by guest contributor, Paula Henderson
How many of you have wondered about loose skin? How many have wondered how to get rid of it? Well, I’m here today to help you out a bit. I work for a medical reconstructive and cosmetic surgery practice in New Jersey and I get this question in emails all the time. People want to lose weight but are concerned about having loose skin. First, let me tell you that I am in no position to give anyone advice, I neither a dietician, nor am I a plastic surgeon but I do work for many surgeons and all my information comes directly from them. The number one thing that they will tell you is to not worry about your loose skin. Being healthy and wanting to be healthy is your number one job. Being healthy leads to a happier you, a happier you leads to a healthy happy life. I will explain further why this is so.
What Happens to our Skin?
Loose skin occurs when you lose a certain amount of weight faster than your skin has time to recoil, so pregnant women after giving birth will have some loose skin, people going through a mild to severe weight loss will also have loose skin. Loose skin occurs because once your body stretches through weight gain or pregnancy; your skin loses its elasticity. To better understand what happens to our skin when we lose weight we should first take a quick look at how we burn fat. When we lose mass by burning fat, the fat doesn’t just disappear as we would like it to, instead our fat changes form. When we eat, glucose and sugar are harnessed from the carbohydrates we consume; this becomes our bodies’ first fuel source and is stored away in the form of glycogen to be released into the bloodstream as necessary. Once our bodies run out of this energy then fat takes over during a process called ketosis. During ketosis our hormones then activate an enzyme in fat tissue which ignites to release triglycerides that then break into three components of glycerol and three fatty acid chains in a process called lipolysis. The liver then absorbs the glycerol for energy and the fatty acids move to the muscles for energy. Because the fat tissue is removed of some of its components, it shrinks and so does the skin but as stated before only to an extent. Skin stretches because rapid weight gain or growth (ex. pregnancy) outpaces collagen production in your skin which causes areas to overstretch. Just as plastic will tear when stretched too far, so will skin in terms of stretch marks. In cases of massive weight loss, where individuals lose 100 lbs. and over, folds of extra skin remains because the skin had become so outstretched that it hangs from the thinner body like a rubber band that has lost its elasticity. In cases of moderate weight loss, skin can certainly shrink back to fit the body’s new size because of its elasticity. However, collagen fibers weaken with age and a few other factors thus resulting in wrinkles. The factors that determine your skins elasticity is dependent upon the individual and include whether the individual smokes, their race, sun damage, genetics, and even how often their weight has fluctuated greatly.
So in a sense, the actual amount of loose skin you might have is unknown as it is dependent on many other factors and also why the concern of loose skin shouldn’t be a factor in your hopes of losing weight. The want and effort to be healthy will do your body and life a million more favors than worrying about loose skin will. Being healthy and doing the necessary actions to be so will add to your motivation in life, your self-confidence, your work ethic, you name it.
Mild to Moderate Weight Loss
In cases of mild to moderate weight loss, surgery is not required and loose skin can actually be prevented. As mentioned before, a protein in the skin called elastin allows the skin to shrink back to a regular size. However, when going through weight loss, losing 20-30 pounds is very different from losing 80 lbs. or more. In cases of moderate weight loss, there are ways to reduce the amount of resulting excess skin through exercise, muscle-building, eating properly, staying hydrated and by losing the weight slowly. Exercise that includes increasing muscle tone can tighten connective tissue and help stretch the skin as it essentially acts as a filler to your skin instead of fat tissue. By consuming the proper amount of food and water every day will ensure that your skin absorbs the necessary nutrients. Water is a crucial component of maintaining skin elasticity and you should be taking in at least 2 liters each day. The two ingredients that keep skin plump and elastic are elastin and collagen, the protein-rich foods to help form these is found in cottage cheese, legumes, tofu, milk, beans, seeds, nuts, and fish. For optimal absorption, try to consume these calories of protein immediately after your workout. Crash diets and excessive amounts of exercise can rapidly shed muscle and fat resulting in a huge loss of support for your skin as the underlying muscular structure that holds skin against your body is lost. It is important to aim for one to two pounds of fat loss per week and be sure to include weight lifting to keep your muscles strong and able. Loose skin may occur and that is okay, it is natural and will shrink to an extent over time. When this occurs it is important to nourish and take care of your skin by daily exfoliation to remove dead skin cells and increase circulation. Skin tightening creams with ingredients such as aloe vera, hyaluronic acid, yeast extract, vitamin E, C, A can help to hydrate and increase collagen and elastin formation. Make sure to stay away from harsh soaps and shampoos while limiting the amount of sun exposure. Tanning booths and chlorinated water will decrease skin elasticity.
