Skin Surgery After Massive Weight Loss

Cosmetic body contouring surgery following massive weight loss is growing in popularity. The most common reason patients choose such procedures is the presence of excess skin. Although significant weight loss can be achieved through lifestyle change alone, one of the most effective modern-day medical weight-loss interventions is bariatric surgery. Such procedures include the gastric band, or “lap band”, the gastric balloon, and the most drastic of the three, the gastric bypass. While these procedures frequently lead to dramatic results, unfortunately, many patients struggle with sagging skin as a reminder of their previous weight. Luckily, there are many beneficial plastic surgery procedures to address these issues.

Doctors define massive weight loss (MWL) as a 50% or greater loss of a person’s excess weight. Following these significant changes, men and women may experience a loss of skin elasticity, excess skin, residual fat deposits, and stretch marks. (1) Achieving significant weight loss is difficult enough, without having to deal with aesthetic deficits afterward. However, the presence of unsightly, uncomfortable sagging skin is incredibly common, even expected. Luckily, there are procedures to address this.

Dr. Gregory Fedele is a Board-Certified Plastic Surgeon with over twenty years of experience. He understands that losing a significant amount of weight for health reasons is an achievement in itself. He performs life-changing procedures to help his patients realize a more contoured, defined physique following dramatic weight loss. So, if you have undergone massive weight loss surgery and you are dealing with excess skin, please get in touch. We’ll arrange your personal consultation with Dr. Fedele and he will formulate an individualized treatment plan for you. Reach us by phone at (216) 464-1616, or book online with our simple contact form.

Before & After Photos

Before and After Photos

Massive Weight Loss

Although some people may think weight loss surgery is a “quick fix”, being a bariatric patient is far more complicated than many people assume. It requires discipline and planning to follow dietary restrictions and the other lifestyle changes necessary for success. Studies demonstrate bariatric patients display strong determination throughout their weight loss journey.  They display bolstered resilience, make positive lifestyle choices and discover a new sense of well-being.(2) However, our skin may not be as resilient. Although bariatric surgery (BS) improves health among adults with severe obesity, it results in excess skin in more than 70% of adults.(3)

The Science of Skin After Weight Loss

Our skin protects our body and regulates our temperature. It consists of layers of tissue with numerous unique functions. It relays sensory information, produces vitamin D, absorbs nutrients, and shields us from harmful substances. However, despite its astounding properties, it does have some mechanical limitations. Our skin stretches to accommodate additional weight, but this stretching causes it to lose elasticity. As a result, many people shed the weight successfully, but their skin cannot contract to their new body shape.

What Happens to Skin After Massive Weight Loss?

Drastic changes in body shape can be distressing. Many patients are unhappy with unsightly skin and soft tissue redundancy following MWL. Common areas with excess skin sagging include:

  • Abdomen
  • Thighs
  • Upper Arms
  • Breasts (male and female patients)
  • Axilla (Armpit)
  • Mid- and Lower Back
  • Buttocks

As well as loose skin, there is also the risk of prominent striae, commonly known as stretch marks, which can be less conspicuous if they are translucent but far more noticeable if they are a darker pink or red. Some natural skin contraction can be expected for about 1 year after the patient reaches a stable weight. However, studies prove there is little change in skin contraction after this period.(4) Essentially, our skin is only able to do so much by itself. For some men and women, a plastic surgical procedure may be the only course of action.

Benefits of Skin Surgery After Weight Loss

Research confirms that patients who undergo surgery to improve physical and hygienic functions experience positive effects on their quality of life.(5) A post-bariatric cosmetic surgery to address excess skin is beneficial for a number of reasons. 

  • Addresses bulges and asymmetry
  • Removes excess skin and soft tissue
  • Restores a natural-looking body contour
  • Eliminates discomfort from friction and chaffing
  • Long-lasting, noticeable results
  • Helps patients achieve a body shape they are proud of
  • Boosts overall self-esteem and body image

Candidates for Skin Surgery

Dr. Fedele assesses patient suitability on a case-by-case basis. Candidates for skin surgery following MWL have adapted well to their post-weight loss lifestyle, and know the scope and limitations of cosmetic procedures to remove skin and reshape the body. Generally, if patients have maintained their goal weight for a demonstrable period of time, and are in good overall health, they may be considered suitable candidates. This type of surgery may not be suitable for patients with these conditions:

  • Unstable weight/inconsistent weight loss
  • Bleeding and blood clotting disorders
  • Autoimmune disorders
  • Other serious chronic health conditions

Personal Consultation

Your personal consultation with Dr. Fedele is an opportunity to let him know the problems you are facing with excess skin. We will ask you to provide some health information beforehand, and the details pertaining to your bariatric surgery, if you had one. He will assess the amount of sagging in the areas you wish to treat and draw up a treatment plan that will help you finalize your slimmer, smoother look. To get started, please contact Dr. Fedele’s Cleveland office at (216) 464-1616. You can also book a personal consultation by filling out a simple inquiry form on our website.

