Question:
What to do? 2 PS opinions on reconstructive surgery.

One surgeon suggested tummy tuck, breast lift and lipo on the arms, legs and the rest. A second told me that lipo is not a good option because it will leave me with more excess skin and it will look bad. He also wants to do a LBL or belt surgery for the lower body of basically going around all of my waist. So now what? Who do I believe? What is best for me?    — Heather M. (posted on June 14, 2005)

June 14, 2005
The best intial surgery is typically the lower body lift. It removes the excess skin and fat, as well as lifting the thighs and buttocks. The breasts, arms, legs can then be done 3 - 6 months later. Sincerely, Joshua Kreithen, M.D. Bradenton, FL lakewoodranchplasticsurgery.com
   — Joshua Kreithen, M.D.

June 14, 2005
I just read through your profile and you have done very well. While not quite as low as you would like, life has to be sooooo much better. Based on your pics, I would say you need to go with the lower body lift and then other work as you can. Just doing lipo is not going to give you the result you want. Trust me I know. I had 3 major PS's last year and one of them was done in preparation for the skin removal on my legs, in order to provide the best end result. When I had surgery on my upper torso (upper portion of a lower body lift) I also had very extensive lipo done on my upper legs. He removed 2 liters of fat from each leg. Then 5 months later he did the skin removal. The lipo definitely left my skin saggier, but we knew in my case things would get worse before it got better. <p>My surgeon has always used lipo in conjunction with skin removal, which works fine. With this last surgery he also do a lot of lipo across my low back to provide more of a curve to my back, before the butt. In this case it was strictly for contouring, so leaving excess skin was not an issue. <p>My recommendation to you is to seek a 3rd opinion. Don't just let $'s drive your decision. When it comes to PS you get what you pay for in many cases. Also don't let them bite off too much work at once. Recovery is tough from a LBL. I would focus on just that first and then look into the next procedures. Make sure you see pics of people the doc has done with similar amounts of skin to remove. This is critical. PS on a former SMO is WAY different than on someone who lost 50-75 lbs, which is most PS deal with.mmIf the surgeon has not done quite a few WLS patients then I would look somewhere else. It is a fine art dealing with us sharpei people. With the right surgeon you will have peace with your choices and know you are doing the right thing. I ended up chaning plastic surgeons after I had my insurance approval. I am so glad I did. The surgeon I ended up using is an hour away, instead of 20 minutes, but he has been wonderful and really has taken an interest in my progress and truly wants to do the absolute best he can for me. I'm one of his projects and he takes pride in seeing the changes. I know in my heart I would not have gotten the same results had I gone with the surgeon I got approval with. So keep looking until you find that surgeon you just have total confidence in.
   — zoedogcbr

June 15, 2005
Hi. The LBL will treat the hips, buttocks, and front/sides of the thighs. Are these problem areas for you? Do you want a skin texture improvement here? If not, a plain tummy tuck (A-plasty) will be fine. I ALWAYS do lipo on all patients because there is some fat to get...however lipo ALONE in a patient with excess skin (i.e. all weight loss patients) is a bad idea. If that's what's being recommended, go the other way.
   — DrL

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