The skin that holds all of your fat tissue before the surgery tends not to shrink down as the fat goes away. Most patients are left with areas of excess skin, especially the abdomen, upper arms, upper thighs, and breasts. Exercise is very important for the patient’s overall success, but it is not effective in shrinking skin. However, excess skin draped over muscle is more aesthetically pleasing than skin that is draped over little muscle tissue. Many patients choose to undergo plastic surgery to remove excess skin. It is recommended to wait 12-18 months after bariatric surgery before pursuing plastic surgery. Also, it is important for a patient to be close to their goal weight and that their weight has stabilized. This allows the best results after plastic surgery. Unfortunately, most post-bariatric surgery procedures are not covered by insurance and you may consider starting to save money for these procedures.