For those who have struggled with their weight for years, bariatric surgery can help you finally see success on your weight loss journey. By making changes to your digestive system, bariatric surgery helps patients lose substantial amounts of weight often in a very short time period. As a result, sagging skin is a very common problem after surgery.
Sagging skin is often thought of as a purely cosmetic concern. But for those recovering from bariatric surgery, skin laxity issues can cause health issues such as rashes, ulcers, hygiene issues, and infections. For a small number of patients, sagging skin may improve over time, or may even respond to noninvasive treatments. eHowever, in the majority of cases of patients who have undergone bariatric surgery, subsequent surgery is the best option to successfully correct sagging skin. Below, we’ll go over some of the most common treatment options.
A Full Body Lift
A full body can tighten and lift multiple areas, such as the abdomen, thighs, breasts, and buttocks and is commonly done after extreme weight loss. To undergo a full body lift, you need to be in good health and at, or close to your ideal weight.
A full body lift is done under general anesthesia. Your surgeon makes incisions in the various treatment areas and then excises excess skin. (In some cases, a small amount of liposuction and possibly fat grafting may be required during the process.) After removing excess skin and fat, your surgeon closes all incisions with sutures. The precise combination of procedures depends on your needs and your surgical plan you have with your surgeon.
While a body lift can be performed on an outpatient basis, many patients will need to stay in the hospital or aftercare facility overnight. You will have bandages and possibly surgical drains in place for the first few days following the procedure, which you will get instructions on caring for prior to leaving the hospital or aftercare facility.
Most patients can resume daily activities within four to six weeks, but individual recovery timelines will vary. Talk to your surgeon about what to expect for your recovery. Swelling and scarring will subside within a few months, at which point you’ll begin to see your results. However, it can take up to a year for the final results to fully take effect.
Panniculectomy
A panniculectomy can help for those who develop a pannus after losing weight post surgery. A pannus is a flap of excess skin that hangs over the belt line and in extreme cases, the thighs. In most cases, it is the result of extreme weight loss.
A panniculectomy is performed under general anesthesia. Your surgeon will make two incisions in the abdominal skin, remove a significant amount of skin between the belly button and the pubis, and then pull the remaining skin together and close it with stitches. The belly button is not moved during a panniculectomy.
Recovery takes six weeks or more — during which time you will need to refrain from heavy lifting and the majority of strenuous activities.
A pannus can cause significant health issues including ulcers and infections, and can limit your ability to exercise. Unlike many body contouring procedures – which are often considered cosmetic in nature – a panniculectomy is considered medically necessary and will usually be covered by insurance.
Tummy Tuck
A tummy tuck is similar to an panniculectomy, in that it can rid you of excess abdominal skin. It differs in respect to how the skin is surgically managed. In a tummy tuck (or abdominoplasty) the abdominal skin is rewrapped over the abdomen and the belly button is moved. If abdominal muscle laxity is present, it is also repaired. Patients interested in a more cosmetic outcome may desire a tummy tuck. A tummy tuck however, is not covered by insurance.
A tummy tuck is performed under local anesthesia and sedation. During the procedure, your surgeon will make an incision, usually from hip bone to hip bone. Then, they will remove excess skin and fat and tighten the underlying abdominal muscles before closing the incision with sutures.
Recovery from a tummy tuck takes approximately six weeks, but talk to your surgeon about your individual timeline. You may have surgical drains in place for the first week following surgery, for which you’ll receive care instructions.
Other Common Options
Sometimes, patients are hoping to target loose skin on specific areas other than the stomach or abdomen. If you do not opt for a full body lift – which can often address multiple areas at once – you may end up undergoing more than one body contouring operation after bariatric surgery.
Common post-bariatric surgery procedures include:
- Arm lift (brachioplasty)
- Face lift (rhytidectomy)
- Breast lift (mastopexy)
- Lower body lift (belt lipectomy)
- Thigh lift
Recovery times vary depending on the procedure, but can last anywhere from a few weeks to several months. Discuss your recovery timeline with your surgeon regarding when you can resume regular activities.
Sagging Skin After Bariatric Surgery: The Bottom Line
Sagging skin is a common problem after undergoing bariatric surgery, but can typically be corrected with body contouring procedures. The right procedure for you depends on your personal goals as well as the severity of your skin laxity issues. A consultation with a professional can help you determine your best treatment plan.
Ready to get started? Leif Rogers, MD is an Ivy League-educated, board-certified plastic surgeon and a standing member of the American Society of Plastic Surgeons. If you’re considering any of the above procedures, get in touch with his team to schedule a consultation.
