Post-bariatric excess skin
By The Treatment Registry editors
After significant weight loss (typically more than 30 kg, often after bariatric surgery), the skin envelope does not fully retract, producing excess folds at the abdomen, arms, thighs, breasts, and back. The condition is a contributor to skin breakdown, hygiene issues, and reduced quality of life. Treatment is staged body-contouring surgery once weight is stable.
Treatment ladder
Conservative options are first-line where appropriate; surgical options are typically reserved for cases where lower-tier options are unsuitable or have failed. Decisions are individual and depend on clinical assessment.
Conservative
- Stabilise weight
Most body-contouring surgeons require at least 12 months of stable weight before surgery, to minimise the risk of the skin envelope changing again. Compression garments and physical therapy can help in the interim.
Procedural
- Non-surgical skin tightening
Radiofrequency and ultrasound devices marketed for skin tightening have limited efficacy in significant skin excess. Reasonable for mild cases; not a substitute for surgery in moderate to severe cases.
Surgical
- Body lift after major weight loss · View procedure page
Staged body-contouring surgery typically beginning with the abdomen (lower body lift), followed by arms (brachioplasty), thighs (thighplasty), and chest depending on the patient's distribution. Each stage carries its own risk profile.
- Arm lift · View procedure page
Excision of skin and subcutaneous tissue from the upper arm. Produces a visible scar; the trade-off is normally accepted by the patient at this stage.
- Thigh lift · View procedure page
Excision of medial thigh skin. Wound healing in this anatomical region can be slower than in other body-lift sites.