The 411 On Spot-Treating Loose Skin

Gaining or losing weight comes down to a simple factor: the swelling or shrinking of fat cells. While there's no set amount of time it takes for a single fat cell to swell or shrink, the cell must expand or contract just enough so that a noticeable difference can be seen. And once those fat cells have shrunk, and depending on how much, you may be left with troubling loose skin.

Noninvasive skin tighteners are big business since they are good for firming up minimally loose skin and can even get rid of small, unwanted areas of fat in some patients. They employ radiofrequency, ultrasound energy or infrared light to tighten the skin below the surface. By heating the dermis, new collagen growth is stimulated (by the activity of fibroblasts, the cells that create collagen) and produced. Rather new to the body-contouring scene, these devices that first gained popularity in Europe and most recently were brought to the U.S. shores.

But deciding on a skin tightening procedure can get a little involved, says Los Angeles dermatologist Rebecca Fitzgerald, MD. "It often depends on what areas you want tightened and whether or not you have surface skin irregularities along with skin laxity. It also depends on the level of laxity-sometimes you have nowhere to go but to a plastic surgeon if you have more than a moderate amount of skin sagging."

As for results, at six months you're going to see what you're going to see results-wise, says San Antonio, TX, dermatologist Vivian Bucay, MD. For small amounts of fat and minimally loose skin, skin tighteners are a great option. It is important to know however that on average, the results from skin tighteners aren't permanent. Maintenance sessions can be done, but results are not predictable since not everybody responds to skin tightening. Also, the "technology is not cheap, and thus the treatments themselves aren't either. Having reasonable expectations for nonsurgical procedures is also important," says Dr. Fitzgerald.

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  • gina
    Posted on

    I had a mommy makeover with a tummy tuck, it was a great fix for my stretched out skin!

  • jules
    Posted on

    i had to have a tummy tuck after loosing nearly 100 lbs last year. i had an extreme amount of loose skin, but it was the best decision i made by far. after all that work dieting and exercising i was thrilled with the results.

  • Neicy
    Posted on

    I'm extremely interested in this debate! It seems like it would be best to bring both options to my doctor, but I worry they go with surgery because it pays more.

  • anon
    Posted on

    have had two thermage treatments on lower face & neck, it did absolutely nothing & they are not inexpensive. in addition it doesn't seem to be predictable as to who is going to get results & who is not. i was 45 years old & had less than moderate sagging.

  • dray
    Posted on

    what could be considered a "moderate amount" of skin laxity?

  • Marcia
    Posted on

    i've been contemplating between a skin tightening treatment or plastic surgery. surgery seems like its more expensive but it seems like its going to be more cost effective in the end since it sounds like skin tightening is going to be done several times. am i correct in this thinking?

  • anonymous
    Posted on

    Can I please have you (the MD experts) comment to their knowledge of when to determine to use radiofrequency vs. ultrasound, vs. infrared tech. in laymans terms/summary? Granted I am not going to make this decision myself, as I am not the Dr., however, I want to have a basic understanding to be sure the Dr. I am speaking with knows the difference themselves! Board cert of not (in Derm and Plastics), there is sometimes range of interest in particular treatment areas... If skin pigment is not an issue and one simply wanted skin tightening, which would you select? Do you find there is patient variability with the different options listed above? For example, have you seen one person NOT respond to one treatment and then another is used with success? Any effect on cellulite at the same time with these procedures that perhaps cannot be highlighted by these companies? Thank you!

  • Earl Parrish Anonymous
    Posted on

    I would agree with most of the comments regarding the role of non-invasive therapies to tighten skin. If the laxity is mild or minimal and the patient has fairly good skin then the procedures are usually moderately effective. Maintenance is usually required after several months. Surgical procedures involve more recovery time but have longer lasting and more predictable results. If you have major skin looseness then you should be thinking about a surgical procedure as your best choice. As always, it is important to be well informed of the limitations and possible complications of any procedure and to have realistic expectations.

  • Meredith
    Posted on

    Has anyone had Thermage? I see signage all the time in my doctor's office but have never asked about it.

  • Leslie
    Posted on

    I have to do more research on skin tightening--heaven knows I need it!