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How To Deal With Loose Skin After Extreme Weight Loss
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How To Deal With Loose Skin After Extreme Weight Loss 

Losing a bunch of weight 鈥 whether it’s through diet and exercise, surgery, or a combination of different approaches 鈥 isn’t all glitter and smiling “after” photos. If you shed a significant number of kilos, having loose skin is normal 鈥 and extremely common. Also normal? Feeling a little bummed about it.

鈥淭his is a legitimate concern that patients have when seeking obesity surgery,鈥 says Dr Vivek Prachand, a bariatric surgeon and associate professor of surgery at The University of Chicago Medicine.

Why does loose skin after major weight loss happen? The maybe-a-little-downer (but real talk) truth: If you were in a larger body previously, excess fat likely stretched out your skin. Couple that with the fact that collagen and elastin (an elastic protein) in the skin naturally decrease as you age, and you’ve got a recipe for excess skin, explains Dr Manish Shah,聽a board-certified plastic surgeon in Denver.

鈥淭here may not be sufficient elasticity for the skin to contract back down to your new, smaller body size,鈥 says Dr Constance Chen, a board-certified plastic surgeon in New York City.

Stretch marks are one sign of skin being, well, stretched past the point of no return: Once you see them, 鈥渋t鈥檚 much more likely that significant weight loss will result in loose, hanging skin,鈥 says Dr Chen.

Does everyone have loose skin after major weight loss?

Nope 鈥 it鈥檚 not inevitable, says Dr Prachand. But it鈥檚 also not easy to predict who is going to experience it, he says. He鈥檚 had some patients who have lost 90 kilos in a year after obesity surgery and have very little excess skin. On the other hand, some have lost as little as 27 kilos and have more.

鈥淭he magnitude of weight loss doesn鈥檛 predict how much excess skin you may have,鈥澛爃e says. Other factors, like genetics, smoking (which degrades collagen and elastin), and sun exposure also play a role in your skin鈥檚 springiness.

It鈥檚 also normal to assume that losing weight quickly could cause sagging skin, but that鈥檚 not necessarily the case, either. 鈥淪ometimes, patients will consider doing surgery that doesn鈥檛 allow them to lose weight as quickly because of the fear of excess skin,” says Dr Prachand. “I understand these concerns, but there鈥檚 no strong evidence that how quickly you lose plays a role.”

Will loose skin ever go away on its own?

It might, but that can take a long time.

鈥淚n general, it can take anywhere from weeks to months 鈥 even years,鈥 says Dr Chen. If after one to two years skin is still loose, it may not get any tighter, she says.

Is it possible to tighten loose skin without surgery?

Sadly, probably not. 鈥淣onsurgical methods that help tighten the skin will generally not be effective enough to tighten the amount of loose skin that occurs with massive weight loss,鈥 says Dr Chen.

For instance, abdominal binders can help relieve back pain but do nada for skin. Compression garments can be worn to hold in excess skin, but they also won鈥檛 do anything to effect more long-term change.

Dr Shah says that if you have small amounts of loose skin, then devices like聽Bodytite and聽Renuvion, both of which are minimally invasive body-contouring technologies, may help. 鈥淭he best results come from surgery by far,鈥 he says.

What is surgery for loose skin like?

Body-contouring surgery often involves a 鈥渢ummy tuck鈥 with arm, breast, face, lower body, or thigh lifts, per the聽American Society of Plastic Surgery.

Dr Prachand and Dr Chen say there are certain indicators they look for before recommending loose skin-removal surgery to patients:

  • Patients have to be at least two years out from their聽weight-loss surgery.
  • Their weight has to have remained stable for at least six months.
  • Their BMI should ideally be under 30.
  • Patients can’t smoke.
  • Patients with diabetes need stable blood-glucose levels.

Oh, and if you鈥檝e had聽bariatric surgery聽to lose the weight, here鈥檚 a surprise: surgery to remove excess skin is tougher to recover from.

鈥淏ody contouring requires more overall body healing than obesity surgery itself, which is a minimally invasive procedure,鈥 says Dr Prachand. It鈥檚 important not to brush off the seriousness of the surgery thinking that it鈥檚 鈥渃osmetic,鈥 because it鈥檚 much more than that.

Indeed, you鈥檒l likely need two to four weeks to recover, with full recovery taking as long as six months after surgery, says Dr Shah. (That means you might not see the results you’re looking for aesthetically until that point, either.)

鈥淭he pain for surgery is relative and only moderate in intensity,鈥 he adds. Still, you probably will be too exhausted to go to work: During the first couple of weeks, a simpler daily routine is a must, says Dr Shah.

You should also know going in that you may need touch-up surgery. 鈥淪cars need to be finessed, some skin loosens and needs to be retightened, and there may be asymmetries to perfect,鈥 he says.

Long-term, this surgery may actually help you keep the weight off. Research in聽Plastic and Reconstructive Surgery聽found that patients who received body-contouring surgery were more likely to maintain their weight loss, compared to those who had bariatric surgery alone.

鈥淎fter body contouring, the improvements in physical and social functioning helps reinforce healthy lifestyle changes,鈥 says Dr Prachand.

This article was originally published on Weight Loss.

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