Skin removal surgery: What you need to know

People who accomplish weight loss of 100 pounds or more – whether surgically or not – achieve a significant milestone in improving their long-term health. But they often discover an unpleasant side effect. After such extreme weight loss, folds of loose skin often hang from the arms, legs, stomach and/or breasts.

This extra skin is more than a cosmetic issue. It can lead to rashes, infections, ulcers, back strain and balance issues. There is a solution: skin-removal (or body contouring) surgery, where the excess skin is removed and the remaining skin tightened and sutured together.

Patients who might be a good candidate for skin-removal surgery are those whose weight has plateaued for at least six months and who have no vitamin or mineral deficiencies.

While it might sound straightforward, skin-removal surgery can consist of a number of different surgeries, depending on the parts of the body involved. Each area involved – face or neck, breasts, stomach, legs, buttocks and arms – requires a separate operation. If more than one operation is needed, they likely will be done at different times. You may need to stay overnight at the hospital after your surgery.

In each area, an incision is made, excess skin is cut away, and the remaining skin and underlying structures are reshaped and sutured together.

Like all surgeries, skin-removal surgery carries its share of risks. They include infection, blood clots, scars and anesthesia complication. There also is a chance the results may not meet the patient’s expectations.

Health insurance may not cover skin-removal surgery unless there are medical problems associated with the excess skin. Often if the surgery is covered, it’s only for abdominal surgery (the most common area for skin-removal surgery). Some insurance companies require documentation of health issues such as rashes that result from the excess skin. Without insurance, the surgery can cost around $20,000.

While the immediate difference will be obvious, full recovery can take up to two years, and scars will remain. However, skin-removal surgery often signifies the end of a long journey for those who have tried everything to lose a significant amount of weight, and the psychological benefits of shedding the excess skin should not be made light of. It can be incredibly emotional for some patients.

Even if a person has skin-removal surgery, they may still see the typical sagging of skin that accompanies growing older – although it may be less extreme. In addition, the skin can stretch out again if the weight is regained.

According to the American Society of Plastic Surgeons, about 45,000 people in the U.S. had skin-removal surgery in 2016.

J. Wesley Culpepper, MD, is a plastic surgeon with Carolina Plastic Surgery & Aesthetics

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