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Old 02-27-2012, 06:08 AM   #1
shinyapple
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Default Excess Skin issues?

Hi folks! Let me preface this by saying I am NOT a post-WLSer, but have lost a significant amount of weight after having part of my pancreas removed due to an insulinoma. My doctor has shaken his head at me more than once since none of them expected this to be a side effect, but regaining my mobility and having a generally improved state of health has been an advantage. My highest weight was 606, though that was brief, and eighteen months since that time has seen me drop to around 350 at 5'2". Still nowhere near tiny, but much smaller.

My question is this: when do you know it's time to consider surgical removal of excess skin? I'm not loving my upper arms being more than half batwings, nor the drapes around my sides and the weasels in a stretched out sock otherwise known as my breasts. My bigger concern though is my pannus and thighs. My lower belly is deflated and mostly just rests against my upper thighs, which are half skin and folds as well.

Since December, I've had an on-and-off issue with what I thought at first was a yeast infection, was finally told was an allergy, and has recurred periodically despite changing to entirely perfume and dye free products. The areas where my legs and body meet, as well as where my pannus hits my upper legs/groin area, are uncomfortable, sometimes itch, and yet there is nothing there. I find myself showering two to four times a day, letting the hardest spray from the hand-held just beat the crap out of the seams of my legs, as that is the only thing that seems to alleviate the feeling for a while. I'm far from dirty, am very particular about what bath and laundry products I use, and still don't know what to do.

So...is this something due to the excess skin? Could I be experiencing skin breakdown or deterioration already? I'm not certain my POS insurance provider will cover the plastic surgery/reconstruction, but if that's the answer and paying out of pocket is the solution, I may bite the bullet and get it done. I can wait on any upper body work, but the health concern is what's getting to me. I've looked and looked and tried to find info, but there isn't much I can find on excess skin after weight loss other than passing remarks about potential infections or the need for surgery to remove it.

Have any of you faced this problem? Am I being paranoid or should I see someone about it? If so, where do I even go? It's not a gyno issue, I doubt a dermatologist wants to check out my crotch, and it doesn't seem to align with what my GP would handle either. I just want to find a solution where I don't feel like I need to either scratch my skin off, scald myself in the shower, or be afraid to ever consider sex again because whatever someone sees on my upper thighs would make me appear diseased. (Yes, I have built it up in my head into something horrible!)

Any advice would be appreciated. Thanks in advance and I hope my question isn't intruding from a non-WLSer.

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Old 02-27-2012, 09:51 AM   #2
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Quote:
Originally Posted by shinyapple View Post
Hi folks! Let me preface this by saying I am NOT a post-WLSer, but have lost a significant amount of weight after having part of my pancreas removed due to an insulinoma. My doctor has shaken his head at me more than once since none of them expected this to be a side effect, but regaining my mobility and having a generally improved state of health has been an advantage. My highest weight was 606, though that was brief, and eighteen months since that time has seen me drop to around 350 at 5'2". Still nowhere near tiny, but much smaller.

My question is this: when do you know it's time to consider surgical removal of excess skin? I'm not loving my upper arms being more than half batwings, nor the drapes around my sides and the weasels in a stretched out sock otherwise known as my breasts. My bigger concern though is my pannus and thighs. My lower belly is deflated and mostly just rests against my upper thighs, which are half skin and folds as well.

Since December, I've had an on-and-off issue with what I thought at first was a yeast infection, was finally told was an allergy, and has recurred periodically despite changing to entirely perfume and dye free products. The areas where my legs and body meet, as well as where my pannus hits my upper legs/groin area, are uncomfortable, sometimes itch, and yet there is nothing there. I find myself showering two to four times a day, letting the hardest spray from the hand-held just beat the crap out of the seams of my legs, as that is the only thing that seems to alleviate the feeling for a while. I'm far from dirty, am very particular about what bath and laundry products I use, and still don't know what to do.

