Loose Skin vs. Excess Body Fat

Both loose skin and excess or stubborn fat can significantly impact the body's shape and contours.

Although loose skin and excess fat affect different parts of the anatomy, they can be easily confused with each other. However, understanding the differences is crucial in determining the best treatments and achieving the highest-quality results.

Many individuals who experience fat or loose skin concerns find that it affects their confidence and comfort in several ways:

Impacting the fit of clothing, especially close-fitting sportswear or swimwear
Reducing confidence in intimate relationships
Physical discomfort caused by skin irritation or mobility concerns
Hygiene challenges which may lead to additional health complications

Body contouring surgeries are among the most popular procedures in the UK. As well as enhancing aesthetics, they effectively address functional concerns, improving quality of life.

Cadogan Clinic has brought together a team of the UK’s leading Consultant Surgeons, specialising in body contouring to address loose skin and stubborn fat.

What is Loose Skin?

Loose or excess skin is skin that has stretched and hangs away from the body. Whereas skin typically sits closely to the body, moving with the underlying tissue and muscle, loose skin tends to be more mobile and can move independently.

Although any part of the body can develop loose skin, it is most common in the:

Abdomen
Upper arms
Inner thighs
Buttocks
Breasts

The skin in these areas is often naturally stretchier, making it more prone to becoming loose.

Loose skin is not usually inherently dangerous to an individual’s health. But it can impact confidence and quality of life:

Impact on body contours and self-image
Chafing and skin irritation caused by friction
Hygiene challenges caused by difficulties in maintaining cleanliness in deep folds of skin

What is Excess Fat?

Excess body fat is characterised by an accumulation of fat throughout the body.

Fat deposits can build up anywhere on the body, but common areas that people have concerns about include:

Abdomen
Waist
Hips
Thighs
Arms
Buttocks

Although the body requires a certain amount of fat to provide structure and insulation, too much excess fat may be associated with certain health and aesthetic concerns:

Disproportionate body contours
Stubborn pockets of fat which are resistant to traditional weight loss methods
Mobility challenges and physical discomfort
Loss of confidence and self-consciousness

Placement of Excess Fat

Fat accumulates in two layers in the body:

Subcutaneous fat – This sits between the skin and above the muscle
Visceral fat – This sits underneath the muscle, surrounding the internal organs

Although too much excess fat in any area can be a concern, excess visceral fat is considered more harmful to health as it releases inflammatory hormones, which increase the risk of developing associated health conditions.

It is important to understand the placement of fat around the skin and muscle, as it affects the possible treatments.

Infographic showing the placement of subcutaneous and visceral fat between the skin and muscle

What Causes Loose Skin and Excess Fat?

Understanding the causes of loose skin and excess body fat is important in deciding on the best treatment to address your concerns.

Although many individuals will be aware of the cause of their concerns, for those with any uncertainty, speaking with a Consultant Body Surgeon ensures a comprehensive assessment and diagnosis.

Loose Skin Causes

Loose skin has many causes; however, it generally arises from conditions that stretch the skin beyond its ability to retract.

Common loose skin causes include:

Ageing

As we age, collagen and elastin, key structural proteins in the skin, break down and are produced more slowly. This causes the skin to become weaker, which can result in stretching.

This is a particular concern in areas where the skin is naturally thinner and stretchier anyway, such as the upper arms and inner thighs.

Weight Loss

Especially in cases of dramatic weight loss, the skin isn’t able to retract as the underlying fat depletes. This can also occur if large amounts of weight are lost very rapidly, or if an individual has experienced ongoing weight fluctuations over a long period of time.

In some cases, Weight Loss Medication may also exacerbate the development of loose skin. This is usually due to dramatic weight loss in a short time, combined with the potential loss of muscle mass sometimes linked to these medications.

Typically, the buttocks and the face are the worst-affected areas, sometimes referred to as Ozempic Butt and Ozempic Face.

Pregnancy

Pregnancy is a common cause of loose skin around the abdomen. As the baby grows, the abdomen expands, leading to the skin stretching.

After the baby is born, the abdomen typically returns to its original shape, but the skin may not be able to fully retract, causing loose skin, particularly around the lower abdomen.

This concern may be exacerbated after multiple pregnancies, where the skin has stretched and retracted several times over a number of years.

Excess Fat Causes

Stubborn fat deposits can develop for many reasons, and weight gain, as a broader concern, is very personal and often sensitive.

Causes of excess body fat include:

Genetics

Genetics play a strong role in the way the body uses energy and distributes fat.

