Weight loss surgery can have a tremendously beneficial effect on overall health and well-being. For many people, it is lifesaving.

However, you may not anticipate the appearance of your skin after major weight loss. Skin tissue may not shrink back into place after weight loss. This extra skin may look unsightly and can even become a health and hygiene issue if moisture is trapped in the folds of skin, causing recurring rashes and skin infections.

The amount of excess skin, especially in the abdominal area, depends on many factors:

• The amount of weight lost. The more weight lost, the more excess skin.
• Your age. Younger patients may have better elasticity in their skin than older patients.
• Exercise. Some people notice less excess skin if they do aggressive abdominal exercises to help tone those areas.
• Genetics. Some people have a greater tendency toward loose skin.

There are safe and effective cosmetic surgery procedures that can remove the excess skin left behind after significant weight loss.  Here are some important things to know.

Insurance Coverage

Insurance companies typically cover weight loss surgery, but don’t always cover cosmetic surgery to remove excess skin after significant weight loss.  Explore the issue of cosmetic surgery with your insurance company.  Some companies will authorize the skin-removal surgery if it resolves a health-related issue such a recurring skin infections from moisture trapped in folds of skin.  You may need to work with your primary care doctor to document that you have worked to reduce these medical issues with other types of treatment, such as anti-fungal skin creams.

The skin-removal surgeries most likely to be covered by a health plan are those for excess abdominal skin. The surgeries least likely to be covered are for extra skin on the arms, thighs and breasts.  Even if the insurance company agrees to cover just a portion of the procedures needed, it will offset the overall cost of having cosmetic surgery.

Lose Most of Your Weight First

To be a good candidate for skin-removal surgery after significant weight loss, you should be in good health and your weight needs to have stabilized. You will not have optimal results if you lose significantly more weight after removal of the excess skin. In fact, insurers who do cover cosmetic surgery after weight loss surgery generally want to see that your weight has been stable for a certain time period, typically three to six months, and that at least 12 or even 18 months have passed since your original weight loss surgery.

Recovering from Cosmetic Surgery

Recovery from cosmetic surgery will be different than recovery from your weight loss surgery. In cosmetic surgery, the incisions are longer, the amount of tissue removed is greater, and nerve endings can make the skin sensitive.

Being less active during recovery from skin-removal surgery will generally not lead to weight gain. Few people put weight back on during the downtime of recovery from skin-removal surgery, even if they can’t exercise. People rarely feel much like eating in the weeks immediately following surgery.

People typically can and should get up and moving as soon after their surgeries as possible, because it helps in healing and reducing pain from tightness. Many are up walking around the same day as the surgery, and while it may be four to six weeks before it is safe to go back to the gym, you can take gentle walks for as long as several miles.

Cosmetic Surgery and Weight Loss

Cosmetic surgery procedures done after bariatric surgery will generally not help you reach a final weight loss goal. Although some fat is removed along with the extra skin, these are body-contouring procedures that typically result in no more than five to 10 pounds of weight loss.