Losing weight takes time and effort. Still, while some people revel in their accomplishments after reaching a goal weight, others may feel less at home in their new body — literally. After significant weight loss, many people experience physical or emotional side effects from having saggy, loose skin around a now-smaller frame.
Skin removal surgery is a surgical option available for people lacking confidence and comfort in their post-weight-loss skin. Skin removal surgery after weight loss can be used for medical or cosmetic reasons.
[READ: Factors That Contribute to Weight Loss and Weight Gain]
What Is Skin Removal Surgery?
Skin removal surgery is a procedure designed to remove excess body skin and/or fat. It is often performed for patients who have lost a significant amount of mass and now have excess loose skin that does not outline their new body composition as closely as it did their former frame. Loose skin can be related to various kinds of weight loss, including if you lost a major amount of weight due to diet and exercise, procedures like bariatric surgery, weight loss medications like GLP-1s or life events like pregnancy. Aging, can also increase the likelihood of developing loose skin that warrants surgical removal.
The extent of loose skin is based on a number of factors, including:
— How quickly the weight is lost
— The percentage of total body weight lost
— How long you were at your starting weight
— Age
To understand how weight changes can result in loose skin, Dr. Mir Ali, a board-certified bariatric surgeon and the medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California, says, “You can think of your skin having elastic fibers — kind of like a balloon. If you overstretch that balloon, because of weight, then that patient will typically end up with loose skin.”
In contrast to fat loss, however, which can at times be lost through diet and exercise, severely overstretched skin doesn’t “shrink back” or typically go away on its own.
“People think oh if they just exercise, they could take care of it,” Ali says. “That’s not usually the case. It’s not a matter of exercising. It’s skin that’s overstretched and has to be removed.”
Today, skin removal surgeries are fairly common, and some procedures appear to be rising in popularity. On social media, certain influencers even use their platforms to shed light on real-life experiences with skin removal surgeries — documenting their surgery preparation and recovery through photos and videos. Not everyone who undergoes skin removal surgery is vocal about it, however, and some may choose to keep conversations safe with a trusted group of friends.
“Not everybody talks about it,” Ali says. “There are people who are more vocal about it on social media and things, but it’s not something that people commonly discuss.”
Types of Skin Removal Procedures
There are various types of skin removal procedures, many of which target different body parts. Some patients may opt for multiple skin removal procedures, whereas others may stick with one option. Many procedures can also be personalized to meet individual needs or goals.
Some types of skin removal procedures include:
— Tummy Tuck (Abdominoplasty): The tummy tuck, which is formally known as abdominoplasty, removes excess skin and fat from the abdominal area, creating a tighter body contour around the stomach muscles. This procedure was the third most popular cosmetic surgery from 2020 to 2023 (following liposuction and breast augmentation), according to the most recent Plastic Surgery Statistics Report from the American Society of Plastic Surgeons.
— Panniculectomy: A panniculectomy is a skin removal surgery that addresses skin hanging below the belly button in an apron formation, known as a pannus. A panniculectomy tightens the skin around the lower stomach, similar to a tummy tuck, but tends not to significantly contour the abdominal region.
— Lower Body Lift: Lower body lifts are skin removal surgeries that remove excess skin and/or fat from the lower torso and upper limbs — such as the buttocks, hips and thighs — to contour those parts of the body.
— Arm Lift (Brachioplasty): An arm lift, or brachioplasty, is a skin removal surgery that trims excess skin from the upper arms to define their shape.
— Thigh Lift: A thigh lift, or thighplasty, is a skin removal procedure that focuses on removing excess skin and fat from the thighs, more closely contouring the patient’s leg.
— Facial Skin Removal: Facial skin removal surgeries remove loose or sagging skin from the face and neck areas, and may be conducted as part of a more comprehensive body contouring plan.
[SEE: Strategies for Gaining Muscle While Losing Weight.]
What’s the Difference Between Cosmetic and Medical Skin Removal Surgeries?
