The skin afterwards

  One of my biggest concerns with WLS is the amnt of skin I will be left with after the weight loss. Im fairly certain my ins would not pay for "cosmetic" surgery to remove it even tho I know its not cosmetic so much as just sanitary to remove it. I weigh appx 350 and stand 5 ft 9 in tall. Arms and legs Im not so much concerned with, but my stomach would be bad. I had a hernia 2 yrs ago that took a while to get repaired and it stretched me some, plus 3 kids hasnt helped, that long with the weight loss...yeah...I gots me a tummy lol. What things can you do to reduce how bad the skin is after WLS if anything? How much is surgery if you have to pay out of pocket and is there anyway of getting ins companies to cover it?

Tina Myspace Welcome Comments & Graphics I am so glad to meet ya. I have that prob. not as much as I thought, but yes  it happens. But if you have a lot of rashes or infected areas or problems with the skin with irritation. Be sure to have it documented with you pcp at each visit. Let them know that you are uncomfortable with the loose skin, make sure that they chart it. When you call the ins. for pre-cert. then it would be considered a medical condition. Hugs Barb

I'm down from 320 to 178 and overall the skin issue hasn't been that bad.  A lot less than I expected.  My understanding is being diligent with the exercise and keeping up your protein intake helps.   

A little background on me...I am 5' 3". Starting weight 300. Current weight 135. I am 53 and have been morbidly obese for just about all of my adult life. I have 2 children. A lot of the issue with excess skin is related to age, genes and how long you have been obese. The skin will continue to shrink some during the year after you reach a stable weight. This is why most plastic surgeons who are experienced in working on WLS patients require that you be at least 18 months post-op AND that you have been at a stable weight for several months. (Mine required a stable weight for 6 months prior to plastic surgery) I was 2 years post RNY when I had my plastics 5 months ago. Check your insurance policy to see if there is any coverage for reconstructive surgery and ask now what the criteria is for establishing medical necessity. If they will cover it based on recurring infections, etc., get any problems documented by your PCP. Most companies who will cover plastics will only cover the removal of the excess skin on the stomach. They generally will not cover muscle repair or any extended skin removal (hips, back, midriff, etc.). Also, the pannus (hanging stomach skin) must hang low enough that a picture taken from the front hides the genital area to the degree that you cannot tell if the person is male or female. In answer to your last question - My insurance company had an exclusion so I paid for my plastics out of pocket. I had a lower body lift with anchor cut and lipo of the outer thighs. This means that I was cut all the way around at the hipline. The underlying muscles were tightened and the skin pulled up and down to meet. The anchor cut is an incision from between my breasts all the way down, crossing the hipline incision. Again, the underlying muscles were tightened and the skin was pulled together removing the excess skin on my midriff and reducing the mons. My entire bill for the plastics was $10,970. I did get a discount because I also had a hernia repaired at the same time. The hernia was covered by my insurance. My sister-in-law had RNY surgery 8 years ago and only has a little loose skin on her tummy. She doesn't have anything hanging down, just mushy skin. She is 2 years younger than me.

Wow, what you described sound INCREDIBLY painful! I just cant imagine going thru that. I had surgery to remove an ovary 8 yrs ago and they cut me from my pubic bone to the top of my bellybutton and that was the WORST pain ever! I dont do well with pain lol or sugery so if I do this its going to be a MAJOR event for me.

A big difference between your surgery to remove the ovary and the surgery I described is that they don't cut the muscles as part of the plastics. They just stitch them back to their normal position. The hernia repair was actually the worst part of this surgery for me. I lost my belly button to the hernia. My surgeon did send me home on some great pain meds. LOL

Susan...  you lost your belly button, but you'll find a new one once you have it tatooed on! lol I'm still working up my courage for the belly button ring!