After losing 295 kg, fattest man trims sagging skin

But Mason, who at his heaviest was known informally as the world's fattest man, had been all but crippled by those 23 kg, loose skin that hung over his body like melted wax over a candlestick. And so its absence has made all the difference.

It took a lot of planning and a great deal of good fortune for Mason, who is 54 and comes from Ipswich, England, to have the operation at all. Lenox Hill Hospital in Manhattan, where it was performed, waived all its fees. So did the four plastic surgeons who operated, and so did the general surgeon, the anesthesiologist and the nurses who took part.

Mason's bills would probably have exceeded $250,000, said Dr Jennifer Capla, the surgeon who led the team at Lenox Hill. Jennifer Capla specializes in loose-skin removal after extreme weight loss, but she had never operated on anyone whose weight loss was so extreme.

The biggest challenge was presented by the many blood vessels in the skin to be removed. There were hundreds, each about four times normal size, Capla said, and they had to be identified and then individually cauterized and tied or clipped, a process that took hours.

“If you miss just one, he could bleed out,“ she said.

It took the doctors more than four hours to remove the first piece of skin, from the area around Mason's midsection, and there was a feeling of triumph as they finally cut it away and laid it out on a table. In the end, the surgeons excised about 12kg from Mason's midsection and perhaps 12 to 13 from his legs, much of it concentrated in his right leg.

Down the line, he hopes to have at least one more operation, to remove the flesh that still hangs from his upper arms. But that is in the future. At the moment Mason is just adjusting to his new self, emerging into a different life; one with more possibility .