Various treatments can help improve post-weight loss skin, and what works for you depends on your needs.
dermal fillers
Juvéderm and Restylane Dermal fillers are one of the most effective and immediate fixes for volume loss from facial weight loss, says Shafer. Of these, hyaluronic acid fillers, including Juvéderm and Restylane, are the most popular. There are several different types of dermal fillers.
For the cheeks, Shafer recommends Juvéderm Voluma XC, and for the jawline, he recommends Juvéderm Volux XC, both of which are FDA-approved for adding volume to these specific areas. (Volux is the only FDA-approved hyaluronic acid filler for the jawline.)
“While these are not permanent fixes, dermal fillers can produce very nice, natural results when injected by an experienced syringe,” says Shafer.
The FDA approved Restylane Contour for midface and cheeks in 2021, and Restylane Lift for cheek augmentation and correction of age-related midface contour defects in 2018.
The effects of these types of fillers can last from six months to two years, “but ‘long-lasting' doesn't mean the full effect is there the entire time,” Shafer points out. “If a filler is said to last two years, I recommend topping up after a year. So if you used two syringes during your initial treatment to get full effect, you may need one syringe per year to maintain results. Everyone Everyone’s body metabolizes it differently, so patients need to understand that fillers may last longer or shorter in different people.”
Hyaluronic acid fillers, including Juvéderm and Restylane, cost an average of $684 per syringe, according to the American Society of Plastic Surgeons. But facial fillers “are not a cosmetic procedure where you can expect to find low prices for a job well done,” Schaefer says, so you shouldn't try to haggle. “Dermal fillers are a tool, but going to a board-certified provider that you research can determine the outcome.
Calcium Hydroxyapatite (Radiesse) and Poly-L-lactic Acid (Sculptra) Per Shafer, Radiesse, and Sculptra are two other dermal fillers that differ from the more popular hyaluronic acid fillers Juvéderm and Restylane.
“Radiesse contains gel microspheres that add volume but also stimulate natural collagen,” he says. It is most similar to hyaluronic acid fillers in that it can be used for precise injections and definition. It lasts one to two years.
Sculptra, which may take a few sessions to see final results, “also works by stimulating natural collagen production under the skin,” he says. Once you've achieved your goals, Sculptra can last two to three years and is better for full body fillers than Radiesse.
“The cost will depend on how much you do and how many treatments you need to get the desired results,” says Saedi. These are typically around $1,000 per syringe, and patients need multiple syringes per visit.
Lasers and Energy-Based Devices
Genius RF microneedling Radio frequency is a newer energy technology, and fractional radio frequency like Genius is even more novel. The FDA approved it for use in the face and body in 2019, Shafer said.
Here's how radiofrequency works: “Small needles pierce the skin and send energy just below the surface to stimulate collagen and tighten the skin,” he says. “Microneedling penetrates and reaches deeper layers that lasers cannot.”
While one treatment usually produces the desired results, two or three treatments may be required. Prices typically start at $3,500, but vary by treatment area, and are often discounted in packages.
fractional distillation of carbon dioxide2 resurfacing Shafer calls CO2 Lasers are the “workhorse of skin tightening” because they have more than 100 FDA-approved uses and are used in 10 medical specialties, including dermatology, plastic surgery, and gynecology. FDA Approved Carbon Dioxide2 Lasers in 2004.
While the downtime can be as long as two weeks, because these lasers treat the surface of the skin, “the results can be dramatic on fine lines and hyperpigmentation,” says Shafer.
Prices start at $3,500 and vary based on body part and level of laxity; most people require an annual treatment. “Additionally, patients need to be prepared for a longer recovery time than techniques that focus energy on a deeper level,” he said, adding that combining treatment modalities can yield better results than just one treatment alone. “It is also important to be aware of skin firming based on energy, including carbon dioxide2 Laser is not the same as surgical skin tightening. Energy therapy cannot achieve the degree of tightening that surgical excision can achieve. “
Ulthera or Sofwave (micro-focused ultrasound) FDA approved Ulthera in 2014 for lifting the brow, chin and neck area, and improving fine lines and wrinkles around low necklines or shoulders. Since 2020, Sofwave has been FDA-approved to improve the appearance of fine lines and wrinkles on the face and neck, and in 2021 received a new indication for lifting the eyebrows and the area around the neck and under the chin.
Shafer says microfocused ultrasound treatments like this one use ultrasound energy to stimulate collagen formation just below the skin's surface. It takes time to produce collagen, so results will become more pronounced within two to three months, sometimes as long as six months.
The procedure takes approximately 30 to 90 minutes, depending on the area treated, after which there is no downtime. Treatments start at $2,000 but vary by body part. “Most patients only need one treatment; however, some may benefit from more than one, depending on how lax their skin is and their body's own biological response to the ultrasound and collagen-building process,” he says.
Yearly follow-up Ultherapy or Sofwave treatments may help maintain results.
