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Loose Skin After Weight Loss Surgery

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It’s natural that people are concerned about excess or loose skin after surgery. Although the risks associated with excess skin are small compared to the life-threatening risks of obesity, you don’t want to trade one problem for another.

While it is important to consider loose skin, you actually need to consider the overall health of your skin. There are many nutrients in the body that have a direct relationship with your skin, for example, iron levels are linked to pallor and alopecia, Vitamin C is associated with wound healing, gingivitis, etc. A very thorough study on this subject called ‘Skin changes after Bariatric Surgery’ was published in 2015 and drew from 83 separate publications on the subject*.

So, the first priority is to ensure you maintain a focus on your nutritional health and that you follow the vitamin and mineral regime recommended by your provider and, importantly, that you attend the clinic for regular monitoring. It’s important to remember that 2/3 people are nutrient deficient even before their surgery so taking the appropriate supplementation and monitoring is likely to lead to an improvement in nutritional well-being.

In our own surgery package (sleeve and bypass) we are unique in offering blood screening in year 1 and year 2 after surgery. This helps to ensure you are enjoying the full health benefits of your surgery.

How much loose skin will I have?

The reality is that it’s impossible to tell how the body will react, some people will have excess skin and some won’t. Here are some of the things we do know and that might help you to weigh up the implications for you personally.

  • The faster you lose weight the more likely you are to have excess skin. We consider a weight of one to two pounds per week being ideal.
  • The longer you have been obese the more likely you are to have excess skin.
  • The older you are the more likely you are to have loose skin. Younger skin retains its elasticity better than the old skin.
  • The more weight you lose the more likely you are to have excess skin. Patients with starting BMI below 40 would be at lower risk of excess skin than those with a  starting BMI of 60.
  • Maintaining nutritional health after weight loss surgery, usually by using the vitamin and mineral supplements recommended, is important for your general health and to maintain healthy skin.

Ideally, you will have treatment to remove any excess skin that is left after your weight loss. Not only can it lead to confidence and quality of life issues but, if substantial and untreated, can lead to chafing, discomfort and some practical difficulty when it comes to maintaining personal hygiene.

6 tips for managing your skin after weight loss surgery

Building your muscle mass can help sculpt the body after weight loss and mask excess skin.

So, here are our 6 tips for managing your skin after weight loss surgery:

  1. Follow the post-operative dietary guidelines closely. 
    a) Keep well hydrated by drinking lots of water,
    b) Keep a high protein content in your diet
    c) Take a multivitamin supplement every day
  2. Try and lose weight steadily. A loss of 1-2 pounds per week is a safe and effective rate of loss that also gives time for the body to adjust to your changing shape.
  3. Take regular exercise, in line with the guidance given, to build your muscle mass.
  4. Attend clinic for your blood tests
  5. Maintain good personal hygiene
  6. Use a high-quality moisturiser

A lot of people ask me at consultation about excess skin. Before discussing it I always emphasise that their weight loss surgery is needed for their health, and they should not let the worry of loose skin put them off. Losing weight at a steady rate and maintaining good nutritional health are two things patients can do to help themselves. If they have excess skin and want to have it removed we’ll make a referral to a specialist cosmetic surgeon with the right expertise.

- Mr Rishi Singhal, Medical Director

How to choose a cosmetic surgeon

If you have loose skin after your surgery and decide to have surgery to have it removed, it’s important to choose your surgeon carefully. We asked Consultant Plastic Surgeon, Anne Dancey what her advice would be to a person looking for a surgeon who is qualified to do excess skin removal surgery after weight loss surgery.

She said, “it is important to find a suitably qualified plastic surgeon who you have a good rapport with and is experienced in weight loss surgery. It can be a minefield trying to find a suitable surgeon, so I recommend you consider the following:

  • Check your surgeon’s credentials: Ensure that the surgeon is on the Specialist Register of the General Medical Council and is a member of the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) or the British Association of Aesthetic Plastic Surgeons (BAAPS).
  • Do your research: If a price sounds ‘too good to be true’ it generally is.  Do not ever feel be pressurised into committing to surgery because of a ‘discount’ or ‘special offer’.
  • Talk to a past patient: Try and talk to people who have had the procedure that you are considering. Independent online review websites are useful but preferably discuss this decision with someone who has had surgery. Most surgeons will have patients who are happy to speak to you.
  • Be prepared for your consultation: Make sure to ask any questions you have about the procedure and if possible, bring a close friend or family member who can help you with recall.
  • Be open-minded: It is important to bear in mind that the procedure that you inquire about may not be the most suitable for you in order to achieve the results you want. The surgeon will discuss the alternatives, along with all associated risks and the pros and cons.
  • Meet the team, look round the hospital: Ask the surgeon if you can meet the team who will be looking after you. It is important that you gain a visual perspective of where you’ll be staying and who’ll be caring for you. Do not be afraid to ask questions concerning any matter with your care.
  • Take your time: A good surgeon will not take a booking on the day of consultation and offer you a ‘cooling off’ period so that you can thoroughly consider your options.
  • Get a price: The hospital should offer a fixed price package, which should include hospital, surgeon and anaesthetist’s fees as well as any implant costs and aftercare.
  • On-going support: Ask how many post-operative visits are included within the aftercare package and make sure you’ll have the follow-up appointments with the surgeon who performed your surgery.”

If you are considering weight loss surgery but concerns about excess/loose skin are causing you to have second thoughts, please call our team on 0800 313 4618 to get a free quote. We’ll be pleased to answer your questions and to a schedule a consultation with one of our surgeons.

*Ana Paula Dornelles Da Silva Manzoni and Magda Blessman Weber, Skin Changes After Bariatric Surgery, An Bras Dermatalogia. 2015 Mar-apr;90(2):157-166

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