X-post: 6 months post TT and brachio pix and unsolicited advice
Hi, everyone! Well, it's almost 3 years after my DS bariatric surgery (love, love, love it!!!!) and six months since I had my plastic surgery, so I thought I would do a major "before and after" for any of you considering plastics.
Cliff's Notes version: While I never thought I would EVER get plastics, I highly recommend it for those who want it! It really is the icing on my weight loss cake. Despite some telltale stretch marks (which, actually, probably are very normal given I had two kids) and some scars, some of the unpleasantness of my obese years has been "erased." I am still the same person, but this has helped me on my journey in a BIG way.
(Beware: half-nekkid pix coming. I do this to help others, as others on OH have generously helped me on my journey. So please be kind!)
After losing 200 pounds, I had lots of extra skin and fat in my upper and lower abdomen and some pretty annoying batwings. (As it turned out, all of that extra stuff weighed about 5-6 pounds. I thought it would weigh more, somehow.)
I fought (albeit a small fight because I followed their documentation hassles to the letter) my insurance to get them to cover my extended abdominoplasty (anchor-style, with a high vertical cut as well as the traditional horizontal TT cut) and self-paid $4,000 for my arms, since I already was going under on the insurance company's dime. Man, that was a great decision and money well-spent!
So here comes the parade of pix:
1) Here is a picture of me before my DS, at 344 pounds and a size 30-32. You can see I carried a lot of weight in my mid-section and arms:
2) Here's a relatively recent "after" picture, about 3 weeks after my TT and brachio. I weigh between 145 and 150 at any given time and wear a size 8 or 10:
3) Here's a "before" plastics pic of my torso and bat wings. It looks like my panni is eating that poor underwear's waistband!!
4) Here's a six-months post-plastics picture:
5) Here's a close-up of one of my batwings, all marked up for surgery:
6) Here's a 6 months post-brachio arm. No more batwings! Scars be damned, I love wearing shortsleeve and sleeveless tops now! (Actually, the scars are not visible from the side or behind.)
7) Here's a pre-plastics picture of my torso, with the plastic surgeon's markings:
8) Here's an "after" in about the same position. Sorry it's blurry, but you get the idea:
Well, as you can see, I've gone through some changes. I honestly can say the plastics were uneventful and exactly as I expected. I expected some pain, some discomfort and got them. But I also got some freedom and major relief in the process. No more sores on my pubic area. No more back aches.
I still wear the same size clothes, but I do not have to wrestle with a 12-pack of muffins on the top of my pants. Not much jiggles when I run after my kids now. Sex is more comfortable and intimate. I feel good in my skin. EXCEPT for this posting, I am hardly ever self-conscious about my body.
My scars are still reddish in places but they are lightening and getting smoother by the day. I rub Bio-Oil on them after every shower. I used silicone sheeting for the first several weeks on them. I have every hope that they will fade well. However, if I stayed this way forever, that would be okay, too.
I DID go in for a small inpatient revision to my bellybutton. I had had a major icky hernia in my bellybutton before my DS and the tissue there stretched and healed strangely--the bellybutton got bigger. My PS did a simple revision a month ago and I like it so much better. This revision was covered by my insurance, as well.
While my thighs are kind of droopy and my breasts are rather deflated, I believe I am done with plastic surgery. I think I look like a 40-year old woman with some well-earned miles on her should look. That's all I ever wanted.
UNSOLICTED ADVICE:
1) If you are considering plastics, please know that plastic surgeons are not magicians. They cannot make us perfect. Have realistic goals, and you will get realistic results. For example, I have a lot of stretch marks. Unless they were in the extracted skin, I STILL have those stretch marks. No biggie, but you should know you may not walk out of this looking like a supermodel.
2) Be sure and find a good plastic surgeon. Ask around. Do online research. Interview them! This is your life--bother to put the work into getting the best you can (as you should have done with the type of bariatric surgery you chose and that particular surgeon). Make sure they have the same philosophy you do. I had a true "artiste" look at me and tell me he could make me look "perfect" in four staged procedures. He was going to remove things I had no idea needed removing! Believe you me, "perfection" sounded good, but not at that emotional and financial cost. I wanted ONE surgery, with the most bang (and least pain) for my buck.
If you want "perfection," by all means, seek an artist. Just make sure you and your doc talk and agree on what constitutes "success" to you. BTW, for those in the Chicago area, I had in-depth consults with three surgeons and went with Michael Lee at Northwestern (www.michaeljleemd.com). I think he and his office staff are super.
