Various treatments can help improve skin after weight loss, and the right approach for you depends on your needs.
Dermal Fillers
Juvéderm and RestylaneDermal filler is one of the most effective and instant fixes for loss of volume as a result of facial weight loss, Shafer says. Of those, hyaluronic acid fillers, including Juvéderm and Restylane, are the most popular. There are a few different types of dermal filler.
For the cheeks, Shafer suggests Juvéderm Voluma XC, and for the jawline he recommends Juvéderm Volux XC, which are both approved by the U.S. Food and Drug Administration (FDA) 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, the dermal fillers, when injected by experienced injectors, can give very nice and natural results,” Shafer says.
The FDA approved Restylane Contourfor the midface and cheeks in 2021 and Restylane Lift in 2018 for cheek augmentation and correction of age-related midface contour deficiencies.
Results from these types of fillers can last between six months and two years, “but ‘lasting’ does not mean the full effect is present for the entire time,” Shafer notes. “If a filler is said to last two years, I suggest topping up after one year. So if you did two syringes to reach your full effect during your initial treatment then you may need one syringe annually to maintain the results. Everyone's body metabolizes differently, so patients need to understand that a filler may last longer or shorter in different people.”
According to the American Society of Plastic Surgeons, the average cost of hyaluronic acid filler (including Juvéderm and Restylane, is $684 per syringe. But facial fillers “aren’t a beauty procedure in which you can expect to find a low price for a job well done,” argues Shafer, so you shouldn’t try and bargain shop. “The dermal fillers are a tool, but going to a board-certified provider that you’ve researched can determine the outcome.”
Calcium hydroxylapatite (Radiesse) and Poly-L-lactic acid (Sculptra)Per Shafer, Radiesse and Sculptra are two other dermal fillers, different from the more popular hyaluronic acid fillers Juvéderm and Restylane.
“Radiesse has gel microspheres, which add volume but also stimulate natural collagen,” he says. It is most similar to hyaluronic acid fillers in that it can be used for pinpoint injections and definition. It lasts one to two years.
Sculptra, which can take several sessions to see final results, “also works by stimulating natural collagen production under the skin,” he says. Sculptra can last two to three years once you meet your goals, and is better for generalized filling than Radiesse.
“The cost will depend on how much you do and how many treatment sessions you need to obtain your ideal results,” says Saedi. These typically are about $1,000 per syringe, and patients will need multiple syringes each visit.
Lasers and Energy Based Devices
Genius radiofrequency microneedlingRadiofrequency is a newer energy technology, and fractionated radiofrequency, such as Genius, is even newer. The FDA approved it in 2019 to treat the face and body, says Shafer.
Here’s how radiofrequency works: “Small needles pierce the skin and send energy below the surface to stimulate collagen and tighten the skin,” he says. “The microneedles penetrate and reach the deeper levels that lasers can't treat.”
While one treatment usually produces the desired results, two to three treatments may be required. Prices typically start at $3,500 but vary by treatment area and are often discounted in packages.
Fractionated CO2resurfacingShafer calls CO2 lasers “the workhorse for skin tightening” because they have more than 100 FDA-cleared uses that can be performed in 10 medical specialties, including dermatology, plastic surgery, and gynecology. TheFDA approved CO2 lasers in 2004.
Although downtime can be up to two weeks long, as these lasers treat the superficial layers of the skin, “the results can be substantial on fine lines and pigmentation,” Shafer says.
Prices start at $3,500 and vary depending on body area and skin laxity; most people need one treatment per year. “Also, patients need to be prepared for longer recovery time than technologies that focus the energy deeper,” he says, adding that combining treatment modalities can yield better results than just one type of treatment. “It is also important to note that energy-based skin tightening, including CO2 lasers, is not equivalent to surgical skin tightening. Energy treatments can not match the degree of tightening achievable with surgical excision.”
Ulthera or Sofwave (microfocused ultrasound)The FDA approved Ultherain 2014 to lift the eyebrow, chin, and neck area, as well as improve lines and wrinkles in the low neckline or décolleté. Sofwave has been FDA-cleared since 2020 to improve fine lines and wrinkles on the face and neck, and in 2021 got a new indication for lifting areas around the eyebrow and neck, as well as under the chin.
Shafer says microfocused ultrasound treatments like these use ultrasound energy to stimulate the formation of collagen below the skin’s surface. Producing collagen takes time, so results can become more apparent over two to three months, or sometimes up to six months.
The procedure takes about 30 to 90 minutes, depending on the area treated, and there is no downtime afterward. Treatments start at $2,000 but vary by body area. “The majority of patients only need one treatment; however, some may benefit from more than one treatment, depending on how much skin laxity they have and their body’s own biological response to the ultrasound and the collagen-building process,” he says.
Follow-up Ultherapy or Sofwave treatments each year may help maintain results.
