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Skin Reduction

Excessive sagging skin on your arms, legs, trunk, or belly after massive weight loss is frustrating. Washington, D.C. plastic surgeon Dr. Paul G. Ruff IV is experienced in helping both men and women who want to complete their personal transformations by removing excessive skin and tissue.

If your self-esteem is affected by excessive skin following pregnancy or bariatric surgery, request a consultation at Ruff Plastic Surgery, which serves Alexandria, Reston, and other areas surrounding D.C. Or call our office at (202) 785-4187 to schedule an appointment.

Paul G. Ruff IV, M.D., F.A.C.S.

Inspiration sparks passion. Passion nurtures excellence. Dr. Paul G. Ruff IV, inspired by his grandfather, knew at an early age he wanted to help people as a doctor. Dreams do come true.

Meet Dr. Ruff
Meet the Doctor
Paul G. Ruff IV

Before & After Photo Gallery

We're as thrilled with our patients' results as they are. Check out our before-and-after photo gallery and see for yourself the kind of work our talented surgeons do.

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Are You a Good Candidate for a Skin Reduction Procedure?

If you are in good health and have realistic expectations regarding the results of your skin reduction surgery, you are an ideal candidate for the procedure. While a skin reduction procedure will reduce the amount of sagging skin and excess tissue, no surgical procedure can re-create the tight and firm skin of your youth.

Additionally, a skin reduction procedure will, by its nature, result in scars. Although Dr. Paul Ruff carefully places incisions in as inconspicuous locations as possible utilizing the tiniest sutures possible and the scars will fade over time, they will always be present. The procedure, along with its limitations, will be discussed with you at length during your initial consultation with Dr. Ruff at his Georgetown plastic surgery office.

Meeting With Dr. Ruff

Prior to scheduling your skin reduction procedure, you will meet at length with Dr. Ruff and the staff at Ruff Plastic Surgery. You will have your areas of concern evaluated, and you will discuss how you want your body to look after the procedure. VECTRA® 3-D imaging software may be used to help you visualize the potential changes your procedure will bring.

Dr. Ruff and staff will:

  • Review the various skin reduction options with you
  • Clearly discuss the potential risks of the procedure
  • Outline in detail how the procedure is performed and what you can expect before, during, and after the procedure
  • Provide detailed cost and payment information
  • Answer all of your questions

You will be asked to provide:

  • Details about your medical history
  • A list of all medications you currently take, including over-the-counter medications such as aspirin, vitamins, and herbal supplements
  • Information regarding your tobacco and alcohol use

How Skin Reduction Is Performed

If your primary concern is that of loose skin, the muscles and tissues beneath your skin are in good condition, and the area to be treated is not substantial, your procedure may be performed under local anesthesia in Dr. Ruff's accredited on-site surgery suite. Local anesthesia plus the addition of IV sedation is also an option, but for those with a great deal of skin to be removed, general anesthesia will be used. Decisions about anesthesia will be confirmed with you at your consultation prior to scheduling your procedure. Dr. Ruff and the staff at Ruff Plastic Surgery are dedicated to ensuring your complete comfort during and after your skin reduction procedure, which may range from an hour to several hours, again depending upon the degree of skin reduction required.

Dr. Ruff will make incisions in the skin and, after lifting the excess skin away from the underlying tissues, will excise the surplus skin. The skin edges will then be joined together with tiny stitches using absorbable suture material. Your individual anatomy determines the best place for incisions, but Dr. Ruff makes every effort to place incisions in a manner that minimizes visible scars.

A supportive dressing will be placed over the treated areas to provide support during healing.

What To Expect After Your Surgery

Activity When
Shower or Bath Day After Surgery, depending upon the magnitude of skin removed
Back to Work Few Days After Surgery
Driving Usually Within a Week After Surgery
Strenuous Activity 3 to 4 Weeks After Surgery
Fading of Scars Several Months to 1 Year

Immediately After Your Surgery

In most cases, you will be ready to go home shortly after the procedure. Because you may be a bit sleepy after the anesthesia and will experience a good deal of soreness in the area of your incisions, it is important for someone to drive you home after your surgery. You may also want to have someone stay with you for the first day or 2 after your procedure, to eliminate the need to lift, stretch, or put any undue pressure on the sutures.

The First 24 to 48 Hours After Your Surgery

During the first 24 to 48 hours after your procedure, you will feel tired from the anesthesia, but because the focus of surgery was on skin rather than muscle, bone, or other tissues, you will likely feel less discomfort than with other cosmetic procedures. Tylenol is generally adequate for discomfort, although Dr. Ruff can prescribe pain medication for you if you need it. Your comfort level will improve rapidly after the first 2 days.

Dr. Ruff will instruct you on showering after your procedure, as the timing for your first post-op shower will depend upon the location and extent of the skin reduction.

In general, your dressings will be removed after a few days at your first post-op visit to our Washington, D.C. plastic surgery office. Subsequent visits are scheduled every 1 to 2 weeks thereafter to confirm continued healing of the skin.

The First 2 Weeks After Surgery

  • You will notice a marked improvement in your comfort level during the first few days after your surgery.
  • Any bruising you experience will usually disappear in about 2 weeks.
  • Some patients experience a burning or itching sensation in their skin, which generally disappears within 7 to 14 days after surgery.
  • Avoid heavy lifting and straining for at least 2 weeks.

Resuming Your Normal Routine

Everyone heals at different rates, and you are the best judge of when you are ready for certain activities, but the following are general guidelines:

  • You can most likely return to work or school within 3 to 5 days after your procedure, unless your work is strenuous.
  • You can resume driving within a week. However, if your skin reduction procedure involved the thighs or buttocks, you may find driving uncomfortable for the first several weeks. Dr. Ruff will advise you as to when driving will be comfortable and permitted.
  • Strenuous exercise can begin about 3 weeks after surgery. Our patients are encouraged to plan an exercise program and discuss it with the staff prior to resuming exercise.
  • The scars should be protected from sunlight for at least a year after surgery.

Things to Be Aware of After Your Skin Reduction Procedure

Your skin may appear shiny due to swelling. Within a few weeks, the swelling will disappear and your skin will return to a normal appearance.

What Are Possible Side Effects or Risks?

Like all surgical procedures, there are risks associated with skin reduction. During your pre-surgery consultation with Dr. Ruff, your individual risks will be assessed and discussed and it will be determined whether you are a good candidate for skin reduction. As with any surgery, you can reduce the risks associated with skin reduction surgery by closely following the instructions provided to you by the staff at Ruff Plastic Surgery. Dr. Ruff and his staff at Ruff Plastic Surgery will be with you every step of the way to ensure a safe and pleasing outcome.

How Long Will the Results of Your Skin Reduction Procedure Last?

Results of your skin reduction are permanent. However, keep in mind that as your body ages, your skin will sag somewhat and wrinkle over time. Avoiding sun exposure will help you maintain good skin health.

Questions You May Have

Will my insurance coverage pay for my skin reduction surgery?

Except in cases of reconstruction, skin reduction is considered a cosmetic treatment and, therefore, is not covered by your insurance. You are responsible for the full payment for your procedure. Cost and payment information will be discussed in detail with you during your initial consultation.

Are there alternatives to skin reduction surgery?

Currently, no other intervention exists that provides the results possible with surgical removal of the excess skin.

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Ruff Plastic Surgery
2440 M St NW #200
Washington, DC, 20037
(202) 785-4187
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