Dr. Alexander Landfield
Board-Certified Neurologist & Medical Director
After significant weight loss, many patients are uncertain about who to see for their skin concerns. Should you book a consultation with a non-surgical aesthetic provider, or should you go straight to a plastic surgeon? The answer depends on several factors, and getting it right can save you time, money, and frustration.
Start by assessing the severity of your skin laxity in each area of concern. The simplest self-assessment is the pinch test. Gently pinch and lift the skin in your area of concern. If the amount of excess skin you can lift is modest, less than an inch or so, and the skin feels somewhat elastic, you are likely a candidate for non-surgical treatment. If you can gather a significant fold of skin, especially if it hangs or creates a distinct pocket when you stand, surgical evaluation is likely more appropriate for that area.
See a non-surgical medical provider first if your skin has become loose and crepey but does not form significant hanging folds. You have mild to moderate sagging in the face, neck, jawline, or upper arms. Your skin quality has changed but you still have reasonable skin thickness. You want improvement without surgery, scarring, or significant downtime. You are willing to accept gradual improvement over three to six months.
Non-surgical providers who specialize in skin tightening can evaluate your skin, discuss realistic outcomes, and offer treatments like Sofwave ultrasound and radiofrequency microneedling that stimulate your body's collagen production. At Rani Beauty Clinic, our Reveal Assessment is specifically designed for this evaluation.
See a plastic surgeon first if you have significant hanging folds of excess skin, particularly on the abdomen, upper arms, or inner thighs. The excess skin creates functional issues like chafing, hygiene difficulties, or skin infections. You want the most dramatic possible improvement and are prepared for surgical recovery. You have been at a stable weight for at least six months.
A board-certified plastic surgeon can evaluate your candidacy for procedures like abdominoplasty, brachioplasty, thigh lift, or lower body lift. These procedures physically remove excess tissue and reposition the remaining skin for a smoother contour.
See both if your laxity varies by area. This is the most common scenario for patients who have lost 40 or more pounds. Many patients have mild to moderate laxity in the face, neck, and upper arms that responds well to non-surgical treatment, along with more significant excess in the abdominal area that may benefit from surgery. In this case, you might pursue non-surgical tightening for the face and neck while consulting a surgeon for the abdomen.
At Rani Beauty Clinic, we are transparent about the boundaries of non-surgical treatment. If we assess your skin and believe that surgical intervention would better serve your goals in certain areas, we will tell you directly and can provide referrals to qualified plastic surgeons in the area. Our priority is your best outcome, not selling you treatments that will not produce the results you are looking for.
Your first step should be whichever consultation feels most relevant to your primary area of concern. If your face and neck bother you most, start with a non-surgical assessment. If your abdomen is the primary issue, start with a surgical consultation. Either way, a qualified provider will help you understand your full range of options.
