After significant weight loss, loose skin frequently remains because the skin has stretched the two uppermost layers, the epidermis, and the dermis. In addition, with aging, There is a significant loss of volume in the face due to facial muscle loss and thinning, fat loss of the face, osteoporosis of the underlying bone or skull, as well as loss of the proteins that give skin its tensile and elastic strength such as collagen and elastin. Repeated sun exposure over time also breaks these proteins leading to further loose skin.
The epidermis is the top layer of skin which is responsible for pigment, pores and texture. The dermis layer is located just beneath the epidermis and contains nerves, oil glands, hair follicles and blood vessels that are responsible for providing nutrients. However, the most notable component of the dermis layer is the skin’s collagen and connective tissue. It is precisely this component which gives out skin its firmness and tightness. unfortunately, with aging, our skin begins to lose its firmness and elastic quality due to natural loss of these proteins resulting in loose skin or skin laxity. The sun also degrades these proteins further exacerbating skin tightness and firmness.
The most effective way to restore firmness back to skin is through energy-based devices and lasers. Lasers and energy-based devices restore elasticity and firmness and tightness back to the skin through stimulating new basement membrane protein remodeling and production (elastin, collagen etc.), as well as tightening the configuration of these proteins through intense heat. The heat produced by energy-based devices can be derived through radiofrequency energy (Thermage, ThermiTight, Morpheus 8, FaceTight, BodyTight) or ultrasound (Ulthera, SoftWave) or lasers (CO2 laser, Fraxel laser, Genesis). The hotter the device can heat up the dermis without burning the patient, the better the results will be in terms of skin tightening.
The basement membrane proteins (collagen, elastin) and connective tissue are responsible for the elasticity in the skin. One important factor resulting in loose skin is rapid weight gain or loss. Gaining weight will stretch the skin and if there is a significant amount of weight loss, the skin’s elasticity could be overworked, leaving saggy skin behind on the face, stomach, thighs, arms, and back. In addition, the natural process of aging causes loose skin. The sun is another important contributor to the development of loose skin. The ultraviolet radiation from the sun (UVA and UVB) is able to penetrate deep in the dermis and break down collagen fibers contributing to loose and saggy skin.
One way to address loose skin is simply to cut it and stitch it up again through plastic surgery. This is the basic principle behind a tummy tuck (abdominoplasty) or and arm tuck (brachioplasty) or a face or neck lift. Those who are surgery averse or who have reservation about scars associated with various nip and tuck plastic surgery procedures can consider a non-invasive skin tightening procedure. All skin tightening procedures utilize the concept of heat to tighten up collagen and create new collagen in the dermis. These procedures can result in tighter skin, improve scar tissue, fix uneven skin tone and encourage the collagen-building process in order to create firmer skin. Lasers accomplish this by Coverting the light of laser into heat deep in the skin. Both the CO2 and Fraxel lasers utilize laser energy for skin tightening. Thermage, Morpheus 8, and ThermiTight use radiofrequency as the source of energy which eventually gets converted into heat in the skin. Ultherapy and Softwave use ultrasound to heat up the skin.
Depending on the area you are treating there may be different options for skin tightening. The face can respond well to both the Fraxel laser and the CO2 laser when it comes to skin tightening. These lasers can also improve texture, fine and deep lines and wrinkles, as well as sun damage in addition to creating new tight skin for you on the face and the neck. The Co2 laser usually accomplishes this in 1-2 sessions whereas the Fraxel laser may take 3-5 sessions. Ultherpy and Softwave is another treatment option for non surgical skin tightening of the face and the neck. Both these devices use a highly focused ultrasound beam to predictably tighten the skin of the face and the neck. Another option includes the Thermage procedure, which employs a patented technology using radiofrequency to tighten skin. It has been clinically proven to tighten and gently lift the skin to smooth out wrinkles and renew facial contours. The incision-free procedure is fast and easy and requires no downtime from normal activities. Unlike lasers, the procedure can be performed on patients of all skin types. The ThermaCool device has been cleared by the FDA for the non-invasive treatment of wrinkles. Many RF Micro-needling procedures also utilize the principle of radiofrequency to deliver heat to the dermis. These devices such as Morpheus 8, Secret RF, and Profound, deliver the radiofrequency energy through puncturing the skin with fine needles referred to as microneedles. The gold standard for skin tightening on the face and the body remains the Themitight procedure. The Thermitight procedure delivers radiofrequency through a probe deep in the dermis precisely heating the layer where collagen and elastin fibers reside. This intense heat delivered deep in the skin, while continuously being monitored through a feedback loop mechanism through the probe of the Thermitight procedure, in addition to an advanced infrared camera focused on the patient continuously monitoring the outside surface temperature of the skin, results in maximal heat being applied to the skin causing the most dramatic skin tightening achievable in a non-surgical manner.
