What nobody explains before bariatric surgery: what will happen to your skin
Dr. Rodrigo Jorrat · Plastic surgeon · Buenos Aires · Lic. MN 1229033 min readBefore bariatric surgery everyone talks about losing weight. Almost nobody talks about what will happen to the skin, and that silence is a real problem. Bariatric surgery solves a great deal; what happens to the skin afterwards does not sort itself out. Knowing it from the start lets you decide with information.
What bariatric surgery solves
The post-bariatric patient carries a long and complex history. Surgery resolves an important part of it: not only weight, but also conditions such as diabetes or insulin resistance, and everyday things like moving freely or fitting into a car seat. Emotionally, it fulfils a wish: being able to do what everyone else does day to day.
Strictly surgically, it changes how and where food is absorbed. There are restrictive and malabsorptive procedures (a bariatric surgeon can explain this far better), and that change produces sustained weight loss, always with nutritional and medical supervision.
What it doesn't solve
After more than ten years accompanying these patients, I believe what surgery does not solve on its own is the relationship with food. Many lose weight and reach their goal, but the urge to eat remains something to keep working on with the nutrition and mental-health team, even after reconstructive surgery. Saying it beforehand doesn't discourage anyone: it prepares them.
What happens to the skin
Back to the silence I mentioned. It is not “you have surgery, you lose weight and everything settles harmoniously”. The cases that descend harmoniously are the minority.
Something concrete happens to the skin: nutrient absorption changes and that affects collagen strength. The skin loosens, shifts and does not always do so evenly. That loss of tension can be asymmetric and usually comes with large folds, with irritation and infections in those areas. When reconstructive surgery comes, there is a lot to discuss about scars and everything involved in solving it.
When we meet and what we assess
I usually meet the patient some time after the bariatric post-operative period, with a stable weight and having completed the process with their team: psychologist, nutritionist, bariatric surgeon. It is not a fixed timeline for everyone; that team defines it and we confirm it in consultation.
That moment is often a peak of euphoria: “the year has passed, I'm ready, I want surgery”. My job there is to assess, talk and give realistic expectations: you are ready for surgery, or we need to keep working. Nobody is left out forever, but processes aren't linear. Life happens, and goals aren't always reached in the time you imagined. Arriving prepared for that decision affects the result.
Bariatric surgery will change your life. Reconstructive surgery can help you recover your shape.
Frequently asked questions
Does the skin go back on its own after bariatric surgery?
In most cases, not completely or evenly. Nutrient absorption changes and that weakens collagen; the skin loses strength and tends to sag. I explain it in detail in chapter 2.
When should I see a plastic surgeon?
When your weight has been stable for a while and your bariatric team considers you ready. There is no number of months that applies to everyone: we assess it with your tests and your history.
Does bariatric surgery solve the urge to eat?
Not on its own. It is something you keep working on with nutrition and mental-health support, before and after any reconstructive surgery.
The information in this article is general and does not replace an individual evaluation.
