November 02, 2026 | Male Procedures
Three men came to my El Paso office in one afternoon. One had lost 70 pounds with diet and exercise and nothing else. One had lost 74 on a GLP-1 and kept it off four months after stopping. One had lost 80 over two years and now trains five or six days a week. All three had the same exam: the fat was gone, the skin was still there. What follows is what I told them, nearly as I said it, identifiers removed.
“Can You Just Lipo It?”
“If we only did liposuction, I think we would get rid of the filling, but then everything would sag more.”
“I have a good handful, so it’s abundant. It’s enough that with liposuction, it’s not going to flatten out. We really need to cut it out.”
“What Does the Tummy Tuck Do?”
“To completely get rid of this loose skin, it would be a tummy tuck. The incision is low, so you can hide it with shorts or boxers or swimsuit. I do have to go past where this fold ends to get rid of it completely. I would actually pretty much be able to get rid of everything from here down, and then use this skin, and we just pull it down. I also take some of the fat off of the mons and lift it up, so that also helps make everything nice and smooth all the way down.”
“I suspect that because you were a lot heavier, there is maybe some separation in the muscles, so I actually repair that, so it makes everything tighter as well. And we combine that with liposuction, especially here on the waistline and here on the lower back, the upper back, and the sides, just to make everything nice and smooth.”
“Why Is It Still Round if I’m Not Fat?”
“You don’t have a lot of fat on the outside, so a lot of the bulging here in the abdomen is some of the fat that’s on the inside pushing out, the visceral fat. Plus, when you were heavier, of course, you stretched out the muscles, so it kind of blows up a little bit easier.”
“When you lay down, does it go pretty flat? Let’s take a look, because laying down gives us an idea of how flat we can get it. Yeah, so that looks a lot better. And sit up for me. You see the diastasis here, that’s the muscle separation. So when we put that together, your stomach will look like this when you’re standing.”
“There’s still some visceral fat that, of course, is always pushing out a little bit. So that limits how much I can tighten everything, but I think you’re ready for the surgery, because there’s not that huge amount of fat anymore on the outside.”
“Do You Use a Mesh?”
“We don’t really need to. I use it when there’s a hernia or like severe diastasis. If we can avoid putting something that we don’t need in the body, it’s better. Just with the sutures, we get great results.”
He asked what happens if I find a hernia. “If I find it, I’ll fix it. I’m a board certified general surgeon too, so I have a lot of experience with hernias. If I find it beforehand, I’ll charge you a little bit. If I find it while I’m doing it, I just take care of it. There’s nothing additional.”
“And the Neck?”
“You have a combination of the fatty tissue that’s on the outside, which is not that much, but there is a fatty tissue that’s a little bit deeper inside, below the muscle itself. And of course, there’s a little bit of the gland here that actually fills that in as well. So to do this, I make an incision that goes right here, and then we do have to make one here on the back of the ear. Once it heals, you really wouldn’t see it.”
“The face and neck is the first thing. We’re seeing a lot more since Ozempic started. I’m almost doing three or four every week now. You lose the volume, and of course you’ve already stressed out the skin.”
“Same Time or Later?”
“The combination is something we could do together. The big advantage is just having that one recovery versus having to take time twice. The face part really doesn’t add anything to the recovery, because there’s really no pain in this surgery. It’s mostly just waiting for everything to heal and the swelling to go down. The tummy takes a couple of weeks to get back to normal, easy going activity, so by that time, your neck would be pretty much looking really good.”
“What About the Arms?”
“So the arms, you’ve lost the elasticity here. There is a little bit of fat, but nothing major. It’s mostly just loose skin. So we would have to do an incision that goes right here, and with that I can cut all that out and really make it tight so it’s uniform all the way and nothing’s dangling. It hides on the inner part of the arm. The arms really don’t add much to the recovery. The tummy is the main thing.”
“And the Chest?”
“So here, what I would do is just liposuction with the skin tightening to get it tight. When I do liposuction here, sometimes we still have this gland here. So through that little same incision, I put in an arthroscopic shaver. I actually take that gland off so that everything is nice and flat, and then we see your muscle instead of any fullness. If we do the chest area, we also give you like a vest.”
“How Long Does It Take, and When Can I Work?”
“It takes about five hours. It’s general anesthesia. We’ll keep you overnight. You go home the next day. Recovery-wise, it’s mostly from the tummy and the muscle repair. Takes about two weeks to get back to normal, easy going activity, driving, things like that. And then six weeks to get back to where you can do exercise, lifting, running, jumping, everything back to normal.”
“You may be able to start doing some at home a little bit earlier, maybe like on day seven or nine. I think the first week’s a little tough, because more than anything, you’re going to feel fatigued, because your body’s working overtime trying to heal everything.”
For the man who works in front of the public: “In two weeks, you would probably be pretty much healed. If you have something really important, I’d say six weeks is when it’s looking its best.”
“What’s the Drain Like?”
“You would have a drain in the tummy area, and that one’s gonna stay between seven and fourteen days. Everybody’s a little different, but what we wanna do is for all that fluid to come out so it doesn’t pool behind your skin, because that can create irregularities or other problems.”
“So the drain is a little tube, and it has a little bulb, and it’s just suctioning fluid into the bulb. Every day, at the beginning it’s gonna be more than once a day, you just empty it into a cup to read the measurement, write it down, flush it down the toilet, and then close the drain and you keep going. You can shower and everything.”
“What if I Keep Losing Weight?”
“If you continue to lose weight, you may see a little loose skin again. You might need like a touch-up. More often than not, no, because I’m really gonna pull on the skin. I’d like you to be pretty close to where you wanna be for the surgery. If you do that, then your results are pretty much permanent.”
“I Live Alone”
“We do offer an overnight stay for people that don’t have anybody to transport them. We also have a transportation service. Eighty percent of my patients are from out of town, so we know how to deal with all these special situations. My nurse does do a visit at your house the day after, for the first shower and going over all the instructions. You can extend that, and we also have a service where somebody can actually be with you twenty-four hours a day for as long as you want.”
“Especially now with the weight loss, it’s becoming more and more common. You did it by yourself? That’s the hard way. If you did it the hard way, it means that you can really keep it off.”
I am a double board-certified plastic surgeon, a Mayo Clinic fellowship alum, and a Clinical Associate Professor of plastic surgery at Texas Tech University Health Sciences Center. If you have lost the weight and the skin did not follow, come in and let me look.
Call the office at (915) 590-7900, text us at 1-866-814-0038, or book a consultation at drworldwide.com.
#StayBeautiful
