Plastic Surgery after Weight Loss

After losing a significant amount of weight, many people find that they have an excessive amount of skin. Some people will elect to have plastic surgery in order to deal with this extra, sagging skin.

Will you have to have plastic surgery after weight loss surgery?

Not necessarily. Not everyone who loses a lot of weight has a problem with sagging skin. Whether or not your skin will snap back into place after surgery depends on several factors:

  • Age: The younger you are, the more elasticity your skin is likely to have and the better chance that it will snap back after weight loss.
  • How much you weighed initially: The more overweight you were before surgery, the more your skin was stretched and may sag after weight loss.
  • How many times you gained and lost weight: The stretching and deflating of weight gain and loss causes the skin to lose elasticity and sag.
  • How you carry your weight: You’re more likely to have problems with sagging if you carried the majority of your weight in one area.
  • Smoking: Smokers develop more loose skin than non-smokers who lose weight because smoking breaks down collagen in the skin.
  • Sun exposure: The more your skin has been exposed to the sun, the less elasticity it will have.
  • Genetics and skin type: Some people simply have more elasticity than others, regardless of other factors.

Even if you do have excessive or sagging skin after weight loss, you don’t have to have plastic surgery. Some people choose to have surgery for cosmetic purposes, while others find that large folds of skin can cause problems like chaffing and rashes. If you have excess skin after weight loss that causes medical problems such as severe rashes or yeast infections, your insurance company may be willing to pay for a portion of your plastic surgery.

What type of plastic surgery removes excess skin?

An individualized procedure (or series of procedures) known as body contouring is used to remove excess skin and fat pockets from various areas of the body. Plastic surgery body contouring often involves multiple areas of the body and multiple surgeries and can cost as much as $30,000 for a complete body contour. Because a larger area of the body is involved, body contouring surgeries are usually more painful and require much longer recovery time than your weight loss surgery.

When can you have plastic surgery or body contouring?

Body contouring should not be performed until you’re finished losing weight and have maintained your weight for at least six months. Ideally, you’ll have body contouring when you’ve reached your goal weight. If you aren’t sure if you’ve lost all the weight you can or if you’ve simply hit a plateau before reaching your goal weight, it’s recommended that you renew your weight loss efforts before making the decision to have plastic surgery. If you have surgery and then lose additional weight, you may have sagging skin again.

In addition to being at a stable weight to avoid new sagging, it’s important to be in good health before undergoing body contouring. Body contouring is an elaborate procedure, sometimes involving multiple procedures, and your risks for complication are reduced if you’re in good health. If you had any obesity-related health problems before having bariatric surgery, they should be resolved before having plastic surgery.

If you’re considering body contouring surgery, talk to your weight loss surgeon. He or she can help you determine if you’re in good enough health for the procedure and refer you to a plastic surgeon who specializes in working with weight loss patients.

Panniculectomy, Abdominoplasty, and Brachioplasty

One of the most common areas to have excess skin after significant weight loss is the abdomen, as this is where many obese people carry the majority of their excess weight. There are two plastic surgery procedures available to resolve this problem and, in some cases, your insurance company may be willing to cover a portion of the cost.

The flap of skin that hangs down from the abdomen is called a pannus and may hang down a few inches or well into the thigh area. A pannus that is particularly long can sometimes interfere with walking. This area is also especially prone to rashes and yeast infections, which is why some insurance companies consider the removal of the pannus a medical necessity.

The pannus can be removed by a panniculectomy or abdominoplasty, surgeries that usually take two to eight hours to complete. A panniculectomy is the surgery that simply removes the extra fold or apron of skin. An abdominoplasty, on the other hand, is a more extensive surgery that involves surgically tightening the muscles of the abdomen. After this surgery, you will likely have a horizontal scar that is fairly easy to hide. This surgery may also remove your natural belly button, which has no actual function, but your plastic surgeon can create a new belly button for you if you’d like for cosmetic reasons.

Recovery for these surgeries often involves wearing a binder to help reduce swelling and support the tissues as they heal. You may also be sent home with two drainage tubes that need to be emptied twice a day, which are usually required for about a week after surgery.

If you have skin flaps that hangs down from your upper arms—sometimes referred to as “bat wings”—you may elect to have brachioplasty surgery. Similar to a panniculectomy, a brachioplasty procedure simply removes the excess skin flap from your upper arm. The scar from this surgery usually runs along the inside of the upper arm and can be difficult to hide because of its length.

Breast Reconstruction/Reduction, Lower Body Lift, and Face/Neck Lift

The breasts are another part of the body that are commonly affected by significant weight gain and weight loss. There are two types of surgery to deal with large or sagging breasts after surgery, and which type you have may determine whether or not you’ll receive insurance coverage.

A breast lift can be performed to resolve sagging breasts. Excess skin is removed and the surrounding tissue is tightened, which gives the breasts a “lifted” appearance. This is typically considered a purely cosmetic surgery and is almost never covered by insurance companies.

A breast reduction, on the other hand, is designed specifically to make the breasts smaller. A breast reduction involves removing excess breast fat, glandular tissue, and skin in an effort to eliminate medical issues associated with having large breasts. Your insurance company may be willing to cover this procedure if you can show that the current size of your breasts is causing back pain, grooves in the shoulder region from bra straps, or infections in the folds under the breasts.

Lower Body Lift

A plastic surgery lower body lift can be performed to correct excessive skin sagging in the thighs and buttocks. A lower body lift is actually a combination of procedures that usually includes abdominoplasty, a thigh lift, and a buttock lift. In addition to the resculpting of the abdominal area, excess skin and fat are removed from the thigh and buttock area to pull the skin up tightly.

Face and Neck Lifts

For some weight loss patients, skin sagging in the face and neck area can make them look older. A face or neck lift can be done to tighten the skin and muscles in these areas in order to resolve this problem. Insurance companies almost always consider these cosmetic procedures, as there is no medical problem associated with looking older.

The incisions for face and neck lifts are carefully hidden behind the ear or in the hair line. However, immediately following surgery, you can expect a great deal of swelling and bruising, including black eyes, which can last for a few weeks.


Bariatric patients who have plastic surgery body contouring procedures after weight loss may also have liposuction in combination with their plastic surgeries.

Liposuction involves sucking the fat out from under your skin with a long tube. Contrary to the description, liposuction is not a weight loss tool used for getting rid of fat stores. It also will not solve the problem of excess or sagging skin. Liposuction is performed on people who have lost a significant amount of weight in order to help smooth out the appearance of newly tightened skin. For example, if you have a lower body lift to remove the excess skin from your thighs and buttocks, you may also have liposuction performed at the same time to remove some of the fat from these areas.

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