Excess Skin Removal After Losing Weight
After losing a considerable amount of weight, you may be left with unwanted loose excessive skin. Other causes of excess skin can be aging, genetic disorders, or an intentional expansion for skin reconstruction. Here we will discuss remedies for excess skin removal after losing a significant amount of body weight.
Excess Skin After Weight Loss
When a person loses a lot of weight, extra skin is left behind, which may droop from the body. However, not everyone who loses weight is left with excess skin. Some people are more prone to have excess skin due to loss of skin elasticity.
Factors That Influence the Loss of Skin Elasticity
- Duration of being overweight: The longer a person has been overweight, the droopier their skin will be after weight loss.
- Quantity of weight lost: Weight loss of more than 40 kg is considered to be a major risk to develop excess skin.
- Age: As people age, there is less collagen than younger skin, which makes the skin more prone to become loose and saggy following weight loss.
- Hereditary: Genes may also influence how your skin reacts to weight changes.
- Sun exposure: Sun exposure has been shown to reduce skin collagen and elastin generation.
- Smoking: Smoking causes a decrease in collagen generation resulting in inflexible skin with poor elasticity.
What Are The Issues Related to Having Excess Skin?
Excess skin hanging off the belly, legs, arms, and breasts can cause both pain and discomfort. Studies have shown that people are uncomfortable with excess skin to such a severity that it can even interfere with daily activity. There is also an increased risk of skin irritation, ulcers, and infection due to excess skin. Excess skin can have negative effects on body image and mood resulting in mental disorders such as depression, body dysmorphia anxiety, and poor self-esteem.
Who is a Good Candidate for Excess Skin Removal Surgery?
An ideal candidate is someone who:
- Has a sudden and massive weight loss but is unhappy with the leftover sagging and excess skin.
- Is in good health without any medical conditions, such as high blood pressure, skin allergy, diabetes, or heart disease.
- Has reached their goal weight and has maintained a stable weight for 6-12 months.
- Has healthy lifestyles without any nutrients deficiencies as this can hinder healing.
- Is a non-smoker
How to Prepare for Excess Skin Removal Surgery?
Surgeons will ask clients to follow some guidelines prior to surgery, which includes:
- Stop smoking at least six weeks before surgery because smoking delays the healing process and increases complications during and after surgery.
- Individuals using oral contraceptive pills must stop taking them before surgery as it can cause blood clots and increase the risk of deep vein thrombosis.
- The client is happy to be kept on a high protein diet one month before and after surgery to decrease the risk of poor wound healing.
- The client should also be happy to take 4-8 weeks off from going to the gym and performing strenuous exercise following skin removal procedures.
What Are The Pros and Cons of Removing Excess Skin?
There are always some pros and cons to every procedure. Some of them are listed below:
- Get rid of excess skin and look good in tight-fitting clothes.
- Boost your confidence.
- Make you look more youthful.
- Feel less stress on the back after excess skin removal surgery.
- Risk of scars after the surgery.
- The surgery outcomes may be influenced or altered by increased weight, lifestyle preferences, and aging even after the surgery.
- It’s expensive and is only partly covered by insurance.
- Sometimes, surgery may not meet the desired expectations.
- Like other surgical procedures, excess skin surgery does come with risks, such as a collection of blood, fluid and infections. Sometimes the blood supply is compromised and results in poor healing and wound breakdown.
- The recovery can be painful because of large incisions required to remove the excess skin
- Time needs to be taken off from work for recovery.
Can I have multiple skin excisions from different parts of my body in the same procedure?
The decision as to which areas of the body need treatment are decided at your initial consultation with Dr Doyle. Several areas of the body can be treated in one procedure and Dr Doyle will make a decision if one, two or three separate operations are required depending on the time taken to perform the procedure. Extremely large amounts of weight loss with poor skin elasticity will result in more skin to be removed, and hence longer operation times.
Types of Excess Skin Surgeries
Various body contouring procedures can remove excess skin after significant weight loss, and these include:
The pannus is the term for excess skin of the lower abdomen that commonly appears after postpartum and weight loss. A panniculectomy reduces the excess skin from the lower belly. The incision is the same as in a tummy tuck, which is located just above the pubic bone. It improves the client’s comfort and helps clothing fit better by restoring a smoother and firmer body.
