Loose skin after a significant amount of fat loss is inevitable for some people. Still, it can be uncomfortable and impact your self-esteem — especially after working so hard to get the weight off.
With so many creams, scrubs, and exercise programs on the market claiming to tighten loose skin, you might be wondering which ones work and which don’t.
So let’s explore all of your natural and surgical options for how to tighten skin after weight loss, starting with why it happens in the first place.
Your skin is composed of two layers: the outer layer protects your body from the elements, while the inner layer gives your skin strength, support, and elasticity[*].
Most of that firmness comes from collagen and elastin, but these can become damaged or decrease due to several different factors. Genetics plays a part in this for some people.
But for most, lax or overstretched skin happens as a result of:
Stubborn Subcutaneous Fat Deposits
What you may consider extra skin may actually be localized body fat deposits. Harmful visceral fat sits between your organs in your abdomen.
Though this type of fat increases your risk for cardiovascular disease, type 2 diabetes, and even breast cancer, you can’t see it[*]. But subcutaneous fat, which makes up around 90% of the fat on your body, sits just under your skin[*].
This type of fat droops, jiggles, and feels “soft” when you squeeze it. So to figure out whether you’re dealing with subcutaneous fat or excess skin, give the ol’ “pinch test” a try.
First, take a small pinch of skin on the back of your hand or the outside of your wrist. There shouldn’t be much substance between your fingers, and it might feel similar to the skin on your eyelid. This is what excess skin generally feels like.
Now, pinch somewhere else, like under your arms or your inner thigh. If you can “pinch an inch” and feel a thick, squishy padding, you’re probably dealing with subcutaneous fat, not extra skin.
Loose skin will visibly sag or drape off your body — and sometimes you can actually pull away two or more inches. But extra skin is not thick like fat; it’s almost papery thin (around 1 mm thick).
If you determine you’re dealing with subcutaneous fat deposits and not excess skin, take a breather. This means you still have some fat to lose.
As you keep progressing on your weight loss journey, your body may naturally eliminate these unwanted deposits all on its own.
How Long You’ve Been Overweight or Obese
When you carry around extra pounds, your skin gradually stretches out as your weight increases. And the longer you’ve been overweight, the less elasticity your skin may have over time.
As Joshua Zuckerman, M.D., surgical director at New York City-based Zuckerman Plastic Surgery, told Men’s Health, “Skin has a finite elasticity, and if pushed beyond the limit of that elasticity upon weight gain, the skin cannot fully contract back down upon subsequent weight loss[*].”
Think about your favorite pair of leggings. If you wear them day in and day out for years, the elastic will slowly start stretching out until they become less hip-hugging and more like comfy joggers. No amount of shrinking in the wash will reverse this.
If you have stretch marks, you may be more likely to wind up with loose skin after your weight loss.
Stretch marks are a sign that your skin has already stretched more than usual, so it may have a harder time snapping back (if it does).
Rapid, Massive Weight Loss Due to Bariatric Surgery or Drastic Lifestyle Changes
Losing five to ten pounds in a year doesn’t usually cause loose skin. Your body has more time to adjust to these changes and gradually shrinks back as the weight comes off.
Skin expands during nine months of pregnancy, for example, and snaps back several months after the baby’s birth. It’s not an overnight fix. However, people who undergo bariatric surgery lose a lot of weight in a very short amount of time. This results in excess skin for more than 70% of patients[*].
Most patients report problems with extra skin on their abdomen, upper arms, and buttocks. According to one study, collagen was significantly thinner in patients who had massive weight loss.
They also had weaker skin and damage to their skin’s elastic fiber network[*]. All these lend to the appearance of saggy skin.
Collagen-rich connective tissue provides your skin with structure and support. But once you hit the age of 20, your body produces one percent less collagen each year[*].
The elastic fibers responsible for your skin’s firmness also tend to get weaker. This means your skin appears thinner and more fragile as you age, which can make sagging and wrinkles more noticeable[*].
Your Skin Health
We all know constant, prolonged exposure to the sun’s damaging rays can cause age spots and wrinkles. That’s because damage from chronic sun exposure reduces your skin’s ability to produce collagen and elastin.
When researchers compared the skin of volunteers from Berlin (low sun exposure) with those from Monaco (high sun exposure), they noticed that extended sun exposure significantly reduced collagen and elastin concentrations[*].
