– It is best to combine the idea of losing weight with a consultation with an aesthetic medicine doctor from the very beginning. He will write out the entire plan of preventive actions, i.e. treatments. Because combining weight loss with aesthetic medicine treatments is healthier for our skin and our appearance – says Dr. Mariusz Kaczorowski*, an aesthetic medicine doctor.
Losing weight has become easier than ever before because drugs have appeared that allow you to get rid of unwanted fat. However, every kilogram less means a change in the appearance of our face and body. Paradoxically, not always to the advantage… Why?
Dr. Mariusz Kaczorowski: When we start the weight loss process, most of us usually have good results in the first few days. This initial weight loss is caused, among other things, by the loss of water in our body. However, this is very bad for our skin, which suffers the effects of this loss the most.
What else happens to the skin during weight loss?
Subcutaneous fat tissue is reduced, and thus the skin loses its soft support and loosens. Additionally, the above-mentioned water loss causes it to become flaccid and dry. These problems with loss of skin tension may appear after losing 2-3 kg, especially when we lose weight too quickly.
Where can you notice these effects of weight loss?
Mainly on the face. Even with a small weight loss of just a few kilograms, it is visible. A patient comes in and says that suddenly, from week to week, her wrinkles have deepened significantly… The problem of skin laxity, i.e. its lack of adaptation to a new situation, i.e. weight loss, also applies to the abdomen, cleavage, upper breasts, and also the arms, on which the so-called pelicans.
Patients who are trying to lose weight say “my face has fallen.” What exactly happens to the face when we lose weight?
In the area of the cheekbones, around the eyes and temporal bones, the volume of subcutaneous fat tissue is rapidly lost. Almost immediately, the effect of the so-called crow’s feet and tear troughs. Another area of the face where the consequences of weight loss are visible is the oval – the skin lowers and begins to “hang” on the jaw, the so-called hamsters. Nasolabial folds and marionette folds also automatically become visible. This is often accompanied by a lowering of the corner of the mouth.
In the United States, the term “Ozempic face” is popular, which means, to put it simply, the face after treatment with a slimming preparation, aged and changed. When I entered the term into Google, I got 21 million results. And what does it look like in Poland?
In the USA, semaglutide-based preparations have been used since the beginning of 2020, and obesity problems affect a much larger part of the population than in Poland. There, slimming treatments concern people with a much higher degree of obesity, and thus the weight loss is much greater. In Poland, we only have one year of experience with these preparations. Their effectiveness is related to the reduction of adipose tissue, and therefore subcutaneous fat tissue of the face. Any pharmacological weight loss treatment should be carried out under the supervision of a doctor. When planning such weight loss to avoid possible surprises such as “Ozempic face”, it is also worth being under the care of an aesthetic medicine doctor.
How to counteract the aging effects of weight loss?
An aesthetic medicine doctor has a whole arsenal of resources at his disposal. Dryness, sagging and loss of volume are problems that can be remedied. However, it is best to combine the idea of losing weight with a consultation with an aesthetic medicine doctor from the very beginning. The doctor, in consultation with the patient and taking into account his expectations, will prepare an entire plan of preventive actions, i.e. treatments, on many levels.
Because combining weight loss with aesthetic medicine treatments is healthier for our skin and our appearance. After losing a few or a dozen kilograms, we don’t want to be left with wrinkles and furrows on our face and a “bag” of skin on our belly.
Thanks to properly selected treatments and sensibly planned weight loss, the skin may shrink as you lose weight.
However, if a patient comes to you and complains: I lost 10 kg, everything on my face has gone down?
There is no one way that will immediately make everything fine or back to the way it was before. If facial wrinkles have become more severe as a result of losing weight, injecting botulinum toxin into the eye area will cause the patient to immediately see improvement. First of all, you need to replenish the volume.
If the physiology of the face allows and the patient wants it, the volume can be supplemented with hyaluronic acid, improving e.g. the area around the cheekbones, or the nasolabial folds can be made shallower. However, if there has been a greater loss of tissue volume, polylactic acid can be used to rebuild it. Its injection will rebuild the volume and, consequently, lift the upper part of the face.
Autologous fat graft can also be used to rebuild significant volumes. It is taken from places where it is found in excess.
The only thing left is to restore the skin’s elasticity…
Technology may come into play. Microneedle radiofrequency is currently experiencing a renaissance of sorts. The treatment involves the head of the device inserting itself into the skin surface. The needles remain in the skin for a programmed time while an RF wave is passed through them. This results in double stimulation of the skin. The pricks stimulate its reconstruction, which takes place in all layers, and the repair processes are additionally enhanced by the RF wave. Before the treatment, the skin surface is anesthetized with an appropriate preparation. The procedure should be repeated at least three times, at intervals of three or four weeks, to allow the skin to regenerate.
