If you have watched some extreme makeover programmes on TV you may well have seen a few patients who have had surgery to ‘repair’ their skin after significant weight loss. This may lead you to wonder if you will experience the same thing after WLS.
Certainly not everyone who loses a lot of weight with WLS will have a problem with ‘hanging’ skin. There are many factors that determine how much loose skin an individual will have after large weight loss. The most important determinant is probably age as skin naturally becomes less elastic as it ages. The older you are when you lose weight, the less likely your skin will ‘snap back’ to its original shape.
The second most important factor is the amount of weight loss. An individual who loses 250 lbs is likely to have more excess skin than someone who loses 80 lbs.
Other less important variables include complexion, amount of sun exposure exposed over a lifetime, heredity (i.e. your genes) and whether you are a smoker. Fair-skinned people in general tend to develop more loose skin than darker individuals. Sun worshippers tend to sustain more tissue damage over the years and consequently more loose skin following weight loss. Some people tend to have ‘better’ skin than others of similar complexion and lifestyle. This may be the result of hereditary factors that are not readily apparent. Finally, smoking breaks down collagen, a major component of skin and other structural components of the body. Smokers develop more loose skin than their non-smoking counterparts.
In other words, having loose skin is one of those things that varies from person to person and frankly, you will not know if it’s a problem or not until it has actually happened.
Most people who lose 100 lbs or more will usually have a certain degree of excess or ‘hanging’ skin upon reaching their goal weight. This excess is usually in the areas of the body where they used to carry most of their excess weight such as the belly. Very rarely does this cause a medical issue such as skin infections. It is mostly a cosmetic issue and, for many patients not significant enough to warrant having something done about it.
What Can Be Done About It?
However for some there is a problem. If you have a lot of excess skin that is an issue for you and you want to have it removed, then you must be referred to a body contouring or body lift surgical specialist for further treatment. This is rarely covered by the NHS or private healthcare insurance and most is funded privately by the individual. In exceptional cases your GP may refer you for contouring on the NHS but you should be prepared for refusal.
Body contouring consists of a number of cosmetic surgery procedures that lift and tighten skin at various locations of the body. Each individual patient usually determines what they are bothered about and then consults with a plastic surgeon to correct the problem. The most common procedures are tummy tucks, neck lifts, arm lifts, thigh lifts, breast lifts and lower body lifts. If several operations are required then they are usually performed one a time with at least 3 months between operations.
Body contouring procedures should only be considered after ones weight has stabilised after bariatric surgery. This can range from 12 to 36 months, depending upon the patients pre-operative weight and the type of bariatric surgery performed.
The bottom line? Worrying about the likelihood of having loose skin is no reason to put off losing weight. Losing weight will leave you healthier and will most likely lead to a longer and fuller life.