So...is this something due to the excess skin? Could I be experiencing skin breakdown or deterioration already? I'm not certain my POS insurance provider will cover the plastic surgery/reconstruction, but if that's the answer and paying out of pocket is the solution, I may bite the bullet and get it done. I can wait on any upper body work, but the health concern is what's getting to me. I've looked and looked and tried to find info, but there isn't much I can find on excess skin after weight loss other than passing remarks about potential infections or the need for surgery to remove it.

Have any of you faced this problem? Am I being paranoid or should I see someone about it? If so, where do I even go? It's not a gyno issue, I doubt a dermatologist wants to check out my crotch, and it doesn't seem to align with what my GP would handle either. I just want to find a solution where I don't feel like I need to either scratch my skin off, scald myself in the shower, or be afraid to ever consider sex again because whatever someone sees on my upper thighs would make me appear diseased. (Yes, I have built it up in my head into something horrible!)

Any advice would be appreciated. Thanks in advance and I hope my question isn't intruding from a non-WLSer.
As a "postie" I'm happy to have you here, and the question you ask is one we all ask ourselves. In general, once your weight is stable, you can start thinking about having surgery to take down some of that skin. In my experience, for about a year that, even, our bodies continue to "remodel" themselves and skin tightens somewhat. Depending on the area of the body, your age, health, genetics, you may or may not have some tightening of your skin. Arms and bellies tend to be the worst -- that's where the worst of my skin was.

What you have under your pannus sounds like intertrigo, which is in inflammation of the skin folds that sometimes becomes infected, usually with yeast. Try to keep the areas as dry as possible. It doesn't take long to get skin breakdown and then it's harder to heal. I would definitely see a doctor about this, even if it's not your surgeon, and instead your primary care provided. Get it documented, because it will help you get your panniculectomy covered by insurance; it makes it not a cosmetic procedure, but rather a medically necessary one.

As for treatment, in another thread (I think in the health forum) I discussed a great dressing material that our wound specialist recommended to prevent skin breakdown in folds and treat infection. I'm sorry but I can't remember the name of it. It's basically a soft fabric impregnated with silver that is awesome. There is a skin fold thread in the health forum, and I started a thread on my own about it so if you search my posts you'll find it. You may need further treatment if you have yeast. Topical products like nystatin are a good place to start; however, many of us require a medicine like Diflucan (a yeast infection remedy) to get rid of it.

In the meantime, keep it dry. That means using a hair dryer on a cool setting after you shower, placing something absorptive between layers (I like the old fashioned OB pads without the sticky on the back) and wear loose fitting clothes. Any time you can get nekkid and expose that area to air will be helpful as well.

Oh and I know it goes without saying, but keeping your blood sugar under tight control is the other part of this. Bugs love sugar and the more food you give them the more they will grow. So keeping control of your sugar will help as well.

Good luck! If you have more questions, feel free to ask. Been there, done that, had the surgery and am doing great now!
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Old 02-27-2012, 09:56 PM   #3
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Quote:
Originally Posted by Miss Vickie View Post
As a "postie" I'm happy to have you here, and the question you ask is one we all ask ourselves. In general, once your weight is stable, you can start thinking about having surgery to take down some of that skin. In my experience, for about a year that, even, our bodies continue to "remodel" themselves and skin tightens somewhat. Depending on the area of the body, your age, health, genetics, you may or may not have some tightening of your skin. Arms and bellies tend to be the worst -- that's where the worst of my skin was.

What you have under your pannus sounds like intertrigo, which is in inflammation of the skin folds that sometimes becomes infected, usually with yeast. Try to keep the areas as dry as possible. It doesn't take long to get skin breakdown and then it's harder to heal. I would definitely see a doctor about this, even if it's not your surgeon, and instead your primary care provided. Get it documented, because it will help you get your panniculectomy covered by insurance; it makes it not a cosmetic procedure, but rather a medically necessary one.

As for treatment, in another thread (I think in the health forum) I discussed a great dressing material that our wound specialist recommended to prevent skin breakdown in folds and treat infection. I'm sorry but I can't remember the name of it. It's basically a soft fabric impregnated with silver that is awesome. There is a skin fold thread in the health forum, and I started a thread on my own about it so if you search my posts you'll find it. You may need further treatment if you have yeast. Topical products like nystatin are a good place to start; however, many of us require a medicine like Diflucan (a yeast infection remedy) to get rid of it.

