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The Trouble with Excess Skin after Surgical Weight loss

The Trouble with Excess Skin after Surgical Weight loss


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Weight loss before and during a period of morbid obesity comes with a series of challenges. Some easier than others. Emotional, physical, and relationship limits are easily tested when faced with the hardships of chronic conditions like obesity. This is because a lot of it has to do with taking back control of your habits, your body, and your hormonal state. Surgical weight loss or any time of weight loss takes a lot of effort, patience, and frustration, as well as sacrifice.

So, it makes sense that the same feelings that can occur after the surgical weight loss procedure. Because the bodies of bariatric patients will still adjust and adapt to the massive weight loss in different ways. One of the major adjustments that come to almost all bariatric patients after a few months is the presence of excess skin. This sort of thing can be frustrating both for aesthetic or practical reasons.  So, let’s look at what sort of obstacles excess skin can cause, how to take care of it, and how a skin removal procedure works.

Where Excess Skin Comes From and How Skin Works

Skin is the largest organ in any mammal. In humans, the skin has multiple functions, some of which are more apparent than others. For instance,  is well known among most people that skin is responsible for being a protective layer over our vulnerable and sensitive organs. We also know that is is part of temperature regulation by way of sweating, and has nerves that exist to let us know when we are touching something or when we are in danger.

But there are other things about the skin that most people don’t know.

For instance, it is part of hormone production, along with other parts of the human body. Also, it functions as a large storeroom for the body. This is why it has a certain level of elasticity. Skin can expand and contract in small increments when there is an excess of fluid or fat cells underneath.

The part of the skin that stores and expands with fat cells is in the deepest layer, the subcutis.

Skin’s Elasticity

But, it is not responsible for the elasticity of the skin. That job designation belongs to the thick middle layer of the skin, the dermis. The dermis produces collagen fibers and elastin which determines elasticity.

This elasticity depends on just how much collagens and elastins are naturally produced. But this elasticity has its limits. If there is too much weight gain in a short amount of time, then the skin would respond by hyperextending.  It will add mass to accommodate the rapid amount of fat cells, to the point of bursting.

So, it will be less likely to snap back and re-tone itself with the drastic nature of surgical weight loss results.

This is explained succinctly by a plastic surgeon in an interview with, “We don’t really understand completely why some people’s skin contracts better than others, but we do know that excess skin is a common problem for people who lose more than, say, 20 or 30% of their body weight.”

Excess Skin Problems

So, what does suffering from excess skin look like? Surely this is something that is strictly a vanity issue, right? Surely it is solvable by techniques aside from surgery? Not necessarily.

For most people who live in a humid area, excess skin management is the stuff of nightmares. Humidity alone can increase issues like chafing, sores, and sanitary issues.  Even after the careful cleaning of excess folds, there is still the chances of things like infections and skin necrosis.

Skin necrosis. A deadly condition in which literal parts of your skin will die off from bad circulation and can send your body into sepsis.

Not to mention the  logistical and psychological issues that come from having excess skin flaps all over the place.  People will still have a hard time finding clothes that fit and will still feel a severe lack of confidence from the presence of excess skin.

While proper diet and exercise along with skin care could tighten things a little bit, there is no real alternative to skin removal surgery when it comes to solving excess skin problems.

A Call to Action

The sad thing is, not a lot of people with this problem will get the contouring done. That is because of the biggest insult to injury, skin contouring procedures  are not covered by a lot of insurance companies.

Because the general public thinks it is a purely aesthetic procedure, much like people stigmatize surgical weight loss, they are quick to deny it as an unnecessary cosmetic instead of a life-saving procedure.

And that can only change when we destigmatize both weight loss surgery and body contouring as medical procedures.  Insurance companies and the general public should not punish patients for being sick by putting obstacles between them and a healthier quality of life.