Dealing With Excess Skin After Weight Loss Surgery

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Our Bariatric Surgeon

A nationally renowned and double-board-certified Denver bariatric surgeon, Dr. Long uses a partnership care model with each patient to tailor care to their individual needs. Patients routinely thank Dr. Long for his warm, compassionate bedside manner. He’s considered to be at the top of his field, having performed over 1,000 bariatric surgeries. Peers praise his technical skill, and he has some of the lowest complication rates among bariatric surgeons in the nation. Dr. Long and the staff at the Bariatric and Metabolic Center of Colorado consider it an honor to serve every patient with the highest quality of care.

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Dr. Joshua Long

MD, MBA, FACS, FASMBS

Will I Have Loose Skin After Weight Loss Surgery?

Are you interested in bariatric surgery, but worried about excess skin afterwards?

After weight loss surgery, many patients lose so much weight (often over 100 pounds) that they end up with loose or sagging skin. Because the skin does not go away, most patients are left with extra skin and say that their skin is looser or saggier than it was before surgery. That’s because when you gain weight, your skin expands around the new mass that your body’s adding. Then, when you lose weight, your skin usually doesn’t have enough elasticity to shrink back down.

How Will Loose Skin Affect Me?

How much will this affect you? It’s difficult to say, because each person is different. The amount of loose skin you’ll have afterwards depends on some things outside of your control, like your old weight, your age, smoking history, and your genetics. It may also depend on what type of surgery you choose. Researchers found that duodenal switch patients experienced more excess skin than Roux-en-Y gastric bypass patients, likely because duodenal switch patients tend to lose more weight. So think of excess skin as a consequence of weight loss; the more weight a person loses the more excess skin they are likely to have. Because most people will experience some extra skin after significant weight loss, it’s important to think about the possible responses. It is a normal human response to feel that the extra skin bothers you, and it is also a natural response to feel that it doesn’t.

If the extra skin does bother you after surgery, then we can discuss options when the time comes. If you want to get rid of the extra skin, the most effective way to deal with this problem is to visit a plastic surgeon who can remove the extra skin and re-establish a normal body contour. Insurances consider plastic surgery cosmetic, meaning that most patients will have to pay out of pocket. However, sometimes when a medical problem arises from extra skin, insurance will cover that portion of the skin removal related to this problem.

Problems With Excess Skin

First, it’s important for you to understand the issues that can be caused by excess or loose skin. Excess skin can cause chafing and rashes, especially when it rubs against other folds of skin or when it stays moist. If you have saggy skin, folds often rub against themselves. Over time, the top layer of your skin–your epidermis–actually tears, which creates the irritation from chafing.

Getting rid of excess skin, and wearing clothes that don’t chafe, can prevent this.

Excess skin can also lead to infections. First off, loose skin creates folds that are harder to clean. Second, if chafing happens it can sometimes cause breaks in your skin, paving the way for infections.

Many people who have excess skin after weight loss surgery may experience chafing in the thighs, groin, underarms or stomach; but it can occur anywhere there is extra skin.

For many people, loose skin also matters because of how it looks. After bariatric surgery, if you stick to your diet and exercise regime, your health will improve, and you’ll look and feel better than you have in years. However, some people may still consider their loose or saggy skin undesirable.

How Can I Avoid Excess Skin After Weight Loss Surgery?

If you’re worried about loose skin after surgery, whether for health reasons or because you’re concerned about how it might look, it’s important to know that there are a lot of ways to minimize sagging skin after surgery. Let’s go through a few of them together:

A Balanced Diet Can Reduce Loose Skin After Weight Loss Surgery

After bariatric surgery, a balanced diet with plenty of protein can help you keep the weight off, retain lean muscle, and feel better than ever. This diet may help to some degree to minimize loose or excess skin.

Getting enough protein may help you maintain and build lean muscle. Loose skin is caused by weight loss, because you don’t have enough muscle and fat under the surface to completely “fill out” your skin. Losing the fat is great, but preventing muscle loss–and even building new muscle–may help fill out your skin, prevent saggy voids, and minimize loose skin.

Getting enough protein may also help to optimize your skin elasticity, so it can more closely accommodate your new frame. After bariatric surgery, it’s important to eat 60-100g of protein per day.

Getting enough vitamins may also preserve some skin elasticity after bariatric surgery. Vitamins C, A, E, K, and B-complex vitamins, as well as trace minerals such as zinc, are all important for skin health. After surgery, we will recommend a comprehensive vitamin strategy.

