With the National Health Survey reporting that one in four Australian men and women are not just overweight, but obese, more people are opting for gastric bypass surgery, or making dramatic lifestyle changes which result in equally dramatic weight loss. With such a large portion of the population struggling with obesity, it’s no surprise that reality weight loss television shows like Excess Baggage, The Biggest Loser, Thintervention, Shedding for the Wedding, and Heavy have gained popularity. These shows, public health initiatives, and other trends have mobilized more people to lose weight to improve their health. But often, after losing 45 to 136 kilos, the same people are disappointed to find themselves struggling with unattractive or painful drapes of skin left behind by such substantial weight loss.

After working hard to lose a significant portion of their body weight, many people face another obstacle between their former obese self and the new, healthier figure they were striving for: excess skin. The skin that previously covered the fat that was lost remains in the form of an “apron” hanging over the abdomen and thighs. Other common complaints after rapid weight loss are loose skin around the neck and sagging skin around the upper arms. In addition to feeling unattractive with so much extra skin, it can also be a source of constant chafing and pain, interfering with daily activities such as dressing and exercising. Fortunately, there are a number of procedures that fall under the category of “body contouring” which can provide a great deal of relief to people who have shed the weight and want a more proportional look.

Body contouring treatments for excess skin

In the United States, 21 percent of gastric bypass surgery patients end up having at least one body contouring procedure, and studies have shown that those who do are less likely to gain the weight back than those who had gastric bypass without any body contouring procedures. For minor weight loss and pregnancy related sagging, noninvasive laser and liposuction procedures can help. While pregnancy weight gain may warrant a single procedure such as a tummy tuck, the massive, rapid weight loss associated with gastric bypass procedures and dramatic lifestyle changes frequently calls for more than liposuction or a tummy tuck. In the latter cases, the hanging skin encompasses the back, abdomen, thighs, and often the arms and neck as well. Rapid weight loss typically leaves loose skin all over, and may require more than one procedure. The types of procedures used to address excess skin after serious weight loss include panniculectomy, lipectomy (“lower body lift”), brachioplasty (“upper arm lift”), gynecomastia surgery (“male breast reduction”), breast augmentation or reduction, mastopexy (“breast lift”), abdominoplasty (“tummy tuck”), and liposuction.

Weighing the pros and cons

For many people, the excess skin is the last reminder of the unwanted weight they shed. Consequently, many decide that the surgical scarring and recovery time that accompanies skin removal procedures is preferable to the constant chafing, rashes, or feeling that they have to wear long sleeves and girdles to cover the drapes of skin. It is not uncommon for 4.5 to 18 kilos of excess skin to be removed after gastric bypass surgery.

Important considerations to get the best results

The time and discipline that enabled major weight loss is also necessary for getting the best cosmetic outcomes. Ideal candidates are nonsmokers without any major medical issues like Diabetes whose weight has been stable for at least six months, if not longer. Often this is 18 months after the original weight loss surgery. Gastric bypass patients in particular must first stabilize their nutrition to be healthy enough for cosmetic surgery procedures, as adequate nutrition is essential to wound healing. Waiting a while after rapid weight loss also allows the skin to shrink, which can take up to two years.

While gastric bypass surgery and other dramatic weight loss achieved through diet and exercise help to restore health, there are also a variety of cosmetic procedures that can help restore confidence in the event that unwanted excess skin remains. A skilled doctor can help identify and prioritize appropriate procedures to help reach individual goals.