Will I Have Excess Skin After Gastric Sleeve Surgery?

One of the most common questions we hear, before and after surgery, is whether loose skin will follow. It is a fair question. Here is what affects it, what you can do, and what the options are if it bothers you.

How common is it?

Very common. In surveys of people who lost a lot of weight after bariatric surgery, most reported some excess skin, most often on the belly, upper arms and inner thighs.

Not everyone is bothered by it. Some people decide it is not something they want to change, and others look into surgery once their weight has settled.

What affects how much you have

• Age. Skin loses some of its stretch over the years.
• Your genes and skin type.
• How much weight you lose, and how quickly.
• How long the skin was stretched before.
• Sun damage and smoking, which break down collagen, the protein that keeps skin firm.

What can help how it looks

A sleeve is about your health, not a cosmetic result. None of these steps can remove stretched skin, but they can help your body and skin look and feel their best as you lose weight.

• Strength training. Building muscle can fill out and firm some areas, and it helps you keep your strength as you lose weight.
• Protein first at every meal, to support muscle and skin.
• Fluids through the day, in small sips.
• Sunscreen, and not smoking.
• Moisturizer for dry or itchy skin. It makes skin more comfortable, although it does not tighten it.

When loose skin causes problems

For some people, skin folds cause rashes, itching or infections, or get in the way of exercise and finding clothes that fit. Keep skin folds clean and dry. Talk to your doctor or care team if a rash does not clear up.

Body contouring surgery

Surgery is the only way to remove excess skin. It is usually considered once you are close to your goal and your weight has been stable for several months, often 12 to 18 months or more after your sleeve. A plastic surgeon assesses what suits you.

• Tummy tuck (abdominoplasty): removes loose skin and fat from the belly and can tighten the muscles. It leaves a scar low across the belly.
• Arm lift (brachioplasty): removes skin from the underside of the upper arms, with a scar from the elbow toward the armpit.
• Thigh lift (thighplasty): removes loose skin from the thighs.
• Breast lift (mastopexy): lifts and reshapes the breasts after weight loss, sometimes together with an implant.
• Lower body lift: treats the belly, sides, buttocks and thighs together.

Every operation has risks, scars and recovery time, and body contouring is usually paid for privately. In studies, cost was the main reason people who wanted it did not have it.