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Leah Rae Russell has lost more than 200 pounds over a decade, but says she didn't fully appreciate her success until she took the final step: tightening and removing nearly 3 pounds of skin hanging from her chest and stomach.
The change is so amazing, she often doesn't recognize herself when she looks in the mirror.
“I feel like I look at myself in the mirror a lot, and I feel like it comes off as very arrogant, but it's just trying to accept the fact that what you see in the mirror is your body. This is not somebody else,” said Russell, 31, of South Sioux City, Nebraska.
Russell had two procedures two months ago to tighten and lift loose, saggy skin on her breasts and stomach. Although she is still healing, she has seen great improvements.
The surgeries were important to her self-esteem. The second package above that also caused problems.
“My stomach is always bleeding and raw,” she said. “No matter how often you shower or powder or something like that, you get to the point where you have so much skin, there's a limit to how much you can treat it without removing it.”
Thanks to effective and popular new drugs for weight loss and diabetes – approx 1 in 8 adults In the US, Ozempic, or similar GLP-1 drugs used – have increased demand for skin lifting and tightening procedures.
“The numbers are staggering,” said Dr. Steven Dayan, a board-certified plastic surgeon and clinical assistant professor at the University of Illinois. “I think we're going to see a lot of patients looking for aesthetic treatments, and we need to figure out how to treat them better.”
In the year In 2022, Wegovy, the first GLP-1 drug for weight loss approved in the US, breast lift and tummy tuck – the two procedures Russell had – increased by 30% and 37%, respectively, from 2019, according to the American Society of Plastic Surgery. Upper arm lifts, sometimes called angel wings to remove sagging skin, increased 23 percent over the same period. Front lift, lower body lift and seat lift also showed similar increases. These processes are completed again in 2023.
The American Society of Plastic Surgery is fueling the trend with the popularity of Ozympic and similar drugs.
“We're lifting from toe to toe,” said Dr. Michelle Shermack, a board-certified plastic surgeon in Baltimore and a spokeswoman for the society.
Shermak says these patients are younger — in their 30s and 40s — than those who traditionally seek facelifts and other skin-tightening procedures. Because of their relative youth and health, people who want to remove skin after weight loss tend to heal faster after their surgery, which is a bonus, she said.
On the other hand, the patients Diane sees after weight loss sometimes don't get the results they want from skin tightening procedures because the weight loss has changed it. Thinner and less elastic.
Diane says he has performed a few lifting procedures on weight loss patients, and although some people are happy with the results, others are not.
“Some of them are like, 'All my skin is still loose.' “There's a limit to how much better you can get these people, so their expectations may not match what they want.”
Russell's struggle with lumps and flaps of sagging skin after weight loss has echoed in online support groups, where people seek advice on how to prevent it, but also what to do. Many say they feel frustrated after working hard and losing weight, only to look in the mirror and see a sagging and wrinkled saddle.
Russell, who is 5 feet 9 inches, has dropped from a peak of 340 pounds to 133.
She credits hard work and a combination of bariatric surgery and weight-loss drugs that helped her recover from the disordered eating she'd struggled with since childhood.
“I went on Weight Watchers when I was in fifth grade with my mom,” she said. “When I entered college at 17, I was 300 pounds.
“I had personal trainers. I made diet plans. Nothing controlled my food addiction and binge eating disorder. It was more than I could handle,” Russell said.
She was afraid that she would die without serious help, so in 2010 In 2012, she underwent bariatric surgery, which resulted in a 120-pound weight loss.
Then she gave birth to her daughter Aurora and gained 50 kg during pregnancy. But she was determined to keep going.
She then turned to the GLP-1 drug Wegovi and a stimulant called Vivance to help control her binge eating, which she did every few days.
“I haven't had it for 16 months or something like that. Nothing like this has ever happened in my life,” she said. “So that was really wild.”
Many victories have been achieved along the way. The numbers on the scale are down. Her health has improved. She has more energy – or at least as much as one could have chasing a lively 2-year-old around all day.
But after all the weight loss, there were still things that bothered Russell. It was very difficult to buy the right size of clothes. If a shirt is tucked in the shoulders, it will be too tight on the extra skin around the middle. If the waist fits, the shoulders will look as massive as the linebacker's, she said. She couldn't afford jeans with a fitted waist because the extra skin wouldn't fit in them.
She promised herself that if she reached her goal weight, she would have surgery to remove the excess skin.
“I was curious about what it would be like if I didn't become obese,” she says.
Insurance sometimes covers skin removal procedures after weight loss. Every plan is different, however, and most don't cover cosmetic skin removal. Many plans require patients to certify that they have health problems such as infections. Some also require people to maintain weight loss for a period of time or try prescription drugs before the surgery is covered.
To get coverage, Russell's plan required the skin to hang for a certain length, and she wasn't too short to qualify. She also needed a tummy tuck called a fleur-de-lis, which cuts through the abdominal skin from thigh to hip and from hip to breastbone to remove excess skin and tighten the underlying muscles. Her insurance would only pay to remove a portion of her extra skin, so in the end, she decided to do it without insurance. She took out a loan paying $13,000 for both procedures.
Russell went online to get support and advice from people who had gone through the same procedure.
some Dangers of skin removal Surgeries include bleeding and blood clots, infections, fractures and swelling. Patients must learn how to cope with some of the most severe movement restrictions early in healing. For example, people with stomach ulcers are advised to wait two weeks for the skin to heal after the procedure.
“I spent a lot of time in Facebook groups, reading support groups and seeing what other people were going through and what complications they had and there were tips and tricks,” she said.
“I've read about some people having very serious surgeries. Your entire stomach is cut open. It's inherently dangerous,” she said.
She was told it could take up to a year for the tumor to completely go down and drain the tissues of the lymphatic system. But after eight weeks, Russell said she felt better. Her movement restrictions are gone. She has no swelling or ulceration. Her scars are minimal.
I am on the way to the best they can hope for.
Shermak says patients who want skin removal should expect some scarring, but it's usually not as bad as they fear.
“The scars are very strategically placed. Typically, they are covered or hidden in areas between different parts of the body,” she says.
Regaining weight is always a risk for patients, especially if they develop a tolerance to their medications or decide to come off them completely.
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Shermack says that people who have had skin removed with bariatric surgery have seen weight gain back, and the fat doesn't seem to go back to where it was before.
“So they tend to gain weight around their liver and around their intestines and things like that,” she says.
Fat Around the internal organs It contributes to problems like high blood pressure, heart disease, diabetes, cancer and fatty liver disease.
“People should just stay on top of it when it comes to their health and wellness and their physical activity,” Shermack said.
And what about prevention? Is there anything to prevent stretch marks after weight loss?
According to Shermak, everyone is different. Biology and genetics often determine how elastic the skin can be, but the rate of weight loss also seems to be important.
“People who lose weight too quickly, I think the skin can't hold it,” she says. “I think that losing weight slowly can reduce the problems.”
Russell said she would definitely recommend it to anyone who wants to have the surgery.
“All bodies are beautiful. And my skin was a part of me, and a physical expression of everything I was going through… and I wasn't ashamed of it,” she said.
“I was having health problems, and I was curious about what it would be like without him. So that's why I moved on,” Russell said. “I have no regrets.”