Excess Skin After Weight Loss

Contributed by: Bram Kaufman, MD | Division Director of Plastic Surgery and Christina Vargas, MD | Plastic Surgeon 

The MetroHealth Weight Loss Center can help you achieve significant weight loss. But when you’ve reached your weight loss goals, excess skin can cause infections, rashes and pain—while limiting your daily activities. Connecting to MetroHealth Plastic Surgery can help you continue your weight loss journey to achieve health.

90% of patients who choose weight loss surgery are successful at losing a significant amount of weight and maintaining that weight loss through support from weight management providers.

Most patients lose 65-75 pounds for every 100 pounds of excess weight as a result of surgery, continuing to lose weight through lifestyle changes post-surgery. With the advances of GLP-1 medication, available through weight management providers at the MetroHealth Weight Loss Center, people are reaching their weight loss goals through other means as well.

But once you reach your weight loss goals, the excess skin left behind may still be a concern.

“Many of the patients I see in consultation have had a dramatic transformation,” says Christina Vargas, MD, a plastic surgeon at MetroHealth. “They are healthier, they feel better, but they are being held back by so much extra skin and the new problems that come along with that.”

• Skin infections
• Skin irritation
• Pain, especially lower back pain caused by carrying the weight of excess skin

According to Bram Kaufman, MD, the Division Director of Plastic Surgery at MetroHealth, there’s an emotional side to having excess skin as well.

“I start my consultations by asking what bothers patients about their excess skin, so we can prioritize treatment,” says Kaufman. “Sometimes it’s about function—putting on clothes, bathing, toileting. But sometimes it’s also about the emotional weight of having the skin—they’ve come so far in their weight loss journey and are still reminded of their pre-weight loss body because of the skin.”

After a person has reached their weight loss goal and maintained that success for 6-12 months, it could be time to consider surgery to remove excess skin.

It’s also important for reducing surgical risk and improving recovery for conditions related to obesity to have resolved—a key reason many people choose weight loss surgery in the first place. Conditions such as diabetes, high blood pressure, high cholesterol, and pulmonary issues often resolve as a part of weight loss surgery, and being healthy in these areas are key to having a safe surgery.

Kaufman starts by asking patients to prioritize the areas of their body—often the lower abdomen, back, thighs, breasts, and arms—that cause discomfort or irritation.

“While we can eventually address all of the areas of a person’s body, we can’t do all excess skin removal surgeries at the same time and be safe,” says Kaufman. “We discuss which surgeries may qualify for insurance coverage and help people navigate a long-term treatment plan.”

Ideal candidates for excess skin removal surgery are people who have lost more than 100 pounds, have reached their weight loss goals, and have a successful plan to maintain their current weight—no plans to gain or lose weight in the future.

Often, patients are referred to MetroHealth Plastic Surgery from their Weight Management providers, who listen to patients regarding not just their physical weight loss but their mental health concerns.

Kaufman sees surgery to remove the excess skin as an important milestone.

“It is transformative,” says Kaufman. “This can be the next step in an amazing transition for people who have lost significant weight.”