Skin removal surgery – What you need to know

John Culpepper, MD

Plastic Surgery

People who accomplish weight loss of 100 pounds or more – whether surgically or not – achieve a significant milestone in improving their long-term health. But they often discover an unpleasant side effect. After such extreme weight loss, folds of loose skin often hang from the arms, legs, stomach or breasts. Plastic surgeon John Wesley Culpepper, MD, explained why you might want to consider skin removal surgery.

“This extra skin is more than a cosmetic issue. It can lead to rashes, infections, ulcers, back strain and balance issues,” he said.

Who might be a candidate for skin removal?

Those whose weight has plateaued for at least six months and who have no vitamin or mineral deficiencies are good candidates for skin removal surgery.

What does skin removal surgery involve?

While it might sound straightforward, skin removal surgery can consist of several different surgeries, depending on the parts of the body involved. Each area involved – face or neck, breasts, stomach, legs, buttocks and arms – requires a separate operation. If more than one operation is needed, they likely will be done at different times. You may need to stay overnight at the hospital after your surgery.

In each area, an incision is made, excess skin is cut away, and the remaining skin and underlying structures are reshaped and sutured together. Full recovery can take up to two years, and scars will remain.

What are the pros and cons of skin removal surgery?

“Skin removal surgery often signifies the end of a long journey for those who have tried everything to lose a significant amount of weight,” Dr. Culpepper said. “There are psychological benefits that come with shedding the excess skin, and it can be incredibly emotional for some patients.”

Like all surgeries, however, skin removal surgery carries its share of risks. They include infection, blood clots, scars and anesthesia complication. There also is a chance the results may not meet the patient’s expectations.

Health insurance may not cover skin removal surgery unless there are medical problems associated with the excess skin. Often, if the surgery is covered, it’s only for abdominal surgery (the most common area for skin-removal surgery). Some insurance companies require documentation of health issues such as rashes that result from the excess skin.

Even if a person has skin-removal surgery, they may still see the typical sagging of skin that comes with aging – although it may be less extreme. In addition, the skin can stretch out again if the weight is regained.