When Did/Should You Go for your First PS Consult?

Hi all,

I am about 10-15 pounds away from goal and almost 10 months out from my RNY. I was just wondering if there are guidelines as to when you should go for your first PS consult? I have read that it is good to wait at least 6 months after you reach goal for the actual PS itself, but I was wondering when you went for the first consult and then how long after WLS did you have your first PS.

Any tips/advice appreciated!

Thanks,
NormaBee

I was at my goal weight for 6 months before seeing a PS for a consult.  Once I decided he was the one, I scheduled the surgery 6 months out.  I wanted to be at a stable weight for one year before doing plastics.

Most surgeon's won't consider you a good candidate unless you've been stable for at least 6 months.  Some a year. Mine would have done me at 6 months, but I wanted to maintain for a year and there was also a half marathon that I wanted to complete before being out of commission for the summer racing season.

Edited to add:  In terms of my WLS, I had that in 2001 - it took me a little longer to get to goal than most.

The one thing you have to ask yourself is "do you know enough about yourself, your eating habits, emotions to be prepared for the physical and emotional changes that plastic surgery adds?"

Regardless of weight loss method, you have to be absolutely certain you are in the right frame of mind to do plastics.

Thank you so much for your response Lisa. Very helpful. However, I am intrigued/concerned about the following:

The one thing you have to ask yourself is "do you know enough about yourself, your eating habits, emotions to be prepared for the physical and emotional changes that plastic surgery adds?"

Could you speak to this a little more? I understand that the recovery from plastics can be quite daunting/challenging, but I wasn't thinking about eating and emotional impacts - can you elaborate? Thank you!

In the grand scheme of things - losing weight is easy compared to maintenance.  The reason why RNY wasn't as successful as it could have been for me was because I didn't learn new coping skills and about 2 years after my RNY, I had a few major life changing events that threw me off kilter.  I couldn't manage everything, so I reverted to old, bad habits.

Between what the RNY did for me and Weigh****chers, I finally got to my goal weight and figured out a whole bunch of stuff about how I react and how I would mis-use food.

So I went through the whole process of figuring out that yes, I have lost weight but how do I see and accept myself as a thin person.  It was the last emotional barrier to get past.  And for that breakthrough, I needed help.  I found a therapist who was amazing in helping me get to the root of my acceptance problem.  

The way I described it to my husband was that I'm having a hard time accepting myself as a "thin" person, I don't want to wake up from plastic surgery and not recognize me physical me either.

Since having come out of both rounds of surgery (and I did them a month apart), I had some really interesting discoveries.  When I lean closer to the bathroom mirror, I get a lot closer.  Panties on me, look like the panties on the models.  I can reach certain areas a lot easier.  I don't have to lift up folds of skin to dry off (and the first few showers I took after surgery, I tried lifting and there wasn't anything there).

People that meet you for the first time now - never knew of your past.  So what do you talk about?  How do you introduce/describe yourself?  Because you are now more than your weight loss.

Lisa, thank you so much for sharing your journey with me. Food for thought, certainly.

Interestingly, I have not really been very open about my WLS. Outside of my immediate family and 4-5 close friends, know one really knows about it and I don't talk about it much since I work from home most of the time. In the last 3-4 months I have been meeting a lot of new people recently, through business networking groups and alumni events, people who never knew me fat, and I find it incredibly freeing not to have my weight be an issue. I finally feel like I am the real me again - a social, career-oriented, outgoing, creative person.

Romantic relationships...now that's a whole load of other issues, for which therapy is something I am looking into!

I was lucky enough that a PS came to my support group when I was 7/8 months out.  He advised that when you were within 10 lbs. or so of your goal weight it would be a good time to schedule your first consult.  The reason is that you are close enough to goal to be ready but also because the insurance process can take a while and you may need to see your PCP for a few months to document conditions that would be due to the excess skin. Some insurance companies require 3 visits, others 3 months, and others even more. The PS office will know the policies.

I will be having my surgery next month.  I started with a consult in late March, and needed to see my PCP for my skin issues (and receive treatment for them****il just a few weeks ago.  Once that documentation was in I was cleared for surgery.  So the process for me will be 6 months from consult untl surgery, which is why you may want to start early. 

Thank you for the info. Yes, a plastic surgeon was supposed to come talk to us at last month's support group but he had an emergency and had to cancel, so thanks for the info. Since I don't have any skin issues, I will most likely be paying out of pocket. However, I do need to document whether my insurance covers reconstructive plastics, I have heard of a few people's who do.

Thanks again!

I paid for my tt and breast lift myself.. and I only waited 6 weeks from consultation to surgery... would have been shorter if I wasn't having 2 procedures done at the same time. Keep that in mind if you find out that your insurance isn't going to pay... it's a lot to take on to find out that you're having surgery so quickly (you can choose to wait I'm sure, but I didn't want to)...

Good luck in whatever you decide!! 

Thank you for the tip! I am still so early out that maybe an initial consult would just be beneficial but as others have said, to wait awhile. I'm not even sure which surgeries I want/need, and I also am concerned about scarring as I tend to form keloids. I also plan on going to several surgeons to see which one I feel more comfortable with.

You should check your insurance.  Some might require only hanging skin that causes back pain or interferes with daily activities.  Skin issues could be a rash or dryness under the folds of your skin that are unresponsive to treatment. I would go in and see a Board Certified PS (and also one who specializes in weight-loss surgery patients) and the patient rep there can see what your insurance will or will not cover.  The PS's office will have the info you need-- they will tell you what is and isn't covered.  A lot of times you may pay a reduced rate because part of the procedure (such as the hospital and most of the surgeon's fee) will be covered by insurance.

The last thing you want to do is pay out of pocket and find out that a part of your surgery could be covered by insurance.  Another reason to start the process when you are close to your goal weight-- you would rather jump through a few insurance loops if it is covered.