If you are overweight, dropping kilos is a healthy and positive thing. Even a modest weight loss, between five to ten percent of total body weight, is likely to produce such health benefits such as improved blood pressure, blood cholesterol, and blood sugars. Keeping those kilos off can lead to improvements in energy levels, physical mobility, self-confidence and general mood.
However desirable it may be to achieve an ideal weight, losing weight rapidly can carry its own risks and complications. What counts as rapid weight loss? It is considered healthy to lose between half and one kilogram per week, which roughly works out to losing one to two pounds. Anything more than that pushes you in the direction of rapid weight loss.
Bariatric and other weight loss surgery, strenuous workouts, fad diets or some combination of the three are the common ways to attain rapid and massive weight loss. Weight loss surgery and diet pills, as well as many fad diets, can have their own negative health effects, but we are not writing about those here. What we are discussing is one of the most common consequences of significant or dramatic weight loss, regardless of the method used to achieve it: the excess skin and fat it can leave behind.
Redundant skin and fat is the most common problem encountered by those who lose a lot of weight quickly.
Before they can celebrate their achievements, some ‘big losers’ discover that they have also lost their shapes, in the body and even the face. The skin that stretched to accommodate that excess body weight does not necessarily shrink back when the body does. Excess skin and the fat layers underneath can literally form an apron in front of the body, sometimes covering the thighs and the pelvic area, and in some cases, reaching as far as the knees. Although all we can see are the excess skin folds, there will also be sagging and laxity in muscles that have lost their tone after weight loss.
This skin and fat apron sometimes forms a continuous fold around the body’s trunk. Excess skin folds can also form in the chest and back. When weight is lost from the arms and legs, the limbs will have loose layers of skin, especially in the upper arms and the thighs. Significant weight loss can also cause the breasts to flatten and hang, with nipples pointing downwards. The face may also look drawn, making a person look ill and unhealthy.
Even if there are no other complications associated with your rapid weight loss, the hanging skin and fat can be a literal wet blanket on your good spirits.
Excess skin and fat left behind by rapid weight loss is not merely an aesthetic issue. It can have serious health repercussions.
Even though you’ve lost a lot of weight, some people may not notice. And if they do, their comments could be in the tune of, ‘you look awful! Have you been ill?’ because they cannot see the new you under the excess fat and skin you carry around.
The best way to deal with the excess fat and skin left behind after rapid weight loss is surgical removal. Usually people who have lost significant weight are asked to wait for at least a year for their weight to stabilise before undergoing body-contouring procedures. If you continue to lose weight following body contouring, you could develop new sagging skin pockets, making the contouring obsolete. And if you rapidly gain weight after contouring, the already weakened and thinned skin can be traumatically stretched. This can cause additional stress, leading to wide scars, visible stretch marks and, in extreme cases, tearing of the skin.
Your weight loss surgeon should be willing to work with your cosmetic surgeon, determining together the right time for you to undergo body-contouring surgery. It is a good idea to check on this before choosing a surgeon for weight loss procedures.
The goal of all body contouring after major weight loss is to improve the shape and tone of underlying tissue, as well as remove obsolete fat and skin.
A number of surgical techniques help contour the different parts of the body following rapid or significant weight loss:
You can read more about panniculectomy, its risks, complications and benefits in the procedures section of this website.
Recovery from the corset lift is much less complicated than recovery from a lower body lift. It takes about the same time as tummy tuck surgery (abdominoplasty). You may need to wear a compression garment for a few weeks, and you will certainly have to rest and take things slowly for about six weeks.
A lower body lift eliminates the hanging apron of skin and fat from the front, flattens the belly and pulls up the droopy pubic area. It lifts up the thighs and, in the back, lifts and helps define the buttocks, creating a better-defined waistline. The obvious disadvantage is the scar extending around the body.
Although this lift is most often performed on men and women after massive weight loss, other groups can also benefit from it. It is an option for women who were never obese, but carry around 14 to 18 kilos of excess weight they cannot seem to lose. People who have undergone liposuction and have excess skin in the lower trunk and thighs are also candidates.
It takes 6 weeks to recover from a belt lipectomy, and you may have to wear compression garments for some of the recovery period. Complete healing can take as much as a year. Until the swelling subsides and recovery is complete, you may not be able to see the outcome of your surgery.
In an article titled Plastic Surgery After Rapid Weight Loss, J Brian Boyd, Chief of Plastic Surgery at the Harbor-UCLA Medical Center in Los Angeles, says that people can end up with one of two scenarios following rapid weight loss. One group ends up with lots of redundant skin but not too much subcutaneous fat, giving them the appearance of a Shar-Pei dog. Others, although they too lose significant weight, retain a lot of subcutaneous fat. This leaves them with a persisting soft bulkiness with the consistency of marshmallow beneath their skin.
According to Professor Boyd, better results are generally achieved in body-contouring dermolipectomies—surgical procedures that correct skin and fat excess in any body part—when skin redundancy is not accompanied by bulky subcutaneous fat. Preliminary liposuction can convert bulky marshmallow to the Shar-Pei dog. He also states that excessive subcutaneous fat severely limits the amount of tightening possible by conventional nip-tuck procedures.
Not everyone needs all of these procedures. Exactly what you need after massive weight loss will only come clear after you have lost the weight.
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