In the meantime, keep it dry. That means using a hair dryer on a cool setting after you shower, placing something absorptive between layers (I like the old fashioned OB pads without the sticky on the back) and wear loose fitting clothes. Any time you can get nekkid and expose that area to air will be helpful as well.

Oh and I know it goes without saying, but keeping your blood sugar under tight control is the other part of this. Bugs love sugar and the more food you give them the more they will grow. So keeping control of your sugar will help as well.

Good luck! If you have more questions, feel free to ask. Been there, done that, had the surgery and am doing great now!
Thank you for the great info, Vickie. I'm still somewhat young (34), but my skin was so significantly stretched that I don't expect much rebound. The last two hundred or so pounds came on pretty quickly over the course of only a couple years due to the damn tumor, and it was painfully stretched in some areas. Maybe I'll get lucky though

I saw a doctor back in December when this started, which was when I found out it's not yeast. He diagnosed contact dermatitis, which is when I switched any products that came into contact with my skin. I'm an avid Aveeno fan these days and rinse super thoroughly and dry, dry, dry. I'll check with a medical supplier for those dressings though. It can't hurt to try and I'm not a fan of using powder if I can avoid it.

I wish the sugar thing was simple! LOL My "stump" of pancreas hasn't been too cooperative thus far, but my endo is amazing about working with me and trying new combinations to try to keep my levels down until the little bastard decides to cooperate and produce the insulin to make up for the missing chunk. It could take a couple more years though, so we're adapting for now.

Thanks again for chiming in. I'll have my PCP check it out, though he's about as stumped as the others about what my body is doing. My surgeon is at the Mayo, several hundred miles away, so somehow we'll come up with an answer. LOL
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Old 03-10-2012, 07:04 PM   #4
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I haven't had WLS, but my belly does hang and rest on my thighs. I didn't have a lot of money and bought white cotton hand towels in the automotive section of Walmart. I got several batches of them and can fold them and use one for each side under my stomach. They stay under there and keep it dry for the most part. They're easy to change if I do get hot and sweaty and they wash easily. They help more than anything.

There are a couple of other things I do, but the main things with the towels is to make sure my stomach doesn't touch my thighs because that irritates the skin.

I use supplements and homeopathics for much of my body care. If the doctor tells me I need a medication I do research to find out the supplements/natural treatments that are needed. I end up taking care of a lot of what my body needs naturally, not all, but a lot of it.

The dressing Miss Vicky mentioned with silver in it sounds like it might be good. I know you are looking for something to help your skin now, but just protecting it from touching might go a long way toward assisting the skin to heal. Our bodies are amazing and wonderful!

Wishing you success in finding what works for you.
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Old 04-14-2012, 04:53 AM   #5
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I also have a hanging belly that produces problems with rashes. I tried the paper towel thing under the fat and it worked, but the most effective thing I found is medicated powder. After I shower and dry off. I lay flat and let the area air dry. I then add copious amounts of powder. IT burns like fire and cools and then that area stays dry all day and it kills the pain of the rash and the rash within an hour. Other people may not have the same success. I used baby powder for years and all it did was create a nasty paste.

Medicated powder is a god send! A while back I had a nasty rash that even the powder couldn't help. I dealt with it for about two weeks, but I noticed when I used the powder that it didn't burn. So I just went and bought a new bottle and when I applied to the area it burned like a son of a gun. Within an hour I had relief. I think maybe I had a weak batch.

I hope this helps with the rash part. I have no info on the surgery part.
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Old 04-15-2012, 11:37 AM   #6
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Lamia, I used the medicated powder and it helped me too. I don't know what's in it but it seems to be very soothing.

The most important thing is to keep things dry, dry, dry. And as we move into summer that's going to be harder. A hair dryer on "cool" setting throughout the day will be your friend, as is anything that will absorb the moisture.

The dressing material I recommended is great, but it's kind of spendy. They have it at amazon, and for a big roll it's $75. OTOH, it's 12 feet of dressing material so it'd last you a very long time. I wonder if it's possible to get it covered by insurance?

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