As well as the health benefits, losing weight can improve your quality of life. It can make you more mobile and energetic, and improve your self-esteem. However, people who lose a significant amount of weight, are often left with a lot of loose skin, which may negatively affect appearance and quality of life.
The skin is the largest organ of the body, made up of three layers:
The dermis consists of proteins, including collagen and elastin. Over time, the environment and aging reduce your body’s ability to produce collagen which makes up 75-80% of your skin's structure, providing firmness and strength. Elastin provides elasticity and helps your skin stay tight. Skin which has been stretched for a long period of time, for example during significant weight gain, often loses its ability to retract after weight loss due to the damage that occurs to collage and elastin.
There are various factors which determine how much loose skin an individual will have and it’s fair to say that not everyone who loses a lot of weight will have a problem with loose skin. The key factors are usually:
Age - our skin naturally becomes less elastic as it ages. The older you are when you lose weight, the less likely your skin will ‘snap back’ to its original shape.
Sun exposure - being exposed to the sun regularly can reduce skin's collagen and elastin production
Smoking - Smoking leads to a reduction in collagen production and damage to existing collagen
Amount of weight loss – evidence shows those who lose more weight, are more likely to end up with more loose skin
If you have a lot of excess skin which is of concern to you and you want to have it removed, surgical treatments such as body contouring are usually necessary to tighten loose skin after major weight loss. Body contouring consists of a number of cosmetic surgery procedures that can improve the appearance of loose or sagging skin. The most common procedures are:
Abdominoplasty (tummy tuck): refers to the abdomen
Upper or lower-body lift: refers to the breasts and back or abdomen, buttocks, hips and thighs
Thigh lift: refers to the inner and outer thighs
Brachioplasty (arm lift): refers to the upper arms
Criteria for body contouring on the NHS varies and most body contouring is funded privately by individuals. Body contouring procedures should only be considered after your weight has stabilised which roughly takes 12 to 36 months, depending on your pre-operative weight and the type of bariatric surgery you have had. Following a body contouring procedure, your recovery time can range from 2-6 weeks and in some cases, even longer.