What would you do? VSG to DS Long post

Best advice, she needs the problem solver, Dr. Keshishian in California.

You already know this but you need to tell her the sleeve failed her. The sleeve is just another diet with a smaller stomach. She should have had the DS from the get go and the surgeon who sold her the sleeve is the failure. The DS is still her best hope to get down to the weight where she can get her knees replaced and get her mobility back. If a panniculectomy will help her, perhaps it can be done with the DS. Ask Dr. K.

I wish there was something better than the DS. A pill would be great. But there is nothing else out there that will give her a better chance. There is one non-surgical option I can think of and that would be Medifast/Optifast till she gets down to a weight where her knees can be replaced. BUT once that's done, there is a very good chance she would regain.

Thanks everyone for your responses, looks like she's going for the DS with Dr. Anthone which I think is the best choice. Even though she will probably end up with the Roux-en-y pouch she is fine with it.

She's gonna follow through with a couple appointments to get an opinion on the Panni removal but she feels getting the DS as her next move is the best one. The hospital requires 3-6 months supervised weight loss, even though self pay. But might as well get it started now so the sooner the better and have it done by end of year.

As a side note, I'm doing this for my sister to help her with the decision. Were both pretty quiet people and neither one of us has any social media accounts. This message board is something she would probably never do either. Just trying to be good brother :)

Thanks,

Bubba

I was advised to get skin removal at 350 pounds (my highest weight was around/over 750) and they would remove a lot of skin. Even then it'd not be anywhere near like 40 pounds, though, without liposuction. They also told me that I'd have had close to a 100% wound failure rate and that I had to be on bedrest for at least 6-8 weeks to minimize it. She would have done it, but she said to expect it would be extremely difficult recovery wise. That's something to keep in mind. I weigh significantly less now and still am waiting to drop more weight.

I would still consult with Dr. K even if she made her decision. Even though I loved my surgeon I still got a second opinion. I mean, I never buy a car from the first car salesman. If I'm going to spend 30k, I'm going to get other opinions... especially being self-pay. The problem with hybrid surgeries is that this phrase isn't very specific. I would clarify what makes it a hybrid and get it documented so she has records of what was done in the event of other complications. He's one of the best, and he will be extremely honest with her regardless of whether he does the procedure or not.

I hate that surgeons are recommending VSG to patients with that much weight to lose! So many are just like your sis. Being that she is self-pay, another option is surgery outside of the DS and will probably be half the cost. Mexicali Bariatrics is the only place to trust in Mexico. Dr. Ungson is one of their surgeons and he trained another surgeon to do DS, but the name escapes me. I wouldn't recommend PS if she intends to lose more weight, or else she will need it all over again.