The less collagen and elastin, the looser your skin will be.
Seriously, you haven’t quit smoking yet? Researchers say if you’re a smoker, you’re more likely to notice sagging skin on your face and body.
That’s because smoking reduces collagen production, damages your existing collagen and elastin fibers, and causes your skin to age prematurely[*].
Many people think loose skin after weight loss is just a matter of physical appearance, but it can go deeper than superficial aesthetics. Having extra unwanted skin can lead to:
Pain and Discomfort
When people lose over 100 pounds, they often report uncomfortable skin irritations, pain, ulcers, and infections due to their loose skin[*].
Less Physical Activity
Nearly 80% of people suffering with excess skin say it impairs their daily physical activity and gets in their way when exercising[*].
Over 45% of people admitted that they avoided physical activity completely due to skin “flapping” and “unwelcome stares from others[*].”
This causes lower physical fitness and may cause previously lost weight to creep back on.
Negative Body Image
Study participants frequently state that they feel embarrassed, less confident, and suffer from psychosocial symptoms due to their extra skin[*].
This decreases their quality of life, contributes to social isolation, and takes away from the positives they should feel after their weight loss achievement[*].
On a ketogenic diet, the goal is to lose weight gradually and sustainably. This gives your body time to adjust and shrink back as you work hard to reach your weight loss goals.
So before turning to surgical options to tighten loose skin, you may want to:
1. Give Your Body Time to Adjust
If you made a lifestyle change to reverse your obesity, you need to give your body adequate time to adjust and shrink back. Take some measurements now and monitor these numbers every few months.
Wait at least one year after you reach your goal weight to explore surgical options, as your skin will probably not shrink more on its own after this period.
If your skin was significantly stretched for most of your life, your collagen and elastin fibers may be too damaged to retract to the level you’re hoping[*].
The same goes if you’ve lost a ton of weight as a result of bariatric surgery. The bigger the weight loss, the more loose skin, and the less likely you are to see this excess skin disappear completely.
2. Build Up Some Muscle
When you lose a lot of body mass quickly, your best option is to build muscle with strength and resistance training to replace it. Adding more lean muscle to your body also comes with several awesome benefits:
First, muscle burns more calories than fat when you’re at rest[*]. So this means you’ll be torching extra calories during your exercises and when you’re relaxing on the couch. If you’re also dealing with stubborn fat deposits, this is a true win/win.
Second, adding muscle to your frame may help fill in the gaps, so to speak, where your excess skin happens to sag.
You’ll look tighter and more toned while you build up your body’s strength. Just eight back squat and deadlift training sessions were enough for women to notice an increase in their lean muscle mass[*].
Worried about bulking up with weight-lifting? Don’t be.
It takes years of heavy lifting to achieve a chiseled physique, and if you’re not into that, you don’t have to take it to that level. Work a strength-training day or two into your weekly workout routine, and have fun with light weights and kettlebells.
3. Try Yoga
Incorporate a few cardio yoga sessions into your weekly workouts, and you’ll help relieve stress, improve your confidence, and burn calories.
Similar to strength-training, yoga allows you to use your own bodyweight to stretch and lengthen your muscles, which can positively affect the tautness of your skin.
Specific yoga positions can tighten a sagging tummy, firm up your quads and glutes, strengthen your back muscles (your largest fat-burner!), and may even decrease the appearance of cellulite.
You can do this type of resistance training at home, at a yoga studio, or remotely with a virtual class. Plus, you don’t need any fancy equipment to get a good workout in.
4. Add More Collagen to Your Diet
We’ve mentioned collagen and elastin throughout this guide, and for good reason.
Collagen is responsible for 80% of your skin’s structure, and it’s what provides your skin with its firmness, form, and strength. Elastin, the other major component of tight skin, supplies your skin with elasticity and helps it rebound after stretching[*].
We already know your body produces less of these critical skin heroes as you age. Unfortunately, researchers say people who undergo massive weight loss create less collagen and experience a decrease in elastic fibers[*]. So does this mean all hope is lost?
Not at all.
Adding collagen-rich foods and supplements to your diet helps your body generate more collagen on its own. Participants in one study significantly increased their collagen levels after supplementing with collagen peptides for just four weeks.
