Sagging Skin After Weight Loss: What Can You Do About It?

Through proper diet and exercise, many people are able to successfully loose large amounts of weight. It can also be achieved through weight loss surgery. Sometimes though, losing large amounts of weight can leave you with results you didn’t plan on. As a result, there’s a distinctive kind of problem that even people who have undergone bariatric surgery can experience: excess skin in significant amounts that hang down from the body. Even after a successful weight loss surgery, these individuals are left with body image issues that can lead to emotional distress, and even to problems that result from the inability and difficulty to maintain adequate hygiene due to problems encountered in cleaning around and under excess skin folds, and hard to reach areas of the body.

The changes that can occur from sagging skin typically affect the chest, upper arms, and facial areas. Concerns about upper body appearances can be resolved through surgical procedures such as an upper body lift. An upper body lift can eliminate excess skin while also lifting and contouring the body to give it a sleek, youthful appearance with more tone which can help a person feel good about the way they look again.

Some Solutions Don’t Always Measure Up

As much as an embarrassment that sagging and loose skin folds can be, the health risks involved are also something that can prove detrimental and should be carefully considered. For instance, it’s very easy for sagging and loose skin to pick up rashes and yeast infections.

Rashes can form easily when perspiration gathers between folds of loose skin, but can be treated with powder or cornstarch to alleviate problems. For some people, using small patches of fabric strategically placed around their bodies helps shield themselves against excess moisture. But in many instances, these are just stop-gap measures that don’t entirely solve the dilemma.

Getting in shape can help with losing weight, but loose skin can present its own problems. Compression garments can help up to a certain point, but imagine putting on a 30 or 40 pound object and wearing it all around just to try and look slimmer. It’s difficult at best and still doesn’t address the root issue.

When there’s a question of what to do about loose and sagging skin from significant weight loss, it will often come down to a decision to undergo a surgical removal to effectively get rid of the excess skin, and to give the body more contour.

Surgical Procedures for Sagging Skin

There are different types of surgical procedures that are recommended for removing excess skin after bariatric surgery or massive weight loss. As one option, plastic surgery procedures can be very effective at cutting away excess skin. These types of procedures also allow for the lifting and reshaping of remaining tissue to flatten and smooth the body.

Besides surgical removal of excess skin, there are other options available. One of the most popular is liposuction which is a procedure that uses suction techniques to remove excess fat. There are also non-invasive procedures that are viable options for people who have mild skin and excess fat, such as ultrasound and radiofrequency skin removal. In these procedures, the skin is heated up which causes it to contract by setting off a process of collagen production. Using micro-needling with radio frequency energy is an option as well. In this procedure, thousands of tiny punctures are made in your skin. The radio frequency delivered during micro-needling helps to generate new collagen and skin tissue for smoother, firmer, and more toned skin.

A plastic surgery procedure that is highly recommended for patients wishing to remove massive amounts of loose skin and fat are upper body lifts. These have been very successful in improving appearances and restoring confidence and self esteem to those people on a journey to improve their quality of life. Read on to learn more about the options that involve body lift surgical procedures.

When Are Body Lifts Best?

Cosmetic surgery is the most effective way to remove excess body skin. Body contouring is one of many procedures used to achieve this, beginning with the body lift.

One of the most important things to know if considering a body lift as an option to remove excess skin and fat is what makes up an ideal candidate for an upper body lift. Ideal candidates for body lifts include people who have lost extreme amounts of weight. The weight loss could have been achieved through traditional diet and exercise regimens or through bariatric surgery. By either methods, the resulting loose and sagging skin on the upper body is what needs to be eliminated. Sometimes female patients have acquired a considerable amount of stretched skin due to childbirth. Female patients with these conditions would be considered to be appropriate candidates for upper body lift procedures.

There are multiple procedures that can be performed during one scheduled surgery visit that can help achieve optimal results for patients. This is because of the advancement of surgical procedures and techniques in the plastic surgery industry. Many areas that need attention can be addressed in one surgical session. An upper body lift is a combination of surgical procedures that address the problems of excess fat and sagging skin. The names of these surgical procedures include mastopexy (breast lift), liposuction, brachioplasty (arm lift) and rhytidectomy (face lift). Upper body lifts target areas that have been affected the most by weight loss extremes. Patients who have elected to have skin and fat removal procedures typically do better both physiologically and psychologically than those who don’t.

