Bariatric surgery can be a transformative journey towards improved health and well-being, resulting in significant weight loss. However, a common concern following such procedures is the presence of excess, loose skin. This article explores the reasons behind this phenomenon and the various surgical and non-surgical options available to address it, helping patients reclaim their figure and confidence.
Why Excess Skin Occurs After Weight Loss Surgery
Excess skin after bariatric surgery, such as a gastric sleeve, typically occurs because the skin stretches beyond its elastic limit during weight gain and cannot fully retract after significant weight loss. Up to 96% of people who get the surgery are affected by loose skin. The extent of excess skin varies depending on the amount and rate of weight loss, age, and genetics.
- Skin Stretching: When a person gains weight, the skin stretches to accommodate the increased volume. This stretching can affect the skin's elasticity, leading to excess skin after weight loss.
- Loss of Elasticity: Over time, the skin loses its ability to return to its original shape, especially with repeated stretching from weight gain. Aging also contributes to this loss of elasticity.
- Rapid Weight Loss: Rapid weight loss, common after bariatric surgery or with medications like Ozempic, doesn't allow the skin enough time to adjust and retract, resulting in sagging and excess skin.
- Personal Factors: Age, genetics, and the amount of weight lost all influence the amount of excess skin a person experiences.
Common Areas Affected by Excess Skin
After significant weight loss, excess skin is commonly found in several areas of the body:
- Abdomen: The lower stomach is a frequent site for loose skin. Excess abdominal skin is often referred to as an "apron." Abdominoplasty, commonly known as a tummy tuck, removes this excess skin and tightens abdominal muscles.
- Thighs: Extra skin can appear near the inner thighs, causing irritation during walking. A thigh lift can provide a solution for slender, shapelier legs.
- Arms: The upper arms are prone to sagging skin. Brachioplasty, or an arm lift, tightens and smooths the underlying tissues to eliminate excess skin and stubborn fat, revealing slender, toned arms.
- Breasts: Flat or drooping breasts may occur. Mastopexy, or a breast lift, firms up breasts by tightening tissue and removing excess skin. In many cases, the body’s own tissue can be used to augment sagging breasts.
- Face and Neck: While less common, weight loss surgery can lead to sagging jowls, a double chin, or a less defined jawline due to the loss of facial fat and skin elasticity. A facelift (rhytidectomy) can give your face a smoother, younger appearance and get rid of excess skin around your neck.
Physical and Emotional Impact of Excess Skin
Excess skin can have a significant impact on both physical and emotional well-being.
- Physical Discomfort: Loose skin can cause chafing, rashes, and pain near skin folds. Increased moisture in these areas can also lead to infections. The additional loose skin on the body could make it harder to bathe and get around day to day. It might even keep people from doing their favorite activities or hobbies.
- Reduced Mobility and Hygiene: Excess skin can make it harder to exercise and maintain proper hygiene.
- Emotional Distress: Many individuals feel self-conscious and less confident due to their excess skin, seeing it as a constant reminder of their past weight. Imagine losing 100 pounds but still feeling “flabby” because of excess skin. Getting rid of that skin can improve self-confidence and self-esteem.
Surgical Options for Excess Skin Removal (Body Contouring)
Body contouring procedures are designed to address sagging skin and restore the overall figure. These surgeries are designed to restore body contours and reshape the areas affected by loose, sagging skin and excess tissue that often comes with significant weight loss. A body lift removes excess skin after a significant amount of weight loss. It not only removes skin but can also improve the shape and tone of the underlying tissue that supports your skin. As with any surgery, there are risks associated with body contouring surgery.
Read also: Weight Loss and Skin Elasticity
- Abdominoplasty (Tummy Tuck): Removes excess skin and fat from the abdomen and tightens the abdominal muscles, resulting in a smoother, flatter stomach.
- Mastopexy (Breast Lift): Firms up breasts by tightening tissue and removing excess skin.
- Brachioplasty (Arm Lift): Removes extra skin and fat from around the upper arms, improving the appearance of saggy arms and leading to a leaner, more sculpted look.
- Lower Body Lift: Removes excess skin and fat from multiple areas, including the abdomen, thighs, hips, and gluteal area. It restores contour and improves definition, tightening the skin and reshaping the lower body.
- Thigh Lift: Gives the inner thighs a sleeker appearance.
- Panniculectomy: Removes the apron of excess skin (called a pannus) that hangs below your belly button.
