As you gain weight, your skin expands to accommodate underlying fat. But in cases of extreme weight loss, such as after bariatric weight loss surgery, patients are often left with unsightly excess skin. Because of its decreased elasticity, this skin tends to hang, sag and give a body a lumpy appearance. According to Dr. Michael Bermant, board-certified plastic surgeon, this is not a problem you can correct with diet or exercise alone. Excess skin must be surgically removed.
The goal of skin removal after weight loss is to surgically reshape the body by removing excess sagging tissue. This type of surgery is, in most cases, a cosmetic procedure and is performed by a team of plastic surgeons and their assistants. In some instances, skin removal surgery is medically necessary, especially if it hinders a person’s mobility or can drastically improve her quality of life.
There are several types of common skin removal surgeries. An abdominoplasty, or “tummy tuck,” removes fat around the midsection and helps to tighten loose abdominal muscles. A mastopexy improves the appearance of the breasts. Likewise, an inner thigh lift reduces sagging of the inner thigh, and brachioplasty reduces underarm waggling. A more extensive approach to skin removal after weight loss is the lower body lift, developed by Dr. Ted Lockwood. The lower body lift is a total reformation of the abdomen, hips, thighs and buttocks performed over a series of surgeries.
Surgeons perform some of the more frequent types of skin removal surgeries as an outpatient procedure under local anesthesia. But if you opt for a more extensive procedure, such as a lower body lift, you will most likely need to undergo several stages of surgery that involve months of recovery time in between. These surgeries require sedation by general anesthesia and a 24- to 48-hour stay in the hospital following the procedure.
Risk vs. Benefits
It’s important to weigh both the risks and benefits when considering excess skin removal. One of the more prevalent risks is seroma, which is the accumulation of fluid under the skin. Most seromas clear up on their own or can be drained by a doctor. Other complications include infection, scarring, blood loss and deep vein thrombosis (DVT), which is a blood clot in the deep veins of the body. DVT can be especially dangerous if the clot breaks free and travels through the bloodstream to the lungs, where it can lead to pulmonary embolism. However, the benefits of skin removal are many and include a more youthful appearance, improved self-esteem, greater skin quality and increased mobility.
When considering surgery to remove excess skin, meet with your surgeon several times beforehand and obtain a second opinion. Doctors advise that before you undergo this type of surgery, you should be at a stable body weight. Safety always trumps beauty, so some surgeons might warn against certain procedures if the dangers are too great. Likewise, diabetics are at an increased risk for some complications, including wound healing problems.
- fat measure image by Kimberly Reinick from Fotolia.com