Help for Excess Skin After Weight Loss

Call it excess skin, hanging skin, or — as doctors do — “tissue laxity,” the problem of what to do with loose skin after significant weight loss is the same. Many people feel that managing excess skin is a necessary step in completing their weight-loss journey.

Weight Loss and Excess Skin: What You May Experience

Whether you will have excess skin after weight loss depends on how much weight you lose and the quality of your skin, says plastic surgeon Jorge de la Torre, MD, director of the Center for Advanced Surgical Aesthetics at the University of Alabama at Birmingham. It is hard to predict exactly how weight loss will affect your body. He advises waiting for a few months after you reach your goal weight so that the weight stabilizes and your body settles into its new weight.

Weight-loss patients may find their excess skin:

• Is uncomfortable during their daily activities
• Can be hard to keep clean and dry
• Makes it difficult to dress stylishly
• Is simply unappealing

Loose skin occurs in a number of places including:

• Under your arms
• On your back (around the bra line)
• At your waist and belly
• On your buttocks
• On your thighs
• Around your knees

The good news is that there are solutions that can have you feeling confident in a tailored suit or exercise clothes.

Weight Loss and Excess Skin: Cosmetic Surgery Options

“Excess skin kind of stigmatizes the patients to themselves. They don’t think they’ve finished losing the weight till the skin is gone,” says Dr. de la Torre. “In general there is nothing a patient can do to change or tighten the skin.” But he adds that he has had at least one patient with excess skin under her arms who was able to tone up considerably with exercise alone.

When exercise isn’t enough, two cosmetic procedures for excess skin may help:

• Laser treatments. “In theory one can tighten the skin by addressing the dermis,” explains de la Torre. “As it regenerates after a laser treatment it generates collagen to help tighten.” But this is not an option if you have a lot of hanging or excess skin, because there is simply too much to manage.
• Body contouring. “Really the only way to address this is to remove the excess skin,” says de la Torre. Body contouring also involves tightening the tissues under your skin for a better “look.” In 2008, the American Society of Plastic Surgeons reported 58,669 body-contouring procedures after massive weight loss. These plastic surgery procedures include breast lifts, thigh lifts, lower body lifts, and upper arm lifts. A new procedure for women was recently developed to target the back, with a scar hidden under the bra line.

Most patients do not regain a significant amount of weight in the year after body contouring, notes de la Torre, but if they did it would be in new places. One bonus to the surgery is that your old, deflated fat cells have been removed and it is not as easy for your body to refill them or create new ones.

Weight Loss and Excess Skin: Set Realistic Goals

De la Torre emphasizes the importance of having realistic expectations of cosmetic surgery. It is possible to be more comfortable in your body and to look good in your new weight-loss wardrobe, but you may not be model-perfect in a string bikini or sleeveless evening gown because of scars.

“We try and put the scars in the least perceptible places,” says de la Torre, who adds that a surgeon will take into account what you want to be able to wear and develop a plan to minimize scarring.

Don’t give up hope of feeling comfortable with your body after massive weight loss — you and your surgeon can address excess skin in a way that suits your style.