Procedures to Tighten Loose Skin from Massive Weight Loss?

Dear Sir:

Congratulations on your massive weight loss.  You should be commended on significantly improving your health and improving your lifestyle. 

I have many patients such as you who have lost a significant amount of weight and developed excess skin and fat in the pubic region.  Typically, male patients after massive weight loss developed significant fat above the penis and lateral to the penis above the scrotum.  When I examined patients, the excess skin and fat in this area typically looks like the letter W. 

Due to your significant weight loss, this is a very typical area to exercise or workout.  Sit ups and lunges do not significantly tighten the skin.  It is not necessarily the lack of exercise or doing the wrong exercise, it is just the skin in the area has been stretched and is unable to contract.  Surgical procedures include an abodominoplasty or a body lift  if your hips and buttocks bother you.

During my body lifts, I make the incision in the pubic region in males, very low to remove this excess skin and fat.  If your abdomen and hips are not bothering you and it is just the pubic region then I do an isolated pubic reduction.  This is done by making a vertical incision just above the penis extending towards the top of the underwear line.  By doing this, an ellipse or football-shaped skin and fat excision is done.  In addition, if the excess skin and fat is significant extending down to the scrotal region, I make an incision in a shape of an upside-down Y so the incision goes on top of the penis and then down the side of the penis onto the scrotum.  Sensation is usually always left intact and erection and fertility usually are not postoperative problems.

 

J. Timothy Katzen, MD, FACS

It's not unusual for patients to develop significant amounts of redundant abdominal tissue following massive weight loss. In patients who have lost over 100 lbs., correction of this type of problem usually always requires surgical intervention. Unfortunately, exercise will have little effect upon loose skin.In your particular case, it's difficult to make a specific recommendation without pictures or a physical examination. Despite this, your clinical history strongly suggests that you would benefit from some type of abdominal skin resection.The type of procedure chosen would depend upon your anatomic findings and aesthetic goals. This procedure would require removal of excess abdominal skin and elevation of the mons pubis. The extent of skin resection would depend upon the degree of skin sag and in some cases, may require a posterior body lift. In some cases, the underlying muscles may be weak and require tightening as well.If you're concerned about redundant abdominal tissue, it's important to consult a board certified plastic surgeon with experience in this area. This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals.

Unfortunately, no amount of diet and exercise can reverse the problem of excess skin in massive weight loss patients.  Generally, abdominoplasty is the only reliable and reproducible method to improve the problem of excess skin in the abdomen after massive weight loss.  The procedure can be tailored for each individual patient to include standard technique, extended abdominplasty, and circumferential abdominoplasty/lower body lift.  Studies have shown that removing the excess tissue can improve one's quality of life.

Congratulations on loosing so much weight.  That is a tremendous accomplishment.  Unfortunately when you loose that much weight your skin never shrinks down.  The common areas include the belly, pubic region, buttock, medial thighs, arms, and chest.  All the exercise in the world will not get rid of the skin.  Even "non-invasive" procedures will not likely give you what you are looking for.  With the kind of weight you have lost it is likely you would benefit from a body lift (circumferential abdominoplasty).  If all the looseness is in the front then a traditional abdominoplasty will be enough.Rodger Shortt, MDPlastic Surgeon Oakville

Congratulations on your weight loss. There are no exercises that will tighten the loose skin on the abodomen or mons pubis. However there are many surgical procedures that can address this issue such as tummy tuck or mons reduction surgery.

Congrats on your weight loss !  Excess skin can often be removed from multiple areas at one operation by doing either a lower body lift or an upper body lift.

You should be at a stable weight before surgery, and also

In the video link below (video at top of page) I talk about insurance coverage and my book for weight loss patients.

People who lose over 100lbs will invariably have excess skin that there body can not deal with and the only recourse is a surgical excision of the skin. This is almost always best handled with a Body Lift procedure.  When  the body gains weight  it does so all over, some areas gain more than others, but there are fat cells under the skin throughout your body. The skin of the body does have some intrinsic elasticity that allows it to retract when one loses a small amount of weight but that limit is greatly exceeded in massive weight loss patients. Your skin actually grows to accommodate the added fat you gain during the process of weight gain. After you lose the weight, remember you are only loosing fat when you loose weight not skin, you are left with skin that has grown in the process. There is currently no way of making this skin go away by itself except to surgically excise it, however,  this does also give opportunities for enhancing contours at the same time.

You have done everything right: lost weight, and got yourself on a good diet and exercise regiment.  The loose skin of your abdomen and pubic area is the skin which was not able to snap back after weight loss.  An abdominoplasty will correct the abdomen and pubic skin excess or a lower body lift will correct the tissue excess of your trunk and pubic area to smooth and contour these areas.  Your surgeon will suggest what procedure would be best tailored to you after an examination.

   Congratulations  in your weigh loss.   The most frecuent  procedure  to removed the unwanted skin is the Lower Body Lift.   That operation will remove and thighting the skin form the pubic area, inner thigh, Lateral thigh and the bottocks.  The  varietion of the surgery will vary depending of the case.   Than You

meohme,

It is actually very common to have a large skin excess around the penis in someone who lost as much weight as you have.

There is unfortunately no amount of exercise that you can do to address the excess skin that is left after a massive weight loss.  The only way to treat it is to remove it through surgery.  We often do this at the time of the tummy tuck, and incorporate the pubic pannus (excess skin) into our abdominal body contouring.

Sincerely,

Martin Jugenburg, MD