Best Time to Get Loose Skin Surgery After Weight Loss?

Hi, After a Weight Loss of 150 - 200 Lbs Still Having 100 - 125 Lbs. to Go when is It Time to Consider Surgery to Remove Loose Skin?

I am not sure of my starting weight as the scale in the doctors office only went to 400lbs., however based on research, comparing pictures. I have done this weight loss without any surgery, diet & exercise, over a long period of time. Approximently 7 years. The last 1 1/2 years I have been working with a weight management program and it's been helpful. I know it takes a personal consultation to be accurate, so I am just wondering "in general" under these curcimstance what is a common story?

Doctor Answers 15

Surgery after weight loss

I usually recommend that patients wait until their weight is stable for at least 6 months.  There is no use in moving ahead with the significant surgery ahead while you are still making strides.  By the way, my sister is a physician and lives in Chico and I will be visiting later this month.  It is such a nice little town.

Timing for surgery after weight loss

Congratulations on losing so much weight- you should be extremely proud of yourself.  Before having your definitive surgery for excess skin, you should be at your goal weight for at least 6 months.  Sometimes, if an extremely large skin apron is causing hygiene problems, an intermediate panniculectomy can be performed.  This is most often not necessary.  Often the first operation patients have is an abdominoplasty, with or without a body lift.  However, when you have your plastic surgery consultation to discuss this, you and your plastic surgeon can establish your priorities.

Bruce E. Genter, MD, FACS
Abington Plastic Surgeon
4.3 out of 5 stars 16 reviews

Surgery After weight loss

I am truly impressed with your accomplishment!  Congratulations.  Surgery after Massive Weight Loss (MWL) is a big undertaking for both you and your surgeon.  In general, the more you weigh the higher the complication rate.  If you have another 100 pounds to go I would hope to see you lose half of that or more before considering surgery.  Ideally it is best to wait until your weight has been stable for 6 months.  Even if it is not "ideal", if it is a weight you can maintain then it may be time to move ahead. Your tissues lost a lot of their elasticity over the years you were heavy.  They will stretch a little after every procedure you have so you don't want to jump the gun either.  Weight stability is the key to long term success.  You have proved your patience and persistence.  Don't forsake them now.  Look hard for the right board certified  plastic surgeon.  Make sure that you choose someone with experience in MWL surgery because in many ways it is different from other body contouring procedures.  Good Luck and Long Life!

Lori H. Saltz, MD
San Diego Plastic Surgeon
4.3 out of 5 stars 27 reviews

Best Time for Surgery after Weight Loss

Congratulations on your wonderful weight loss!  You should delay any surgery ideally until you have reached your weight goal.  If you plan on significant further weight loss as you do, surgery may need to be performed again if you have it done now.  Therefore, it would be best to wait.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Massive Weight Loss Surgery Timing

There's no question that the timing of massive weight loss surgery is extremely important. When patients are close to their ideal body weight, the results from these procedures are better. This also decreases the potential for complications with these procedures. For these reasons, we prefer that patients be within 10% of their ideal body weight at the time of surgery.

Unfortunately, reaching an ideal body weight is easier said than done. The vast majority of patients are unsuccessful at losing this additional weight. It's also important to realize that even when patients are overweight, they can potentially benefit from massive weight loss surgery. We, therefore, evaluate every patient on an individual basis.

We encourage patients to lose weight before surgery and prefer that their weight be stable for at least six months. We realize that some patients will have difficulty losing weight. We, therefore, encourage patients to be in a supervised weight loss program. Even with that help, some patients will be unsuccessful in their effort to lose weight. Even without optimal weight loss, many of these patients will still potentially benefit from this type of procedure.

It's important to realize that weight loss following body lift and other massive weight loss procedures can affect the final result This could even result in the need for revisional surgery. For these reasons, it's important to thoroughly discuss this issue with your plastic surgeon before proceeding with surgery.

Best Time to Get Loose Skin Surgery After Weight Loss?

It is always best to be at or very close to your goal weight before proceeding with skin removal surgery.  I would then wait a few months to make sure your weight remains stable.  I commend you for your dedication to the steady weight loss.  You obviously know that the maintenance that comes out of the complete lifestyle change is the hardest part of the process.  Best of luck!

Paul Fortes, MD
Houston Plastic Surgeon
4.3 out of 5 stars 8 reviews

One Option: Start with a smaller procedure to boost motivation and get the rest of the weight off!

Congratulations on your success so far – you’ve obviously made a MAJOR life change to get so much progress…definitely keep up the good work. I’m sure you’ve come to realize that although you’ve managed to lose the weight, there are many side effects of the weight on your body that you cannot improve no matter how hard you try. With another 100 or 50lbs left to go, there obviously will be more changes that occur and more loose skin to deal with, so I would not suggest doing any definitive surgery until you are closer to your goal (in your situation waiting until you were ~25-30lbs from your goal would be reasonable). You may want to think about a little something in the mean time to make getting around & hygiene a little easier. Often times we will start with an abdominal panniculutomy to remove the fold of tissue overhanging at the lower abdomen for just those reasons. You will have to plan on a formal tummy tuck or body lift later, but starting with the panniculutomy now may help you be able to more easily reach our goal in the long run and make those later surgeries easier on you since a large proportion of the tissue will already have been removed. Removal of that extra tissue may also give you a little of that mental boost that is needed to keep up the fight! Best of luck with your continued journey!

Stable weight before considering surgery

Generally speaking, surgical outcome and your safety is drastically improved when patients are at a stable BMI within the normal range. It's fantastic that you've lost so much weight, however you should lose that last 120-125 before considering plastic surgery. Best of luck to you, I know you can do it!

Timing for Body Lift

Once you have reached your goal weight and you are no longer losing weight for 6 months, you can consider body contouring options.  One of the most popular procedures after massive weight loss is a lower body lift.  If you are considering a lower body lift - this procedure (LBL) is also referred to as  circumferential body lift = belt lipectomy.  This procedure is essentially 3 procedures in one: extended tummy tuck + waist/lateral thigh lift + buttock lift.  The buttock lift can also include buttock augmentation.  The lateral thigh lift will help contour the lateral aspect of your thighs.  The procedure can taken between 5-7 hours depending on the amount of tissue/skin that needs removal/treatment.  Please see a board certified plastic surgeon to learn more about your options.

Dr. Sugene Kim

Timing for body lift surgery

Your best result and healthiest recovery will come by performing the procedure once you reach your goal weight.   So I would recommend trying to lose the final 100 pounds, then maintaining this weight for 6 months prior to proceeding with skin removal.
I do think it is beneficial to visit with a board certified plastic surgeon specializing in bariatric surgery at this stage to help you develop a plan for your skin excision.   They can take into account your goals and offer a surgical plan to help guide you from beginning to end.

Congratulations on your weight loss and I wish you much success in reaching your longterm goals!

Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 82 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.