The idea of excess or hanging skin after bariatric surgery is a significant concern for many patients. It sometimes prevents them from moving forward with what can otherwise be a life-changing and even life-saving procedure. Excess skin, of course, is a fact of life and weight loss. It occurs when the skin has been stretched beyond its elastic limit and cannot snap back to what it was before. We commonly see this as stretch marks. Pregnant women and those who have gained and then lost a significant amount of weight are most susceptible to this sagging skin that can be unsightly and irritating.
Excess skin is a fact of life, and how obvious and concerning it is will vary between patients and their circumstances. The following is why some patients may experience more significant amounts of excess skin than others.
Genetics. Yes, you may have your family to blame for that excess skin. Some of us are naturally born with more elastic skin, while others will naturally develop stretch marks and consequent sagging more easily. Of course, there’s not much we can do about this other than following the advice below.
How we lose weight is critically important in the development of excess skin. Losing a significant amount of weight very quickly will not allow the skin to retract uniformly. Patients who lose weight too quickly will often complain of excess skin as a result. Those with relatively lower starting BMIs will benefit most from measured weight loss.
As we age, the collagen and elastin in our skin diminish. This is just a natural part of life and is why we develop wrinkles in middle age and later. The same happens to the skin around our abdomen, arms, and legs. We do not have enough of these compounds to return the skin to what it was.
Your starting weight will also affect how much excess skin you will experience afterward. The more weight you had initially, the more stretched your skin has become. Patients that lose 100, 200, or even 300 pounds or more will undoubtedly have more excess skin than those that have less weight to lose in the first place.
Lastly, muscle-building exercises will go a long way in reducing the appearance of excess skin. Building muscle will undoubtedly fill in some of that skin, and while you still may experience some sagging, it may not be as problematic as if you didn’t build that muscle in the first place.
What Can You Do About It?
Excess skin is something that almost every bariatric patient should expect to have after their procedure. The degree to which they will experience sagging skin depends on a combination of the abovementioned factors. Some patients wear their extra skin as a sign of incredible achievement and life change. Others can’t wait for the day that they can have it removed. Some patients will qualify through insurance for a panniculectomy (skin removal) surgery. This procedure is performed and covered only when it is a medical necessity. For example, if the skin impedes the patient’s life or lifestyle. Patients may also opt for a tummy tuck, arm lift, or total body makeover from a plastic surgeon that essentially achieves the same removal of excess skin but also improves cosmesis.
However, bariatric surgery’s primary focus is the patient’s health. As such, while excess skin should certainly be a consideration for how you proceed both before and after surgery, it shouldn’t be a defining factor in whether you should have surgery. Ultimately, obesity is a dangerous disease that results in follow-on concerns like heart disease or cancer and affects virtually every part of the body. Most importantly, speak to your primary care physician and watch our online seminar to learn more about whether bariatric surgery may be the right option for you, especially if you have not had luck with weight loss medications, diet, and exercise.