HIFU treatment can also be used to firm the skin – especially the contours of the face, chin and neck. It involves the creation of controlled tissue micro-injuries by high-frequency waves.
Such stimulation triggers regeneration and repair processes through increased collagen production. Within a dozen or so weeks, the skin regains elasticity, becomes stronger and tighter.
An alternative is a treatment using a fractional laser, which has a strong effect, both superficial and stimulating. It will smooth out fine wrinkles, refresh the skin superficially, and also stimulate the production of collagen and elastin. It brings particularly good results to people with very thin skin.
And the threads? After all, they can also be used to lift the skin?
In cases after volume loss, when the skin is thin and flabby, they should be left for later. The skin must first be restored to volume and elasticity, and only then should we think about implanting threads to pull and tighten the tissues.
What if the neck shows that we have lost weight?
Microneedle radiofrequency and laser can be used here.
After losing weight, wrinkles appear on the neckline, and the skin itself does not look as good as before the treatment.
The skin on the neckline is thin and delicate. Thick mesotherapy is used to firm and moisturize it. You can perform a fractional laser treatment that will regenerate its surface. Vertical wrinkles can be eliminated with polylactic acid, which can also be used to firm the skin of the arms. If someone doesn’t like these treatments, you can always use PDO threads. Once incorporated into the skin, they will dissolve after some time and firm the skin.
What if we lose belly fat? The skin then sags and it does not look aesthetic. Are there ways to do this?
The belly is a difficult area. We should shout: “all hands on deck!” From the very beginning, you need to implement treatments that will ensure that after achieving a certain weight loss goal, you will no longer have a “bag” on your belly. There is no point in delaying, it is wrong to assume “Doctor – first I will lose weight and then we will do something about it.”
From the beginning of the slimming treatment, it is a good idea to use treatments to concentrate and thicken the skin – not only microneedle radiofrequency, but also fractional laser treatments. The idea is to avoid the effect that also occurs in post-pregnancy skin. During pregnancy, the skin tightens to the limit, stretch marks often appear, and then, after giving birth, everything wrinkles and a network of small wrinkles appears on the belly. The same applies to weight loss. The laser beam will regenerate the surface of the abdominal skin and additionally stimulate collagen in the skin.
However, there are extreme cases. Let’s imagine a patient who has lost 25-30 or even more kilograms. Then I refer him to a friendly plastic surgeon because the entire flap of skin needs to be removed to avoid the bag effect.
What about local fat deposits that often remain after weight loss?
They can be dissolved with a special preparation, i.e. performed injection lipolysis. Injection lipolysis is a very precise procedure, it is even used for leveling after liposuction procedures. The second option is cryolipolysis – a treatment during which the continuity of the skin is not interrupted. We apply low temperature to fat tissue for a precisely defined period of time, and this “freezing” also produces the desired effects.
What advice would you give to people who want to lose weight?
Some patients want to lose weight too quickly. They say: “I have a wedding in three months and I need to lose 15 kg.” This is not a good idea, let’s lose weight wisely: half a kilogram a week, a maximum of 2 kg a month. And at the same time, let’s use the previously mentioned treatments. After a few months, the patient will see a reduction in weight and there will be no major problems with the skin.
Let’s drink. When losing weight, you need a large supply of water, at least 2.5 liters a day. Let’s hydrate ourselves so that losing weight does not involve losing water.
Let’s not forget about movement. Appropriate exercises are also very important to strengthen the muscles. Be sure to go regularly, two or three times a week, e.g. to a fitness center, a gym, or run on a treadmill, because running activates all muscle groups. Remember: in order to lose weight from fat tissue, there must be a disproportion between the calories consumed and energy expenditure. To lose 1 kg, we need to burn an additional almost 8,000. kcal.
If we are thinking about real weight loss, and not about losing 2-3 kg, we should do it under the supervision of a doctor and with consultations with a dietitian. If we are thinking about larger volume losses, we probably shouldn’t do it on our own. So let’s lose weight wisely.
*Dr Mariusz Kaczorowski – certified aesthetic medicine doctor, associated with aesthetic medicine for over ten years. Member of the Polish Society of Aesthetic and Anti-Aging Medicine and the Polish Society of Preventive and Anti-Aging Medicine. A graduate of the Postgraduate School of Aesthetic Medicine of the Polish Medical Society in Warsaw. Trainer and trainer in the field of modern aesthetic medicine techniques. He specializes in non-surgical and laser corrections of aesthetic defects of the face and body. Performs treatments to prevent premature skin aging. Collaborator and medical consultant of several renowned clinics and offices in the country.