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Cosmetic Surgery after Gastric Band Weight Loss

Cosmetic Surgery after Gastric Band Weight Loss

There are many benefits to having a gastric band fitted if you are dangerously overweight and have struggled to lose this weight through the traditional routes of a healthy diet and regular exercise. Gastric bands are an effective way for people to lose weight quickly, but the procedure isn’t without consequences. People who have a gastric band fitted can expect to use around half of their bodyweight in around two years and losing so much weight, so quickly, can mean you are left with loose excess skin.

What causes excessive skin?


The skin is a highly adaptable organ due to collagen, which is the structural protein that gives skin its elasticity. When people gain a moderate amount of weight and then lose this weight gradually, collagen enables the skin to gradually return to its usual shape. When an individual gains an excessive amount of weight, this can put pressure on the skin and over-stretch it so that the collagen fibres weaken and can’t return to their normal shape after weight loss, especially if this weight is lost quickly. This is what causes the excessive folds of skin you may experience after extreme weight loss. This excess skin usually has multiple stretch marks on it as these occur when the skin has stretched so much that it’s ‘cracked’ and can’t repair itself.

What increases the chances of having excessive skin?

The key reason which can increase the chance of having excessive skin after weight loss is the length of time a person has been overweight for. If the skin has been stretched over a long period of time then it’s less likely to return to its normal shape after weight loss. This explains why many women are able to ‘snap back’ into shape after pregnancy as, for most women, it’s only really the last four months of pregnancy where the skin is overly stretched and the collagen in the skin can more readily return to its usual shape. The process of weight gain in obese people tends to begin during childhood which means the skin is under pressure for an extended period. This can damage the skin beyond repair which means the skin is highly unlikely to shrink back after weight loss.

Other factors affecting loose skin include:

  • Age – Collagen in the skin deteriorates with age so the older a person is when they lose weight, the less likely their skin is to shrink back into shape.
  • Genes – Genetics can influence how much elasticity the skin retains.
  • Sun exposure – If skin is damaged by the sun then this can cause the collagen to break down more quickly which can reduce the skin’s elasticity.
  • Smoking – Smoking deprives the skin of oxygen which can affect the skin tone, causing it to sag. Combine this with weight loss and the chance of the skin regaining firmness is very unlikely, especially on the face.

Why do people choose to have excess skin removed?


Excess loose skin can make people feel self-conscious as well as making everyday tasks such as bathing, buying clothes or even just wearing regular clothes more difficult. For some people, the excessive skin can be so bad that it can cause health problems such as irritation or soreness which can lead to recurrent skin infections.

Although resistance exercises, such as weight training, can improve the skin tone to some extent by tightening the muscles, there is very little that can be done to reduce the amount of excess skin, this is why people often choose to have cosmetic surgery (cosmetic surgery after weight loss is known as bariatric surgery).

Areas most affected by extreme weight loss include:

  • Breasts – Breasts can lose shape and volume as a result of weight loss and can benefit from the skin being tightened and, in some cases, implants being used to create fuller, more rounded breasts. A sagging chest after weight loss isn’t just an issue women experience, men who have lost a lot of weight may find that they have loose skin around the chest area as well.
  • Face – Losing weight quickly can cause the face to sag, resulting in people look a lot older than they are. Some people who have had weight loss surgery choose to have a facelift as part of their post weight loss cosmetic surgery.
  • Tummy – The tummy is often the area of the body which is most affected by extreme weight loss and folds of excess skin can often hang down from the tummy, covering the groin area. A tummy tuck can remove this excess skin and reinforce and tighten the abdominal wall.
  • Thighs – Wrinkled skin is one of the main problems people find in the thigh area when they’ve lost a lot of weight. A thigh lift removes extra skin from the thighs and leaves a smooth finish to the skin.
  • Arms – Losing a lot of weight can leave sagging skin on the arms which is also known as ‘bingo wings’. An arm lift will smooth out wrinkly arms by removing excess skin.
  • Bottom– When a person loses a large amount of fat, they also lose a lot of volume from their skin and this loss is particularly noticeable in areas where we naturally carry larger amounts of fat, such as the buttocks. After weight loss, the bottom area in particular can look flat and deflated and can benefit from a bottom lift to create a more rounded behind.

How soon after losing weight can I have surgery?

After your weight loss surgery, you will need time to adjust to your new healthy eating and exercise routine, both of which will continue to affect your body shape until you reach a stable weight. Most cosmetic surgeons will recommend waiting a year to 18 months after weight loss surgery before having cosmetic surgery to ensure your body weight and shape have stabilised. If you have cosmetic surgery too soon after your weight loss operation and then continue to lose weight, you may find that you require further cosmetic surgery to retighten your skin.

What surgery is available?

  • Body lift
    A body lift usually includes tightening of the tummy, buttocks and thighs, although it’s important to note that what’s included in this procedure can vary between surgeons. Having a number of procedures done at once can be beneficial as you will only need one operation, however, there is a higher risk of complications as the surgery is longer than just having one procedure.
  • Abdominoplasty
    Also known as a tummy tuck, abdominoplasty can remove excessive skin and stretch marks from the abdomen and reshape the abdomen. Although mini abdominoplasty surgery is available, which treat the area below the tummy button, a full abdominoplasty is usually recommended for weight loss patients.
  • Panniculectomy
    A ‘pannus’ is the apron of skin which hangs down over the groin area after a person has lost a significant amount of weight. A panniculectomy is the removal of this tissue and it differs from an abdominoplasty as only the excess skin is removed and no changes are made to the underlying tissue on the abdomen, such as the abdominal muscles.
  • Brachioplasty
    An arm lift involves tightening the skin on the upper arm. An incision is made just at the top of the armpit and along the inside of the arm to the elbow to remove the skin. The incision in made in this area to minimise scarring.
  • Breast surgery
    As well as having a breast uplift to remove excess skin from the breast area to minimise sagging, you may also wish to have breast implants to increase the volume of the breasts.
  • Thigh lift
    During a thigh lift an incision is made from the groin down the back of the thigh. The skin and tissue of the thigh is then reshaped to create a smoother finish.

Is there an alternative to surgery?

Exercise to improve muscle tone can help tighten the skin to some extent but it isn’t going to reduce the amount of excess skin. Skin conditioning techniques such as skin scrubs and firming creams may help improve the texture of the skin but they are not going to reduce the amount of excess skin a person has either. For extensive weight loss, the only solution to improving the look of loose skin is surgery.

What potential issues should I be aware of?

Only you can decide whether or not you choose to have cosmetic surgery but you can discuss your decision with a surgeon to help you weigh up the pros and cons of the procedures. Any type of cosmetic surgery comes with a range of considerations but there are some specific factors relating to cosmetic surgery after weight loss.

Things to think about:

Recovery time – at least a couple of weeks; four for major surgery such as a tummy tuck. This will mean postponing your exercise routine, so talk to a fitness expert if you think your motivation will wane during this gap.

Scarring – this is likely to be significant after major surgery and there are no guarantees about how well your scars will heal. Talk to your surgeon about any concerns before proceeding.

What next?

If you are considering having surgery to remove excessive skin after weight loss then speak to Stephen McCulley who will happily discuss your options with you and advise you on the best course of treatment should you decide to go ahead. You can arrange a call or meeting with Stephen by calling his secretary Valerie on 0115 962 4535.

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