What pre-ops need to understand about loose skin

It's something that I myself didn't comprehend at all until pretty recently, and I say that as someone who's got plenty of the stuff. Loose skin, that is. Pre-op and until the last month or so I thought, "Okay, so after WLS and rapid, major weight loss, we'll have loose skin. Big deal. We were fat before; now we'll have some flab and folds in exchange for a thinner, healthier body. Everything's a trade-off -- why do people get so tense about it? It's worth it!"

Well, I was right about that last part. It is worth it. Definitely. And I did understand that, depending on how much weight one has to lose, excess skin can pose health and logistical problems at the end of the line that will need to be corrected with reconstructive surgery.

But the great big secret that I didn't understand as a pre-op? (Post-ops would touch upon this in posts on message boards, but they didn't go into detail, so I didn't get it -- and actually, I don't know that you can really get it until you're there.) After a certain point (and it's going to vary from person to person depending on [re-op starting weight and pounds lost), our deflated skin assumes vastly different properties from the skin we had when it was stretched over the fat we used to carry. To compare the two different kinds of skin is like comparing apples and oranges. At least when we were fat, something (er, that would be the fat itself) supported the skin, held it up, gave it something to wrap around, so to speak. After rapid weight loss, however, it's truly like letting air out of a big balloon that's been inflated for a long time: the elasticity is gone, and the skin is just -- there in this kind of frighteningly inert way. It just lies there, limp, almost as if it were dead and in the post-rigor phase. I'm not talking about literal necrosis here, of course, but the major head-trip is that the skin begins to feel like a separate entity appended to your body -- not truly part of it or of you at all.

And that's a damn freaky feeling, I can tell you.

Frankly, I only fully understood this whole syndrome this morning as I was shimmying into my Spanx control panty undergarment. I was having trouble getting into it and this puzzled me because I bought it at least 20 pounds ago. It couldn't be too small for me, I thought, and then decided that I simply must not have dried myself off thoroughly after my shower and dampness was making the process difficult. I grabbed a towel, redid the job, and tried again.

Shimmy. Tug. Shimmy. Tug. No go.

Sighing, I peeled the garment down and began putting on as if it were a pair of panty hose instead of just tugging it on over myself as I would a pair of underpants. You know, getting into it, tugging it up in phases, making sure each segment has been pulled up and smoothed before you adjust the next segment -- and that's when I realized what was going on.

I was having to stuff my extra skin into the Spanx garment, almost as if I were tucking the excess fabric of a shirt into the waistband of a pair of pants. It's not that the garment didn't fit -- it's the the extra skin just lay there like dead weight and had to be pushed and dragged into place.

Um .... EEEEWWWW! Seriously, EEEEEEEEEEEEEEEEEWWWWWWWWWWWWWW!

I assure you that the freak factor was not how ugly my loose skin looks but rather how I feel in it when it's not functioning the way it used to. I mean, intellectually I understood before why people would choose reconstructive surgery following massive weight loss, but I understood it only superficially. I didn't understand that living with excess skin might feel similar to living with a necrotic limb or a giant cyst!

Now, does this mean I'm racing out to consider plastics? No, I'm still desperately hoping that a) I won't want it; b) I'll adjust over time; c) my hernia will not require repair so that I won't be faced with a choice of doing a tummy tuck and abdominoplasty at the same time. I do not want more surgery.

But the freak factor was high today.

Labels: Head-trips

Comments

[*S*]

Eew! I asked the nurse at the first place I was considering surgery why she didn't discuss the fact that many - if not most - WLS patients would want some type of surgery to remove excess skin. She explained that although they did touch on it in the orientation, that they didn't want to frighten people. She also likened the situation to where we were collectively with breast cancer reconstruction 30 years ago, in terms of what insurance companies will pay for. In summary, she said really that she thought of WLS as the first of a two part surgical package.

[sparkly_jules]

And people wonder why I balked after my first surgery was cancelled---the thought of more surgery (to remove the world's biggest body-lichen) scared me even more. Will I still do it someday? Probably. Am I excited? No way, man. No way.

[Kate]

Ahhh, yes. The "unabsorbed conjoined twin" as I call it. I keep grabbing it, hanging there off of my thigh, wondering why it doesn't do something to contribute to my overall wellbeing or just go away.

[Lesley]

I know what you mean I never thought I would have the excess skin removed but I used to feel like I was laying in a puddle of skin and I had to wear lycra bike pants all the time so that my legs didn't flap and slap together when walking. I used to hide under clothes to cover the fat and then to cover the flapping skin. I couldn't win. So with tummy tuck and arm reduction Op 1, Posterior Lift, leg liposuction Op 2 (those suckers wouldn't shrink even after losing 80kgs) Thigh Reduction Op 3, Hopefully, I see the end in sight. I hope you don't need the surgery, but the journey isn't all bad. Best wishes to you on your journey.

[Dagny]

If I may extend a little hope to some... I am 46 and for whatever reason I have not developed an excessive skin problem. Yes I am a little flabby but it's not much different from what many women my age who've had children might have. I discuss it and include photos on my blog.

[Danyele]

Eeek! Maybe I shouldn't have read this 5 days pre-op :-b

[Dagny]

Danyele, aren't you in your twenties? Don't sweat it girlfriend!

[Danyele]

I'm 32 - oh well, I definitely not going back now!

[ezpy]

First, belated congratulations on hitting the century mark. Amazing, isn't it?Second, omigod do I hear you about the skin. My Uhoh moment was when I was sitting in the bathtub and I could see a pool of my own skin floating up above my body, tethered somehow, but seemingly not at all part of the rest of me. Even then I stayed in denial but the breakdown is getting too bad, too may rashes and too much discomfort. My mom, in encouraging me to look into the reconstructive surgery soon, pointed out that the longer I wait, the worse the problem will get as my skin is actually stretching more under its own weight.It is hard. Worries about making my skin issues worse have kept me from pushing to lose another 20 pounds -- not that I especially want to anyway, it's just some fixation with being in the 150s.For people that thinkt this can be somehow prevented by exercise, lotions and hydration, think again. I did everything I was supposed to do, including building a pretty good muscle base under my skin -- but the skin isn't close enough to it for the muscle to matter. It's a crapshoot as to whether your skin has the elasticity to come back after the fat loss or not. I'm worse than some better than others.Would I trade back the fat to get rid of the lose skin? Not even on my most painful days. But I've lost close to 190 pounds -- more than I currently weigh. My skin used to cover twice the human being it now does. There's just too much of it. I've got a referal to a reconstructive surgeon next month. Meantime well, I'm just enjoying the skin I'm in even if there is a bit much of it.