The recent popularity of bariatric surgery (gastric bypass and lap band) has led to a growing population of patients seeking removal of excess skin following massive weight loss. After massive weight loss the skin often loses its elasticity and remains loose and stretched out. Working out and toning your muscles will not tighten the skin significantly. Surgery is the only remedy. The most common reasons patients come to see me after these types of procedures include tightening and lifting the breasts, abdomen, arms and thighs. Skin tightening involves skin removal and therefore fairly extensive scarring. However, most patients find the scars acceptable and easily hidden. Patients undergoing skin tightening procedures are usually very happy with their results, with a dramatic improvement in their appearance.