Breast Lift Procedures

An increase in a woman’s weight can lead to an increase in the volume of the breasts, which can cause the skin to stretch. After a major weight loss, decreased breast volume is the typical result. The loss of weight along with the stretched skin causes the breasts to sag and position lower on the chest wall. Breast lift procedures that remove excess skin and help reposition the breasts on the chest wall help restore a more youthful look. Breasts that have sagged can also cause the nipples to increase in size, so along with the breast lift procedure, the nipples can also be repositioned and resized to look natural once again. The procedure can also include implants, which can give the breasts extra fullness and volume.

Gynecomastia Surgery

When men have excess loose and sagging skin due to a large weight loss, they too can benefit from a body lift to correct their physical appearance. Men will often get stretch marks or enlarged breast tissue on their chests. Using gynecomastia surgery and re-sculpting the chest through liposuction is a common solution. These surgical techniques which can include a repositioning and resizing of the areola help give the chest a masculine and firmer shape once again.

Brachioplasty (Arm Lift)

Aging and weight loss can cause the arms to become heavy with excessively loose and baggy skin. The condition is often referred to as “bat wings,” when the loose skin hangs down from the upper arms and “flops” back and forth when the arm is swung. Removing the excess skin involves surgery including liposuction to remove the fat pads that have been stationed in loose upper arms. During the procedure, incisions are made on the sides of the arms where the scars will be hidden. Having an arm lift helps people achieve the toned, athletic looking arms they’ve always wanted.

As a solution to eliminating arms of loose and sagging skin, brachioplasty has built up a popular following over the last decade. According to statistics that were published by the American Society of Plastic Surgeons, arm lift procedures shot up from over 300 performed in 2010 to about 16,000 in 2013.

Ideal candidates for arm lifts are generally healthy, non-smoking adults with a significant amount of laxity in the upper arms. Patients who have lost a significant amount of weight but have also managed to control their weight make up the majority of arm lift patients. And because the condition often occurs in older women, it’s an optimal solution for them to remedy their under arm looseness

Removing and tightening the skin is a process that begins with incisions being made and hidden in the armpits if there’s a moderate amount of excess skin on the arms. If there is a significant amount of skin, incisions can be made along the inner aspect of the arms to minimize the visibility of the incisions. With the removal of the excess fat complete, underlying supportive tissue is tightened and reshaped using internal sutures. With the contour of the “new” arm formed, the remaining skin is smoothed over it. Compression sleeves are used and placed around the arms to reduce swelling and promote healing after the incisions are closed.

Recovery times for sagging and loose skin removal procedures can vary quite a bit depending on what kind of work was performed. If the surgery performed was part of a post-bariatric surgical procedure, it will be especially true. If a patient is having a brachioplasty on its own, a week away from work spent in recovery is typically normal. To allow for complete healing, strenuous activities should be avoided for several weeks. Results should be readily visible almost immediately following the surgery, and over the next 6 to 12 months, any scars will fade away to an extent.

The Benefits Of An Arm Lift

Patients who undergo an arm lift or brachioplasty procedure will see some of these benefits:
  • Excess arm skin reduction
  • An improved sense of confidence and self-image
  • Less self consciousness and more confidence to wear short sleeved apparel
  • Discovering how much better clothing fits


Liposuction

Many people who experience massive amounts of weight loss can be left with fat deposits on their backs. Liposuction can help this by targeting the fat deposits to remove them. For women who are undergoing breast enhancement surgery and have fat deposits on their backs, they can request to have the fat deposits from their liposuction procedure added to their breasts during the enhancement procedure. The benefit in this is that the fat grafts make the breasts look and feel as natural as possible. The most frequently treated areas for liposuction in women are the chin, abdomen, thighs, hips, knees, arms, back, buttocks, calves, and ankles. Liposuction procedures that are performed on men concentrate mainly on the neck, chin, abdomen, flanks or “love handles”, and especially the chest. The procedure for removing excess fat from the male breast is called a “gynecomastia.”

The Benefits Of An Upper Body Lift Procedure

An upper body lift does not require additional body contouring and liposuction procedures to remove excess fat. However, upper body lifts should never be used in place of proper weight loss procedures. This is because an upper body lift’s main purpose is to remove excess skin, in general because of a patient’s extreme loss of weight.

