Excess skin or body fat?

Over about 4-5 years I have lost 30+kgs, I now weigh 75 kgs and I am happy about everywhere I look but I have been wanting to put on size for a while now, but cannot until I flatten my stomach.
My stomach is the only part left holding me back and have been trying for about a year to get rid of it, but it's still there.
As I have lost a huge amount of weight, sometimes I start thinking it's excess skin, it's really soft.
My arms, legs chest and that are fine it's just my stomach, in a t-shirt I look pretty slim, just taking it off my stomach is still pretty flabby though.

How do I know if it's excess skin or fat? I'm just kind of concerned now for trying for so long, any suggestions?

Also I will add, my dad is a doctor and a couple of months ago I was talking to him and explaining how difficult it is just that last final step, as I have done the most hardest part and losing a bit over 30 kgs but I just can't get over this last hurdle before I can try put on some more muscle mass.

He had a look at my stomach and felt it and told me it he thinks it may be excess skin and suggested a tummy tuck (it's not liposuction where you take fat out, just tuck excess skin in).
I wasn't big on the idea and would feel kind of embarassed right now doing it, but I hear it is extremely hard to lose excess skin, so I am hoping it's fat so perhaps I can try something new to get rid of it.

I want to know how to find out if it's skin or fat, maybe I am thinking about just seeing one of those doctors to just tell me at least and if it's fat I will have to work much harder, but if it's skin, where do I go from there?

Well since your father is a doctor I would say he knows better than most on here. What is your height? I know 30Kgs ( 60lbs ) would be different on someone who is 6ft than say someone who is 5'7

How about posting a picture?

I know a few people who actually *have* excess skin (Read: Lost 50 kilos), it should look sorta similar.

[QUOTE=Fitz84]Over about 4-5 years I have lost 30+kgs, I now weigh 75 kgs and I am happy about everywhere I look but I have been wanting to put on size for a while now, but cannot until I flatten my stomach.
My stomach is the only part left holding me back and have been trying for about a year to get rid of it, but it's still there.
As I have lost a huge amount of weight, sometimes I start thinking it's excess skin, it's really soft.
My arms, legs chest and that are fine it's just my stomach, in a t-shirt I look pretty slim, just taking it off my stomach is still pretty flabby though.

How do I know if it's excess skin or fat? I'm just kind of concerned now for trying for so long, any suggestions?[/QUOTE]

There are 12 things you should know about loose skin after very large weight losses:

1. Skin is incredibly elastic. Just look at what women go through during pregnancy. Skin has the ability to expand and contract to a remarkable degree.

2. Elasticity of skin tends to decrease with age. Wrinkling and loss of elasticity is partly the consequence of aging (genetic factors) and also a result of environmental factors such as oxidative stress, excessive sun exposure, and nutritional deficiency. The environmental parts you can fix, the genetics and age part, you cannot. Advice: Get moving and change the things you have control over... Be realistic and don't worry about those things you don't have control over.

3. How much your skin will return to its former tautness depends partly on age. The older you get, the more an extremely large weight loss can leave loose skin that will not return to normal

4. How long you carry extra weight has a lot to do with how much the skin will become taut after the weight loss: For example, compare a 9 month pregnancy with 9 years carrying 100 excess pounds.

5. How much weight was carried has a lot to do with how much the skin will resume a tight appearance. Your skin can only be stretched so much and be expected to "snap back" one hundred percent.

6. How fast the weight was gained also has a lot to do with how much the skin will resume a tight appearance. Your skin can only be stretched so quickly and be expected to "snap back."

7. How fast weight is lost also has a lot to do with how much the skin will tighten up. Rapid weight loss doesn't allow the skin time to slowly resume to normal. (yet another reason to lose fat slowly; 1-2 pounds per week, 3 pounds at the most if you have a lot of weight to lose, and even then, only if you are measuring body fat and you’re certain it's fat you’re losing, not lean tissue).

8. There are exceptions to all of the above; i.e, people who gained and then lost incredible amounts of weight quickly at age 50 or 60, and their skin returned 100% to normal.

9. There are many creams advertised as having the ability to restore the tightness of your skin. None work – at least not permanently and measurably – and especially if you have a lot of loose skin. Don't waste your money.

10. If you’re considering surgical skin removal, consult a physician for advice because this is not a minor operation, but keep in mind that your plastic surgeon may be making his BMW payments with your abdominoplasty money. (Surgery may be recommended in situations where it's not 100% necessary). Surgery should be left as the ABSOLUTE FINAL option in extreme cases.

