After weight loss surgery, many people discover an unwanted side effect—loose skin. Even though it represents an extraordinary achievement of significant weight loss, loose skin can feel unsightly, uncomfortable, or even painful.
Causes of Loose Skin After Weight Loss Surgery
As you gain weight, the skin stretches. Many people who have weight loss surgery were obese for a significant amount of time, often for many years. When skin has been stretched for a prolonged period of time the proteins in the skin, including collagen and elastin, can become damaged, losing elasticity and the ability to retract with weight loss. People who lose a significant amount of weight, especially more than 100 pounds, will generally have more loose skin.
Some other factors can contribute to poor skin elasticity including:
- Age: People who are older have less collagen in the skin.
- Genes: Genetics can affect how much collagen and elastin you have..
- Sun Damage: Collagen and elastin production may be reduced by too much sun exposure.
- Smoking: Smoking damages collagen, restricts blood flow, and deprives skin of nutrients.
Caring for your Skin’s Health
Many people who undergo weight loss surgery experience some loose skin as a result. There are some tactics you can use to optimize the health of your skin, which may help reduce loose skin or its appearance, but these may only be effective for those with mild to moderate weight loss.
Feed Your Skin
As you go through our pre-surgical education, you’ll learn all about how to develop a healthy relationship with food, including the importance of a balanced diet full of vitamins and nutrients. Eating a healthy diet can help minimize loose skin after weight loss surgery, to a certain extent.
After extreme weight loss, loose skin results from the absence of fat or muscle under the skin’s surface. Muscle under the skin can help fill out areas that appear loose or saggy. Having enough protein can be helpful in building new lean muscle and may promote better skin elasticity.
After bariatric surgery, your vitamin regimen is more important than ever. Among the many health benefits of incorporating the proper vitamins in your diet are how they help your skin. Vitamins A, C, D, E, K, as well as zinc are all important contributors to optimizing your skin elasticity. Drinking enough water is another simple, but critical, way to prevent problems with your skin’s elasticity.
Focus on Fitness
In your pre-surgical education, we’ll help you build a routine of physical activity to promote weight loss. If you want to focus on improving the appearance of loose skin, you’ll want to work your way up to a fitness routine that incorporates a more aggressive strength-training regimen. Building muscle mass can help fill out your loose skin, minimizing its sagging appearance after weight loss surgery.
General Skin Care
Some people believe techniques such as dry brushing the skin can help improve collagen and elastin in the skin. There haven’t been any major medical studies on the benefits of dry brushing, but it should provide good skin exfoliation, leaving the skin softer and smoother, as well as providing increased circulation to the skin, which can help improve its appearance. However, it likely won’t have a dramatic minimizing effect on large amounts of loose skin.
Massage is also a technique that can be tried. Massage may help increase circulation, and some studies have indicated massage can boost collagen and elastin production, but there have been no studies looking at the effects of massage on loose skin following weight loss surgery.
You can also opt for wearing compression clothing and using powder to prevent chafing, rashes and infections. These won’t actually reduce your loose skin, but powder may help you feel more comfortable and compression clothing may help minimize the appearance of loose skin and provide additional comfort.
Surgical Options to Remove Loose Skin
Often the most effective way to get rid of loose or sagging skin after bariatric surgery is to have cosmetic surgery to remove the skin. Before choosing this option, however, it’s important to follow your doctors’ guidelines on how long to wait after bariatric surgery. Your body needs to recover before undergoing another surgery. Additionally, you need to give your weight time to stabilize after your initial surgery. You may also find that loose skin begins to tighten up after your original weight loss. It’s recommended to wait 12 to 18 months after bariatric surgery before having cosmetic surgery.
There are several body contouring surgeries that can target loose skin:
- An abdominoplasty, or tummy tuck, is a procedure to remove excess skin and fat from the abdominal area.
- A medial thighplasty, or inner thigh lift, is a surgery to remove excess skin and fat from the inner thighs.
- Brachioplasty, or arm lift, is used to remove excess skin and fat from the upper arms.
- A body lift is an extensive procedure in which excess skin is removed around the circumference of the body. It can be performed on the lower body (abdomen, hips, thighs, and buttocks), the upper body (chest or breasts and back), or a full body lift.
Cosmetic surgery to remove excess skin is often not covered by most insurances, but sometimes people are able to get some coverage if their excess skin is causing health problems.
One study showed that a non-surgical technique packaged as VelaShape ® could lead to loss of excess skin around the abdomen and arm. This technique uses infrared light, radiofrequency, light suction, and massage. This is a non-invasive, less expensive option than surgery, but the effects are unlikely to be as dramatic as surgical removal of loose skin.
One Step at a Time
Weight loss through bariatric surgery can be life-changing, but it’s a process that is life-long. If you’re just beginning your weight loss journey, it’s best to focus on adapting to new healthy behaviors. These may help you achieve weight loss more sustainably and may even minimize the appearance of loose skin after weight loss. The right time to think about surgical options to remove excess skin is at least a year after your surgery once your weight has stabilized.