*Results may vary.
Immediately following a Thermage procedure, your skin may feel tighter, smoother and more youthful. Over time, you will notice additional tightening. Unlike many laser procedures requiring four or more sessions, a single Thermage treatment has produced results in the majority of patients. Your physician will determine the course of treatment that is right for you. The Thermage procedure can take anywhere from twenty minutes to two hours, depending on the size of the treatment area. Additional time may be required for skin preparation prior to the procedure.
Due to genetics and the inherent nature of skin and fat, many unsightly conditions simply cannot be addressed with diet and exercise alone. Fortunately, Dr. Rokhsar’s practice offers a wide variety of options to combat these stubborn areas.
The best treatment option for achieving your ideal body contours remains tumescent liposuction. Dr. Rokhsar’s performs all his minimally invasive liposuction procedures under local anesthesia for best results and maximum patient safety. Dr. Rokhsar uses very small cannulas to suction the fat after administering tumescent fluid to numb the areas to undergo liposuction. Using microcannulas, Dr. Rokhsar can achieve the smoothest results with the least amount of fat or skin irregularities. Various lasers can be utilized to aid the liposuction procedure. SmartLipo, is an example of such a combination of minimally-invasive liposuction and skin tightening laser procedure. By combining these together, Dr. Rokhsar can dramatically reduce the circumference of problematic areas for better skin tightening. Dr. Rokhsar can also combine his minimally invasive liposuction procedures with the ThermiTight procedure for maximal skin tightening. The procedure involves tiny incisions, local anesthesia, and a few days of downtime. However, the results are quick and patients are left visibly leaner, while creating the curves and contours that define an attractive body.
Another popular body contouring procedure is Coolsculpting. CoolSculpting relies on the concept of freezing the fat. Fat cells are probe to injury at temperatures below 4 Degrees Celsius. The target temperature for the Coolsculpting procedure is somewhere below 4 degrees Celsius and above 0 degrees Celsius (the freezing temperature of water). The Coolsculpting applicator sucks in the desired area of the treatment through vacuum suction into the applicator cup of the machine and takes the tissue through cycles of cooling to damage the fat cells. Each cycle is roughly half an hour. Patient can expect 10-20 percent improvement in the treatment areas. Multiple treatments may be necessary. the Coolsculpting procedure no downtime or incisions but the results are never as good as liposuction.
Another useful body contouring procedure is Kybella injections into localized deposits of fat. Dr. Rokhsar injects Kybella into neck fat (double chin), jowls, bra fat, back fat, love handles, or any localized areas of fat. Kybella disrupts membranes of fat cells leading to their destruction. There is notable swelling after Kybella injections for a few days to a couple of weeks. Multiple Kybella injections sessions may be needed to reach the desired cosmetic outcome. Another helpful use for Kybella is treating lumps and bumps or irregularities associated with a poorly performed liposuction procedure which has left areas of lumpy fat or irregular skin. Kybella can be injected directly into lumps and bumps resulting from uneven liposuction, smoothening the contour and resulting in a more even result.
With an ever-increasing amount of options for patients to consider, talking with Dr. Rokhsar can help you decide how to best meet your body contouring goals.
Ulthera or Ultherapy is an innovative cosmetic device option that utilizes acoustic or sound energy deep into the soft tissue to promote collagen formation and skin tightening. The device can emit the energy at various levels, allowing Dr. Rokhsar to precisely administer the right amount of energy based on the particular area of the face being treated. common areas of treatment for skin tightening include the face, the neck, and the eyebrow areas for a non surgical eyebrow lift. The procedure roughly takes two hours to perform. There is no downtime associated with the Ultherapy procedure.