Skin removal surgeries can have medical and cosmetic purposes. For instance, some people may pursue skin removal surgeries for emotional reasons such as to look and feel more confident, whereas others may pursue skin removal surgeries for health reasons. Some may pursue skin removal surgery for both reasons.
Health effects from too much loose skin
In some cases, excess, loose skin can cause health problems because it can form folds that trap moisture and bacteria, causing infections, rashes and other irritations. Some reasons that may qualify your procedure as medical include:
— Itchy, painful rashes, called intertrigo
— Yeast infections that cause discomfort and itchiness
— Chafing that can lead to bleeding or infection
— Mobility issues as extra skin gets in the way of moving your body freely
Ultimately, if you are pursuing skin removal surgery for weight loss, the reasoning behind your decision is up to you — so long as your doctor deems your surgery safe and appropriate for your body. If you are hoping to have the cost of your surgery covered by insurance, however, your doctor will likely have to provide proof that this is medically necessary.
[SEE: Questions to Ask Before a Cosmetic Procedure]
Cost and Insurance Considerations
The cost of a skin removal procedure can vary greatly based on the type of procedure you are getting done, the complexity of your case — including how much skin or fat you are looking to get removed, how much anesthesia is needed to safely put you under and any pre- or post-operative care that you might need. Your surgeon’s expertise, popularity and geographic location may also influence costs. With that in mind, it can be smart to consider various factors about your surgery that may influence the price you pay for it, including:
— How much does your surgeon charge for their expertise?
— Does your insurance cover the procedure you are considering, and if so, under what conditions?
— If your insurance covers the procedure, how much of the procedure will they pay for? Are there any additional fees that you will be responsible for?
— Does your surgeon or surgical center offer any payment plans to help you pay for your surgery? If so, do you qualify for these?
Who Is a Candidate for Skin Removal Surgery?
Your doctor can help you understand if you are healthy enough for the procedure and, if not, what steps you may need to take before you get there.
— Stable weight. You’ll want to have reached a goal weight for your body and have maintained that for a couple months — some experts say at least six months — before the procedure.
— Overall health. Patients need to be healthy enough to undergo anesthesia and to withstand other parts of the surgery and healing process.
— Non-smokers. Smoking can inhibit the healing process, so quitting smoking before the procedure is recommended.
— Realistic expectations. Candidates should have realistic expectations about the post-surgery results. For instance, remember that skin removal surgery will not change your bone structure or anatomy.
— Lifestyle adjustments. Talk to your doctor about any preoperative requirements or lifestyle adjustments you need to make.
Preparing for Skin Removal Surgery
Each person’s anatomy is unique to them, and everyone’s journey is different,” says Dr. Dahlia Rice, board-certified plastic surgeon and founder of plastic surgery practice DMR Aesthetics in the Chicago area, explains that the extent and length of your soreness can vary based on your procedure. She encourages patients to bring “wish pics” to their surgeon in initial discussions. This can help express your desires for your results, and gives the surgeon an opportunity to correct any unrealistic expectations.
Some things to consider prior to having skin removal surgery:
— Consultation. Find a board-certified plastic surgeon for an initial consultation to discuss goals and assess if skin removal surgery is suitable for your individual situation.
— Medical evaluation. Schedule a pre-operation appointment and undergo any necessary medical tests to determine if you’re fit for surgery.
— Lifestyle adjustments. Following a healthy diet and keeping a regular fitness regimen can help to maximize results.
— Smoking cessation. Quit smoking at least six months prior to surgery for optimal healing.
[10 Ways to Prepare for Surgery.]
What to Expect During the Procedure
Prior to having surgery, it’s important to discuss with your board-certified plastic surgeon what the process entails and specific details regarding your procedure.
A few things to ask your doctor:
— Anesthesia. Typically, general anesthesia is used for patient comfort. Discuss any concerns or prior surgery experiences with your doctor that may impact the type of anesthesia. you receive.
— Incisions. Where the cuts will be, and how visible scarring will be minimized.