You should also make sure to drink enough water. After completing your 6 week post-operative dietary progression back to regular food, your minimum water intake should be at least 64 oz/day. But, because your body (including skin) is mostly water, you should begin to increase consumption up to a maximum of 100 oz/day. Drinking plenty of water makes your skin healthier and may make your skin more elastic.

After your surgery, our experienced team will work with you every step of the way to create a balanced diet that works for you. We’ll help you eat to maximize your weight loss, feel your best–and minimize any loose skin.

Exercise

Exercise can prevent loose skin after weight loss surgery for the same reason that eating protein can. When you avoid losing lean muscle mass, you decrease the looseness of your skin. When you gain muscle, you actually fill out your skin more.
After surgery, our team will work with you to create an exercise regime that helps you lose weight, feel amazing, and minimize any excess skin.

Taking Care of Your Skin

Your skin is an organ, just like your liver or kidneys; and if you want to avoid loose skin after weight loss, taking care of this organ can help.

One tip we recommend after surgery is to brush your skin with a soft bristle brush. This feels great, and it may increase circulation in your skin, which will help carry collagen and elastin throughout your skin. That may help your skin to optimize its elasticity, so it can shrink around your new thinner body after bariatric surgery.

Excess skin is often made worse or better by your overall health and skin health in particular. If you ignore your skin and diet, you’re going to end up with more loose, saggy skin. But if you take care of your skin and your body overall, you can end up with tight skin that will look good even after you lose weight.

Cosmetic Surgery

Doing all of the above will help, but the fact is that after losing 100 or 150 pounds, it is realistic to expect that you’ll still have some excess skin after weight loss surgery. Most of our patients find that even when they follow the above recommendations they still have some saggy skin. Again, because people are different some people do not feel that this is anything that they really need to worry about, while others feel that it is a significant concern.

If you end up feeling that your excess skin is a problem that you would like to definitively resolve, then cosmetic surgery can be a powerful solution. The National Institute of Health found that 65.6% of bariatric surgery patients reported improved cosmetic appearance after cosmetic surgery.

Cosmetic surgery removes excess skin and fat from your body. A tummy tuck after weight loss surgery is one of the more common procedures. Cosmetic surgery does leave scars, but a good surgeon can often conceal these scars in body creases so they’re not very visible.

If you do decide to move forward with surgical body contouring, timing is very important for the best results. To maximize your body contour you will need to wait until your weight stabilizes at your new size for several months (usually around 18 months after bariatric surgery). Otherwise, as you continue to lose weight you are likely to develop additional excess skin and you’ll need another skin removal operation after you lose more weight. If your weight has been stable for 6 months, it may be a good time to consider cosmetic surgery.

If you’re looking at this option, it’s important to go with a reputable plastic surgeon with lots of good reviews. The American Society of Bariatric Plastic Surgeons is a good place to start. Or, contact our office and we’ll be happy to make a recommendation.

Again, it is important to expect that cosmetic surgery is not covered by most insurances. If you’re considering this option, you should call your insurance provider (or review your policy) to find out if any potential conditions may qualify you for skin removal.

Should I Get Bariatric Surgery?

If you’re considering bariatric surgery but are concerned about loose or saggy skin afterwards, you should know that there’s a lot that you can do to minimize sagging skin. A good diet, exercising regularly, taking care of your skin, and cosmetic surgery can all help you minimize your loose skin and look fantastic.

Is Bariatric Surgery Right For Me?

Has your weight gotten in the way of your life? Do your joints ache, and do you have difficulty doing normal daily activities with your friends and family like going for a walk? Do you suffer from diabetes or high blood pressure and constantly wonder if you can ever be healthy again?

You are not alone. In fact, many of our patients have been precisely where you are now, just a few short months ago. Bariatric surgery helped them lose weight, keep it off, and regain their quality of life.

With weight loss surgery, you can expect to lose about 65-80% of your excess weight. That could mean losing 150 pounds or even more. Imagine how that would feel.

If you’re concerned about loose or sagging skin, that’s human and understandable. It’s important to fully address your concern and make sure you have the information to look your best after surgery. It’s also important to recognize the benefits of bariatric surgery. Don’t let a fear of excess skin stop you from making a life-changing decision. Make an appointment today.

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This page was medically reviewed by Dr. Joshua Long, MD, MBA, FACS, FASMBS. Dr. Long is a double-board-certified bariatric surgeon and bariatric medical director for Parker Adventist Hospital.
Full Bio: Dr. Joshua Long, MD, MBA, FACS, FASMBS
Page Updated: June 7th, 2020

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