5 ways to manage excess skin

From weight bearing exercise to skin removal surgery, we ask the experts to give us the options for managing excess skin.
Published 22 March 2017

What to do with loose skin?

While the benefits of weight loss are undeniable – from increased energy and confidence to improved fitness and health – the fear of carrying excess skin can put some people off losing weight. But don’t let it stop you, says Dr James Savundra, president of the Australian Society of Plastic Surgeons. “Not everyone who loses a large amount of weight has skin excess,” he says. “It varies – some people have severe stretching from not losing much weight and others may lose 40kg and barely have any skin excess.”

Dr Tony Bartone, vice president of the Australian Medical Association, says, “Genetics, age, nutrition and sun exposure all affect the overall quality of our skin tissue and how much it will stretch.” For many, these extra folds of skin are a source of embarrassment because they serve as a constant reminder of their formerly overweight selves. And to make matters worse, they can cause a range of uncomfortable skin problems.

“When there’s skin-on-skin rubbing and there isn’t good air circulation around the surface, you can develop any number of chronic skin conditions,” says Dr Bartone. “In particular, fungal infections and intertrigo (an itching, burning rash that affects skin folds) can develop. The moisture from sweating can make it worse, especially in the presence of synthetic undergarments or clothing.”

But don’t cancel your gym membership just yet – there are several ways to deal with excess skin. We asked the experts to give us the lowdown on the five main treatment options.

1. Practice self love

Embracing your body just the way it is should always be your first point of call. Focus on what your body can do rather than how it looks. WW member Miriam Pohto suggests “Finding clothes that are flattering and that empower you and your new body without highlighting anything you aren’t happy with,”. “Being healthy and fit is more important than the cosmetic issue of loose skin. I’m currently learning to love my body for what it is – even with saggy skin.”

Average cost: Free.

2. Weight bearing exercise

Although going to the gym won’t magically make the folds disappear, exercises that increase your lean muscle mass, such as lifting weights or body-weight exercises, will make your body appear stronger and firmer.

“Exercise is an important part of the treatment for excess skin,” says Dr Bartone. “If your muscles are toned, it adds to the quality of the outcome.”

Average cost: Free if you exercise outdoors or at home using an app such as Sworkit, or one of the WW workouts you'll find online. Gym memberships start at about $15 per week.

3. Firming creams

Creams containing collagen and elastin – the proteins that give skin its firmness and elasticity – claim to tighten the skin. But do they really work? “There are a lot of claims made about all these creams and potions, but I believe they have more of a maintenance role post weight loss than a significant tightening effect,” says Dr Bartone.“Get a recommendation from your treating specialist before buying a particular product.”

Average cost: From less than $10 for pharmacy brands through to hundreds of dollars for high-end brands.

4. Non-surgical procedures

Laser, intense pulsed light (IPL), radio frequency and ultrasound skin-tightening treatments all stimulate the production of collagen – which plumps and tightens the skin – by heating or destroying tissue in the epidermis and dermis. Recovery time is generally minimal, but the procedures aren’t cheap and they’re not covered by Medicare.

“For patients who have a small amount of skin laxity that isn’t worth having surgery for, these treatments can be worth considering,” says Dr Savundra. “But I’ve had patients spend thousands on them without getting the results they wanted.”

Dr Bartone also cautions against expecting a dramatic change. “The amount of tightening varies significantly from person to person,” he says. “These procedures may have a role to play in terms of toning up some of the skin, but not in the reduction of severe skin excess.”

Average cost: Costs vary depending on the type of treatment, the number of sessions and the size of the area you’re targeting, but expect to pay anywhere between $1000 to $5000.

5. Surgery

For people who have significant amounts of loose skin, surgery is the only fool-proof way to get rid of it for good. “Medicare and private health insurance cover surgical procedures for the removal of excess skin if you’ve lost a minimum of five BMI (body mass index) units,” says Dr Savundra. “For a 165cm female, that means going from 90kg to 78kg. To qualify, Medicare also requires that you have chronic skin problems. But you’ll still have some out-of-pocket expenses.”

The most common procedures are the abdominoplasty or “tummy tuck”; the body lift (removal of skin from the lower abdomen, hips, outer upper thighs and upper buttocks); thigh lift; arm lift and breast lift. “People will often do one or two areas at once and come back later to do more,” says Dr Savundra. “If you have a problem in one place, you often have a problem in others too.”

But before you start planning your extreme makeover, remember these are significant surgeries that will require time off work and your regular activities. “For an abdominoplasty, expect to stay in hospital for one to five days, take a week off driving, two weeks off sedentary work like an office job, six weeks off manual work and three months off exercise. It takes some planning,” says Dr Savundra.

You should also expect substantial scarring. “But it’s very uncommon for a patient to wish they hadn’t had the surgery because of the scars,” says Dr Savundra. “I’ve never heard that before – it’s generally a high-satisfaction surgery.”

Average cost: A tummy tuck costs between $6000 to $10,000, depending on whether your private health insurance covers the hospital fees. You may be eligible for a Medicare rebate of $400 if you meet conditions. An arm lift costs between $5000 to $10,000 (with a possible $400 Medicare rebate). A body lift can set you back nearly $20,000. Some clinics can charge a lot more so shop around, but make sure you use a reputable clinic. Ask about the surgeon’s qualifications, find out how long they have been doing the procedures and ask to see recent examples of their work.