Sagging face after weight loss: how to restore facial contours

Facial fat does more than fill the face; it supports the skin from beneath. When that volume disappears, the skin that was stretched over it is left with less support. How well it adapts depends on several factors:

• speed of weight loss — rapid loss, whether through diet, medication or bariatric surgery, gives the skin little time to adjust;
• age — after about 35–40 the skin has less collagen and elasticity and shrinks back less well;

You cannot fully prevent sagging, but you can give the skin a better chance to adapt:

• lose weight gradually where possible, as your doctor advises;
• eat enough protein and a varied diet to support tissue repair;
• drink enough water and avoid smoking;
• protect your face from the sun every day to preserve collagen;
• keep a consistent skincare routine.

When the changes are small and the skin still has good quality, general practice offers several non-surgical treatments:

• radiofrequency and focused ultrasound devices, which heat the deeper skin and can give mild tightening over a few months;
• threads, which give a light, temporary lift;
• skincare and professional skin treatments, which improve texture rather than lift.

After weight loss, part of the problem is lost volume. In general practice, injectable volume is sometimes used to fill hollow cheeks and temples, and this can make the face look fuller for a period of time. However, injections do not remove loose skin or lift tissue that has slid down, and they need repeating.

When there is clear excess skin on the lower face and neck, a surgical lift is the method that removes it and repositions the deeper tissues:

Timing matters as much as technique. A facelift gives the best and most lasting result when your weight is stable:

• wait until you have reached your target weight and it has stayed stable for several months — often around six months or more; the surgeon will advise in your case;

City Medical Centre performs surgical facelifts only: the standard SMAS facelift, the full (circular) facelift, the neck and lower face lift, and the endoscopic brow and temple lift. After weight loss, these operations remove excess skin and lift the deep tissues of the face and neck. Devices, threads and injectable volume are described here as general information; the clinic does not offer them.