Will I Lose Facial Fullness After Bariatric Surgery?

Deciding to undergo weight loss surgery, such as gastric bypass, gastric sleeve, or duodenal switch, is critical for better health. Some positive effects include increased energy, better blood sugar control, and a reduced risk of heart disease. However, few bariatric surgery patients are prepared for a lesser-known aftereffect: a thinner facial appearance that may take some time to match their body.

After bariatric surgery, your stomach can hold far less food than before (Just an ounce or two immediately after the procedure and slightly more later). This means your calorie consumption is restricted, resulting in rapid weight loss. Every part of your body will change, and the face and neck are no exception. As you lose fat, you might see sagging excess skin in jowls or a double chin. And the older you are, the more pronounced the effect can be, though genetics, the amount of weight lost, and the speed at which the weight was lost all play a role.

So, does improving your health with bariatric surgery mean you must accept the facial changes accompanying it? Not at all. Many procedures are available to restore a more youthful look after your surgery. It’s just a matter of finding the ones that work and having them performed at the right time.

Remember: Timing Is Everything

When restoring your facial fullness after weight loss surgery, don’t be too quick to seek treatments. It’s best to wait until you are close to your goals – otherwise, you might see diminished results. Talk to your doctor about how long you can expect to lose weight. (Most patients see their weight loss begin to level off after about a year and a half after surgery.) When the time is right, you might consider one or more of the following treatments:

Dermal Filler

This is one of the quickest and least-invasive options for restoring a youthful look to your facial skin. It can be done at a doctor’s office within a few minutes and has little downtime afterward. Dermal fillers are injected just underneath the skin and work by adding volume and smoothing fine lines and wrinkles. Weight loss surgery patients often opt for filler in their lips or cheeks. If your eyes are sunken, you can also consider getting filler in your tear trough – the line extending from the inner corner of your eye to your cheek. Fillers usually last about 12 months before the body metabolizes them.

Neck Lift

Sagging skin on your neck after weight loss surgery can create a “turkey neck” look. However, there are a few surgical procedures to address it. The first, cervicoplasty, involves removing excess neck skin. Another, known as platysmaplasty, removes saggy skin and tightens the platysma muscle in your neck. Many dermatologists also offer non-surgical options to improve the look of the neck, especially if the needed improvements are minor. If you are interested in a neck lift, speak to your bariatric surgeon, who can work with you to schedule a consultation with a plastic surgeon. With surgery, however, you must be especially careful as there is significantly more risk because of anesthesia. As such, we ask our patients to wait at least 18 months and sometimes two years before surgery.

Facelift

People who lose significant amounts of weight after being obese or overweight are often left with large amounts of excess facial skin, leading to droopiness and a “deflated” look. A facelift procedure, known as a rhytidectomy, removes excess skin, repositions facial tissue, and sometimes moves the underlying muscles. The surgeon can often perform a brow or eyelid lift simultaneously if needed. The result is a rejuvenated look. Several techniques can be used for a facelift; when choosing a plastic surgeon, ensure they’ve had experience working with weight loss patients to address their specific needs.

Microneedling

If you’ve got milder skin laxity after weight loss, you may be able to use a minimally invasive treatment like microneedling to help improve the elasticity of the skin on your face. Microneedling applies tiny needles to problem areas of your face, creating wounds. The “injuries” stimulate your body’s healing response. As your skin heals from the needle pricks, it will become smoother and more youthful looking. Microneedling is incredibly convenient because it’s performed in a doctor’s office on an outpatient basis, with little to no downtime after the procedure.

The Bottom Line

A surge in the popularity of facial aesthetics has opened the door for new and exciting surgical and non-surgical treatments. While we want to help our bariatric patients find the most appropriate aesthetic options, it’s also incumbent upon us to caution them about the potential pitfalls. Beyond the cost and possible risk of getting these aesthetic options performed, any intervention, especially surgery, must be timed appropriately after the bariatric procedure to ensure safety and effectiveness. Always include your bariatric surgeon in any conversation about follow-up surgery and aesthetic procedures as you lose weight.