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Managing Excess Skin After Weight-Loss Surgery

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A Q&A With Dr. Neil King and Dr. Christine M. Jones

Posted by Temple Health

Weight-loss surgery — also known as bariatric surgery — helps people who have tried other weight-loss methods achieve lasting results.

While this surgery often improves overall health and quality of life, many people do experience excess loose skin after this significant weight loss and may want that skin removed.

Excess skin can be distressing since it affects not only appearance, but also function and health. But at the Temple Bariatric Surgery Program, we believe the benefits from bariatric surgery outweigh this potential side effect. And if a patient does experience excess loose skin after having bariatric surgery, there are excellent options for treatment.

In this Q&A, Dr. Neil King, bariatric surgeon, and Dr. Christine Jones, plastic surgeon, will answer some common questions patients ask about excess loose skin after bariatric surgery.

Jump to a question:


Q: What actually causes excess loose skin after weight loss?

Dr. Neil King, bariatric surgeon: After a lifetime of having a higher body mass index (BMI), a person’s skin is chronically stretched out, much like a water balloon. When a patient loses a lot of weight, the skin really doesn’t have the capacity to retract and snap back to where it was before that weight gain.

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Q: Does everybody have extra skin after after bariatric surgery?

Dr. King: The amount of excess skin a person may have after bariatric surgery depends on genetics, bodyweight distribution, and how much weight is lost. Most of my patients have excess skin to some degree, but if they’re on the lower end of the BMI spectrum, they’re not going to have as much extra skin to contend with.

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Q: What do you tell your patients about excess skin?

Dr. King: I let my patients know that excess loose skin is a normal part of the weight-loss process and that there are options for dealing with that skin if they have it. I don’t take the idea of having excess skin lightly. I see it all the time, I understand patients’ concerns, and I want them to know that they shouldn’t be embarrassed to talk about it with me. At the same time, I remind my patients that bariatric surgery has so many benefits, and I encourage them to keep that in perspective when making their decisions about whether to pursue a weight-loss procedure.

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Q: Can you get rid of loose skin with surgery?

Dr. Christine Jones, plastic surgeon: Yes, there are several procedures that can help. The type of surgery recommended typically depends on the area or areas of concern for my patient. The abdomen, breasts, arms, or thighs are the most common areas for treating excess skin. Sometimes, surgery is performed on the area under the chin or on the face.

In general, the goal is to remove the excess tissue and then try to contour the remaining tissue. But the details of that come down to each patient’s specific area of concern, their anatomy, their current weight distribution, and other factors.

For the abdomen, the most common surgery performed is an abdominoplasty, or “tummy tuck.” That involves removing overhanging skin and contouring the mid-abdomen to match the contour into the thighs and pubic region. We can also “smooth out” the area around the belly button and make a new spot for the belly button.

For female breasts, we can perform a breast lift. In many cases, I use the body’s own tissue to augment sagging breasts. There are also options available for men, including chest contouring. These approaches vary based on a patient’s anatomy and body type.

For arms and legs, another option is an arm or leg lift, also called a brachioplasty or a thighplasty. These procedures involve making incisions in the inner part of the arm or the inner part of the thigh to help contour those regions.

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Q: Who might be a candidate for excess skin surgery?

Dr. Jones: My first concern is always safety. That’s why, for instance, I want to see that my patients are free from smoking or using any kind of nicotine product for at least six weeks before having skin surgery. That’s important because tobacco use can interfere with wound healing. Many times my patients already know that because tobacco cessation is a criteria for bariatric surgery as well. It’s also important to have any coexisting medical conditions a patient might have, such as diabetes, under control before skin surgery.

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Q: How soon after bariatric surgery can someone have treatment for excess skin?

Dr. Jones: In general, I like to do surgery for excess skin about 18 months after bariatric surgery. This is 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. For example, the skin could appear uneven if they gain weight, and losing more weight can cause the skin to sag again.

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Q: What are some benefits of surgery to treat extra skin?

Dr. Jones: The biggest gain is self-confidence. A lot of my patients have a long story behind their decision to pursue bariatric surgery. In some ways, the excess tissue serves as a reminder of the parts of them they wanted to leave behind, and it interferes with the way they want to present themselves to the world.

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. Some of my patients have already tried things like wearing shapewear clothing before they come to me to discuss skin surgery.

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Q: How do patients benefit from the collaboration between Temple’s bariatric and plastic surgery teams?

Dr. Jones: We have a long history of collaboration with the bariatric program to serve patients who have had bariatric surgery and then want plastic surgery. We believe this collaboration benefits our patients. We are part of the same team, so the transition of care is seamless.

The Temple Bariatric Program offers proven weight-loss surgery procedures, including gastric bypass and gastric sleeve surgeries.

Temple Plastic Surgery offers all the latest procedures, carefully listening to you, explaining your options and working with you to achieve your desired results.

If you want to know more about bariatric surgery, consider attending our free online seminar. Learn about the qualifications for bariatric surgery and find out if you may be a candidate.

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