YouTube star Nicholas Perry aka Nikocado Avocado, who is known for his extreme Mukbang videos, is no stranger to garnering attention on social media. The 32-year-old shocked his 4.6 million followers on YouTube when he shared his drastic weight loss transformation — he lost 250 pounds (nearly 114 kg).
But the transformation didn’t end there. On February 12, he shared another
video with his followers, this time talking about the skin removal surgery he underwent in which doctors removed five kilogrammes of excess skin. “I had a lot of loose skin… I knew I would have some and I was hiding it in my clothes… it’s just skin, you can kind of tuck it under your pants and hide it.”
Finally opening up about this…. revealing my loose skin and showing you my body without clothes on. I also show you the results of my body lift that I got done last week! https://t.co/mjZJ6oPAaW pic.twitter.com/ilrgHE0lhV
— Nikocado Avocado (@real_nikocado) February 13, 2025
He explained that he had undergone a “360 body lift” also known as a circumferential lift, aka a belt lipectomy, along with an abdominoplasty.
Notably, the YouTuber isn’t alone in opting for this kind of surgery. Doctors and medical experts note that the increased use of weight-loss drugs such as Ozempic, Wegovy, Zepbound, and Mounjaro has led to a surge in patients seeking loose skin surgeries.
But what exactly are these procedures? And more importantly, how are they linked to weight loss?
What is skin removal surgery?
As the name suggests, the ‘360 body lift’ removes excess skin and fat from the abdomen, hips, buttocks, and lower back. It is typically performed to remove areas of excess fat and skin after a patient has undergone significant weight loss.
Experts note that a skin removal surgery is a more comprehensive alternative to the tummy tuck and addresses the excess skin and fat envelope 360 degrees around the body, including the love handles and rear end.
In this procedure, doctors will make incisions around the body, removing a wedge of skin and fat that is shaped like a boxing championship belt, wide in the front and narrow in the back. This will create a flat belly, lift the pubic area, create as much waist definition as your anatomy allows, and lift your thighs and buttocks.
The goal of the surgery is to improve the overall contour and appearance of the body by tightening and reshaping the affected areas.
But a ‘360 body lift’ or skin removal surgery is no joke or cheap affair. In the US, these procedures range from $10,000 (Rs 8.6 lakh) to $25,000 (Rs 21.6 lakh), including anaesthesia and facility fees. Also, there’s a lot of post-operative care that one needs to look at. Plastic surgeon Dr J Vicente Poblete, MD, also told Cleveland Clinic that patients who wish to undergo this surgery or have undergone this procedure should take ample time off to recover.
Experts also add that after the body lift initial recovery phase, one may notice some wrinkled or loose skin in some areas. However, this is normal as it takes at least six months to a year before the new tissues become stabilised with little risk of shifting.
And how safe are skin removal surgeries?
A skin removal surgery or a body lift is generally very safe. However, there are some risks involved. These include:
- Infection
- Scarring
- Blood clots
- Fluid buildup (seroma)
- Numbness or changes in skin sensation
However, most surgeons note that these complications are rare, especially if one follows the proper pre- and post-operative care guidelines.
Dr Michele Shermak, a board-certified plastic surgeon in Baltimore, noted that patients who undergo skin removal surgeries, will have some scarring but it’s not as bad as they may fear. “The scars are very strategically placed. Typically, they’re camouflaged or hidden in areas that are between different body regions,” she was quoted telling CNN.
How are skin removal surgeries linked to weight-loss drugs?
Medical experts and plastic surgeons note that there’s been a rise in skin removal surgeries since the introduction and adoption of weight-loss drugs such as
Ozempic, Mounjaro and others.
As Dr Lee from PanAsia Surgery told Channel News Asia when someone experiences massive weight loss, the soft tissues of the body (underlying skin and fat) deflate as weight is shed. “The skin that had been previously stretched out would now appear as loose skin with folds.”
And this is exactly what happens when an individual starts off on Ozempic or one of the similar GLP-1 medicines. They lose a lot of weight but struggle with the loose skin. For instance, Leah Rae Russell, a resident of South Sioux City, Nebraska. She lost over 200 pounds but struggled with a lot of loose skin. She only gained confidence when she underwent a body lift. However, she explained it wasn’t just about vanity — the skin hanging from her midsection would rub and cause rashes. A second roll of skin above that was also causing problems.
Speaking to CNN, she said, “My belly button would be bleeding and raw all the time. No matter how often you’re showering or powdering or anything like that, it gets to a point where you have so much excess skin, there’s a limitation to how much you could just treat it without getting rid of it.”
Russell and Nikocado Avocado echo what’s being said by many others who are experiencing faster weight loss thanks to GLP-1 medications.
Doctors also agree that weight-loss drugs have led to a rise in skin removal surgeries. As per the American Society of Plastic Surgery, the number of body lifts has increased year on year. It increased by 28 per cent in 2022 from 2019 and another five per cent in 2023.
Dr Michele Shermak, a board-certified plastic surgeon in Baltimore and a spokesperson for the society, was quoted as telling CNN, “We are lifting from head to toe.”
Echoing similar sentiments, Dr Michael Stein, a New York-based plastic surgeon, told the Wall Street Journal, “Many patients weren’t prepared for the results of sudden weight loss. They didn’t realise that after significant weight loss, there would be skin that doesn’t stretch back. Patients were almost caught by surprise by the need for plastic surgery after GLP-1 drugs.”
At the end of the day, those who opt for this procedure say they are happy with their skin, no pun intended.
With inputs from agencies
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