Questions about Excess Skin and the Tummy Tuck

by Anonymous
(North Carolina)

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I’m thinking about having gastric sleeve surgery. I learned through your site that many patients lose so much weight that sagging skin becomes a problem. I have a few questions about this. First, how likely is it that sagging skin will be a problem? Do most patients have this issue? For those who do, what percentage do you recommend tummy tuck or other plastic surgery for? What criteria do you use to decide to make that recommendation? Thanks for any advice!

– Anonymous in North Carolina

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Surgeon Response to "Questions about Excess Skin and the Tummy Tuck"

by: John Rabkin, M.D., Pacific Laparoscopy

Dear Anonymous in North Carolina,

Excess skin following massive weight loss from any method (dieting or weight loss surgery) can be an issue for patients following their weight loss. The amount of excess skin varies depending on the amount of weight loss achieved, the age and underlying health of the patient as well as the elasticity of the skin. In my experience, about two-thirds of my female and one-third of my male weight loss surgery (WLS) patients request reconstructive (excess skin removal) surgery. In many cases the problems faced by these patients include associated back pain and/or posture difficulties as well as intertriginous skin fold rashes and skin integrity breakdown. Other patients simply find the excess skin to be a functional liability as well as a cosmetic issue.

The recommendation to proceed with reconstructive surgery is individualized based on the difficulties experienced as well as the desires of the individual patient. Certain patients find the excess skin more of a problem than others. For example, women, as a group, fall into the former category in part due to our societal acceptance of excess skin being more 'forgiving' for men than for women.

The most significant issue for most patients, however, isn't the decision to have the reconstructive surgery but is how to afford it as many (if not most) insurance companies are reluctant to cover the service as a covered benefit in many cases.

Best regards,

John Rabkin, M.D.
Pacific Laparoscopy

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DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.

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