In a case like this, it is going to require a combination approach. Firstly, we need to look at treatments to stimulate collagen and elastin production in the skin, to get the skin's elasticity as restored as possible and to start the action of tightening up the loose skin. treatments such as ND:Yag Skin tightening, Radiofrequency, carboxytherapy, Needling and Titan are all possible treatment options. The second thing that will need to be addressed is the issue of volume loss. Often when someone loses a lot of weight, they also lose facial volume, causing the skin to sag and look aged, so replacing some of the lost facial volume with dermal fillers can be extremely helpful. Lastly, a good homecare regime needs to be planned for you, in order to hydrate, restore and protect your skin. Good medical topicals go a long way to reinforce and maintain your treatment results.