What bariatric surgery patients need to know about excess skin removal

by Elizabeth Alexandra Zubowicz, MD, Bariatric Surgeon
April 10, 2018

Over the past few decades, weight loss surgery, also known as bariatric surgery, has become increasingly common. As such, we’ve begun to see more patients who could benefit from an additional procedure after weight loss: skin reduction surgery.

Almost everyone who has weight loss surgery will have some excess skin. When a patient loses 100 pounds or more, the skin can’t always bounce back and firm up. Some people aren’t bothered by this at all because they feel so much healthier. Others might be uncomfortable with how the excess skin looks. But for some patients, excess skin can cause painful or even debilitating health issues.

The amount of weight lost after bariatric surgery may cause a little bagging and sagging or can result in 40 to 60 pounds of excess skin. Skin reduction surgery (or excess skin removal) is elective, which means it’s totally up to the patient to have it or not. About 20 to 30 percent of our bariatric surgery patients choose to have skin reduction surgery, including both men and women.

LISTEN: Dr. Zubowicz discusses skin reduction surgery after bariatric surgery in this Medical Intel podcast.

Why do patients choose to have skin reduction surgery?

The majority of our skin reduction patients choose to have the procedure for cosmetic reasons. If a person’s excess skin issues are small or purely cosmetic, they can wear support garments to keep the skin up and tight. But when a patient has gone through all the hard work of preparing for and recovering from bariatric surgery and has lost a lot of weight, it can be hard to see all that excess skin in the mirror. Taking off those pounds of excess skin can be tremendously helpful for a patient’s self-esteem and can make exercise and hygiene easier.

When a patient has done all it takes to go through #bariatric surgery and has lost a lot weight, taking off extra pounds of excess skin can help with self-esteem. via @MedStarWHC

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For some patients, excess skin causes physical health problems. The skin folds can become a warm, wet environment that is prone to yeast infections or bacterial infections that can result in painful irritation, especially during exercise or work. Severe cases can be debilitating. Patients can help their excess skin from becoming a health concern by keeping it clean and dry, and by using antifungal powders to prevent rashes. But for long-term health, skin reduction surgery is a safe and easier option for many patients.

I’ve never had a patient tell me they regret having had bariatric surgery because of excess skin issues. Almost always, they feel so much better emotionally and physically once they lose a lot of weight. Their joints hurt less, their overall health improves and they can start exercising again. Still, a significant number of patients eventually want to have their excess skin removed as the next step to their healthier, more confident life.

How does skin reduction surgery work?

During the procedure, we surgically remove the excess skin by making incisions in the affected areas of the body. To remove excess skin on the stomach area, we make an incision at the bikini line. On the arms and legs, we make incisions on the inside of the limbs. There will be some scarring, and the surgeon will work to keep the scars as small and hidden as possible.

Patients should see doctors who are specifically trained in skin reduction surgery procedures and who do it often. Because we perform so many bariatric surgeries at MedStar Washington Hospital Center, our plastic surgeons are experienced in excess skin removal, and our cosmetic and bariatric surgeons partner closely together to ensure our patients get the best care.

We usually recommend waiting at least a year after having bariatric surgery before skin reduction surgery. Patients often continue to lose weight during this time, and if they get the surgery and then lose another 30, 40 or 50 pounds, they’ll have more excess skin and will be back where they started.

Is skin reduction surgery covered by insurance?

Health insurance coverage for skin reduction surgery varies. Many insurances only cover the procedure if a patient is having documented health issues, such as rashes, infections or irritation. Even then, it’s often covered only for the stomach area and not the arms or legs.

We understand the documentation insurance carriers require to get coverage for the procedure, and if you qualify, we can help with this process. Many patients who don’t qualify under their insurance still opt to get the procedure, paying for it out of pocket because of how much the excess skin affects their quality of life.

If you choose to have bariatric surgery, it’s important to go to a bariatric center like we have at MedStar Washington Hospital Center. You’ll have access to an entire team of surgeons, dietitians, psychologists and cosmetic surgeons who understand how to make weight loss surgery a success and are knowledgeable about living your best life after surgery.

If you have questions about weight loss or skin reduction surgery, call 855-546-1974 or click below.

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Category: Healthy Living, Medical Intel     Tags: bariatricexcess-skinreductionweightweight loss surgeryweight-loss