— Duration. How long the surgery will last and how much skin will be removed.
— Additional procedures. What follow-up procedures (if any) are needed such as liposuction.
Recovery and Aftercare
While skin removal surgery can highlight the look of your weight loss, don’t expect to show off results right away — especially at the gym. Like other intensive surgeries, skin removal surgery can require a hefty aftercare routine, which may include rest and refraining from exercise for a few weeks after the operation.
Depending on the extent of your surgery, you may expect post-operative recovery and aftercare protocols such as:
— Hospital stay. An overnight hospital stay may be required, depending on procedure.
— Medications. Prescription pain management medications needed for comfort. In some cases, you may be prescribed medications to help you manage your pain, whereas in others you may be recommended to take over-the-counter pain relievers as needed.
— Soreness or pain. You may also feel discomfort or soreness in the days following your operation. Rice explains that the extent and length of your soreness can vary based on your procedure. People undergoing abdominoplasty, for example, tend to feel “deep soreness” for two to three days after their procedure. Individuals undergoing a facial-skin removal procedure, like a neck lift, eyelid or brow lift tend to feel “more tightness more than pain.” In some cases, you may be prescribed medications to help you manage your pain, whereas in others you may be recommended to take over-the-counter pain relievers as needed.
— Bandages or compression wearables. Wearable bandages or compressive shapewear to optimize results.
— Activity restrictions. Exercise and movement restrictions typically last about six weeks.
— Follow-up appointments. Keep your appointments with your surgeon to monitor your healing and progress.
To control pain and manage results, abdominoplasty patients are often recommended to take non-opioid medications and wear a compressive binder or a faja — a type of shapewear — at night, Rice says. They can receive lymphatic massages starting week two, following the procedure. Facial-skin removal patients may be recommended over-the-counter pain medications following their procedure, in addition to wearing a facial garment and keep their head elevated for the first few nights post-operation.
Additionally, most skin-removal patients are asked to wait a full six weeks before regaining full activity after surgery. Light exercise or movement can be incorporated into your routine sooner, and walking can often be started immediately. These restrictions can be hard for some patients, particularly those who crave movement and activity, but can be a crucial part of the healing process to ensure safety and best results.
“Most people struggle with wearing tight compression garments and being unable to resume normal activities and exercise normally for six weeks, plus the possibility of minor setbacks like fluid collections or wound healing delays,” Rice says about abdominoplasty recovery. For any skin removal surgery, people may find it challenging to cope with activity restrictions or surgery side effects, like swelling, which can be a natural part of the healing process.
Rice reminds patients that swelling is normal and should subside in the weeks or months following your procedure — so long as you follow recommended recovery and aftercare routines.
“Once swelling subsides, clothes fit smoothly, which gives many (abdominoplasty) patients a major confidence boost,” Rice says.
[READ: A Guide to Exercise After Surgery.]
Risks and Complications
Some potential risks and complications with skin removal surgeries include:
— Anesthesia complications. Potential issues related to anesthesia.
— Infection. Risk of infection at incision sites.
— Scars. Potential for visible scars.
— Blood clots. Risk of blood clots forming post-surgery.
— Swelling. The surgical area and surrounding tissue may swell.
To have a risk-averse experience, choose a surgeon whom you have confidence in and be sure to ask them lots of questions about their process and what to expect. It is also important to follow aftercare guidance and not take off bandages or increase activity levels prematurely.
Benefits of Skin Removal Surgery
Significant weight loss can take years — and recovering from skin removal surgeries can take an additional few weeks or months. Your persistence really can pay off, however, and experts say results can last a lifetime.
Some benefits of skin removal surgeries include:
— A more slender body contour
— Increased mobility
— Improved hygiene and increased ease in maintaining personal hygiene routines
— Boosted self-esteem, self-image and confidence
“Patients may feel a confidence boost after their surgery heals,” Rice says, and “the outside finally matches how energetic the patient feels.”
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What Is Skin Removal Surgery? originally appeared on usnews.com