Severe Weight Loss
As mentioned previously, in cases of a severe massive weight loss of 100 lbs. and over through traditional weight loss or weight loss surgery there are some serious health concerns. First, weight-loss surgery is not a quick fix, surgeons recommend having a regular diet and exercise plan even after the surgery to keep your weight stable to ensure the efforts of the surgery are maintained. Weight-loss surgery of over 100 lbs. will result in loose skin and while medical surgeons will remove the weight, the excess skin is not removed. This is something not all patients know before-hand resulting in patients having a poor body image as it was not what they were expecting sometimes causing emotional stress. The excess skin that results from weight-loss surgery and a severe drop in weight (100lbs.+) can cause health defects only because there is so much loose skin that the skin becomes a health problem itself. Folds of skin from a massive weight loss can result in psychological and physical problems. The physical problems that result from lose loose apron-like skin is intertrigo—a bacterial, fungal, or viral infection that occurs often due to the difficulty in keeping these folds of excess skin clean and dry. The skin can also cause back pains and ulcerations. Psychological problems occur when body image expectations are not met; an individual may lose 100+ pounds and not realize the effects of loose skin. So their incredible effort into losing weight results in having apron-like folds of skin. There are a few treatment options for these severe cases of massive weight loss and most are solved with plastic surgery. Post-bariatric surgery and body lifts involve many body areas as patients have loose skin not only on their abdomen but also through the face, neck, thighs, buttocks, arms and breast. Surgery will leave small and large noticeable scars though most patients find these acceptable and enjoy more self-confidence when wearing a bathing suit. Depending on the patient, procedures can be chosen selectively focusing on the most problematic areas. For example, a patient who has lost a moderate amount of weight but has a mild amount of loose skin can have just a tummy tuck to remove remaining fat and skin in the abdomen area. Men who have gone through a massive weight loss sometimes result in sagging or large breasts also known as gynecomastia. Here liposuction alone may be satisfactory, however, this is not typical and breast augmentation or reduction may be necessary. Each individual is different which is why it is crucial to first speak or have a consultation with a board certified plastic surgeon. Your surgeon will be able to identify if you are a good candidate for surgery and will guide you through different procedures that will ultimately give you the satisfactory body you would like to achieve. There are insurance options for severe cases as those mentioned above; this is because excess skin can cause serious medical problems and is not just cosmetic. Again it is best to speak with a surgeon to create an entire plan that is best for you.
The Bottom Line?
Being healthy is of far greater importance than excess skin. If you are a severe case, then you should plan to speak to a board certified surgeon to receive more advice and help on the issues that concern you. For mild to moderate cases excess skin can be prevented through diet and exercise, the same thing you’ve been doing so well at. Keep in mind the amount of loose skin is dependent on many different factors and every individual is different so comparing yourself to others is redundant. If your question is will I have loose skin after losing weight? The answer will probably be a “Yes”, everyone who loses a good amount of weight will but taking preventive measures and allowing time to shrink your skin will help and eventually you will have the “you” you have pictured along with an incredible amount of self-confidence and self-acceptance.
Paula works for the Plastic Surgery Center of Summit Medical Group, a medical reconstructive and cosmetic surgery center in New Jersey. She has two kittens and loves to write about all things beauty, women, health and fitness! She spends her days outside and at the center where she learns as much as she can from the board certified surgeons. This plastic surgery center specializes in not only body surgery such as post-bariatric surgery, Liposuction and Breast Augmentations but also facial plastic surgery such as rhinoplasty.