I have lost a total of 126lbs with my sleeve, and excess skin was definately an issue. with dropping the weight in such a quick amount of time (first 90lbs in 7 months) I definately had a large pannus of skin. I had a circular tummy tuck this April, which made a huge difference, but not so much in the size of clothing. They removed 13.8lbs of skin off of me but remember that most of this skin is usually what we are used of hanging over our jeans. With the removal of skin, I went from a size 14 pant to a size 12, however made a HUGE difference in how I was able to wear my clothing. Nothing hangs over anymore :)n