Lost 80 lbs in my late 20s and while my skin issues are not so bad that I HAVE to get plastic surgery, I did decide to consult a surgeon. The amount I have on my abdomen and arms is not concerning to me - if anything, I think the little bit of extra skin on my belly will help me avoid stretch marks if I ever get pregnant - but I do have some loose skin on my butt and upper legs that's complicated by cellulite. I don't think I'll be going ahead with surgery, but I just wanted to see how much it'd cost and what would be a realistic outcome. Your friend is GUARANTEED to have loose skin. From what I've heard from every single bariatric patient I've ever talked to, and from every single bariatric surgeon (I've worked with a few), the type of results I had are considered phenomenal - and I STILL have some loose skin.