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.