Abdominal skin excess is usually described as hanging — a fold that falls downward. For a proportion of people after very large weight loss, there is a second direction to it: the skin is also too wide, gathering horizontally across the abdomen rather than only hanging below it.
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This page is about recognising that, because it is the difference people most often do not know to look for.
How to tell
Stand in front of a mirror. Take the skin at each side of your abdomen and draw it towards the midline.
- If the abdomen flattens and looks close to what you wanted, the excess is mainly vertical — the usual pattern.
- If drawing the sides in produces a large amount of overlapping skin, with obvious width to spare, there is horizontal excess as well.
Another sign: a vertical crease or fold up the midline, or an abdomen that looks wide and flat rather than hanging.
Why it matters
The two patterns are not corrected the same way, and an approach that addresses only the vertical component on someone with both leaves width behind. That is the whole reason this distinction exists.
It also changes the scar. Correcting horizontal excess means a vertical scar up the midline in addition to the horizontal one — a longer, more visible scar for a flatter result. That is a real trade and people weigh it differently.
This site cannot tell you which applies to you. It can tell you the question exists, so that you recognise the answer when you hear it rather than hearing it for the first time in a consultation.
Who tends to have it
Most commonly people who have lost very large amounts of weight, and people whose weight was carried for many years before it came off. It is uncommon after moderate losses.
If it applies, the circumferential page is usually relevant too — the two often occur together.
The readiness assessment covers timing.
What this involves surgically →
For the operations themselves, Dr Kumar’s procedure guides cover each one in detail, including staging, Medicare and recovery.