Tightening up stretched-out skin

July 21, 2003|by KATE COLEMAN

Your skin really keeps it all together.

The largest organ of your body, skin performs many essential functions.

It prevents substances - germs and chemicals - from entering. It prevents essential body fluids from escaping.

Although skin itself is susceptible to damage from the sun, it protects underlying tissues from harmful rays.

Skin helps to regulate body temperature, and it contains the nerve endings that sense pain, pressure and touch.

Skin is flexible. It stretches to accommodate the big belly of a pregnancy. It expands with a gain in weight.

To a point - and that point is different for different people - skin is resilient. It bounces back.

What can you do if your skin hasn't bounced back after you've lost weight? What can you do about that sagging skin?


The answer, my friend, may not be blowing in the wind, but if you feel like your triceps are, read on.

Cindy Davis lost 76.8 pounds in less than a year. Her clothing size has dropped from 18 to 6.

Davis, 50, says she lost weight by joining Weight Watchers last August. She previously had avoided the more than 40-year-old international weight management organization, telling her friend who leads area Weight Watchers groups, "I'm not ready to eat salads every day of my life."

She learned she didn't have to, joined and lost weight.

But then: "I'm losing all this weight, and I still look terrible," she said.

In March, Davis started working out - under the guidance of trained fitness technicians at Curves for Women, a fitness center that is one of 6,000 franchises in the United States and beyond, according to Jean Clark, manager at the Hagerstown location. Davis is committed and enjoys her three-days-a-week 30- to 40-minute sessions on body-part specific, hydraulic-resistance exercise equipment.

The time has helped her skin look more toned.

"Actually, I look really good," Davis says. The "dimply skin" on her thighs is gone, she adds.

Although there are individual differences in skin elasticity, and everyone's skin elasticity weakens with age, strength training is important, says Angela Kershner, exercise specialist at Washington County Health Department. Strength training - working muscles enough to feel it, or to the point of fatigue - may help to reduce the appearance of loose skin, she explains.

Mathew McIntosh, director of the Hagerstown Community College Wellness and Cardiac Rehabilitation Center, would agree. Toned muscles pull everything up, he says.

Toned muscles also can increase metabolism - staying active even while you're sleeping. The cells do what has to be done to stay alive and burn calories at the same time, according to the Web site of the National Institute on Aging at

Heredity is responsible for 80 percent of your body type, McIntosh says. Although control of 20 percent may not seem like much, over a lifetime, it's a lot, he says.

"It's important to be realistic," Kershner says. Skin elasticity declines with age. Yet another reason to exert control where you can. Avoid unnecessary weight gain, she adds.

There are plastic surgery options.

A tummy tuck, or abdominoplasty, and the more extensive panniculectomy remove excess fat and skin from the abdomen while tightening the muscles along the abdominal wall, according to the Web site of the Columbia University Department of Surgery at

So far, Samuel Clingan hasn't opted for the surgical removal of excess abdominal skin his doctor said he might need.

The 53-year-old Hagerstown resident has lost 320 pounds since he had gastric bypass surgery in March 2002. He says he was "just about wheelchair-bound" prior to his operation. Although he hasn't embarked on a rigorous formal exercise regimen, he's walking and able to go up and down stairs and work in the yard. The skin on his stomach is not really a problem, he says.

Other plastic surgeries after weight loss include brachioplasty, which removes excess skin and fat from underneath the arms, and belt lipectomy, which includes the abdomen, but extends around the body, according to the Web site of the American Society of Plastic Surgical Nurses at

None of these operations leave small scars, says Cherish Eby, a certified physician's assistant in the Hagerstown plastic surgery practice of Dr. Salvatore DiMercurio.

Also, such surgery usually is considered cosmetic and therefore not covered by health insurance, Eby says.

Chris Anne Beardslee, special programs coordinator at Results Therapy and Fitness in Chambersburg, Pa., says that a long-term approach to weight loss through diet and exercise - most guidelines recommend no more than two pounds per week - yields better results and limits sagging skin.

Kershner advises people who have achieved weight loss and are experiencing "loose skin syndrome," to look on the bright side - keep eating better, keep exercising and be happy with what you've accomplished.

Cindy Davis is happy about her weight loss and smaller size, and the benefits eclipse any problem with sagging skin.

She says she can outdo her adult daughters during a walk. She feels stronger. "I feel 100 percent better," she says.

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