It is my understanding that the only way to reduce the appearance of the extra skin is to change your body composition by exchanging the fat with muscle. This can be impaired of course by age related loss of skin elasticity and other skin changes as we age. If you do have a medical problem related to the extra skin, discomfort, rashes or infections between the folds or chaffing for example you can sometimes have your physician negotiate with your insurance company and get the surgery covered under insurance. In general I believe that the insurance companies require you to prove that you have maintained your approximate weight(loss) for two years before this is allowed. No sense going through the hassle of surgery if you are going to return to a cycle of weight gain once more. Then again, no sense gaining the weight back that you worked so hard to lose either.
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