Tammy Slaton's surgeon reveals 'hardest moment' of skin removal surgery process as she shows off dramatic transformation

Tammy Slaton's surgeon has opened up about what the 'hardest moment' of her skin removal surgery process was as she showed off her dramatic transformation post-surgery.

Fans of the 38-year-old reality TV star have been following her emotional weight loss journey - which saw her impressively lose as much as 500lbs - since 2020, with her latest update giving TLC viewers a glimpse at the results of her eight-hour excess skin removal surgery - which removed 15 pounds of the excess skin.

Both Tammy and fans alike were incredibly impressed with the results following the eight-hour operation, which was performed by Dr. J. Peter Rubin, M.D., chair of the Department of Plastic Surgery at UPMC (University of Pittsburgh Medical Center).

Keen to hear a little more about what such a surgery entailed, we exclusively sat down with Dr Rubin, who is also director of the UPMC Life After Weight Loss Program, as he told Tyla everything people are desperate to know about the ins and outs of the process.

How does the lead-up to surgery work?

Giving Tyla an overview on the pre-surgical assessments and criteria that guided his plan to remove over 15 lbs of excess skin from Tammy's chin, arms, and abdomen during the op, Dr Rubin explained: "Tammy had an extensive pre-surgical evaluation that included a thorough review of her past medical history, careful physical examination, communication with her other physicians caring for her, and a thorough evaluation by our anaesthesia team.

"Additionally, based on the initial evaluation, we made recommendations for optimising her medical status in preparation for the surgery, obtained additional medical tests to maximise safety, and set benchmarks for what needed to be achieved before we could move forward with the surgery."

Before surgery

Now, Tammy had initially struggled to get approved for the procedure due to her vaping habit.

This is because nicotine can delay healing and increase the risk of infection.

Explaining a bit more detail about why her nicotine use was a 'big issue', the doctor shared: "Most people don't realise that smoking and/or vaping greatly increases the risk of wound healing complications after plastic surgery and also increases risk of problems during anaesthesia.

"Tammy did a great job kicking that habit prior to the surgery. We know how hard it is to break a nicotine addiction, and, like many plastic surgery practices, we will test for active nicotine use."

Tammy Slaton's before-and-after transformation photos following her excess skin removal surgery (TLC)

During surgery

Telling Tyla which surgical techniques were used, Dr Rubin noted: "We used modified techniques for abdominal plastic, brachioplasty, and face/neck lift, which were designed specifically for Tammy's anatomical features.

"This is really key in the highly specialised area of plastic surgery after weight loss that we will design versions of the operation individualised for each patient.

"We had to be very thoughtful in how we selected the operations for this particular stage of surgery so that we best addressed Tammy's highest priorities, maintained safety throughout the procedure, and performed the procedures in a way that fit into a plan for possible future surgical procedures if Tammy decided to pursue more skin removal at a later time."

The challenges

We also quizzed the surgeon over some of the unique challenges - like operating on areas with considerable volume loss - he may face when working with patients after a 500-lb weight loss.

"This is a great question," Dr Rubin replied. "When patients reach a very high body weight, all of the extra tissue needs nutrition. Our arteries and veins get bigger to bring nutrients and oxygen to the tissue and then return that blood supply back to the heart.

"After weight loss, these enlarged blood vessels remain the same size."

Because of this, the doctor continued, surgeons are 'working in tissues that have a much higher risk of bleeding and the operation becomes more technically challenging'.

"Additionally," he added, "anatomic structures in the body can actually be displaced from their normal locations, requiring constant vigilance by the surgical team."

The 1000-lb Sisters star, 38, has been on an emotional weight loss journey since 2020 (TLC)

The healing process

Now, as we know, Tammy healed so well she went home four days early - but was this typical, we asked Dr Rubin, and what protocols supported such a fast recovery?

"Tammy had a very good recovery course," he congratulated. "Wound healing problems are very common after these procedures even under the best of circumstances.

"Tammy's hard work to stop vaping and boost her protein intake both contributed to her smooth recovery."

The 'hardest part' of the process

"One of the hardest parts of the process is having to tell a patient like Tammy who worked so long and hard to successfully lose weight that she is not medically ready for skin removal surgery and there's still more work to be done in order to be approved for the surgery," Dr Rubin admitted.

However, he went on to explain that helping patients to 'optimise their medical status; is a necessary step to increase safety of the surgical procedures and help achieve the best outcomes.'

The doctor resolved: "In such cases, it's usually not a 'no' answer to the question of proceeding with surgery, but a 'not yet'."

And, as for the most touching moment throughout the process?

Dr Rubin gushed: "Seeing the big smile on Tammy's face and sharing in her joy when she saw the results for the first time.

"Being part of her weight loss journey and being able to help her reach her goals is gratifying beyond words."

Congratulations Tammy!