Fraxel Re:pair is an ablative CO2 laser Which vaporizes or removes tissue. Fraxel Re:pair is a powerful and hot laser. Not only does it ablate or removes the epidermis (the outer layer of skin) and the upper layers of the dermis in a fractional manner, but the intense heat of the laser causes dramatic skin tightening or contraction. This laser has unparalleled and impressive skin-rejuvenation results after one or two treatments. The procedure has about 1 weeks down times. the results last roughly 3 to 5 years. Dr. Rokhsar is considered a world expert in CO2 laser treatments. Dr. Rokhsar’ results with the fractional CO2 Fraxel repair lasers are unmatched. Patients fly from all around the United States and the world to see Dr. Rokhsar for the CO2 laser procedure as it is highly technical and requires a lot of experience and skill to perform.
Fraxel Re:store is non-ablative laser resurfacing procedure which also result in skin tightening due to the heat of the laser. The Fraxel laser is a non ablative fractional laser. this means that the laser does not evaporate tissue but rather coagulates it resulting in a precise damage tricking the body to replace it with new skin. Because of its non ablative nature, the Fraxel restore procedure has less recovery time and less post-treatment peeling, redness, and swelling compared to the Fraxel Repair or CO2 laser. Multiple treatments are needed to achieve optimal results.
ThermiTight remains the most effective procedure for skin tightening on the face and neck in addition to any area of the body. Dr. Rokhsar was one of the first physicians to perform the Thermitight procedure in the United States. Dr. Rokhsar has trained numerous physicians around the country on The Thermitight procedure. He also introduced the ThermiTight procedure to Brazil. Thermitight heats up the skin from inside out through the radiofrequency energy delivered through a long needle or probe to underneath skin after the patient is numbed. The procedure is monitored through the use of an advanced infrared camera to safely heat up the skin to maximum safe temperatures for maximal skin contraction or tightening. The Thermitight procedure is a more advanced version of the FaceTight or BodyTight Procedure and far superior to the Morpheus 8 RF microneedling procedure.
Losing weight can be a challenging task, and while it has numerous benefits, one downside is the possibility of developing loose skin. Loose skin can be caused by various factors such as aging, genetics, sun damage, or rapid weight loss. However, there are some steps you can take to minimize the chances of developing loose skin after weight loss.
One way to avoid loose skin after weight loss is to lose weight gradually. Experts recommend aiming for 1-2 pounds per week, which translates to 4-8 pounds per month. Gradual weight loss allows your skin to adjust as you lose weight, reducing the chances of developing loose skin.
Another way to avoid loose skin is to eat a healthy diet rich in lean proteins. Eating protein after strength training is particularly helpful for building muscle. Exercise can also help minimize the appearance of loose skin after weight loss by building muscle mass and tightening muscles. Strength training exercises like weightlifting, squats, and lunges can be particularly helpful.
Hydrating your skin by drinking plenty of water and using a skin moisturizer with vitamin E can help keep your skin firm and prevent wrinkles. Additionally, many studies suggest that quitting smoking and limiting sun exposure may help prevent loose skin.
Finally, rebuilding your muscles is crucial to minimizing loose skin. As you lose weight, the underlying layers of tissue shrink under a much larger surface area. Building muscle tissue can help to fill in this space and reduce the appearance of loose skin.
Loose belly skin can be a concern for those who have lost a significant amount of weight or given birth. While there are surgical options available, non-surgical methods can also be effective in tightening loose belly skin.
One method is exercising to strengthen your stomach muscles, specifically the transverse abdominis, which helps with posture and keeping internal organs tucked in tightly. Incorporating weight training can also help build muscle and tighten the skin.
Taking care of your body is also important. Drinking plenty of water to stay hydrated can help maintain healthy skin and elasticity. Eating protein-rich foods and foods high in collagen can also promote skin elasticity.
The most effective non surgical method to tighten the skin of the abdomen is the thermitight procedure. All non surgical laser and energy based devices use the concept of heat for skin contraction. Whether the source of the energy is ultrasound (Ulthera), lasers (Fraxel, CO2), or radiofrequency (morpheus, thermitight, thermage, exilis), the end result in the skin is that the energy is converted to hear to make loose skin tighter. The Thermitight procedure is the most effective at making loose skin of the belly better, because the energy is delivered deep in your skin through a probe that emits radio frequency energy. After the area of the belly is numbed with some numbing fluid, the probe is inserted underneath the skin to heat it up while the temperatures on the outside are monitored by an infrared camera. The Thermight is the safest and most effective way to heat up the skin to make the belly tighter.
