Abdominoplasty, often called a "tummy tuck," is a surgical procedure to remove excess skin on the abdomen.

Patients who experience significant weight loss, whether through diet and exercise, balloon therapy, or surgical therapy, can develop significant extra skin on their abdomen. Some patients will consider surgical removal of this skin – a procedure called abdominoplasty, and sometimes referred to as a “tummy tuck.”

There are medical reasons to consider removal, with the most frequent being irritation and skin ulcer formation due to the folding of the skin, usually caused by a fungus called candida. In hot weather, candida can be particularly difficult to treat even with prescription medications. Skin removal usually resolves this issue. For those whose develop very low lying skin folds (usually to the mid-thigh or knee) the fold can interfere with the patient’s walking, and can lead to falls. Clearly, this skin should be removed, and in this case, the procedure is usually covered by insurance.

However, the most common reason to seek skin removal is to improve body image. Patients who lose extreme amounts of weight can still struggle when they see the cosmetic results. It is perfectly appropriate to seek skin removal in this setting.

Unfortunately, skin removal is not, by itself, a weight loss procedure. Even in extreme cases, the total weight of skin removed is rarely more than 15 pounds. In addition, weight loss through excision rarely leads to improvement in a patient’s weight related medical problems such as diabetes, sleep apnea, and hypertension, among others.

Finally, patients who have had weight loss surgery and are still losing weight should delay skin reduction surgery. I usually recommend waiting until the weight has been stabilized for three to six months, which usually occurs between 15-18 months post-procedure.

Matthew Brengman, MD, FACS, is a weight loss surgeon in Richmond, Virginia, specializing in minimally-invasive bariatric techniques, as well as advanced gastric motility diseases such as gastroparesis. For more information about weight loss surgery, or to schedule a consultation, contact Dr. Brengman's office at 804-360-0600.

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