How Risky Is Skin Removal Surgery After Weight Loss?

Photo: Courtesy of WE TV.
Mama June's controversial new weight-loss show, From Not To Hot, has already come under its fair share of fire. But you can't deny that it offers a look at the process of extreme weight loss that many of us simply don't see. And, in an emotional new clip from an upcoming episode of the show, June cries while saying goodbye to her daughters before leaving for skin removal surgery. That got us wondering: What actually happens during the procedure? And how risky is it to get that excess skin removed?
"Any time someone loses a significant amount of weight they will 100 percent have excess skin," says Matthew Schulman, MD, a board-certified plastic surgeon based in NYC. "It’s not something they can exercise or diet away — it will just be there." That means that, for people who have lost at least 100 pounds, surgery is really the only option to get rid of that skin.
Although the procedure is often referred to as a "body lift," Dr. Schulman says that's a really vague term. He differentiates between "upper" (e.g. the upper back and arms) and "lower" (e.g. abdomen and lower back) body lifts instead. But because skin is, you know, everywhere, patients often require more than one procedure.
"It's common for people to need two or three surgeries," he says, "and we can't combine everything into one." Depending how pumped patients are to get back into surgery, Dr. Schulman says they'll probably need to wait between three and six months between procedures.
So how safe is it for people to have their skin removed, especially if the process involves multiple surgeries? As with any surgery, there are the risks of having anesthesia, which — while incredibly rare — can be very serious. Dr. Schulman also explains that it's common for patients who've lost a lot of weight to be recovering from a weight-related condition, such as high blood pressure, that needs to be accounted for before surgery and can make things trickier.
But it turns out that the biggest issue is just a fact of the way the surgery is done. "A lot of skin is cut off," Dr. Schulman says, "so the most common complications are problems with the incisions healing." But these tend to be minor "nuisance complications," as Dr. Schulman calls them, such as small infections.
However, another potentially major issue is the cost of the procedure. Dr. Schulman says that patients can expect to pay at least $15,000, and possibly as much as $50,000 to $75,000 if they require multiple surgeries. And don't count on your insurance to help you out here — patients usually have to be able to document that their extra skin is causing a medical problem (e.g. pain or a rash) in order to have coverage, and that may not be easy. Many plans also specifically exclude coverage for skin removal surgery after weight loss altogether, Dr. Schulman says, so you're looking at a huge bill no matter how badly you need the procedure.
Obviously, this means that having skin removed isn't a decision that anyone takes lightly. It's often a complex choice with emotional and psychological factors coming into play, Dr. Schulman says. So, although we may not be the biggest fans of her new show, we're happy that Mama June is able to make a decision that makes sense for her.

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