Whether you you’ve lost 50 pounds or a few hundred, significant weight loss can change your life for the better. It can reverse obesity, as well as such serious conditions as diabetes and sleep apnea, and it can reduce your risk for heart disease and cancer. But once the weight comes off, many people are left to deal with another challenging problem: excess skin that sags.

In addition to the fact that some people find it embarrassing, excess skin is prone to rashes and fungal infections between the skin folds. Other potential challenges range from limited mobility to difficulty urinating to problems with sexual function.

A type of plastic surgery called “body contouring” is an increasingly common solution. The decision to have this type of surgery is a deeply personal one. It’s important to understand the pros and cons, and to talk to an experienced surgeon about how to prepare yourself for the procedure.

“Body contouring may be an option if you feel embarrassed about having excess skin,” says Michael Alperovich, MD, a plastic surgeon in the Yale Medicine Post-Bariatric Body Contouring Surgery Program. “You've done a lot to get yourself healthy, and you deserve to have an improved quality of life and the appearance you’ve wanted. Body contouring surgery can help complete the journey.” 

When people gain a lot of weight, the skin stretches, and it may not have enough elasticity to spring back after dramatic weight loss. Body contouring removes the excess skin and tightens surrounding tissue. Typically, the surgeon makes an incision on the targeted area, removing fat either directly or with the help of liposuction. Underlying supportive tissues are then tightened using sutures to achieve a result you cannot reach by exercise alone.

There are a number of body-contouring surgeries available. They target different parts of the body (arms, breasts, face, thighs, abdomen) for people who have lost weight with the help of diet and exercise or weight-loss surgery. Your surgeon may suggest multiple body-contouring surgeries at the same time, or that you have them gradually, over a period of months or years.

The goal of body-contouring surgery is to remove excess sagging skin and improve the shape of underlying supportive tissue. Body contouring typically requires large incisions that enable the surgeon to remove the fat. Advanced plastic surgery procedures are used to locate the scar where it won’t be easily seen and minimize its appearance.

Body-contouring surgeries are typically performed using general anesthesia. You will wake up from surgery with a temporary tube under your skin to drain any fluids that often build up under the wound. The results of the surgery are immediately visible, although in some cases you’ll need to wait for swelling and bruising to subside.

Wait until you have reached a stable weight before you have body-contouring surgery, since gaining or losing weight can cause problems in areas that have been contoured. Speak frankly with your surgeon to make sure your goals are realistic, and plan to stay committed to maintaining a healthy lifestyle.

Like any surgery, body contouring is not without risks. Risks for this type of surgery depend partly on how much tissue needs to be removed. The risks may be higher for people who have lost a lot of weight, especially if they lost that weight through surgery. Because of these reasons, it’s beneficial to choose a board-certified plastic surgeon who is skilled at body contouring and to have your surgery performed at an academic medical center.

Yale Medicine has been a leader in innovative, post-bariatric, body-contouring surgery research that has helped change the approach to reconstructive and cosmetic surgery after significant weight loss.

Our plastic surgeons provide comprehensive state-of-the-art body contouring for patients who have lost a significant amount of weight. They enjoy working closely with Yale Medicine Minimally Invasive & Bariatric Surgery. “We work as partners with our patients, helping them understand whether body contouring is the right choice for them and helping them determine what body contouring changes they want to make,” Dr. Alperovich says.