Big weight loss wins come with undeniable health benefits, but they also can trigger one of the body’s biggest challenges: skin quality. Whether weight comes off naturally, surgically or with the help of GLP-1 medications, the skin often struggles to keep pace with laxity issues, hollowness and a change in texture.
“Patients lose a lot of the facial fat that’s critically important to maintaining the integrity and strength of the face,” says Wayne, NJ facial plastic surgeon Jeffrey Wise, MD. “There are dozens of fat pads that give the face structure, and when a person loses those, the face naturally will droop and sag.”
Featured Experts
- Dr. Jeffrey Wise is a board-certified facial plastic surgeon in Wayne, NJ
- Dr. Joel Schlessinger is a board-certified dermatologist in Omaha, NE
- Dr. Daniel Schlessinger is a board-certified dermatologist in Omaha, NE
- Dr. Dilip Madnani is a board-certified facial plastic surgeon in New York
- Dr. Deborah Longwill is a board-certified dermatologist in Miami
Why does skin look different after weight loss?
The underlying support system of the face and body often can’t rebound to its pre-weight state. “The platysma muscle in the neck stretches during weight gain, and when people lose a lot of weight, it rarely contracts back to its original tautness,” Dr. Wise explains. “The result is laxity of the cervical facial fascia, which leads to sagging skin.”
New York facial plastic surgeon Dilip Madnani, MD sees the same story play out daily. “The stretching tends to thin the overlying skin and with acute weight loss, faces are left with laxity which results in loss of jawline and neck definition,” he says.
Miami dermatologist Dr. Deborah Longwill adds that loss of firmness, reduced elasticity and hollowing are common signs. “The skin can’t always keep up with the rate of weight loss, especially if collagen and elastin levels are already compromised due to age, sun exposure or genetics.”
And it’s not just the skin itself. Omaha, NE dermatologist Daniel Schlessinger, MD notes that hair and nails often take a hit too. “When you suddenly cut your body’s metabolic supply, everything takes a hit, and many experience hair shedding called telogen effluvium, the same thing that happens after getting COVID or in postpartum mothers.”
What treatments make a difference?
What you do about skin quality after weight loss really depends on the severity say the experts. “For patients who need a big lift, facelift and necklift procedures are the best option,” Dr. Madnani says. “On the nonsurgical side, tightening devices that stimulate collagen and elastin can help, but results depend on the quality of the skin to begin with.”
In Miami, Dr. Longwill relies on collagen-stimulating treatments like Morpheus8 radio-frequency microneedling and biostimulatory injectables. “Skinvive or Sculptra hydrate and stimulate your own collagen production, giving the skin a plumper, healthier look over time,” she says.
For Omaha, NE dermatologist Joel Schlessinger, MD a combined approach works best. “In-office treatments such as Sciton’s SkinTyte and SkinSmooth paired with medical-grade skin care can move the needle on elasticity,” he explains.
When it comes to stacking your vanity with the right products, he also says there are head-to-to solutions to start incorporating into your routine as soon as possible. “Products like SkinCeuticals A.G.E. Interrupter Ultra Serum ($185), Revision Skincare BodiContour ($162) and Alastin Restorative Skin Complex ($230) all play a role in supporting collagen and improving skin contour.”
Managing expectations
One thing every expert we spoke to emphasized is that managing expectations is just as important as the treatment itself. “The consultation process is thorough,” Dr. Madnani says. “My role is to educate and give the patient a roadmap so they understand what is possible and what isn’t. Then we decide together what will make them feel the most confident in their new body.”
“The skin is a living organ, not shapewear. If you’ve lost a significant amount of weight especially quickly, some degree of skin laxity is completely normal,” adds Dr. Longwill.
For patients on GLP-1 medications, the conversation is layered. “These medications work amazingly for so many medical conditions, but they do have real side effects on your perceived age,” says Dr. Daniel Schlessinger. “Some patients are spending all of their disposable income on the medication itself, leaving them without the funds to afford their regular Botox or fillers.” In the end, the experts say the goal isn’t to choose between treatment and appearance, but to create a plan that supports both health and confidence long-term.
