, yeast, soy protein, vitamin C, vitamin E can help in hydrating and increasing collagen formation in the skin. Vitamin E based creams work very well for stretch marks. Skin care routine also includes limiting sun exposure, avoiding smoking and staying away from artificial chemicals
  • Increasing body’s muscle mass : As skin becomes loose after rapid weight loss, engaging in muscle building activities, the ones that specially focus on the loose skin can give the appearance of a tighter skin by filling it with more muscle and more metabolically active tissue

Are the skin tightening procedure worth the cost ?

Even though one can tighten loose and sagging skin with or without surgery, it does not always mean that one should. It has to be noted that people selecting an easy way out, must be willing to commit to a disciplined lifestyle that comprises of a healthy diet and exercise regimen to maintain the results of the expensive skin tightening procedures and it just does not end with getting a cosmetic procedure done. Data has shown that the rebound effect of drastic weight loss is likely to happen and even a small amount of weight gain can change the way the skin looks. It is also wise to weigh the risks. The surgical methods of skin tightening come with their own risk such as bleeding, scarring, fluid accumulation, tissue necrosis like any other post-surgery risks

Conclusion

For some people, the time and cost invested in the skin – tightening cosmetic procedures provides enough inspiration to follow a disciplined and healthy lifestyle and keep the weight in check. The elasticity of skin naturally decreases with age. But since every individual is different, it works differently for everyone. It is important to evaluate and assess all possible options available at hand and consider long – term objectives and goals before choosing the ‘best’ treatment for the loose skin. It is important to discuss the options with a specialist to avoid the possible pitfalls.

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5404777/
  2. https://www.plasticsurgery.theclinics.com/article/S0094-1298(08)00137-5/fulltext
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2922712/
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