I’ve had a few questions recently about loose skin due to weight loss. Specifically, loose skin due to large and/or rapid weight loss. I can only tell you what I know, what I experienced, and what I learned from my plastic surgeon.
If you lose a lot of weight, you’ll probably have some loose skin. How much depends on what your highest weight was, what your lowest is, and genetics. I had a lot of skin removed after losing 200 lbs, and my surgeon was really good about explaining to me the mechanics of what you see happening in your skin as you increase and decrease. Basically, if you have a lot of stretch marks that have filled in with that translucent light shade after their initial appearance as red streaks, that shimmery light color is new skin growing to accommodate your body as you gain weight (disclaimer: this applies to Caucasian skin – I don’t know about other skin but I’d welcome the information).
The next question I get is: Should one plan to lose slowly, then, to allow the skin to shrink? Well, the answer I received is that once that new skin has filled in the stretch marks, you have grown new skin. That’s pretty much all there is to it – you now have new skin and there’s nowhere for it to go when you lose but to sag. If you are extremely lucky, you may have extremely elastic skin that doesn’t get stretch marks and bounces back without leaving you with excess folds. But if you are not (like me), you are going to have loose skin no matter how slow or fast you lose.
My philosophy is if you need to lose anyway, then lose it however works best for you, learn to keep it off via maintenance, and deal with the loose skin when you have time. Personally I’d rather have loose skin than full skin that inhibits living my life.
Now, about my own personal skin: I had two major surgeries to remove loose skin, one in 2005 and one in 2006. The first one was a belt lipectomy. My surgeon took a 12-inch wide strip of skin from all the way around my torso. The surgery involved almost 10 hours under anesthesia and I was off work recovering for a full month, wearing a medical corset for that entire month. I also had some drains which I had to empty several times a day for the first week or two, as well as staples and stitches.
Over the course of the next year the internal dissolving stitches which had been used to secure what some of my friends affectionately call my “skin pants” dissolved and the scar dipped considerably low at each of outer hips, likely because I carry a LOT of my weight in my “saddle bags.” The scar tissue wasn’t able to hold up the weight and so my surgeon decided to do a re-section of my outer thighs to put in permanent internal sutures and pull up the thigh tissue, and while he was at it I asked him to do an inner thigh lift (no wikipedia entry found).
The scar for the resection simply followed the previous scar along the outer hips, however the scars for the inner thigh lift were significant. They include scars in each groin crease and a scar running down the inside of each thigh to a point about 2-3 inches above each knee. The skin and tissue in my groin has been secured to the pelvic bones with permanent internal stitches to keep the weight of my thighs from pulling the groin area down over time. This surgery took less time – 6 hours if I remember correctly – and the recovery was only 2 weeks off work, during which I needed to wear compression pants down to the knee. Unfortunately, because I was unable to find compression pants that were long enough I had some complications which resulted in the formation of a seroma right above the inner knee on my left leg which didn’t resolve on its own despite several visits to have the doctor drain it with a needle. I underwent one more procedure (in-office, local anesthesia only) to cut out the lining of the seroma and a final drain placed for another week or so. This may have been the most stressful procedure for me due to being wide awake.
I have never once regretted the decision to have my extra skin removed. Even during the long weeks of painful Vicodin-fogged recovery, there was never a moment when I wished I hadn’t done it. I had so much loose skin that my body looked like a deflated balloon. It wasn’t going to shrink back – I’d stretched it beyond that capability when I was at my highest weight. In fact, I’d always had an apron pannus from the earliest age I can remember – even as a child. Getting rid of that badge of dishonor was one of the easiest decisions I’ve ever made.
HOWEVER. The scars on my inner thighs have been a source of on-going angst over the years. You see, when I gain weight they have to stretch a bit, and when they stretch they hurt. It’s a stinging, pulling sensation that doesn’t feel good in any way whatsoever. So over the last couple of years as I’ve gained back these 50 pounds, my scars have been hurting. And now that I’m losing? They haven’t hurt in weeks.