Loose Skin Blues
Massive weight loss is a huge decision, most of you reading
have either gone through a massive weight loss or are contemplating going
through a massive weight loss. One of the most common hesitations in losing
weight is the resulting loose skin that occurs once your body has gone through
a significant weight loss. It is common knowledge that losing weight = loose
skin. Loose skin not only occurs with a massive weight loss but also with
natural body occurrences such as pregnancy. This is because once your body
stretches through weight gain or through pregnancy; your skin loses its
elasticity. I work for a medical reconstruction and cosmetic surgery practice
in Kansas City, here our surgeons see many individuals on a day-to-day basis
that have these exact concerns. First they come in to talk about weight-loss
and bariatric surgery, how it works and your results. Many patients, however,
decide they want to go the less expensive and natural way by strict diet and
exercise but are concerned about the loose skin. Our doctors always tell
patients to be realistic, being healthy is far more important than having loose
skin. Even when you have loose skin after weight- loss there are ways to remove
it such as tummy tucks. The loose skin, although it may not seem like it, is a
proud reminder of how far you’ve come and if you take that extra step to remove
the loose skin, your body will be an entire trophy dedicated to yourself. In
this post, we will see why and where that extra skin came from and how to
reduce or remove it.
How We Burn Fat
As we all know, matter cannot be created nor destroyed, so
when you exercise and diet fat is not simply “disappearing” off your body. What
occurs is a form change, just like water and steam. The glucose and sugar that
is harnessed from carbohydrates are the first fuel sources. Once the glucose
runs out, fat takes over. Your body is a constant interconnected conveyor belt
that removes essential nutrients from the fat and delivers them to specific
body parts. Hormones that regulate our blood sugar levels activate an enzyme in
fat tissue called lipase. Lipase ignites fat cells to release triglycerides,
which is what makes fat cells fat. When they receive a signal from lipase to
exit the fat cells, the triglycerides break-up into glycerol and fatty acids
and then enter the bloodstream for use in your body. The process of breaking
down triglycerides into reusable energy is called lipolysis which is shuffled
and reshuffled to produce heat, water, carbon dioxide, and ATP. Since the fat
tissue has lost some of its components, the cells shrink.
Why the Extra Skin?
When fat tissue is worked and the cells shrink, wouldn’t it
make sense that your skin would shrink as well? Yes and no. In the cases of
moderate weight loss, skin can certainly shrink back to fit the body’s new size
because of its elasticity due to collagen in the skin. However, collagen does
have its limits. Collagen fibers weaken with age and results in wrinkles. Rapid
growth or weight gain also outpaces collagen production in the skin causing
areas to over-stretch, leading to stretch marks commonly seen in pregnancy and
adolescents going through puberty. In cases of massive weight-loss, the skin
that has been stretched has lost its collagen strength making it very difficult
if not impossible for the extra skin to shrink back to its former shape. Those
undergoing gastric bypass surgery or bariatric surgery feel this pain. As the
number of patients going through weight loss surgery increases, so do
corrective surgeries for the unwanted and uncomfortable skin. This extra skin
can actually be a serious problem and can actually cause infections, rashes and
even back problems.
Treatment Options
The most important determinant of how much loose skin an
individual will have following weight loss is their age. Younger patients tend
to have less loose skin than those who are older because of the strength of
collagen in your skin. The next most important factor is the amount of weight
loss. An individual who loses 200 lbs. is more likely to have excess skin than
someone who has lost 80 lbs. There are other factors of who is more likely to
have loose skin such as smoking, sun damage and skin color.
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Exercise: Exercise that includes increasing
muscle town can tighten connective tissue. For patients who have undergone
bariatric surgery are recommended to add a regular exercise regimen that is
helpful to maintain ones weight and can also serve to tighten loose skin to some extent.
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Losing weight slowly: Your skin has already lost
its collagen from either age or being stretched to its max. By losing weight
slowly the loose skin from each pound of fat burned has more time to shrink
itself back. This will only be noticeable by small measures and the amount of
loose skin shrunk depends on the individual.
