How Do I Tell if I Have Excess Skin or if It's Just Fat?

You wouldn't be able to feel individual fat cells, they're microscopic. It's really tough to distinguish between fat and loose skin, but loose skin typically includes some stubborn fatty tissue.

Looking at solutions for excess skin and/or fatty tissue depends on your problem areas (which you didn't really define here) and more information about what's bothering you. For example, if we're talking about the abdomen, liposuction would deal only with fatty tissues whereas a tummy tuck would deal with muscle, skin and fat. A dermatolipectmy would only deal with excess skin (not muscle or fat). 

The only way to know what your true options are would be to schedule a consultation with a board certified plastic surgeon to discuss what bothers you. The plastic surgeon will be able to map out your options and answer all of your questions, very specifically.

by Ricardo L Rodriguez
 

Hello, thank you for your questions regarding what to do after weight loss. It is impossible to tell exactly what you need without a thorough physical examination or without pictures. You describe that you feel something underneath the skin which you believe are "fat cells". These balls that you feel under the skin are probably lipomas, not fat cells. You cannot feel individual "fat cells".  Alternatively, these lumps can be areas of scar tissue after weight loss.  If you just want to get rid of the lumps, I would suggest VASER liposuction.  During VASER liposuction, fat and scar tissue is melted. Then, a traditional liposuction cannula is used to remove melted scar tissue and fat.  However, you mention you have lost weight. If you have lost more than 100 pounds and are over 35 years old, I would suggest you also have skin removed. I specialize in plastic surgery after massive weight loss. There are several different surgeries which can address different body parts. During a tummy tuck or abdominoplasty, the abdomen is tightened.  This is achieved by tightening the abdominal (rectus abdominis) muscle and removing excess abdominal skin and fat.  Alternatively, the tummy tuck can be converted into a lower body lift. The lower body lift is also called a 360 circumferential lower body lift.  During this procedure, the incision is carried around the hips towards the buttock. During the lower body lift, not only is the abdomen flattened, but the hips and buttocks are raised and reduced.  Also, if the inner thighs bother you, a medial or vertical thigh lift can be performed. During the thigh lift, an incision is made from the groin to the knee and an ellipse of inner thigh skin and fat is removed. If your breasts bother you, a breast lift can be performed with or without breast implants. If your arms bother you, arm liposuction is and an incision is made from the armpit to the elbow. I would suggest you analyze your body and see which body part bothers you the most. Before making any decisions regarding an abdominoplasty, 360 circumferential lower body lift, thigh lift, breast lift, or arm lift, I would suggest you seek a consultation with an expert. Please seek an experienced, board-certified, plastic surgeon.  Travel out of state if you must to find such an expert. If you have any more questions regarding a tummy tuck, abdominoplasty, 360 circumferential lower body lift, thigh lift, breast lift, arm lift, or plastic surgery in general, please contact my office.  Sincerely Dr. Katzen. (Certified by the American Board of Plastic Surgery and member of the American Society Plastic Surgeons, International Society of Aesthetic Plastic Surgery, and American Academy of Cosmetic Surgery.)

Depending upon the degree of weight loss that you've experienced, you may have loose skin, residual fat or both. There's only one way to know for sure, and that involves a physical exam. For this reason, it's appropriate 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 deformity and achieves your aesthetic goals.

Hi there-

It will be very difficult or impossible for you to reliably tell how much of your problem is due to excess fat and how much is due to excess skin. 

Your best bet is to visit a good surgeon for a consultation and examination.

Hi MusicJunkie89, congratulations on your healthier lifestyle and weight loss! There's no simple way to tell whether it's excess skin or just fat without examining you. I recommend that you make an appointment to see a plastic surgeon who you feel comfortable with and discuss your concerns and questions with her or him.

Good luck! JT

Without a photo and some idea of which areas are troublesome to you, all I can suggest is a visit to a plastic surgeon for an in person evaluation.  RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S.

Since you describe losing a lot of weight, chances are that you skin has lost elasticity and that you have excess skin, perhaps along with excess fat. If that assumption is correct, it seems most likely that you would be a candidate for a skin reduction procedure at the site or sites in question  (tummy tuck, body lift, arm lift, etc).

Thank you for your question, best wishes.

The best advice I can give you is to visit a BCPS who can examine you, explain what your options are surgically that will help your reach your aesthetic goals. Best wishes.

The best way to tell if you have excess skin or excess fat is to see an experienced plastic surgeon.  That is what we are here for.  There is only so much information that can be given over the internet.  People are all different.  Some patients lose massive amounts of weight and their skin recoils beautifully.  Unfortunately for others, it does not.  Some may need a tummy tuck, others might just need lipo and still others might need a body lift procedure with or without lipo.  Find a Board Certified Plastic Surgeon in your area and ask their opinion.

Dear MusicJunkier89,

Once the tissues of the skin have been stretched past a certain point, they lose the ability to retract or shrink with weight loss.  This is a very common problem for patients who have lost a great deal of weight.  Also, as we age, our skin also loses some of its ability to shrink/retract.

If this is the situation you are facing, then then best option is surgery to remove the excess tissues.  There are no non-invasive techniques that can give the results that surgery can-no matter what their marketing directors advertise.

In order to get an evaluation of your concerns, please consult with a board-certified plastic surgeon who can best direct you on which options are right for you.

Hope this helps and best of luck.

Fat cells are microscopic in size, you cant feel them. You are feeling the nodularity of the fat attached to the skin. A consult with a plastic surgeon will help you determine what surgery can accomplish vs further weight loss. When you have significant skin laxity and excess there are no techniques short of surgery to correct that.