11. Give your skin time. Your skin will get tighter as your body fat gets lower. I've seen and heard of many cases where the skin gradually tightened up, at least partially, after a one or two year period where the weight loss was maintained and exercise continued.

12. Know your body fat percentage before even THINKING about surgery. Loose skin is one thing, but still having body fat is another. Be honest with yourself and do that by taking your body fat measurement. This can be done with skinfold calipers or a variety of other devices (calipers might not be the best method if you have large folds of loose skin. Look into impedance analysis, underwater weighing, DEXA or Bod Pod).

Suppose for example, a man drops from 35% body fat all the way down to 20%. He should be congratulated, but I would tell him, "Don't bitch about loose skin, your body fat is still high. Press onward and keep getting leaner.”

Average body fat for men is in the mid teens (16% or so) Good body fat for men is 10-12%, and single digits is extremely lean (men shouldn’t expect to look “ripped” with 100% tight skin on the abs unless they have single digit body fat, and women low teens).

Except in extreme cases, you are very unlikely to see someone with loose skin who has very low body fat. It's quite remarkable how much your skin can tighten up and literally start to “cling” to your abdominal muscles once your body fat goes from “average” to "excellent." Someone with legitimate single digit body fat and a ton of loose skin is a rare sight.

So... the key to getting tighter skin is to lose more body fat, up to the point where your body composition rating is BETTER than average (in the “good” to “great” category, not just "okay"). Only AFTER you reach your long term body fat percentage goal should you give thought to "excess skin removal." At that point, admittedly, there are bound to be a few isolated cases where surgery is necessary if you can’t live with the amount of loose skin remaining.

However, unless you are really, really lean, it's difficult to get a clear picture of what is loose skin, what is just remaining body fat and how much further the skin will tighten up when the rest of the fat is lost.

[QUOTE=Fitz84]Over about 4-5 years I have lost 30+kgs, I now weigh 75 kgs and I am happy about everywhere I look but I have been wanting to put on size for a while now, but cannot until I flatten my stomach.
My stomach is the only part left holding me back and have been trying for about a year to get rid of it, but it's still there.
As I have lost a huge amount of weight, sometimes I start thinking it's excess skin, it's really soft.
My arms, legs chest and that are fine it's just my stomach, in a t-shirt I look pretty slim, just taking it off my stomach is still pretty flabby though.

How do I know if it's excess skin or fat? I'm just kind of concerned now for trying for so long, any suggestions?[/QUOTE]
Congratulations on your weight loss!

Body building can help tighten the abdominal muscles but do not help with loose skin.

[url=http://www.plasticsurgery4u.com/a/after_weight_loss/index.html][u][b]After massive weight loss[/b][/u][/url], skin and and stretched tissues sometimes only contract so far. For many, the connective tissues have broken (stretch marks) that just does not behave like unstressed tissue. Many can benefit by trying to be patient and see how the skin changes. Once the tissues have stabilized, you may need to explore other options. Losing weight / body fat to a comfortable level before surgery is better than trying to lose fat after surgery.

[url=http://www.plasticsurgery4u.com/procedure_folder/abdominoplasty/index.html][u][b]Tummy Tuck Abdominoplasty[/b][/u][/url] can help tighten the loose abdominal wall and skin. There are many pages of before and after surgery pictures. However, most revealing is how the tissues move before and after surgery. Check out these [url=http://www.plasticsurgery4u.com/procedure_folder/abdominoplasty/tummy_tuck_movies_video.html][u][b]movies of patients before and after surgery[/b][/u][/url]. The movies better show the problem and quality of the surgical sculpture than limited still photographs.

You can read many experiences about this sculpture [url=http://www.plasticsurgery4u.com/pt_qna_folder/pt_qa_tumescent_tummy_tuck.html][u][b]here[/b][/u][/url]. There are pages of patients experiences posted there. You can also [url=http://www.plasticsurgery4u.com/procedure_folder/abdominoplasty/hear_tummy_tuck_stories.html][u][b]listen to patient experience here[/b][/u][/url]. The audio files let the emotion of the patient get expressed much more than written words.

Hope this helps,

Michael Bermant, MD
[url=http://www.plasticsurgery4u.com/procedure_folder/abdominoplasty/index.html][u][b]Learn More About Tummy Tuck Abdominal Sculpture[/b][/u][/url]