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Body Contouring Procedures: For those that are
losing 80 lbs. to over 100 lbs. surgical procedures are available to tighten
skin and remove the extra pockets of skin that inhibit your body from being as
toned and tight as the individual would like. Below are the most common
procedures for massive weight loss patients.
Abdomen, Thighs and Buttocks- The abdomen is usually one of
the greatest concerns for individuals following massive weight loss. In both
men and women, excess fat is stored both in the abdomen and beneath the skin of
the abdominal wall. Consequently following weight loss in those areas, extra
skin appears. Large amounts of hanging skin can lead to the collection of
moisture between the skin folds resulting in a condition called intertriginous
dermatitis, which leads to irritation, redness and pain. Occasionally, the skin
may even breakdown, bleed and become infected. With proper documentation, many
insurance companies recognize this problem and provide full coverage from
surgical removal through a tummy tuck or abdominoplasty. The abdominoplasty
will solely remove the excess skin from your stomach which is ideal for women
following pregnancy. However, for those who have undergone weight loss surgery
or a massive weight loss, excess skin is not limited to the stomach but also
results in the buttocks and thighs. Because of this, surgeons will perform a
procedure specifically for weight-loss patients called a body
lift. This involves an abdominoplasty, thigh and buttock lift all at one
time. This addresses and removes loose skin and cellulite along the thighs and
buttocks as well as the abdomen. Although the resulting scar is lengthy, it is
confined to the waistline and is hidden by underwear, panties, or a bikini.
Breasts- Following a great weight loss, breast size and
shape often change significantly in both men and women. Everyone worries about
sagging breasts as we age but few know that massive weight loss greatly
accelerates the process. As women advance from girls to teens to twenties and
into their later years, the glandular portion of breasts is replaced by fat.
The original glandular tissue is significantly more firm than fat and
consequently the skin becomes unable to retract completely and produces
severely ptotic or sagging breasts. This is called breast involution. There are
many treatment options for women following weight loss. If a woman desires less
sagging and wants to be larger, a breast lift or mastopexy is needed. Again,
surgeons will tell you your options and also remind you to be realistic with or
breast
augmentation may be satisfactory.
The problems in men are similar however treatment is slightly different.
Men tend to have larger breasts when over-weight. Depending on a man’s age,
degree of weight loss, and a few other factors he may result in large breasts,
large and/or sagging breasts, or satisfactory breasts following weight loss.
Large and/or sagging breasts in men is called gynecomastia. Here liposuction
alone may be satisfactory, however this is not typical. Most men with both
sagging and large breasts go through a two-staged procedure. The first stage is
liposuction and is performed to remove excess fat and some glandular tissue.
Over the next few months, the breast skin will retract slightly. Three to six
months later, the patient will return to evaluate the situation and determine
if the outcome is satisfactory. Delaying the second stage allows for
significant skin retraction and if a skin tightening procedure is desired it is
likely to require smaller incisions.
The Bottom Line?
Being healthy has far greater importance than excess skin.
Although, having excess skin can lead to some serious issues there are
non-surgical ways of preventing infections such as keeping your excess skin
dry. For those who are able and want to remove the excess skin, it is important
to remember that these procedures should only be considered after ones weight
has stabilized; especially after weight loss surgery. This can range from 7-18
months after weight loss. The most important factor in finding a plastic
surgeon who can perform these procedures is that they must be board certified.
If your plastic surgeon’s website or office does not advertise that they are
board certified you must RUN! For everyone who has heard horror plastic surgery
stories, this is probably where it started, having a surgical procedure done
without a board certified surgeon. Use ASPS (The American Society of Plastic Surgery)
to find a board certified surgeon near you.
Post written by: Jen is a
writer for a medical reconstructive and cosmetic surgery center in Kansas City.
She has two kittens and loves to write about all things beauty, women, health
and fitness! She spends her days outside and at the center where she learns as
much as she can from the board certified surgeons. This plastic surgery center
specializes in breast augmentations and breast reconstruction.
Jen also has a personal blog Littlefurrymusings.tumblr.com where she
writes about all kinds of things that she thinks others would enjoy.
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