In short. Removing skin means long scars. Where they sit for each area, how they mature over a year, what keeps them conspicuous, and what to settle first.
Key points
- Genetics matter most, and no surgeon can change them.
- So does tension on the closure, which is why the amount removed at one stage is limited and why a stage may be planned conservatively.
- Wound problems such as infection or separation worsen a scar permanently.
The operation that removes excess skin leaves scars. Not small ones, not ones that disappear, and not ones that can be placed wherever you like. They are long, they are permanent, and no operation that removes skin avoids them. That sentence belongs at the beginning of the decision rather than at the end of it.
Where the scars sit
Removing skin from the abdomen usually means a scar across the lower abdomen, often extending towards the hips, and sometimes a second one around the navel. Arm surgery leaves a scar along the inner arm, from near the armpit towards the elbow. Thigh surgery leaves one on the inner thigh or in the groin crease. Breast surgery leaves a scar around the areola, vertically below it, or in the fold beneath. Back and buttock surgery leaves scars that follow the fold. Each is placed where clothing covers it, if clothing covers it at all.
How a scar matures over a year
For the first weeks it is a healing wound. It is typically red, firm and slightly raised for the first months, which is when it is most noticeable and when patients worry most. It then softens and fades. Judging the final scar before a year has passed is judging something still in motion.
What determines how it looks
Genetics matter most, and no surgeon can change them. Skin type and age matter. So does tension on the closure, which is why the amount removed at one stage is limited and why a stage may be planned conservatively. Wound problems such as infection or separation worsen a scar permanently. Sun exposure in the first year darkens it. Some of this you control and some you do not.
Scars that stay conspicuous
Some scars thicken and stay raised, and a tendency to this runs in families and in certain skin types. A scar under more tension than the skin can bear widens. A scar that becomes infected or opens heals with a worse mark.
Why the conversation comes first
None of this is a failure of effort on your part. It is why the honest conversation about scars belongs before the operation rather than afterwards.
Deciding whether the trade is worth it
Ask whether you would accept the scar if the shape turned out exactly as you hoped. If the answer is no, the operation is wrong for you, because the scar is the part of the result that is certain. If the answer is yes, ask where it will be, how long it will be, and whether your usual clothing covers it.
Scars that need review
- A scar that is spreading, opening, or discharging.
- Increasing pain, warmth or redness in a healing scar.
- A new lump in or near a scar, which should always be examined.
Why the amount removed at each stage is limited is explained in Staging Body Contouring, and the areas themselves in Which Areas Loose Skin Affects. Scar and pigment aftercare is provided by colleagues at Dermatology.
Frequently asked questions
Can the scars be hidden?
They can be placed where clothing usually covers them, and they can be planned to follow natural creases where the body has them. Hidden is not the same as absent. Clothing that covers a scar in one position may not in another, and a scar that is easy to conceal in winter may not be in summer. That is a practical question worth asking directly.
How long before a scar looks its final appearance?
A scar is still maturing for many months and is usually considered settled at around a year. In the first months it is typically red, firm and slightly raised, which is when it is most noticeable and when patients worry most. Judging the final scar before that year has passed is judging something still in motion.
What if I form bad scars?
Tell the surgeon before the operation. A personal or family history of raised, thickened or spreading scars changes how a closure is planned and what aftercare is arranged, and it may change whether a particular area is the right first choice. It is one of the few scar risks that can be anticipated rather than discovered.
Risks & Limitations
- Long, permanent scars. Where they sit is decided before surgery; they mature over a year but never disappear.
- Seroma, a collection of fluid under the skin, which is common after body contouring and may need repeated drainage.
- Wound healing problems, which are more frequent after major weight loss because of nutritional status.
- Blood clots in the legs or lungs, a rare but serious risk that prevention is planned for.
- Numbness or altered sensation over the treated areas, which may be permanent.
- Asymmetry and contour irregularity, and the possibility of a further stage to refine the result.
- Staging means more than one operation and more than one recovery, and each carries its own risk.
- General risks of anaesthesia and of a long operation, which a hospital setting manages but cannot remove.
When to Seek Care
- Chest pain, shortness of breath, or calf pain and swelling — seek emergency care immediately.
- Rapidly increasing swelling, a tense painful area, or bleeding that does not stop with gentle pressure.
- Fever above 38 °C, spreading redness, warmth, or discharge from a wound.
- Skin in a fold that is red, raw, weeping, foul-smelling or ulcerated and not healing.
- Swelling of an arm or a leg, a new lump, or weight loss you did not intend — all need medical assessment.
References & Further Reading
- American Society of Plastic Surgeons (ASPS) — body contouring after massive weight loss
- International Society of Aesthetic Plastic Surgery (ISAPS)
- American Society for Metabolic and Bariatric Surgery (ASMBS) — post-weight-loss care resources
- National Institute for Health and Care Excellence (NICE, UK) — obesity and body contouring guidance
- Cochrane Library — systematic reviews in body contouring and wound healing
This page is patient education, not medical advice, and it does not cite individual studies. Discuss your own case with a qualified clinician. To arrange an assessment at Chongqing West District Hospital, see Contact & Consultation.