Excess skin. A 49 year old man with an apron of excess skin following extreme weight loss. This man had bariatric surgery, initially a gastric balloon replaced later by gastric bypass. He lost about 70kg over one year. A lack of elasticity in the skin due to age, combined with the rapid weight loss, means that the skin cannot adjust to the new body shape and excess skin is left. In this extreme example, blood pooling in the skin leads to bruising, and there can be hygiene issues as keeping the folds of skin clean is problematic. In the UK (as of 2013) most National Health trusts will only fund the bariatric surgery and not later excess skin removal.