"There are 12 things you should know about loose skin after very large weight losses:



2. Elasticity of skin tends to decrease with age. Wrinkling and loss of elasticity is partly the consequence of aging (genetic factors) and also a result of environmental factors such as oxidative stress, excessive sun exposure, and nutritional deficiency. The environmental parts you can fix, the genetics and age part, you cannot. Advice: Get moving and change the things you have control over... Be realistic and don't worry about those things you don't have control over.

4. How long you have extra weight and stretched skin has a lot to do with how much the skin will become taut after the weight loss: For example, compare a 9 month pregnancy with 9 years carrying 100 excess pounds.

6. How fast the weight was gained also has a lot to do with how much the skin will resume a tight appearance. Your skin can only be stretched so quickly and be expected to "snap back.

8. There are exceptions to all of the above; i.e, people who gained and then lost incredible amounts of weight quickly at age 50 or 60, and their skin returned 100% to normal.

10. If you’re considering surgical skin removal, consult a physician for advice because this is not a minor operation, but keep in mind that your plastic surgeon may be making his BMW payments with your abdominoplasty money. (It’s possible that surgery may be recommended in situations where it's not 100% necessary). Surgery should be left as the ABSOLUTE FINAL option in extreme cases.

12. Know your body fat percentage before even thinking about surgery. Loose skin is one thing, but still having body fat is another. Be honest with yourself and do that by taking your body fat measurement. This can be done with skinfold calipers or a variety of other devices (calipers might not be the best method if you have large folds of loose skin. Look into impedance analysis, underwater weighing, DEXA or Bod Pod).

"Average body fat for men is in the mid teens (16% or so) Good body fat for men is 10-12%, and single digits is extremely lean (men shouldn’t expect to look “ripped" with 100% tight skin on the abs unless they have single digit body fat, and women low to mid teens).

So... the key to getting tighter skin is to lose more body fat, up to the point where your body composition rating is BETTER than average (in the “good" to “great" category, not just "okay"). Only AFTER you reach your long term body fat percentage goal should you give thought to "excess skin removal." At that point, admittedly, there are bound to be a few isolated cases where surgery is necessary if you can’t live with the amount of loose skin remaining.