Individuals who have direct family members who have stubborn deposits of fat, which impact the contours and comfort of the body, may find they experience the same concerns.

The severity of these concerns may vary among family members, and other relatives may not experience them at all.

Underlying Health Conditions

Medical conditions such as an underactive thyroid gland (Hypothyroidism) can cause unexplained fat to accumulate.

This typically resolves once the condition is diagnosed and is being managed effectively with medical supervision.

Other health conditions which can cause excess fat include:

Polycystic Ovary Syndrome (PCOS)
Cushing’s Syndrome
Mental health concerns, such as high stress and depression

Calorie Intake

Your body requires calories for energy. However, regularly consuming more calories than the body can use leads to increased fat levels.

This fat can accumulate in any part of the body; however, the abdomen is often disproportionately affected.

How to Tell the Difference Between Fat and Loose Skin?

Excess body fat and loose skin are often confused, as they both affect the shape and contours of the body.

This can cause frustration as individuals may attempt to lose weight to address excess fat, when the cause of their concerns is loose skin, which will not respond to weight loss.

Being able to determine the difference between loose skin and fat ensures the most suitable and effective treatment.

Signs of Loose Skin

Common signs and symptoms of loose skin are:

Skin which hangs away from the body, often forming folds
Feels thin and crepey, lacking firmness
When pinched, it snaps back slowly or not at all
Easily stretches
Moves independently of the underlying tissue

Signs of Excess Fat

Signs of excess fat depend on the type of fat present:

Subcutaneous fat:

Gives a fuller appearance with limited sagging
Feels soft and dense
Returns to its original position quickly when pinched
Overlying skin typically looks smooth and has a malleable texture

Visceral fat:

Typically cannot be pinched through the skin
Feels firm and smooth – resulting in a ‘beer belly’
Skin is usually pulled tight over the area

Can You Have Loose Skin and Excess Body Fat Together?

It is possible to have both loose skin and excess body fat at the same time.

Typically, the visual signs of loose skin are more obvious than the underlying excess fat, as the fat will not fill out the skin.

However, it may be possible to feel the excess fat under the loose skin when it is pinched. The fat may feel uneven in different areas, affecting the contours and balance of the body.

The Best Treatments for Loose Skin and Excess Fat

For long-lasting, effective treatment of both loose skin and excess body fat, surgical procedures are typically the best option.

Although non-surgical procedures can address both loose skin and excess fat, their results are often limited and may not provide long-term relief.

How to Treat Loose Skin?

There are several options for effectively treating loose skin:

Body Contouring Surgeries

Body Contouring Surgery can be performed on various areas of the body, depending on a patient’s specific concerns.

These procedures typically involve removing excess skin and tightening the underlying muscle and tissue to create a toned and proportionate appearance.

Abdominoplasty – One of the most popular Body Contouring procedures, also known as a Tummy Tuck, loose skin is removed from the upper and lower abdomen, and the muscles are tightened and repaired
Arm Lift – Also known as a Brachioplasty, this procedure tones the upper arm skin, addressing bingo wings by removing excess skin and tightening the muscle
Thigh Lift – To tone and balance the inner or outer thighs, a Thigh Lift creates proportionate upper legs by removing loose skin and repositioning and tightening the underlying muscle
Buttock Lift – To address sagging buttocks, the excess skin is removed and the gluteal muscles are tightened

All Body Contouring surgeries are performed under general anaesthetic, and typically take 2-4 hours to complete, depending on the extent of the procedure.

Breast Lift

Also known as Mastopexy, Breast Lift surgery involves removing excess skin from the breasts and repositioning the breast tissue to create lifted and balanced breasts.

The procedure involves an anchor-shaped incision made underneath the breast and running up to the nipple.

Breast Lift typically takes 2-3 hours to complete and is performed under general anaesthetic.

Body Lift

Body Lift surgery involves combining various loose skin removal procedures to create a bespoke treatment for patients concerned about excess skin, especially following dramatic weight loss.

Upper Body Lift – Typically combines Abdominoplasty, Arm Lift and Breast Lift
Lower Body Lift – Typically combines Abdominoplasty, Thigh Lift and Buttock Lift

Depending on the extent of the procedure, Body Lift can either be performed as a single surgery or over multiple stages. It can take up to 5 hours to complete, and is carried out under general anaesthetic.

Mummy Makeover

Mummy Makeover surgery is a combination of procedures carried out to address post-pregnancy concerns.

It often involves performing an Abdominoplasty with Breast Lift, Breast Reduction, or Breast Augmentation to reduce excess skin and tone the midriff and breasts.

