Many patients who come to my practice are interested in bariatric or weight loss surgery, but worried about excess skin afterwards.
This is a reasonable concern. Many patients lose so much weight, over 100-200 lbs in some cases, and up with loose or sagging skin. This is related to the fact that their skin, which expanded around their body mass, does not have enough elasticity to shrink back down with the rapidity of their weight loss.
That being said, the extent of loose skin depends on a number of different variables: the patient’s old weight, age, smoking history, and genetics. The rapidity of weight loss also affects the propensity to develop loose skin. For example, patients who opt for duodenal switch (which results in very rapid weight loss) may experience more loose skin than those who opt for a Roux-en-Y gastric bypass.
What are some of the problems that come with excess or loose skin? Patients tell us that excess skin can cause chafing and rashes, and sometimes infections. For many patients, these are less of a concern than the overall cosmetic appearance of excess skin.
There are some surgical and non-surgical options to help reduce the appearance of loose or excess skin. We counsel that our patients follow a balanced diet with plenty of vitamins (A, B, C, E, K) and protein, participate in regular exercise (particularly weight-lifting and strength-building exercises that build muscle), drink at least 64oz of water daily (increases skin elasticity), and taking care of your skin (we recommend brushing your skin with a bristle brush to increase circulation in your skin).
Finally, we can help recommend and refer patients to plastic surgery if you express interest in cosmetic surgery such as a tummy tuck to remove excess skin from your body. The National Institutes of Health found that 2/3rds of patients reported a good outcome from cosmetic surgery. Typically, we recommend to wait to pursue surgical body contouring until after your weight has stabilized at your new size for about 6 months (usually around 18 months after the bariatric surgery). In terms of finding a plastic surgeon, we recommend starting with those listed on the American Society of Bariatric Plastic Surgeons website.
Ultimately, we would advise you not to let concerns about excess or loose skin deter you from pursuing bariatric or weight loss surgery. While this concern is very human and understandable, know that the health and psychological benefits of weight loss go a long way to improving one’s quality of life. Further, the tendency to develop loose skin is both contingent on a number of factors, and can be managed with both nonsurgical and surgical solutions.