2) Call your insurance company immediately and ask about any plastics coverage you may have. Use words like "reconstructive surgery" instead of "plastic surgery"--there's a difference. Follow their requirements to the letter. Document the hell out of ANY issues you have as you lose weight! Sores, back aches, depression, body image issues--anything that affects your activities of daily living or mental health.
By "document," I mean get your doc to take pix (or take them yourselfand date them), take notes and prescribe stuff like creams, medicine, etc. You MUST show that the excess skin is affecting you negatively and that you have made every reasonable effort to treat these issues non-surgically. If your current insurance does NOT cover reconstructive surgery, STILL document the hell out of your condition. Maybe your next policy will offer the coverage. Check it out during your next open enrollment.
3) Oh, and if you are a newbie considering weight loss surgery, please consider the duodenal switch (DS). It has the best long-term results and the most "normal" lifestyle in MY opinion. Today, I ate bacon, eggs, cheese, crescent rolls and a Diet Coke for breakfast. For lunch and snacks I grazed on cheese, crackers and doughnut holes. For dinner, I ate a big portion of bleu cheese meatloaf and mashed potatoes and Diet Coke. And I ate three huge Myrtles (chocolate, caramel, pecans) for dessert. No dumping, no foamies, no gas, no stuck food, no anything untoward. In fact, I am about to amble off into the kitchen for some more meatloaf before bedtime. For more info on the DS, visit: www.dsfacts.com
If you have any questions, feel free to PM me. I will help you if I can.
All the best,
Nicolle
Cliff's Notes version: While I never thought I would EVER get plastics, I highly recommend it for those who want it! It really is the icing on my weight loss cake. Despite some telltale stretch marks (which, actually, probably are very normal given I had two kids) and some scars, some of the unpleasantness of my obese years has been "erased." I am still the same person, but this has helped me on my journey in a BIG way.
(Beware: half-nekkid pix coming. I do this to help others, as others on OH have generously helped me on my journey. So please be kind!)
After losing 200 pounds, I had lots of extra skin and fat in my upper and lower abdomen and some pretty annoying batwings. (As it turned out, all of that extra stuff weighed about 5-6 pounds. I thought it would weigh more, somehow.)
I fought (albeit a small fight because I followed their documentation hassles to the letter) my insurance to get them to cover my extended abdominoplasty (anchor-style, with a high vertical cut as well as the traditional horizontal TT cut) and self-paid $4,000 for my arms, since I already was going under on the insurance company's dime. Man, that was a great decision and money well-spent!
So here comes the parade of pix:
1) Here is a picture of me before my DS, at 344 pounds and a size 30-32. You can see I carried a lot of weight in my mid-section and arms:
2) Here's a relatively recent "after" picture, about 3 weeks after my TT and brachio. I weigh between 145 and 150 at any given time and wear a size 8 or 10:
3) Here's a "before" plastics pic of my torso and bat wings. It looks like my panni is eating that poor underwear's waistband!!
4) Here's a six-months post-plastics picture:
5) Here's a close-up of one of my batwings, all marked up for surgery:
6) Here's a 6 months post-brachio arm. No more batwings! Scars be damned, I love wearing shortsleeve and sleeveless tops now! (Actually, the scars are not visible from the side or behind.)
7) Here's a pre-plastics picture of my torso, with the plastic surgeon's markings:
8) Here's an "after" in about the same position. Sorry it's blurry, but you get the idea:
Well, as you can see, I've gone through some changes. I honestly can say the plastics were uneventful and exactly as I expected. I expected some pain, some discomfort and got them. But I also got some freedom and major relief in the process. No more sores on my pubic area. No more back aches.
I still wear the same size clothes, but I do not have to wrestle with a 12-pack of muffins on the top of my pants. Not much jiggles when I run after my kids now. Sex is more comfortable and intimate. I feel good in my skin. EXCEPT for this posting, I am hardly ever self-conscious about my body.
My scars are still reddish in places but they are lightening and getting smoother by the day. I rub Bio-Oil on them after every shower. I used silicone sheeting for the first several weeks on them. I have every hope that they will fade well. However, if I stayed this way forever, that would be okay, too.
I DID go in for a small inpatient revision to my bellybutton. I had had a major icky hernia in my bellybutton before my DS and the tissue there stretched and healed strangely--the bellybutton got bigger. My PS did a simple revision a month ago and I like it so much better. This revision was covered by my insurance, as well.
While my thighs are kind of droopy and my breasts are rather deflated, I believe I am done with plastic surgery. I think I look like a 40-year old woman with some well-earned miles on her should look. That's all I ever wanted.
