After Weight Loss

Skin Tightening after Massive Weight Loss

One of the fastest growing areas of plastic surgery is in the arena of massive weight loss. Lap band and gastric bypass patients routinely lose significant amounts of weight, and a determined few are able to accomplish this through hard work and determination. Frequently, after the weight has been shed, many of our San Diego patients are left with excess skin most commonly in their abdomen, but also in their arms, thighs, breasts and faces. An entire subspecialty of plastic surgery has emerged to help patients manage the excess skin and produce a body that better reflects the healthier and more attractive you.

Gastric bypass surgery has become almost commonplace in today’s society and is safer than ever before. Although the weight loss results have been dramatic, many patients aren’t appropriately counseled regarding some of the cosmetic consequences that can – and frequently do – result. The numbers of patients undergoing surgery are approaching 200,000 patients every year.

With weight gain, your skin must stretch to accommodate the excess fatty tissue. Sometimes, the skin must stretch beyond its capacity and “breaks” resulting in visible “stretch marks” or striae on the skin. Also, secondary to an unhealthy lifestyle and bad eating habits, overweight patients tend to have poor elasticity of their skin. This combination makes patient’s skin unable to contract or “snap back” after 100+ pound weight loss. When this happens, excess skin may result which obscures a newly toned and in-shape body beneath the excess skin. Patients can also suffer from skin irritation and rashes, an inability to find clothes that fit, and most commonly a need to continue to manage the redundant skin by wearing loose fitting clothes.

Fortunately, there exist numerous operations that are designed to treat and manage these issues wherever they arise, helping to recontour and reshape your body to more accurately reflect the hard work it took to achieve your weight loss goals.

Timing of Surgery

One of the most important factors to consider after a patient is able to lose a significant amount of weight is the duration that weight has remained off. It is also important to ensure that not only does the weight stay off, but also that we allow for enough time for the patient to lose all the weight they have intended. I want to be able to tailor the operation to your new “ideal” body weight to best achieve your cosmetic goals. Massive weight loss cosmetic surgery is much like going to the seamstress – you want to have your clothes tailored at a weight that you are going to be able to maintain.

Patients can lose weight over different time intervals than others and even in different areas on their body. As long as I feel that we can achieve your goals in the area to be operated on (but possibly not in other areas on your body), then we can usually proceed with surgery in the successfully “completed” area. However, if you have lost a significant amount of weight, but have a significant amount to lose, then I will routinely recommend waiting until all of your weight is lost in the areas of concern. Skin with less fatty tissue attached is more flexible and allows me to produce an even better result.

Plastic Surgery Procedures for Weight Loss

There are numerous procedures available for the weight loss patient and your particular circumstances and goals will dictate what options are available to you. All of this will be explained in detail at a complimentary in-office consultation with Dr. Marin. Call our La Jolla, CA office at (858) 638-9800 to see if massive weight loss surgery is right for you.


Abdominal surgery aims to correct the stretch of the abdominal wall and remove excess skin and stretch marks caused by weight loss.


Arm lift or brachioplasty is perfect for those who suffer from the saggy appearance of the arms as affected by significant weight loss.


Buttock and thigh lift are procedures to improve the contour of the hips and produce a shapelier thighs and buttock after weight loss.

Combination Procedures

As with most of our surgeries, patients see a significant benefit to combining procedures to limit their postoperative down-time, the number of times they need to undergo general aesthesia and the overall cost. This is most evident in massive weight loss surgery. Many of the problems are directly related to other areas and it this allows me to produce a more “complete” result.

Scars are an expected consequence of massive weight loss cosmetic surgery. These scars, although significant, are much less of an issue for nearly every patient in light of the often “life-changing” transformations produced with these procedures. I make every effort to place these scars in locations that are easily concealed wherever possible. The majority of issues that arise with respect to scarring can be easily revised in the office under a local anesthetic.

Skin that has undergone significant stretch from weight gain followed by significant weight loss (either via surgery or diet and exercise) is frequently forever changed with respect to its elasticity. As an analogy, the rubber band has been stretched too far and the “spring” has been forever lost. Thus, we often expect a “secondary relaxation” of your tissues, even with maximal tightening, after many of these procedures. A secondary tightening procedure may be required after the procedure and, unfortunately, is related to the quality of skin that we are working with. We don’t see this as a complication, but more as an expectation. If we attempt to address this issue at the first surgery, your skin will stretch at its weakest point, and that has been proven to be at the scar itself. Thus, you will may develop widened, depressed or irregular/uneven scars – not a trade I am willing to make.

Overall, massive weight loss surgery is wonderfully successful means to rid you of the unwanted memory of your former self, and an opportunity to begin a new life where your exterior matches the health and vibrancy of the individual hidden beneath.

From Our Blog