Lower Body Lift
This technique contours the hips, outer thighs, belly, waist, and buttocks through a cut made around the girth of the body. It is done for those who have relaxed skin in the hips, the front, back and outer side of the thigh, buttocks, and abdomen. Dr Doyle tightens stretched abdominal muscles then reduces excess, drooping skin from the front, back and sides of the body, and lifts the remaining tissues to give a firmer, more shapely lower body appearance. A body lift does not change the appearance of the inner thighs.
Back Lift/Bra Line Back Lift
The technique used in bra line back lift surgery combines liposuction and skin removal to reduce bra rolls and restore a smoother, firmer upper back contour. Incisions are generally found along the bra line, where scars can be easily hidden by clothing.
Tummy Tuck reduces excess skin, and fat of the abdomen, removing stretch marks and tightens skin in the upper and lower belly. The scar will be along the natural crease within the bikini line and a circular scar around the umbilicus.
Liposuction can modify the shape of the hips, chest, flanks, thighs, neck, upper arms, and knees. It is often used with other plastic surgery procedures following dramatic weight loss to refine the contours of the body and allow the remaining skin to be pulled tighter. Liposuction without skin excision will make droopy skin worse.
Most of the female clients are worried about sagging breasts after weight loss. A breast lift will place the breasts in a higher position on the chest wall, correct sagging nipples, correct breast asymmetry and reshape the areolas. Breast implants can be done during a breast lift to increase the size and replace lost volume.
Upper Arm Lift
An arm lift is also called Brachioplasty. After drastic weight loss and aging, the skin of the upper arms become loose and flabby. Through an incision along the inside of the upper arm, excess skin and fat are removed to create a firmer, more shapely upper arm appearance.
Thigh Lift and Buttock Lift
Thigh lift surgery reduces extra skin and fat of the outer thigh and removes excess skin from the buttock area to create tighter, lifted and more shapely buttocks. The scars are placed within the bikini line where scars can be hidden by a swimsuit.
Inner Thigh Lift
Excess skin and fat of the inner thighs can be removed by inner thigh lift surgery. The technique involves using liposuction to remove extra fat and loosen the skin and then by using a vertical incision down the inside of the thigh, remove excess skin and fat.
Male Chest Lifts
After significant weight loss men may be left with drooping skin of the chest. Male chest lifts can remove excess skin and fat to make a flatter and firmer chest appearance.
Recovery after Excess Skin Removal
The recovery will depend on the methods that were used for excess skin removal. For example, you can go back to work within one week and be prepared to continue exercise within one month if the surgery you are getting is only an upper arm lift or breast lift. For lower body lift, you will need a longer recovery and may also require a short hospital stay. You may need 6 plus weeks of rest before going back to work or performing any strenuous exercise.
Results from Excess Skin Removal Surgery
Individuals who are overweight or obese often obtain outstanding results from excess skin removal. It is not uncommon for patients who have had this surgery to lose more weight because of an increase in the ability to exercise because of the removal of skin folds.
Cost of Excess Skin Removal
A plastic surgeon’s expense for body contouring surgeries will depend on the areas of the body that need treatment and how much loose skin needs to be removed. Body contouring expenses includes anaesthesia fees, hospital charges, lab tests, surgeon fees, medication, etc.
For more information on this, please view our pricing resources:
Excess Skin Removal Surgery Frequently Asked Questions
What occurs during the removal of excess skin?
These are often treated with liposuction to achieve maximum fat loss and better contours before the excess skin is removed. All wounds are then sutured using multiple layers of stitches and dressings applied. All areas then have pressure garments placed over them to minimise swelling and fluid collection following the surgery.
Often with large skin excisions, Dr Doyle will routinely use suction drains and pain pumps. A pain pump consists of a small plastic bottle filled with a local anaesthetic. This automatically injects local anaesthetic through a small plastic tube under the skin to minimise pain following the surgery. These are most commonly used after body lifts and abdominoplasties.
What happens after the removal of excess skin?
Healing from excessive skin removal techniques can take time. After the procedure, clients need to stay in the hospital for 24-48 hours. Mobilisation will occur within 24 hours of the surgery. Most patients will go home one to two days following surgery usually with pain pumps and drains still connected. An appointment is made in Dr Doyle’s office three to four days following the surgery to remove dressings and any drains still attached.
