Excess Skin Removal

What is excess skin removal surgery?

Various plastic (cosmetic) surgery procedures to remove excess skin. Surgery can reshape your body. You may need body contouring after a significant weight loss (typically 100 pounds or more).

Who does excess skin affect?

People with obesity may lose weight with bariatric (weight loss) surgery or diet and exercise. Significant weight loss can leave you with excess, sagging skin.

When you carry extra weight, skin and tissue stretch to accommodate the body’s larger size. This stretching causes skin and tissue to lose elasticity. When you lose weight, the stretched skin can’t conform to your new shape and may be saggy and hang loosely from your body.

Why do people have excess skin removal surgery?

Having excess skin may affect your self-confidence. It can be hard to find clothing that fits well. Heavy skin can be painful. Skin folds can also increase your risk of skin infections, skin fungus and skin rashes.

Who is a candidate for excess skin removal surgery?

Plastic surgeons (sometimes called cosmetic surgeons) perform excess skin removal procedures. Your doctor will conduct a physical exam and other assessments to determine if surgery is right for you.

In general, you may be a good candidate for excess skin removal surgery if you:

• Maintain your goal weight for at least six months following major weight loss.
• Commit to a healthy lifestyle (nutritious diet and exercise) to help keep off the lost pounds.
• Don’t smoke or use other tobacco products. Smoking slows wound healing and can increase the risk of surgical complications.
• Are in generally good health, without any significant medical problems that might make surgery too risky.
• Have realistic expectations about what the procedures can accomplish.

What are the types of excess skin removal procedures?

There are several different procedures for removing excess skin. Most people need a combination of surgeries to get the look they seek. Your doctor can help determine which procedures will benefit you the most.

Excess skin removal procedures include:

• Arm lift (brachioplasty) to remove excess skin that hangs down from your upper arm.
• Breast lift (mastopexy)to firm up breasts by tightening tissue and removing excess skin.
• Facelift (rhytidectomy) to give your face a smoother, younger appearance and get rid of excess skin around your neck.
• Lower body lift to remove excess skin and fat from your stomach, butt and outer thighs.
• Panniculectomy to remove the apron of excess skin (called a pannus) that hangs below your belly button.
• Thigh lift to give your inner thighs a sleeker appearance.
• Tummy tuck (abdominoplasty) to remove excess skin and tighten weak or separated abdominal muscles.

What can I expect before excess skin removal surgery?

Follow your doctor’s recommendations when preparing for surgery. You may need to:

• Get blood work (lab tests).
• Stop taking certain medications that increase bleeding risk, such as aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs).
• Not take vitamins and herbal supplements.
• Quit smoking or using tobacco products.

What happens during excess skin removal surgery?

Depending on the procedures, you may have surgery at a hospital and stay overnight. Or the procedure may take place at a surgical facility, and you’ll go home the same day (outpatient procedure).

Excess skin removal often takes place in stages. You may need multiple surgeries. Certain procedures, such as a lower body lift or a panniculectomy combined with a tummy tuck, can occur during the same surgical appointment.

Can excess skin removal take place at the same time as another weight loss surgery?

No. Excess skin removal surgeries can only take place after bariatric (weight loss) surgery. A plastic surgeon can’t remove the excess skin until you lose the extra weight. It may take one to two years to achieve your goal weight after bariatric surgery. You also need to maintain that weight loss for at least six months before getting body contouring procedures.

Also, two different types of surgeons perform these procedures:

• Bariatric surgeons perform weight loss procedures like gastric bypass and gastric sleeve.
• Plastic (cosmetic) surgeons perform body contour procedures.

You may have heard that you can have liposuction and body contouring, such as a tummy tuck, at the same time. Liposuction can help remove stubborn fat deposits, but it isn’t a weight loss surgery. Your surgeon can discuss if a combined procedure is right for you.

Does excess skin removal surgery cause scarring?

Yes, you will have scars from the incisions. When possible, your doctor will make incisions in your hairline, a natural crease or covered areas that are less noticeable. For instance, doctors make panniculectomy or tummy tuck incisions in the pubic region or bikini line.

How painful is excess skin removal surgery?

Excess skin removal procedures are major surgeries. You can expect to have pain for a few weeks. Your healthcare provider will prescribe pain medicine and offer tips to ease discomfort.

You may have more pain when moving around, climbing stairs or getting off the couch. It may help have a loved one or other support person stay with you during the first week of recovery.

What are the potential risks or complications of excess skin removal surgery?

It’s important to have realistic expectations before you get body contouring procedures. Plastic surgery can improve appearance, but it can’t give you a perfect body shape. It also can’t help you lose more weight beyond the weight of the skin your surgeon removes.

All surgeries have risks. Potential risks of body contouring procedures include:

• Bleeding.
• Blood clots like deep vein thrombosis (DVT).
• Bruising and swelling.
• Changes in skin sensations or numbness due to nerve damage.
• Infections.
• Scarring.

What is recovery like after excess skin removal surgery?

How you’ll feel during recovery — and when you can resume activities — depends on the procedures. A full recovery can take several months.

After surgery, you may:

• Have temporary tubes to drain fluid out of your body. You may go home with these tubes, which may stay in place for a week or two.
• Take pain relievers or NSAIDs.
• Change bandages and apply ointments frequently.
• Need someone to drive you places for at least the first week.
• Not lift anything heavy or do strenuous physical activity for at least six weeks.
• Return to work in one to three weeks, depending on the procedure.
• Not stand upright for a few days after an abdominal procedure.
• Sleep with pillows elevating the knees after lower body procedures.
• Drink plenty of fluids to stay hydrated and walk to prevent blood clots.

How soon will I see results after excess skin removal surgery?

Your body needs time to heal between procedures and after the final surgery. It may take up to two years to achieve final results from body contouring.

How long do results from excess skin removal surgery last?

The long-term effects of body contouring surgery partly depend on your ability to keep the weight off.

Everyone experiences weight fluctuations throughout life. But if you regain a substantial amount of weight after body contour surgeries, your skin will stretch. If you re-lose those pounds, the skin will sag again.

When should I call the doctor?

You should call your healthcare provider if you experience:

• Chest pain or shortness of breath.
• Dizziness or fainting.
• Nausea and vomiting.
• Signs of infection, such as fever, redness or yellow discharge at the incision sites.
• Severe pain.
• Swelling in your limbs.

A note from Cleveland Clinic

When you experience significant weight loss, it’s understandable to want your body to look a certain way. Excess skin can also be painful. If you’re bothered by sagging skin after weight loss, you can talk to a healthcare provider about body contour procedures. These procedures can remove excess skin and fat. They also tighten tissue to give skin a firmer, smoother look. You may need several body contour procedures to remove excess skin and get the look you seek. A plastic surgeon can determine the best body contour procedures for you.