Plastic Surgery Choices After Weight Loss

Abdominoplasty (Tummy Tuck) – Following pregnancy or massive weight loss, excess skin often cannot simply “snap back”. This can lead to chafing and clothing limitations, as well as embarrassment and self-consciousness. Much of our subcutaneous fat and deeper visceral fat is located in the abdomen. So, when that fat dissipates after massive weight loss, considerable amounts of excess skin can remain. An abdominoplasty procedure involves the placement of a long incision from hip to hip at the underwear line. Dr. Fedele removes the necessary amount of skin, then sutures the incision for a smoother, more contoured appearance.

Breast Lift (Mastopexy) – Weight loss, pregnancy, and the aging process can make the breasts sag. The lower position of breasts on the chest, and nipple ptosis (where nipple location is also lower) can cause issues with body confidence and physical discomfort. Dr. Fedele can use one of a number of different incision methods in a mastopexy procedure to remove excess skin and tissue and reestablish a stronger breast profile. For male patients, gynecomastia treatment can address sagging breast tissue and restore a more masculine chest appearance following significant weight loss.

Brachioplasty (Arm Lift)Arm lift surgery addresses sagging skin in the upper arms. Dr. Fedele places strategic, discreet incisions along the underside of the arm. He excises excess skin and sutures the arm for a slimmer arm silhouette. 

Thigh Lift – As with the arms, excess skin in the upper leg is common after massive weight loss. Despite a patient’s concerted efforts to become slimmer and lead a healthier lifestyle, this skin is virtually impossible to remove through any other means but surgery. As with the breast lift procedure, during thigh lift surgery, Dr. Fedele can tailor incision locations and the amount of skin removed according to a patient’s individual circumstances.

Cost of Skin Surgery in Cleveland, OH

Dr. Fedele will create an individualized treatment plan for the areas of excess skin you are unhappy with. As every patient has specific needs, the price of skin surgery will vary. For more information about funding your treatment, please see our financing page. Reach your aesthetic goals! Get in touch with us today at (216) 464-1616 or complete an inquiry form to book your individual consultation with Dr. Fedele.

Read more about Dr. Fedele’s surgical and non-surgical services on his blog.


How can I get rid of sagging skin after bariatric surgery?

Excess skin is very common after massive weight loss. Though the skin can recede naturally to an extent, it often cannot produce form-hugging effects. Many patients turn to cosmetic skin removal procedures to improve their body contour. Abdominoplasty (tummy tuck), brachioplasty (arm lift), mastopexy (breast lift), and thigh lift surgeries can all reduce excess skin for a more comfortable, confident post-weight loss life. 

Can skin surgery get rid of stretch marks after weight loss?

Though every patient is different, a plastic surgeon can often remove problematic stretched skin following bariatric surgery or dramatic weight loss through lifestyle change. If some skin remains with stretch marks, there may be med spa treatments your doctor can recommend to reduce the appearance of stretch marks.


  1. Cabbabe, S. W. (2016). Plastic Surgery after Massive Weight Loss. Missouri Medicine, 113(3), 202–206. 
  2. Gilmartin, J., Long, A., & Soldin, M. (2014). Changing Body Image and Well-Being: Following the Experience of Massive Weight Loss and Body Contouring Surgery. Healthcare, 2(2), 150–165. 
  3. Baillot, A., Brais-Dussault, E., Bastin, A., Cyr, C., Brunet, J., Aimé, A., Romain, A. J., Langlois, M.-F., Bouchard, S., Tchernof, A., Rabasa-Lhoret, R., Garneau, P.-Y., & Bernard, P. (2017). What Is Known About the Correlates and Impact of Excess Skin After Bariatric Surgery: a Scoping Review. Obesity Surgery, 27(9), 2488–2498. 
  4. Sami, K., Elshahat, A., Moussa, M., Abbas, A., & Mahmoud, A. (2015). Image Analyzer Study of the Skin in Patients With Morbid Obesity and Massive Weight Loss. Eplasty, 15, e4. 

Boswell, C. B. (2010). Body Contouring Following Massive Weight Loss. Missouri Medicine, 107(3), 189–194.

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