Why the NHS should have paid for my saggy skin surgery, instead of forcing me to spend £8,500 to have it removed in Turkey and leaving me in agony…

Hannah Thompson has one word for what it took to get her size 10 physique: “Hell.”

It wasn’t the weight loss itself, though – because Hannah, 31, a beautician from Liverpool, underwent bariatric surgery on the NHS which was quickly effective.

However, her weight loss left her with “large” amounts of saggy, irritated, excess skin.

“My stomach dropped, my breasts were empty sacks hanging down to my stomach and my arms had bingo wings,” she says. ‘I had flaps of excess skin everywhere.’

But Hannah found herself unable to undergo the surgery needed to remove the excess skin on the NHS.

“I was told it was ‘cosmetic’ and they wouldn’t help me,” she says.

After pregnancy with her youngest child made the loose skin even worse, she ended up paying thousands of pounds to go to Turkey to have the operation.

It was a decision she now bitterly regrets. Not only did she wake up from her eleven-hour surgery in excruciating pain, Hannah says she has “permanent nerve damage in both arms.”

‘I have pain in my arms like I’m being stabbed, and bad pins and needles all the time. I can’t even lift my arms in certain positions,” says Hannah, whose children are now aged 12, six and four.

Experts say they are seeing more and more cases like Hannah’s, and are warning people considering weight-loss surgery to be aware of the potential downsides.

About 70 percent of patients who undergo bariatric surgery will need to have body contouring surgery (that is, the removal of excess skin) afterwards, says Mark Soldin, a plastic surgeon at St George’s Hospital, South West London, and previously chair of the body contouring committee at the British Association of Plastic Reconstructive and Aesthetic Surgeons.

A high percentage of these patients will develop complications, he warns. While most of these will disappear, he 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, from a size 14 to a size 28. At one point her weight reached 21st 7 pounds. At 6ft tall, her BMI was over 51 and she was classified as ‘morbidly obese’.

Dieting didn’t work, and she eventually asked her doctor if she wanted to have weight-loss surgery. At age 24, she underwent gastric bypass, in which a pouch was created at the top of the stomach and then connected to the small intestine to bypass the stomach.

“When I gained weight, I felt relief that I was finally going to lose weight,” says Hannah. ‘I was warned about excess skin, but when I was young I thought it wouldn’t be that bad.’

Hannah found herself ‘feeling the weight off’ – indeed losing twelfth place in less than two years. But losing weight so quickly came at a price.

“I had a lot of excess skin,” she says. ‘I tried to hide it by wearing tight clothes. But as soon as I took off my clothes, my skin hung in flaps around my body. I felt terrible.’

Excess skin is a common side effect of substantial weight loss, as skin that was once stretched “deflates.”

A number of factors can contribute to this, Mr. Soldin explains, including genes, age (younger skin is more elastic) and the rate of weight loss (skin will cope better 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 percent of their excess body weight, have a BMI of 30 or less, have maintained a stable weight for at least twelve months and have a ‘functional impairment’ should be offered skin removal surgery on the chest . NHS.

“It’s not about feeling embarrassed about undressing in front of your partner, or not liking yourself in the mirror,” says Mr. Soldin. ‘These involve significant functional problems, such as infections in the skin folds and abscesses, or being unable to move because the skin is too wobbly.’

However, because it is left to local health authorities to decide whether they will fund these operations, only a small number of people have the operation on the NHS, and they often have to wait well over a year for it.

Even then, surgery usually doesn’t cover all four areas where sagging skin typically occurs: the stomach, inner thighs, inner arms and breasts, says Mr. Soldin. ‘It will usually only cover the areas that the surgeon believes meet the criteria for body contouring.’

Hannah was told she was not eligible for the operation because her problem was ‘cosmetic’ and did not affect her quality of life – ‘even though it did affect my mental health’.

“I was desperate because I had lost weight but still looked terrible,” she says.

An operation on these four areas costs around £30,000 privately in the UK, so it is not surprising that people are tempted to go abroad for their operation.

In 2022, Hannah saw advertisements on social media for the operation in Turkey. “It cost a third of the price of it in the UK, and people posted pictures afterwards looking fantastic,” she says.

Hannah opted for a breast lift and had the sagging skin on her stomach and bingo wings removed at a clinic in Ankara. Her parents said they would pay the £8,500 bill.

“When I came to, I heard a woman screaming in pain – and realized it was me,” Hannah recalls. Despite being in terrible pain and ‘bewildered with shock’ due to dangerously low iron levels, the hospital wanted to discharge her that same day.

“But I refused and was kept in until the next morning,” says Hannah.

Five days later she flew home.

Cosmetically, the surgery was largely a success. ‘My stomach was flat, my breasts firmer and all the excess skin was gone,’ says Hannah. ‘My arms had terrible scars, but were toned and slim.’

But over the next few months, she developed excruciating pain in her arms. However, because the operation had been carried out abroad, her GP told her the NHS could not help.

Hannah privately visited a plastic surgeon five months ago, who diagnosed nerve damage. “But they couldn’t do any surgery on my arms because that would make the pain worse,” she says.

Mr Soldin says British plastic surgeons are seeing more and more similar cases.

“The number of complications with this type of surgery is enormous: probably between 50 and 100 percent of patients develop complications after body contouring after weight loss,” he says.

That’s true in Britain as elsewhere, he adds, but the key is the availability of follow-up care.

“This type of surgery requires close, continuous follow-up care from a qualified team consisting of nurses, physiotherapists and surgeons,” Mr Soldin explains.

‘If people go abroad, they can’t get that. Three or four days after surgery, these patients are back on a plane, often with drainage tubes hanging out of their bodies, and the advice they are given is to see their GP if they have any problems.

‘But the NHS will 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 the surgeon before the first operation. Unfortunately, patients are often unaware of this.

‘The high complication rate of body contouring surgery means you’re rolling loaded dice when you travel to another country.’

What can those affected do then?

“Live with it or pay for it; there is no magic solution,” says Mr. Soldin.