Apart from the positive emotional and psychological benefits you’ll get from this surgery, you’ll also experience these benefits from upper body lift surgery:

  • Multiple areas of the upper body can be covered in one single operation
  • Multiple treatments in one operation means a more efficient recovery
  • The procedure reshapes the upper arms & lifts the breasts
  • Excess back tissue can be used to augment the breasts

Who Is A Good Candidate For An Upper Body Lift?

  • Someone with sagging skin on the chest, arms, and back
  • Someone who has undergone a large weight loss but still needs body contouring
  • Someone who is close to reaching their ideal body weight
A typical body lift involves what is known as a circumferential body lift. In a circumferential body lift, the surgeon makes a backside incision and then progresses around the flanks and abdomen, cutting away at some of the skin excess that’s present. The skin tightens back in place due to the suturing of the incision. Patients can shed roughly 10 to 15 pounds of excess loose skin. As the standard go-to procedure to eliminate excess skin for many people, doctors can attest that the greatest difference for people who have this procedure performed is in their appearance after the procedure is completed. Patients will also find that their insurance providers are more likely to cover the cost of this surgical procedure because it has tangible physiological benefits. And it also does a wonderful job of boosting a person’s personal outlook and psychological well being.

After losing significant amounts of weight, body lift procedures to remove excess skin can include a variety of surgeries to achieve the look a patient is hoping for. Upper body lifts can vary, but typically include an arm lift and back lift, plus a breast lift for women. Full upper body lift procedures include surgeries on both upper and lower part of the body, and will be scheduled several months apart so that scars can properly heal the most between procedures.

Details surrounding the procedures a patient will be undergoing will be determined by the number of procedures they’ve decided to have. If a procedure is being focused on one area of the body, the entire lift will be performed in an operational session. For multiple surgeries, they’re performed in stages, so that adequate and sufficient time for healing between procedures can be achieved.

Smaller surgical procedures can be performed as an outpatient, or with the addition of a short hospital stay of up to two days (for a lower body lift).

Surgeries involving body lifts can last for four hours or more, depending on what the individual needs of the patient are. In an article appearing on Doctors on RealSelf, doctors expressed a preference to extend body lift procedures across several stages of surgeries, with a time limit of 6 hours for each procedure.

General anesthesia is given to put a patient into a full, deep sleep. While the patient is asleep, the surgeon will proceed to remove the extra fat and skin while lifting and tightening the skin that remains to achieve a more sculpted look. The process uses a surgical incision for liposuction and the cutting off of excess tissue.

What Will My Scars Look Like?

Depending on the procedure (or procedures) you get in an upper body lift, the scars that will be left behind as you heal and will be treated in such a way as to make them look as invisible as possible. The surgeon will work with you for the best possible solution.

Upper body lifts serve a primary purpose of countering the residual effects caused by massive weight loss, which in turn can help you realize the body shape that you’ve always wanted.

When Are Lower Body Lifts Best?

Loose, flabby skin and excess fat deposits can prove to be problematic when they appear on the hips, thighs, outer thighs, and buttocks. This is why a lower body lift is often chosen to correct the issues surrounding those affected parts of the body.

A lower body lift usually consists of a butt lift, thigh lift, tummy tuck, panniculectomy, and/or monsplasty.

The procedure for a lower body lift involves removing the excess skin and fat from the hips, outer thighs, and buttocks. Along with the tightening of loose and sagging skin and smoothing out of fatty folds, a patient can restore their skin to one that radiates a more youthful tone and more defined body contour. Now, while tummy tucks and liposuction procedures help to diminish fatty tissue in other areas of the body, plastic surgeons do not wish to use the procedures on a targeted problem area that is circular by its own design. Lower body lifts work best for correcting wider areas that appear on the lower half of body.

Hanging skin that has been caused by age, pregnancy, and the loss of a significant amount of weight will benefit from undergoing a lower body lift procedure. And in cases where there’s abdominal muscle separation, it also shows improvement.

For patients who have had bariatric surgical procedures, lower body lifts are generally recommended. It’s also a good recommendation for people who have shed a lot of weight from dieting. Mothers who have given childbirth and wish to recover the look that their bodies had before pregnancy are also good candidates for lower body lifts, along with those who have acquired cellulite below their waistlines. While every lower body lift is unique to the individual, it’s wise to remember that the results from a lower body lift will also vary from person to person.

