Sugar Land Post Weight Loss Skin Reduction Surgery
- Years of being overweight…
- Self consciousness…
- Can’t find clothes that fit…
- Don’t enjoy vacations…
- Trying to lose weight but always frustrated…
Taking that leap to having weight loss surgery is a major decision. I see patients who have lost weight after gastric sleeve, bypass, banding and other surgical weight loss procedures all the time. There are quite a few things those patients have in common after they’ve lost all that weight.
There’s an excitement in imagining all the things that will be different after you lose a massive amount of weight after surgery. New clothes, more vacation and beach time, people looking at you differently. You know you’ll feel like a different person, and you have an image in your head of what you’ll be—thin, shapely and confident.
Reality is that when a person loses lots of weight (hundreds of pounds in some cases), there is a lot of skin left over that just won’t go away on its own. When most patients’ weight loss has plateaued, the huge pieces of extra skin take a lot away from the body that they thought they would have.
Anatomic reasons for loose skin after weight loss
Human skin is made up of several layers. Just under the surface is a layer called the dermis. It’s made up of dense connective tissue that gives skin its strength and tone. Patients who are morbidly obese have so much tissue under the skin that the skin becomes very stretched out, just like a woman’s abdominal skin stretches out with pregnancy.
And just as with pregnancy, weight loss surgery leaves stretched out skin when the fat under the skin is gone. Unfortunately, when the skin stretches out to that degree the dermis loses its strength and that strength can’t be restored. The redundant skin will just sit there.
That means that if you have weight loss surgery and lose a massive amount of weight, you’ll still have to wear clothes that are much larger than they should be. That amount of extra skin takes up space and has to fit within your clothes. You might be uncomfortable in clothes that expose your arms and legs because the loose arm and thigh skin cause self-consciousness. When you look in the mirror you just won’t look as small as you probably imagined.
Surgery to remove extra skin after weight loss surgery should be considered part of the weight loss journey. Patients who go through weight loss surgery are doing it not only to be healthier but to look better and feel more confident. Skin removal surgery is the last part of the journey.
Abdomen: after weight loss surgery the most common place patients have extra skin is the abdomen. It’s usually a large flap of skin that hangs down over the beltline and has enough bulk that when it’s under clothes you look overweight again.
Chest/Breast: For both men and women who have weight loss surgery, the chest will be left with stretched, loose skin. For women that can be addressed by a breast lift, breast reduction or breast implant placement. For men, a procedure similar to the one used for gynecomastia (male breast tissue) can be used.
Thighs: Loose skin on the thighs is usually worst at the topmost part of the inner thigh. That is the area that is managed with a thigh lift using a horizontal incision in the groin. This allows pulling the skin upward to alleviate laxity in the up-down direction. When the skin redundancy is extreme it will be loose going around the thigh as well, which can’t be corrected by pulling upward on the skin. In those cases a longitudinal (lengthwise or up-and-down) incision has to be made and the skin can be cinched together going around the thigh.
Arms: Probably the second most common complaint I see is loose arm skin after weight loss. Obese patients have very large upper arms (and surprisingly normal-looking forearms). The loose skin left after weight loss is mostly in the circumferential direction and swings around like a large flap whenever the patient lifts their arms. This can be reliably changed to a smooth, shapely upper arm contour by removing the extra skin. A lengthwise incision is usually needed to deal with this, extending from the armpit to the elbow.
Upper back: Commonly called the “bra roll” in women, this area looks like one that liposuction can reduce and flatten. Unfortunately, that’s impossible—in a weight loss patient the redundancy is caused by excess skin, not fat. If you have this problem, you can see why skin removal has to be done by raising your arm as high as possible and stretching the skin out. Now that it’s flattened out, see how much the skin bunches up when you lower your arm.
Buttocks and Lower Back: Many patients complain of a “saggy” or flat butt after losing a large amount of weight. This is caused in part by loose back skin, which causes sagging of the entire area. A fair amount of improvement comes from pulling the skin of the buttocks upward and removing skin from the lower back to tighten the area. Increasing buttock volume is more challenging. That is accomplished in the non-weight loss patient by fat grafting, but weight loss patients don’t have much to harvest.
Face and Neck: Massive weight loss leaves loose skin on the face and neck just as it does on other parts of the body. Just as in non-weight loss patients with sagging facial skin, a facelift or neck lift are reliable ways to restore facial shape.
Where to start?
It’s tempting to want to take off all the loose skin on your body at once. There are several reasons that is not a good approach:
- Length of surgery: Each of the operations described above takes time. They may involve only skin removal, but because of the large amounts of skin it can take a while to do the procedures. While it’s perfectly reasonable to have skin removed on more than one area at a single operation, the combination of areas to be done together has to be carefully planned to keep the surgery safe.
- Blood loss: When large amounts of skin are removed, the incision length and exposure of areas under the skin can be extensive. Even if there aren’t areas of brisk bleeding, the sheer incision length and the amount of time the incisions are open can lead to major blood loss if too much skin is removed at once.
- Infection Risk: Removing skin from more areas means more incisions, and some of those incisions are in areas that can be difficult to keep clean. The more the total length of the incision, the higher the chance that a part of the incision becomes infected.
- Recovery: It’s simply too difficult to recover if too many parts of your body have been operated on. If you can’t move around after surgery, you’re at a very high risk of developing a blood clot (DVT or deep vein thrombosis).
It takes patience to complete the post-weight loss body contouring process but doing it the right way ensures that you’ll be thrilled with your results and can recover safely.