Hannah Thompson has one word to describe what it took to get to her size 10: “Hell.”
It wasn’t the weight loss itself, however, because Hannah, 31, a beautician from Liverpool, underwent bariatric surgery on the NHS which quickly proved effective.
However, her weight loss left her with “large” amounts of excess, loose, irritated skin.
“My stomach sank, my breasts were empty pockets hanging from my stomach, and my arms had bingo wings,” she says. “I had flaps of excess skin everywhere.”
Hannah Thompson underwent bariatric surgery on the NHS but her weight loss left her with “large” amounts of loose, irritated and excess skin.
But Hannah found herself unable to undergo the surgery needed to remove the excess skin on the NHS.
“They told me it was ‘cosmetic’ and they wouldn’t help me,” he says.
After pregnancy with her youngest son made her sagging skin even worse, she ended up paying thousands of pounds to go to Turkey to have the surgery there.
It was a decision he now bitterly regrets. Not only did Hannah wake up from her 11-hour operation in excruciating pain, but she also says she has “permanent nerve damage in both arms.”
‘My arms feel like they’re being stabbed, and they sting constantly. I can’t even lift my arms in certain positions,” says Hannah, whose children are now 12, six and four.
Experts say they are seeing an increasing number of cases like Hannah’s and warn people considering weight-loss surgery to be aware of the potential downsides.
About 70 per cent of patients who undergo bariatric procedures will subsequently need to undergo “body contouring” surgery (i.e. removal of excess skin), says Mark Soldin, a plastic surgeon at St George’s Hospital in the South West. of London, and formerly chair of the body contouring committee of the British Association of Aesthetic and Reconstructive Plastic Surgeons.
A high percentage of these patients will develop complications, he warns. Although most of them will be resolved, she says, there are also stories like Hannah’s.
The mother of three had no idea what awaited her before her bariatric surgery in 2016.
She had gained weight after the birth of her first child, James, going from a size 14 to a size 28. At one point her weight reached 21.7 pounds. With a height of 5 feet 4 inches, her BMI was above 51 and she was classified as “morbidly obese.”
The beautician, pictured before her bariatric procedure, was unable to undergo the surgery needed to remove the excess skin on the NHS and paid thousands of pounds for the treatment in Turkey.
Dieting didn’t work and she eventually asked her doctor about undergoing weight loss surgery. At the age of 24, she underwent gastric bypass, in which a pouch is created at the top of the stomach and then connected to the small intestine to bypass the stomach.
“When I came to, I was relieved that I was finally going to start losing weight,” Hannah says. “I was warned about excess skin, but when I was young I thought it wouldn’t be so bad.”
Hannah discovered that she “lost weight”; in fact, she lost 12th place in less than two years. But losing weight so quickly came at a price.
“I had a lot of excess skin,” he says. ‘I tried to hide it by wearing tight clothing. But the moment I took off my clothes, my skin hung in folds around my body. I felt terrible.’
Excess skin is a common side effect of substantial weight loss, as once-stretched skin becomes “deflated.”
Several factors can contribute to this, Soldin explains, including genes, age (younger skin is more elastic), and rate of weight loss (skin is more likely to hold up if weight loss is more gradual).
However, removing excess skin on the NHS is a “postcode lottery”, he says.
According to NICE guidelines, patients who have lost 50 per cent of their excess body weight, have a BMI of 30 or less, have maintained a stable weight for at least 12 months and have “functional impairments” should be offer skin removal surgery on the NHS.
“It’s not about feeling embarrassed about undressing in front of your partner or not liking how you look in the mirror,” says Mr. Soldin. “These are major functional problems, such as infections in skin folds and abscesses, or not being able to exercise because the skin wobbles too much.”
However, because it is up to local health authorities to decide whether they will fund these operations, only a small number of people have the surgery on the NHS and they often have to wait more than a year for it.
Even then, surgery typically doesn’t cover the four areas where sagging skin typically occurs: the stomach, inner thighs, inner arms, and breasts, Soldin says. “Typically, it will cover only areas that the surgeon feels meet the criteria for body contouring.”
Hannah was told she was not eligible for surgery because her problem was “cosmetic” and did not affect her quality of life, “although it did affect my mental health.”
“I was desperate because I had lost weight but still looked horrible,” she says.
Having surgery in these four areas privately costs around £30,000 in the UK, so it is not surprising that people are tempted to go abroad for surgery.
In 2022, Hannah saw ads on social media about the surgery in Türkiye. “It costs a third of the price in the UK, and people post photos looking amazing afterwards,” she says.
Hannah opted for a breast lift and had sagging stomach skin and bingo wings removed at a clinic in Ankara. Her parents said they would foot the £8,500 bill.
“When I came to, I heard a woman screaming in agony and realized it was me,” Hannah recalls. Despite being in terrible pain and “convulsing with shock” due to dangerously low iron levels, the hospital wanted to discharge her that same day.
“But I refused and made them hold me until the next morning,” says Hannah.
He flew home five days later.
Aesthetically, the surgery was largely a success. “My stomach was flat, my breasts were perkier, and all the excess skin was gone,” says Hannah. “My arms had terrible scars, but they were tight and thin.”
But over the next few months, he developed agonizing pain in his arms. However, as the operation had been carried out abroad, her GP told her the NHS could not help her.
Hannah saw a plastic surgeon privately five months ago, who diagnosed her with nerve damage. “But they couldn’t operate on my arms because it would make the pain worse,” she says.
Soldin says UK plastic surgeons are increasingly seeing similar cases.
“The complication rate for this type of surgery is enormous: probably 50 to 100 percent of patients will have complications after body contouring after weight loss,” he says.
This is true both in the UK and elsewhere, he adds, but the key is the availability of follow-up care.
“This type of surgery requires close and continuous monitoring by a qualified team including nurses, physiotherapists and surgeons,” explains Mr Soldin.
‘When people go abroad, they can’t get that. Three or four days after the operation, these patients return to the plane, often with drains hanging from their bodies, and the advice they are given is to go see their GP if they have any concerns.
‘But the NHS does not accept people who have complications from surgery in the private sector unless they are going to die from those complications (such as open wounds or infections).
‘Follow-up treatments should be agreed between the patient and surgeon before the initial operation. Unfortunately, patients are often not aware of this.
“With the high complication rate of body contouring surgery, if you travel to another country you are rolling the dice.”
What can those affected do then?
“Either live with it or pay for it, there’s no magic solution,” Soldin says.