After major weight loss, the face can look older or more hollow because facial volume decreases. The cheeks may flatten, lines may become more pronounced and loose skin can gather around the neck and jawline. Dr Ellis Choy is a Specialist Plastic Surgeon who can assess these changes and explain which surgical or nonsurgical options for facial rejuvenation may be available to you. His practice is in Northbridge, on Sydney’s lower north shore.
How Major Weight Loss Changes the Face
Loss of Facial Volume and Fat
The face has distinct pads of fat that give the cheeks and temples their shape. When losing fat in other areas, weight loss can also occur in these fat pads, causing certain areas of the face to lose their underlying volume. Large amounts of weight loss are connected to both fat loss and increased skin laxity. These effects can happen with any kind of weight loss, whether it is achieved with diet and exercise, bariatric surgery or GLP-1 medication.
Skin Elasticity and Collagen Changes
Skin stretches to accommodate added weight, and it does not always retract after major weight loss. Collagen and elastin fibres, which help the skin with retraction, lose tension with age and can become damaged with rapid weight changes. How much skin firmness remains after weight loss depends on factors like age and how much weight was lost.
Jawline, Jowl and Neck Changes
Pockets of skin and fat can settle along the lower face to form jowls, due to the effects of gravity and loss of skin elasticity. The neck can change at the same time, with loose skin developing below the chin and vertical bands that appear as the platysma muscles show through thinner neck tissue.
Brow and Eyelids
In the upper third of the face, brows may begin to descend and add weight to the eye area. Excess skin can collect and make the eyes look tired or hooded. Sometimes, these changes can be more noticeable after weight loss than they were before.
Finding the Right Facial Rejuvenation Procedure for Your Concern
Facial Fat Grafting for Hollowing and Lost Volume
Facial fat grafting restores fullness by moving fat from another part of your body, such as the abdomen or thighs, into the cheeks, temples and under-eye area. Fat grafting replaces lost volume but does not remove loose skin, so if skin laxity and tissue descent are your primary concerns, a facelift may be more suitable.
Facelift for Jowls and Midface or Jawline Descent
A facelift repositions facial tissue and removes loose skin along the cheeks and jaw. The deep plane facelift works beneath the muscle and connective tissue layer called the SMAS and lifts descended midface tissue as one unit. Dr Choy selects the technique based on how far the tissue has dropped and the quality of the skin.
Neck Lift for Loose Neck Skin and Bands
A neck lift tightens loose skin below the jaw and repairs the vertical bands caused by a slack platysma muscle. The neck and the lower face often change together after weight loss, so neck surgery and a facelift are frequently considered as part of the same plan.
Brow Lift for Heavy or Lowered Brows
A brow lift raises the position of the eyebrows and reduces forehead lines. When the brow has dropped after weight loss, lifting it can open the eye area and reduce facial heaviness. It suits patients who have heaviness from the brow rather than the eyelid.
Upper Eyelid Surgery for Excess Eyelid Skin
Eyelid surgery, known as blepharoplasty, removes excess skin from the upper eyelids and can address puffiness on the lower lids. It suits people whose main concern is loose or crepey skin in the upper eyelids rather than from the descent of the brow. The incisions are within the eyelid creases, where they are harder to see once healed.
Liposuction for Stubborn Fat Under the Chin
Not every change after weight loss is a loss of volume. Some people still have a pocket of fat beneath the chin that refuses to go away with weight loss. Liposuction removes this localised fat to refine the line between the chin and neck. It works best where the skin is firm enough to retract on its own.
Nonsurgical Options for Mild Laxity
For mild skin looseness, or for those not ready for surgery, energy-based skin tightening may help. Treatments that use radiofrequency or ultrasound heat the tissue to prompt some tightening over the following months. These options are available through our sister aesthetic clinic and are better matched to early changes than to advanced skin laxity.
Timing Facial Rejuvenation Procedures After Weight Loss
Generally, Dr Choy asks patients to wait for surgery until their weight has been steady for six to twelve months. If you lose more weight after surgery, additional skin looseness may develop, and regaining weight can stretch the skin again. Skin also keeps adjusting on its own for a period of time after major weight loss, so waiting until this process is complete will allow for a more comprehensive view during the treatment planning stages. If you are still taking GLP-1 medication, discuss your plan with Dr Choy and your prescribing doctor to find the right time to operate.
Facial Rejuvenation as Part of Your Full Post-Weight Loss Plan
The face is rarely the only area affected by major weight loss. Many patients also notice loose skin on the abdomen, arms, thighs or breasts. Post-weight loss body contouring includes a range of procedures that address various body areas after your weight has stabilised. Larger plans may involve more than one operation and a longer total recovery.
Will I Have Visible Scarring?
Any surgery that removes skin leaves a scar. Dr Choy places incisions where they are less obvious, such as within the hairline, behind the ears or under the chin. Scars fade in the months after surgery but do not disappear fully, and how they settle varies from person to person. Good scar care during healing supports a flatter, paler mark. Dr Choy talks through the expected scar pattern for your procedure and scar minimisation techniques at your consultation.
Book a Facial Rejuvenation Consultation With Dr Ellis Choy in Sydney
Faces respond to weight loss in different ways, so your plan should start with an in-person assessment. Dr Ellis Choy will examine your skin and tissue and explain the surgical options that fit your face. He will also talk through the risks and the recovery involved for any procedure you consider. To arrange a consultation at Dr Choy’s Northbridge practice, call (02) 8962 9388 or book your visit online.
Categories: