While weight-loss surgery can be a life-changing and life-saving experience for many people, the after-effect can leave problems with sagging skin.

After the fat is removed, patients still have stretched skin hanging. The surgery can also leave patients with rashes, infections, hernias and even psychological problems.

To combat these troubles, more insurance companies are now covering plastic surgery or body contouring for weight-loss surgery patients.

Sue Dunham was 316 pounds just before she had gastric bypass surgery four years ago. With surgery, a healthier diet and regular exercise, Dunham has lost 150 pounds. The weight loss left her with lots of sagging skin, however.

“There was just no elasticity in it at all. I was just going to have to get something done,” Dunham said.

Duke plastic surgeon Dr. Detlev Erdmann says Dunham's problem is common among people after weight-loss surgery.

“Some of these patients are desperate,” Erdmann said. “And some of them even refer to themselves as looking like a freak.”

Dunham had a big tummy tuck and a thigh lift. Now she wants to have surgery on her upper arms, where she said the extra skin cuts into the bra line and causes rashes.

Dunham said that recovering from the body contouring was more difficult than the gastric bypass surgery.

“It was rough, but it was worth it. I don't regret doing it because I have more energy. I have myself back,” Dunham said.

Skin sagging can be severe, with one patient having skin from their stomach hanging below the knees, preventing her from walking. It took surgery get her out of a wheelchair.

Plastic surgery or body contouring can leave scaring.

“We can only limit the scarring to areas that can be well hidden,” Erdmann said.

To make sure body contouring or plastic surgery of this kind is covered by an insurance company, patients and doctors will need to carefully document the health problems that excess sagging skin causes the patients.