How lengthy is skin removal surgery?
Dr Doyle decides on the quantity of skin to be removed and the area depending on which areas the patients hate the most. At that time an estimate will be made as to how long the surgery will take. It varies from person to person, for some, it can take 2 hours, and for some, it can take 5 to 7 hours.
How comfortable is skin removal surgery?
It is normal to feel nervous regarding possible pain during or after surgery. Dr Doyle works with his anaesthetists to make your surgical experience as pain-free as possible. This includes pain medication given intravenously, with tablets and pain pumps. You will be given pain killers and antibiotics to take when you leave the hospital.
What are the complications and risks of excess skin removal surgery?
Excess skin removal surgery, like any other surgery, can result in some complications. Some of these include:
- Bleeding at incision sites
- Blood loss
- Nerve injury
- Numbness and persistent pain
- Fluid collection (seroma)
- Blood collections under the skin (haematoma)
- Blood clots in the leg veins (DVT) and pulmonary emboli
- Reaction to stitches
The most common complication is a fluid collection under the skin. Drains are often used to minimise this problem and these usually resolved after one to three weeks.
Will I have loose skin after losing weight?
For those who have lost small quantities of weight, the skin will likely tighten on its own. People who have accomplished large weight loss may need medical procedures to tighten their loose skin.
How long does it take for skin to regain elasticity?
Skin may never regain its elasticity in those patients who have been overweight for a long period of time.
Does excess skin removal leave scars?
There will be scars, but most of them will fade after some time. Scar management using multiple types of treatment are important in these patients to achieve the best results
What is the ideal weight for abdominoplasty?
The best results from these procedures occur when the patient’s weight is as close as possible to their goal weight. Most surgeons would not consider these procedures in patients with a BMI over 40. For more information on this, view our blog Ideal Weight and Best BMI for Abdominoplasty.
Book a Consultation
If you would like more information, or to book a consultation with Dr Doyle, please contact us today.
- The Best BMI and Ideal Weight for Abdominoplasty
- How to Know if Your Abdominal Muscles Were Torn During Pregnancy
- Will Medicare Cover my Abdominoplasty Tummy Tuck?
- Bra Line Back Lift Surgery for Excess Loose Skin (and Stubborn Back Fat)
- How to Lose Weight Before Surgery
- Combining Plastic Surgeries: When Can Multiple Procedures Be Combined?
- Dixit, VV; Wagh, MS (May 2013). “Unfavourable outcomes of liposuction and their management”. Indian Journal of Plastic Surgery. 46 (2): 377–92. doi:10.4103/0970-0358.118617
- Seretis, Konstantinos; Goulis, Dimitrios G; Koliakos, Georgios; Demiri, Efterpi (2015). “Short- and Long-Term Effects of Abdominal Lipectomy on Weight and Fat Mass in Females: A Systematic Review”. Obesity Surgery. 25 (10): 1950–8. doi:10.1007/s11695-015-1797-1
- Hernandez, Teri L; Kittelson, John M; Law, Christopher K; Ketch, Lawrence L; Stob, Nicole R; Lindstrom, Rachel C; Scherzinger, Ann; Stamm, Elizabeth R; Eckel, Robert H (2011). “Fat Redistribution Following Suction Lipectomy: Defense of Body Fat and Patterns of Restoration”. Obesity. 19 (7): 1388–95. doi:10.1038/oby.2011.64. PMID 21475140. S2CID 35092104.
About Dr Mark Doyle FRACS (Plast) – Queensland Plastic Surgeon
Servicing patients in Gold Coast, Brisbane, Sunshine Coast, Cairns and New South Wales NSW – Northern Rivers, Byron Bay, Ballina, Lismore and more.
Dr Mark Doyle is a Specialist Plastic Surgeon with over thirty years of experience performing Breast, Body, Face and Nose surgery. As a highly esteemed plastic surgeon, Dr Mark is driven by an intense passion for helping patients achieve a happier, more beautiful self through advanced cosmetic surgery procedures.
He maintains a strong commitment to achieving the best possible results for all his breast, body, face and nose patients, both men and women.