Plus, researchers noticed the positive results of their supplementation 12 weeks later[*]. Collagen can be found in keto staples like:
- Collagen peptides
- Bone broth
- Gelatin-rich cuts of meat (like oxtail and short ribs)
The higher your collagen intake, the less sag and greater firmness you may notice in your skin. But skip the “firming” skincare creams and lotions with collagen and elastin.
Though these may promise to tighten your skin after weight loss, collagen and elastin molecules are too big for your skin to actually absorb.
5. Add these Essentials to Your Diet to Support Collagen Production
Along with supplementing with collagen, you can also boost your body’s collagen production with help from:
Omega-3 Fatty Acids
Researchers in one small study noticed a 10% increase in participants’ skin elasticity when they took a supplement rich in natural fish oil for three months[*].
Fatty fish like salmon, tuna, mackerel, sardines, herring, oysters, and anchovies are excellent keto-friendly sources of omega-3s. If you’re plant-based, opt for flax seeds, chia seeds, and walnuts.
Your body needs vitamin C for collagen synthesis.
The best low-carb sources of vitamin C on a keto diet include[*]:
- Bell peppers (especially red and orange ones)
- Brussels sprouts
Studies show that around 30% of all weight loss surgery patients will at some point seek plastic surgery to correct their excess skin woes[*].
So if you’re in this camp, or you’ve tried all the natural options to tighten loose skin after weight loss mentioned earlier, there are several surgical options you can explore, such as:
1. Body-Contouring Surgery
Body-contouring surgery is the most popular choice for people who’ve lost a significant amount of weight. With body-contouring surgery, a plastic surgeon will make a large incision where your excess skin hangs.
The surgeon will remove the fat and skin together. Then, they’ll reshape and lift the remaining tissue. Your surgeon will suture up the incision with fine stitches to reduce scarring.
The most common body-contouring surgeries include a/an:
- Upper-body lift to remove skin from the breasts and back.
- Arm lift (Brachioplasty) to remove skin from the upper arms.
- Tummy tuck (Abdominoplasty) to remove excess skin from the abdomen.
- Lower-body lift to remove skin from the belly, buttocks, hips, and thighs.
- Medial thigh lift to remove skin from the inner and outer thighs.
You can choose to isolate one part of your body or opt for multiple surgeries on different parts. But keep in mind that these invasive procedures can be expensive and may not be covered by your medical insurance.
They also typically require a one- to four-day stay in a hospital. Recovery time at home can last anywhere from two weeks to two months. So you’ll definitely need to take at least one week off from work (and probably more).
After surgery, you’ll need to commit to your diet and exercise for the long haul, so you don’t regain weight.
However, studies show removing excess skin leads to improvements in a patient’s appearance, well-being, and enhances their physical, psychological, and social health[*].
2. Alternative/Less Invasive Medical Procedures
Body-contouring surgery is the most common medical procedure to get rid of extra skin post weight loss.
But if you’re looking for something less invasive that carries a lower risk for complications, you can also research:
Using a combination of infrared light, radiofrequency, and massage, this procedure can lead to significant reductions in excess belly and arm skin.
This procedure utilizes a suction technique to remove subcutaneous fat, which may lessen the appearance of excess or sagging skin.
This relatively new non-surgical procedure uses controlled cooling to reduce subcutaneous fat.
In a study of just two patients, physicians noticed significant reductions in fat and skin tightening on the flank and buttocks[*].
These less invasive options may not provide the same results as body-contouring surgery, which is still the gold standard. They seem to work best with patients who have minimal amounts of excess skin to lose.
A ketogenic diet gives your body a healthy, sustainable way to shed pounds, which may prevent loose skin once you reach your weight and wellness goals.
This gradual decrease provides your skin with the time it needs to snap back after stretching out over the years. But if you’ve experienced rapid weight loss due to bariatric surgery or significant diet and lifestyle changes, you may wind up with excess skin that causes discomfort or dissatisfaction with your body.
Natural remedies to tighten loose skin after weight loss, such as supplementing with collagen and building more muscle, are effective and help improve the elasticity of your skin.
However, if you’ve tried these methods or were severely overweight most of your life, you may want to speak with your doctor about surgical options or try less invasive alternative procedures.