Well, I wanted the sleeve but GERD issues eliminated that choice, so I have a distal RNY. I wouldn't necessarily say, though, that the sleeve is the least intrusive. Yes, you don't have any intestines bypassed, but they do remove a large portion of your stomach, whereas with the RNY, your stomach remains in the body and the surgery can be "reversed" if serious complications develop.
I have loose skin and yes, it is disturbing some times. However, a good body shaper hides so much and only you (and your partner if that applies) will ever see it. When I occasionally get annoyed with my appearance, all I have to do is open up my preop pictures and reality comes back in a flash. I didn't go this route for vanity, but for health, and as much as I'd love a beautiful body, I'm so happy that my comorbidities are gone and I am so much more active and painfree.
There is no way of determining if you'll have a little loose skin or a lot. Options do exist, though, if the loose skin is too bothersome. Many people get tummy tucks and other cosmetic surgery procedures to eliminate their problem areas.
I guess it comes down to what you want out of the surgery and what your expectations are. One of the reasons surgeons require psych evals is to make sure the surgical candidate realizes that WLS is not a panacea where everything becomes perfect. You might not lose all your weight, you might have a ton of excess skin, you might have food intolerances for life, etc. Only you can examine your expectations to determine if they are realistic or not.
Total Weight Loss (HW 5/2010)
Post WLS (8/1/2011)