UNSOLICTED ADVICE:
1) If you are considering plastics, please know that plastic surgeons are not magicians. They cannot make us perfect. Have realistic goals, and you will get realistic results. For example, I have a lot of stretch marks. Unless they were in the extracted skin, I STILL have those stretch marks. No biggie, but you should know you may not walk out of this looking like a supermodel.
2) Be sure and find a good plastic surgeon. Ask around. Do online research. Interview them! This is your life--bother to put the work into getting the best you can (as you should have done with the type of bariatric surgery you chose and that particular surgeon). Make sure they have the same philosophy you do. I had a true "artiste" look at me and tell me he could make me look "perfect" in four staged procedures. He was going to remove things I had no idea needed removing! Believe you me, "perfection" sounded good, but not at that emotional and financial cost. I wanted ONE surgery, with the most bang (and least pain) for my buck.
If you want "perfection," by all means, seek an artist. Just make sure you and your doc talk and agree on what constitutes "success" to you. BTW, for those in the Chicago area, I had in-depth consults with three surgeons and went with Michael Lee at Northwestern (www.michaeljleemd.com). I think he and his office staff are super.
2) Call your insurance company immediately and ask about any plastics coverage you may have. Use words like "reconstructive surgery" instead of "plastic surgery"--there's a difference. Follow their requirements to the letter. Document the hell out of ANY issues you have as you lose weight! Sores, back aches, depression, body image issues--anything that affects your activities of daily living or mental health.
By "document," I mean get your doc to take pix (or take them yourselfand date them), take notes and prescribe stuff like creams, medicine, etc. You MUST show that the excess skin is affecting you negatively and that you have made every reasonable effort to treat these issues non-surgically. If your current insurance does NOT cover reconstructive surgery, STILL document the hell out of your condition. Maybe your next policy will offer the coverage. Check it out during your next open enrollment.
3) Oh, and if you are a newbie considering weight loss surgery, please consider the duodenal switch (DS). It has the best long-term results and the most "normal" lifestyle in MY opinion. Today, I ate bacon, eggs, cheese, crescent rolls and a Diet Coke for breakfast. For lunch and snacks I grazed on cheese, crackers and doughnut holes. For dinner, I ate a big portion of bleu cheese meatloaf and mashed potatoes and Diet Coke. And I ate three huge Myrtles (chocolate, caramel, pecans) for dessert. No dumping, no foamies, no gas, no stuck food, no anything untoward. In fact, I am about to amble off into the kitchen for some more meatloaf before bedtime. For more info on the DS, visit: www.dsfacts.com
If you have any questions, feel free to PM me. I will help you if I can.
All the best,
Nicolle
I had the kick-butt duodenal switch (DS)!
HW: 344 lbs CW: 150 lbs
Type 2 diabetes and sleep apnea GONE!
Thanks!
As to your situation, just keep an eye now, as you are losing weight, on any issues you see with your skin. From sores to back aches, etc. and start documenting them as they pop up. It will help you crystallize your thinking on plastics and make you ready when the time comes.
Keep up the good work!
Nicolle
As to your situation, just keep an eye now, as you are losing weight, on any issues you see with your skin. From sores to back aches, etc. and start documenting them as they pop up. It will help you crystallize your thinking on plastics and make you ready when the time comes.
Keep up the good work!
Nicolle
I had the kick-butt duodenal switch (DS)!
HW: 344 lbs CW: 150 lbs
Type 2 diabetes and sleep apnea GONE!
Hey you are looking great!!! WOW!!!!
What kind of documentation did the insurance company require. I know every insurance company is different, but I would like to have an idea of what I might be in for. I have more weight to lose but I can tell already that I am going to have a lot of lose skin. My highest weight was 358. I am now down to 235 (I would like to get down to 165, that is the weight I need to be at for my BMI to be normal) and there is skin hanging off of me. Especially on my inner thighs and tummy. My boobs are a lost cause...hahaha. After I get to 165 I would like to get plastic surgery...hopefully I will get to 165.
It's too bad I have all this fat and extra skin because with all of this working out I have been doing I can feel the muscles in arms and legs but it's hidden under a mile of fat and skin.
What kind of documentation did the insurance company require. I know every insurance company is different, but I would like to have an idea of what I might be in for. I have more weight to lose but I can tell already that I am going to have a lot of lose skin. My highest weight was 358. I am now down to 235 (I would like to get down to 165, that is the weight I need to be at for my BMI to be normal) and there is skin hanging off of me. Especially on my inner thighs and tummy. My boobs are a lost cause...hahaha. After I get to 165 I would like to get plastic surgery...hopefully I will get to 165.
