Post-surgery tightness leaves most patients very satisfied.

Q: I lost 130 pounds after a gastric bypass. I expected to see my belly hanging after I lost the weight but am shocked to see how much skin I still have over my arms, hips, thighs, and buttocks. I work out almost every day but the skin isn’t shrinking at all. Have you seen this before? Can plastic surgery fix my loose skin?

-Alejandra C. Chino Hills, CA

A: Alejandra, first of all, you are to be congratulated for having lost so much weight and for making exercise an important part of your life. Studies have shown that such weight loss after surgical procedures dramatically improves the health of the patients who have lost the weight. I am sure that you have worked very hard to achieve this remarkable result so far. But you are not alone in noticing that the skin does not go back to its pre-stretched appearance after weight loss.

Over the years, I have seen many patients who have lost large quantities of weight like you have. Twenty five years ago, however, it was rare to have a patient come in for skin reduction surgery after such significant weight loss – I would see one or two such patients each year. But now such patients come in to see us weekly! With the advent of laproscopic surgery, lap band surgery and more sophisticated bypass and stapling techniques, the efficacy, safety and popularity of such procedures has sky rocketed. This year over 220,000 such “bariatric” surgical procedures will be performed in the United States, and the popularity of such procedures just keeps on growing.

The areas which we can address with plastic surgery are the ones you mentioned – the inner arms, abdomen and back of the trunk, hips, thighs and buttocks, as well as the breasts and faces. Removing such skin excesses is serious surgery and may require multiple sessions to achieve an optimal result. Long scars result but the improvement in contour and tightness leaves most patients very satisfied with their final results. Unfortunately, although the bariatric surgery itself might be a covered benefit, almost universally the skin reduction procedures are not covered by insurance companies.

The best way for me to illustrate what we can accomplish is with photographs. If you still have any questions about these procedures, your best bet would be to see a board certified plastic surgeon to review your options but be sure to check out the doctors’ track record with such large scale recontouring as such procedures are relatively new and not performed frequently by all surgeons. Ideally, your surgeon should have extensive experience with such procedures, be a board certified plastic surgeon and belong to the American Society of Bariatric Plastic Surgeons (https://www.asbps.org/user_details.php?detail_id=551.)

(Actual patient of Dr. Bunkis) 50-year-old female with excess inner arm skin after loosing more than 100 pounds, before and after arm recontouring.

 (Actual patient of Dr. Bunkis) 36-year-old, overweight mother of three children, after a 75 pound weight loss, before and after an abdominoplasty and a liposuction of the posterolateral hips and flanks (1,800 cc.)

 (Actual patient of Dr. Bunkis) This 60-year-old female presented to Dr. Bunkis, after 180 pound weight loss, using a walker because the skin of her legs and knees was preventing her from normal ambulation. Showed here before and after a thigh lift.



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