Surgical options, such as an abdominoplasty or tummy tuck, which removes extra fat and skin and tightens the muscles in the abdominal wall, should be considered a last resort. Laser resurfacing with the Fraxel laser is also a highly effective procedure for tightening loose skin, although it does require some downtime.
Overall, there are several non-surgical and surgical options available for tightening loose belly skin. It’s important to consult with a board certified dermatologist to determine which method is best for your specific situation.
If you are looking for ways to tighten loose skin on your arms, there are several options to consider:
Remember that the effectiveness of these methods can vary based on the individual’s skin type and the amount of loose skin they have. It’s always best to consult with a dermatologist or plastic surgeon to determine the best course of action for your specific needs.
There are various ways to tighten loose skin on the stomach without undergoing surgery. One important step is to stay hydrated by drinking plenty of water. Another way is to consume a diet rich in protein which can help build muscle mass and enhance fat loss. In addition, increasing collagen production naturally can play an important role in re-tightening belly skin.
Non-surgical treatments such as Thermitight and laser treatments can also effectively tighten the skin on the stomach. Thermitight uses radiofrequency technology to restructure collagen fibers and stimulate the production of new collagen by delivering heat to the skin inside out. This is the most effective procedure to tighten the skin of the stomach. The results with Thermitght in experienced hands is far superior to Thermage, Ultherapy, Morpheus, and other skin tightening procedures. Similarly, laser treatments like the Fraxel laser can heat deep into the skin without wounding the top layer and help tighten skin all over the body.
In addition to these non-surgical treatments, targeted exercise can also help tighten loose skin on the stomach. A recommended exercise is to lie on your back, bend your legs at a 90-degree angle to the floor, lift your arms toward the ceiling, curl your upper back and shoulders off the floor, hold for a few seconds, and release slowly. Repeat this exercise for 10-15 times.
Finally, non-surgical skin tightening procedures in general work by using targeted energy to heat deeper layers of skin, which stimulates collagen and elastin production and gradually improves skin tone and texture. However, while these non-surgical treatments may be effective in some cases, they may not be sufficient for individuals with severely loose skin on the stomach where surgery may be required.
Loose skin after pregnancy is a common concern for many women. While it can be frustrating, there are several things you can do to tighten loose stomach skin after pregnancy. Here are some strategies you can try:
Overall, a combination of exercise, hydration, healthy diet, weight training, and skin protection, liposuction and Thermitight can help tighten loose stomach skin after pregnancy. Remember that it may take time and patience to see results, but with consistency, you can regain your pre-pregnancy body.
Loose skin under the chin can be a frustrating and confidence-damaging issue for many people. Fortunately, there are several ways to treat this condition:
Loose skin on thighs can be a result of aging, weight loss, sun damage or pregnancy. There are several ways to tighten loose skin on thighs, and here are some of the most effective methods:
Loose skin on the arms can be caused by aging, weight loss, sun damage or pregnancy. Fortunately, there are various ways to tighten loose skin on the arms:
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Dr. Cameron Rokhsar, MD, FAAD, FAACS, is the founder and medical director of the New York Cosmetic, Skin, & Laser Surgery Center. Dr. Rokhsar is a graduate of Harvard College and NYU School of Medicine. Dr. Rokhsar is double board certified in dermatology and micrographic dermatologic surgery, being one of the few select dermatologists in the country who is also fellowship trained in laser surgery. A researcher and innovator, Dr. Rokhsar is the creator of the non-surgical nose job and has been instrumental in the research and development of laser systems such as the Fraxel, CO2, Mirady, Vbeam, Themitight, and Ulthera devices. An Associate Professor of Dermatology at Mount Sinai Hospital in NYC, Dr. Rokhsar actively teaches the cosmetic dermatology clinic to the resident at Mount Sinai. An expert injector of fillers, and a trainer for many companies, patients fly in from around the world to see Dr. Rokhsar in his Garden City and Manhattan offices in New York.
Dr. Rokhsar was chosen by
magazine as a top dermatologist in its Best Doctors 2017, 2018, 2019, 2020, 2021, 2022 and 2023 issues.