Mummy Makeover can be performed as one procedure or split into stages. It is carried out under general anaesthetic, and depending on the extent of the procedure, usually takes up to 4 hours to complete.

BodyTite

BodyTite is an innovative and minimally invasive surgical procedure which is suitable for treating mild to moderate loose skin.

A small incision is made in the treatment area, before a radiofrequency probe is inserted under the skin. This encourages the production of collagen and elastin, allowing the skin to tighten during the recovery period.

BodyTite is suitable as a standalone procedure for mild to moderate cases of loose skin, but can also be combined with other loose skin removal surgeries to enhance the final results.

It is performed under general anaesthetic and takes 1-2 hours to complete, depending on the number of treatment areas.

How to Treat Excess Fat?

Addressing excess and stubborn fat is often highly personal, requiring careful, bespoke treatment.

The best treatment for excess fat depends on the extent of the concern and the desired results of the patient.

Liposuction

Liposuction is a Body Contouring procedure that addresses stubborn fat deposits under skin in various areas of the body.

It can be performed in almost any area of concern, but popular treatment areas for Liposuction include:

Abdomen
Waist
Hips
Thighs
Arms
Buttocks

It is important to remember that Liposuction is not a weight loss procedure, and patients should have maintained their ideal weight for 6-12 months ahead of surgery to ensure they can maintain their results.

To prevent loose skin from forming after Liposuction has been carried out, BodyTite can be combined into the same procedure to tighten the skin.

Liposuction is performed under general anaesthetic, and depending on the number of treatment areas, usually takes 1-3 hours to perform.

Weight Loss Medication

For patients who have extensive excess fat which has been resistant to other weight loss methods, Weight Loss Medication can be a highly effective and life-changing treatment.

There are several options available depending on the patient’s needs:

Injections – Ozempic, Wegovy and Mounjaro are all injectable Weight Loss Medications which suppress the appetite and make the patient feel fuller for longer, limiting calorie intake
Tablets – Orlistat prevents around a third of the fat from the food you eat from being absorbed. When paired with a controlled diet, this prevents further weight gain and can also encourage weight loss.

It is essential that Weight Loss Medication is properly supervised by a qualified doctor to avoid unwanted side effects and achieve the best results.

Treating Combined Loose Skin and Excess Body Fat

For patients who are concerned about both loose skin and excess fat, Body Contouring surgeries can be combined with Liposuction to achieve the highest-quality results.

Liposuction can be carried out alongside:

Abdominoplasty – Known as a Brazilian Abdominoplasty
Arm Lift
Thigh Lift
Buttock Lift
Body Lift
Mummy Makeover

By removing stubborn areas of fat before removing loose skin, the remaining skin sits more smoothly when repositioned, making this a popular option for many patients.

Words From Our Founder

Mr. Bryan Mayou

Both loose skin and excess fat are common concerns affecting body contouring, mobility and comfort. Since I introduced Liposuction to the UK over forty years ago, it has been highly gratifying to see how this procedure has been developed and utilised to enhance the results of other procedures, as well as being a highly effective standalone procedure.

Mr. Bryan Mayou

Frequently Asked Questions

What does fat look like under the skin?

Fat which is placed under the skin, but above the muscle, is known as subcutaneous fat.

It creates a soft shape, filling out the overlying skin, with a spongy feeling when pressed inwards.

Why is belly fat so stubborn?

Many people find that belly fat is especially stubborn and resistant to weight loss methods such as dieting or exercise.

Stubborn belly fat is metabolically active, meaning that it is influenced by hormones such as cortisol (the stress hormone). It also contains specific receptors that protect the fat, meaning it releases less energy than fat in other parts of the body.

These factors make stubborn belly fat especially tricky to address for many people.

What does fat feel like under the skin?

The feeling of subcutaneous fat under the skin is one of the key signs in distinguishing it from loose skin.

The pinch test is one of the best methods for telling the difference between excess skin or belly fat. When the tissue is pinched gently:

Excess skin feels stretchy and thin, it doesn’t retract back to its original shape quickly
Stubborn fat feels soft and thicker, it retracts back into shape quickly, similar to a sponge

Are bingo wings fat or loose skin?

Bingo wings are the sagging areas of tissue affecting the upper arms. They can be made up of either loose skin or fat, or both.

To tell the difference between arm fat or loose skin, there are a few signs to consider:

Loose skin is more mobile, and may appear to move independently of the upper arm
Arm fat will feel softer and spongier, retracting back into shape quickly when it is pinched

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