Important Considerations Before Surgery
- Weight Stability: Your weight should be stable before you have body contouring surgery. It is generally recommended to wait until a patient’s weight has been stable for at least a year or longer before considering skin removal surgery. This is to ensure the skin has reached its “new normal,” so the final amount of excess skin is clear. It is also because if patients undergo surgery before their weight stabilizes, weight loss or gain can affect the end results. Dr. Jones likes to do surgery for excess skin about 18 months after bariatric surgery, because patients need to be at a stable, healthy weight for a steady 6 months before having skin surgery. If they gain or lose weight after the plastic surgery procedure, patients can lose the aesthetic benefits.
- Smoking Cessation: Patients should be free from smoking or using any kind of nicotine product for at least six weeks before having skin surgery, because tobacco use can interfere with wound healing.
- Consultation with a Specialist: Consulting an expert in body contouring is an important step toward achieving body contouring objectives.
- Realistic Expectations: Understand that the recovery process can vary depending on the procedures performed.
Recovery After Surgery
- Tummy Tuck: After a tummy tuck, most patients will be able to move around within the first few hours after surgery and can return to normal activities within three weeks. Most patients fully recover within three to six months.
- Arm Lift: Patients can usually return to work or school within two weeks and normal activity levels within six.
- Lower Body Lift: Most patients will be able to move around within the first few hours and recover safely at home, experiencing complete healing within six to eight weeks.
- General Recovery: After surgical treatments, initial recovery takes 1 to 2 weeks, with swelling and bruising expected. Final results are often obscured for several weeks, but you may notice immediate improvements to your overall figure.
Non-Surgical Options for Skin Tightening
While surgery is often necessary to remove excess skin, non-surgical treatments can improve skin elasticity and appearance.
- Muscle Tone: Muscle tone can significantly contribute to maintaining skin elasticity. Well-developed muscles form a supportive structure beneath the skin, helping to prevent sagging and promoting a youthful appearance.
- Exercise: Exercise also increases blood circulation, delivering essential nutrients that encourage skin cell turnover. Strength exercises might help build muscle to fill the space left from fat weight loss, which might reduce the appearance of sagging or loose skin after bariatric surgery.
- Recovery: Non-surgical treatments may cause mild redness, swelling, and tenderness for a few days. Cool compresses and over-the-counter medications can provide relief. Avoid sun exposure and use gentle products during recovery.
The Benefits of Body Contouring
The benefits of body contouring are more than just cosmetic. The emotional and psychological improvements can be more dramatic than the physical improvement.
- Improved Self-Confidence and Self-Esteem: Getting rid of that skin can improve self-confidence and self-esteem. A lot of Dr. Jones' patients have a long story behind their decision to pursue bariatric surgery, and the biggest gain is self-confidence.
- Reduced Weight Regain: A recent study showed that bariatric surgery patients who have body contouring surgery experience less weight regain and have an improved quality of life than those who do not have body contouring.
- Better Mobility and Hygiene: Benefits of these surgeries can include better mobility and hygiene and more comfort and confidence. Excess skin can also cause medical issues like infections and skin rashes. And having a lot of loose, excess skin can make it difficult for people to fit into clothes.
The Role of Exercise
Exercise plays a crucial role in achieving and maintaining a healthy weight after bariatric surgery, and can also aid in managing loose skin.
- Preparation: Before undergoing bariatric surgery, it’s essential to start preparing your body for the journey ahead. This includes incorporating exercise into your daily routine.
- Low-Impact Activities: Focus on low-impact exercises like walking, swimming, or stationary cycling.
- Strength Training: Building muscle can aid in preserving lean muscle mass during weight loss.
- Flexibility Training: Stretching exercises can increase flexibility and reduce the risk of injury.
- Post-Surgery Guidelines: Follow your bariatric surgeon’s instructions carefully regarding when to start exercising after bariatric surgery. Typically, patients can gradually resume physical activity a few weeks after the procedure.
- Start Slowly: Begin with gentle exercises such as short walks and light stretching.
- Build Consistency: Consistency is key to long-term success.
Minimizing Excess Skin After Weight Loss Surgery
While loose skin usually cannot be avoided after weight loss surgery, steps can be taken to minimize and manage it.
- Gradual Weight Loss: Gradual weight loss can give the skin more time to retract and adjust to a changing body shape.
- Hydration: Staying hydrated can keep the skin supple and resilient so it can more effectively manage changes from weight loss.
Read also: Surgical Options for Excess Skin
Read also: Weight Loss and Red Light Therapy