Benefits Of A Lower Body Lift

  • A single lower body lift procedure can address a number of areas on the body experience excess fat such as the buttocks, thighs, and possibly the abdomen
  • Folds of body fat can be reduced
  • The torso and abdominal muscles can be flattened and sculpted
  • Liposuction can also be used in conjunction with other procedures to reduce fat in other regions of the body

Recovery From A Lower Body Lift

A lower body lift is a highly involved and intricate surgical procedure, so as such, it has a lengthy period of recovery time a patient has to endure. For the postsurgical care and recovery a patient will need, the plastic surgeon can have a detailed discussion with the patient. In talking with the doctor, a patient can find out what sort of symptoms they can expect to experience, along with the complications that may arise, care for drains, the medications that are required to be taken in order to prevent infections, and subsequent checkups to monitor healing.

Post-op recovery generally consists of recuperation for a minimum of two days of hospital stay where nursing care is available. The areas where treatment has been applied is covered with bandages and surgical drains, and instruction will be given on how to take care of the incision sites. At first, treated areas will feel sore and have redness and bruising associated with them. Pain will occur, primarily after the anesthesia has worn off. With the painkillers you’ll be prescribed, you can adjust and cope with the pain better. However, if pain persists, get in touch with the physician right away.

Swelling and pain from the surgery should diminish in about a couple of weeks following surgery. But during that time, refrain from any strenuous activities — especially heavy lifting for a period of between four and six weeks. Compression garments should be worn all throughout the period of recovery so that incisions can heal properly. The benefit of compression garments is that they diminish swelling and provide support to skin tissues that are in suspension, and also, they help keep the skin smooth. In two weeks, sutures should be removed, and a special diet may be recommended by the surgeon.

About two weeks following surgery, pain and swelling should begin to recede. But engaging in any strenuous activities, heavy lifting or similar activities should be avoided for an additional four to six weeks.

Patients should adhere to the instructions the surgeon will provide post-surgery. Make sure to go to weekly follow-up visits to have healing progress tracked, check ups on any discomfort or unusual pain, and to insure that no infections have popped up. Full healing will take a minimum of four weeks to achieve. Procedural scars will last longer, but should become less pronounced after about a year.

Can Loose Skin Go Away On Its Own?

Loose skin doesn’t typically disappear on its own, which is why surgical procedures are often necessary. Doctors agree that depending on the degree to which excess skin is left over from a weight loss, and how positively the skin responds to the loss of weight initially, the quality of the skin, age, genetics and other circumstances, loose skin will respond in its own natural way. Changes may be noticed in any case.

Younger patients whose skin quality is still adequate even though they’ve had weight gain, patients without prior stretch marks, and others in this category may experience the disappearance of loose skin on its own. It’s the quality of the skin that’s the key factor to any improvement.

Panniculectomy surgery may be all that’s needed if loose skin is located in the midsection. A panniculectomy is a surgical procedure to remove excess skin from the lower abdomen. It differs from an abdominoplasty, which, in addition to removing excess skin and fat, will help to tighten abdominal muscles. A mini-tummy tuck also can also remedy sagging skin in the lower belly region and results in less scarring than from a full tummy tuck procedure.

When it’s time to seriously consider surgical procedures for excessive skin removal, at Aristocrat Plastic Surgery, our goal is to attain the highest level of patient satisfaction. A full staff is here and stands ready to help every patient reach all of their physical appearance goals. From the time you enter our beautiful waiting room, you can expect to receive the highest level of care. Our facilities are equipped with the latest and safest technologies in the field of plastic and reconstructive surgery.

Dr. Kevin Tehrani, MD, FACS, and founder of Aristocrat Plastic Surgery and MedAesthetics, is certified by the American Board of Plastic Surgery and is a fellow of the American College of Surgeons. He earned his medical degree at SUNY Downstate Medical Center, and became Chief Resident in General Surgery during his residency at New York’s Beth Israel Medical Center. Dr. Tehrani holds the academic position of Assistant Clinical Professor in the Department of Surgery at SUNY Downstate Medical Center, and proudly served as a Lieutenant Commander in the Naval Reserves Medical Corps.

Dr. Tehrani has also been named one of the Top 10 Doctors in New York, an ExpertInjector™, a Realself TopDoc, and is a member of the American Society of Plastic Surgeons, and the American Society for Aesthetic Plastic Surgery. Dr. Tehrani will treat your journey through cosmetic and plastic surgery with the utmost respect.

We invite you to bring your cosmetic surgery and weight-loss concerns to Aristocrat Plastic Surgery, where you can relax knowing you’re in the best hands.