So your unwanted excess weight is gone – hurrah and well done, you! It may not have been easy, but you finally did it. Whether you shed it through methodical lifestyle changes involving nutrition and movement, or through an intervention like bariatric surgery, it’s time to celebrate, shop for a new wardrobe and embrace a healthier, happier post-weight-loss (PWL) future!
For many of us, though, shedding excess fat does not mean getting our figure back. We still have loose skin after weight loss that prevents us looking and feeling our best. According to Singapore-based Brazilian plastic surgeon Dr Marco Faria Correa, these problems happen when the skin and tissues have lost the elasticity to bounce back – to conform to your new, reduced body size.
Dr Marco sees a lot of people who come to him for body restoration after significant weight loss. The tummy is a major culprit, he says, along with the thighs, arms, bra-line and bottom. Jowls and a sagging neck can also be problematic. If you have loose skin after weight loss it may be a good time to at least consider plastic surgery. Known as post-weight-loss (PWL) surgery, it involves surgical body contouring to remove excess skin and lingering fat pockets.
Getting rid of loose skin is not just vanity
Of course, there’s no shame in wanting to look your best, but there are also health and medical reasons for PWL surgery that go way beyond vanity:
- Loose skin can cause the inner thighs to rub together, causing friction and skin irritation.
- Excess skin under the breasts can likewise lead to localised skin inflammation and discomfort.
- Redundant skin folds hanging from the lower belly like an apron can cause skin rash or irritation, fungal infection and lower back pain – even interfering with personal hygiene and restricting walking. The procedure to remove this belly apron is known as panniculectomy. It’s not only a cosmetic procedure, but also brings significant functional and medical benefits.
3 factors that can increase loose skin after weight loss
#1 Rapid weight-loss
Where you have a large amount of weight to lose, dropping it more slowly can help to reduce the amount of excess skin. Remember, skin is a living, growing and self regenerating organ that, given time, can sometimes shrink on its own.
#2 Time spent overweight
Being overweight or obese for a long time – years or even decades – can permanently affect the skin’s ability to retract after weight loss.
Age at the time of weight-loss is another consideration. As you’d expect, the skin of younger, healthier people may bounce back more quickly and easily.
Q & A with Dr Marco
Who is your typical PWL surgery patient?
Both men and women, but predominantly men, generally aged over 40. About 40 percent lost the weight following bariatric surgery. Interestingly, studies show that people who opt for surgical body contouring after massive weight loss are less likely to regain the weight they lost.
How do you assess a patient’s suitability?
Their weight should have been stable for at least a year, and they should be doing regular exercise. I also suggest that post-bariatric surgery patients who have undergone gastric balloon, gastric bypass or lap band surgery wait at least a year before undergoing PWL surgery. For any kind of surgery, there is a list of pre-surgery check-ups such as: radiological scans, blood and urine tests and heart checks. You also need clearance from your physician to confirm that you’re fit for surgery.
What are the procedures available to get rid of loose skin after weight loss?
- Tummy tuck, or abdominoplasty
- Breast lifting, or mastopexy
- Upper arm surgery, or brachioplasty
- Thigh lifting, either circumferential or limited to the inner part of the thighs
In a case involving multiple procedures, is it better to do them separately or together?
To some extent, it’s true that the body can be expected to take the same time to heal whether you undergo one or multiple surgeries simultaneously.
There may be a cost saving on surgical fees, as we would charge for the major surgery at the usual fee and for any additional surgery at a reduced fee. But, we have to consider the patient’s state of health, together with the total time under anaesthesia.
What order do multiple surgeries take?
Abdominoplasty usually comes first, and can be done in association with brachioplasty. Once you have a firm abdomen without flabby skin, a thigh lift can be done. And a thigh lift can be done during the same session as a breast lift, breast reduction, or breast lift with implants.
How long does it take to recover from PWL surgery?
This is variable, depending on the kind and extent of surgery or surgeries. You may need a few days’ stay in hospital, and some surgeries require you to wear a pressure garment for a period of time. In most cases, we remove the stitches within two weeks.
Is scarring an issue?
The main priority for my patients is to get rid of flabbiness and redundant or loose skin. They are less concerned with scarring. What’s more, scars are placed in the bikini or underwear line, and will fade over time.
Can you give us some idea of the costs involved?
The cost depends on the complexity of each individual case. For example, if we are simply removing the apron of abdominal skin without repairing any hernia or rectus diastasis, the cost could start from $12,000. For a more complex case involving a circumferential tummy tuck with rectus diastasis or umbilical hernia repair, the cost can go up to $30,000.
A simpler brachioplasty alone could start from $10,000 to $15,000, depending whether it’s done together with a tummy tuck.
This article on getting rid of loose skin after weight loss first appeared in the September 2023 edition of Expat Living. You can purchase the latest issue or subscribe, so you never miss a copy!
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