When you work to lose a bunch of weight, you dream of a tighter, toned body. You don’t picture extra, loose skin. But that’s a real possibility, and one that can cause health problems and a poor self-image.
“It’s frustrating to patients who have put all this hard work and commitment into their weight loss journey and new bodies to be left with extra skin that doesn’t reflect that effort,” says Jason B. Lichten, MD, a plastic surgeon in Columbus, OH. “Often, they feel that their extra skin hangs on them the same way their old clothes from before their weight loss would, only they can’t take it off.”
Why Skin Doesn’t Snap Back
The elasticity of your skin depends on how long you were obese. It doesn’t matter if you dropped pounds quickly or slowly. The longer it was stretched out, the less likely it is to bounce back.
“It’s like a balloon,” says Marie Jhin, MD, a dermatologist in San Francisco. “When you first blow up a balloon, it’s really small and tight.” You have to stretch it first, she says. But when it’s deflated, it doesn’t return to its original shape.
A lot of it has to do with age and genetics, too, she says. “Everyone starts to lose [elastic tissue] as they get older.”
Bothers and Burdens
“Perspiration gets trapped, and you can get a rash,” Jhin says. “I recommend powder or cornstarch. It will help absorb [the moisture].” Some people, she says, even put a little fabric underneath.
While compression garments can help, loose skin can also make getting in shape tricky. “Imagine strapping 30 to 40 pounds to the front of you,” says Jennifer Capla, MD, a plastic surgeon in New York City. “It changes your center of gravity. It’s harder to move.”
No Easy Fix
Building muscle will help plump your skin some, Capla says, but there’s “no magic cream” or drug that will push and pull it back into place.
“It’s something that has to be dealt with surgically,” she says.
But only 20% of weight loss surgery patients get body contouring, says John Morton, MD, president of the American Society for Metabolic and Bariatric Surgery.
A big reason for that is the expense. A total body lift can cost $30,000 . Health insurance might pay for a tummy tuck because stomach folds can often get infected, but it won’t pay for most other body parts. Companies claim those surgeries are for cosmetic reasons and not reconstructive.
“The most common areas we treat, in order, are belly, backside, breasts, thighs, arms, male chest, and face,” Lichten says.
A surgeon will only remove extra skin if you keep the weight off for 6 months. And they’ll only work on one or two areas at a time. That cuts down on the risk of complications, says Claude-Jean Langevin, MD, DMD, a plastic and reconstructive surgeon at the Cedars-Sinai Plastic and Reconstructive Surgery Center in Los Angeles. Plus, it won’t hurt as much to move during recovery.
Surgery does leave scars, but they can usually be covered with clothes. No one has ever said the scar wasn’t worth going under the knife, Capla says.
Then again, not everyone wants the surgery. Susan Hawkins, 67, of Atlanta, lost 150 pounds after gastric sleeve surgery. She doesn’t love the sags left behind, but accepts them.
“My clothes do a remarkable job of hiding the aftermath,” Hawkins says. “[I’d] take the excess skin any day [to being obese]. For me, it’s my badge of honor.”
Others have trouble accepting their new look.
“Many view excess skin as a reminder of their old life and associations with emotional issues that they were struggling with when they were at a higher weight, such as anxiety, depression, loneliness, and low self-esteem,” says Alexis Conason, PsyD, a psychologist in New York City.
It’s healthy to embrace your new body, skin and all. Tanisha Shaneé, 30, of Brooklyn, NY, did just that. She lost more than 140 pounds with diet and exercise.
“There are challenges for one to accept with this journey,” she says. “I had to relearn how to love my body and accept the new, healthier one.”