It's too bad I have all this fat and extra skin because with all of this working out I have been doing I can feel the muscles in arms and legs but it's hidden under a mile of fat and skin.
Thanks!
You're doing great! I see plastics in your future. Keep on truckin'!
Basically, document anything that "affects your activities of daily living." Back aches, sores, rashes, emotional issues from the extra skin, inability to exercise as much because of said sores and rashes, inability or unwillingness to have sexual relations because of sores, extra skin, etc. ANYTHING that affects your ability to move through life without pain and mental duress. Throw the kitchen sink at them!
And anything that impedes your ability to KEEP the weight off. For example, exercise is thought to be a cornerstone of maintenance, particularly with non-malabsorptive surgeries (band and VSG) and those that lose their caloric malabsorption (like RNY). If you cannot continue to exercise without pain or discomfort, then you will regain, become obese again and become the insurance company's financial nightmare again (diabetes, high blood pressure, spine problems, arthritis, heart trouble, etc.)
You have to show that you have done everything non-surgically to treat these issues, first. From creams to therapy to oral medications. Your doc's notes would cover this.
If you send me your email address, I will send you the letter I ghost-wrote for my PCP to send to my plastics doc (who then submitted it all to insurance). It's short, but gives the relevent info.
I hope it helps!
Nicolle
P.S.
My BC/BS of IL policy's wording on reconstructive surgery:
Procedures are considered reconstructive and therefore may be considered medically necessary when there is documented evidence of physical functional impairment; OR
Documentation for reconstructive surgery must include appropriate medical record documentation and may include any of the following:
The plan requires medical records for determination of medical necessity. When medical records are requested, a letter of support and/or explanation may be helpful, but alone will not be considered sufficient documentation to make a medical necessity determination.
Abdominoplasty
When the following conditions are met:
The end.
You're doing great! I see plastics in your future. Keep on truckin'!
Basically, document anything that "affects your activities of daily living." Back aches, sores, rashes, emotional issues from the extra skin, inability to exercise as much because of said sores and rashes, inability or unwillingness to have sexual relations because of sores, extra skin, etc. ANYTHING that affects your ability to move through life without pain and mental duress. Throw the kitchen sink at them!
And anything that impedes your ability to KEEP the weight off. For example, exercise is thought to be a cornerstone of maintenance, particularly with non-malabsorptive surgeries (band and VSG) and those that lose their caloric malabsorption (like RNY). If you cannot continue to exercise without pain or discomfort, then you will regain, become obese again and become the insurance company's financial nightmare again (diabetes, high blood pressure, spine problems, arthritis, heart trouble, etc.)
You have to show that you have done everything non-surgically to treat these issues, first. From creams to therapy to oral medications. Your doc's notes would cover this.
If you send me your email address, I will send you the letter I ghost-wrote for my PCP to send to my plastics doc (who then submitted it all to insurance). It's short, but gives the relevent info.
I hope it helps!
Nicolle
P.S.
My BC/BS of IL policy's wording on reconstructive surgery:
Procedures are considered reconstructive and therefore may be considered medically necessary when there is documented evidence of physical functional impairment; OR
- services are rendered primarily to correct documented progressive impairment of physical functions that interferes with the performance of activities of daily living.
- the conditions of impairment must meet the definition of reconstructive services in the benefit contract of the member for whom a procedure is being considered.
Documentation for reconstructive surgery must include appropriate medical record documentation and may include any of the following:
- photographs; and/or
- consultation reports; and/or
- operative reports and /or other applicable hospital records (pathology report, history and physical); and/or
- office records; and/or
- letters with pertinent information from:
- providers
- subscribers
The plan requires medical records for determination of medical necessity. When medical records are requested, a letter of support and/or explanation may be helpful, but alone will not be considered sufficient documentation to make a medical necessity determination.
Abdominoplasty
When the following conditions are met:
- panniculus hangs to or below the level of the pubis; and
- The panniculus causes chronic intertrigo that consistently reoccurs or remains refractory to appropriate medical therapy that includes systemic antibiotics, topical anti-infectives, anti-inflammatory medication and appropriate skin hygiene.
- repair of diastasis recti in the presence of a true midline hernia (ventral or umbilical)
The end.
I had the kick-butt duodenal switch (DS)!
HW: 344 lbs CW: 150 lbs
Type 2 diabetes and sleep apnea GONE!
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