Ask the Plastic Surgeon, Dr. Repta: Skin Removal After Weight Loss

Dr. Remus Repta, Board Certified Plastic and Reconstructive Surgeon of Scottsdale, answers the questions that you, the public, have submitted. Dr. Repta and Arizona Foothills Magazine are excited to help bridge the void between the curious public and the expert for safe, informative, and real answers.

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Q: I’ve lost over 150lbs and have a lot of loose skin all over.  What are my options for skin removal after weight loss?  Thank you, Laura.

A:  Hello Laura.  First, congratulations on the weight loss.  That is a huge accomplishment and one that will pay health dividends for the rest of your life. There are many options for skin removal/skin tightening after weight loss.  The basic idea is that skin had been stretched out beyond its ability to bounce back and skin removal/skin tightening is the only current available treatment to correct this.  Below is a list of areas where excess skin after weight loss may be seen and the procedure/procedures that can help contour the area.


-Face and Neck:  “Jowling”, droopy cheeks, and “turkey neck” are all terms that people use to describe loose skin in common areas of the face and neck after weight loss.  Small amounts of loose skin can be treated with replenishing the volume lost from the face with things like filler and fat transfer.  More significant loose skin and often most patients, require a face lift and neck lift to reposition the deeper tissue of the face and neck and tighten the loose skin.  Fat transfer at the same time is also often performed.  In our goal of loosing weight and decreasing fat, we also unfortunately loose weight/fat from our face and this leads to a “deflated” appearance.


-Abdomen:  Most patients will notice a significant amount of weight loss and therefore loose skin in their abdominal area.  This is often the most important area for patients to address.  There are a myriad of abdominal contouring options including: full tummy tuck, extended tummy tuck, flour-de-lis tummy tuck, lower body lift, upper body lift.  The goal is to match up the procedure with the patient in terms of what is needed and what is desired.  All of the tummy tuck procedures require an incision but if the tummy tuck is designed properly the incision will be hidden low within the underwear line.


-Arms:  Loose arm skin following weight loss is very common.  Sometimes referred to as “bat wings”, it is an area that really bothers patients who have lost a lot of weight.  A brachioplasty or arm lift is designed to remove this loose skin.  The length of the incision will vary depending on how much loose skin there is.  Often, patients will benefit from an incision that goes from the elbow to the arm pit.  This can be combined with a breast lift or with a bra line back lift.


-Breast:  Both men and women actually end up having loose skin on their chest and breasts after significant weight loss.  For women, the breasts can be filled up with an augmentation and then lifted with a breast lift.  For guys, a chest reduction surgery is the only thing needed.  The incision can be just around the areola or the whole width of the chest half.  For women, the incision is often around the areola and down the breasts.  Breast lift and chest contour surgery can also be combined with a Bra Line Back Lift procedure.


-Upper and Middle back:  The upper and middle back area can also develop loose skin.  This loose skin will be seen as one or multiple folds in the middle back area and sometime in the lower back area as well.  An incision across the back at the level of the horizontal part of the bra strap for women is used to tighten the back area.  For guys, this incision can be readily hidden but it is often a welcomed trade off for a more contoured back.


-Legs;  The inner and outer thighs are often contoured separately.  The outer thighs are contoured with a lower body lift while the inner thighs require a separate incision.  Either a vertical inner thigh incision (for a lot of loose skin) or a smaller groin fold incision (for less loose skin) can be used.


As you can see, the options are almost endless.  For those concerned of scars I do recommend Embrace scar therapy, particularly on the tummy tuck, arm lift, and Bra Line Back Lift incisions.


I hope this helps.
All the best,
Dr. Remus Repta

For more information on Dr. Repta at AAA Plastic Surgeryclick here.

For more information on Dr. Repta’s tummy tuck and body contouring procedures, click here.

To ‘Ask the Surgeon’ yourself, email (all inquiries will remain confidential). The top questions will be featured in each month’s “Q&A Ask The Plastic Surgeon” featured blog.

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