Repost from main board: Plastics yet? Fat or skin?

I had lap RNY in March 2009 and started at 297 lbs. I am now 164 pounds and still losing I think but have saggy boobs, ripply skin on my stomach and the huge pannus or tummy roll that I've always had and always thought was just fat but now am wondering if it's actually excess skin and not fat. No idea. I feel weird that I can't even tell the difference...I guess because it's always been there and I thought it would go away with WLS but hasn't. Weird.

So I'm 30 lbs from my goal...well, 34 lbs..of 130 lbs. Should I wait longer and get down to goal or lower and then go for plastics or start looking into it now? I feel icky about my body but it's not a huge deal to me. I can take it or leave it right now I think. I also worry about insurance coverage because I haven't complained about rashes or anything so I'm worried my insurance wouldn't pay for it. I have state insurance right now but will be going under my company's insurance soon and am wondering too if I should hurry and do it under state coverage because they may cover more than a private company.

So many questions!

Its probably a combination of both excess skin and fat. My PS removed 4 lbs from me and I know most of that was not loose skin. It's different for everone though, I have heard of people having more than 10lbs of excess skin removed.

It would'nt hurtto start looking into plastics now, just so you know where to stand. If you decide to go the insurance route, I think they will only coer the panni, anything else like the tummy tuck has to be proven to be medically necessary and from what I hear it's very difficult and very time consuming.

It's definatley worth looking into because this is a big life changer and major surgery if you can get it covered then what do you have to lose, the worst they can say is no you are'nt covered, but at least you will know.

Good luck to you.

 Book a consultation with a plastic surgeon now.  Your weight loss surgery clinic should be able to give you a recommendation. My plastic surgeon specializes in weight loss surgery patients and wants them to be within 10 pounds of where they want to stay for life. Losing or gaining more than that starts to mess up the surgery.

The things you want to have done probably will not be covered by insurance.  If you need to self-pay then you need to work out a plan for payment.  It is reasonable to anticipate about $35,000 to have everything done.  I think it is well worth it.

People gladly spend $35,000 or $40,000 for a car that they will trade in a few years. Your new body will be with you for life.  Weight loss surgery gave me back my health, plastic surgery restored my self-esteem (quote Weight Loss Surgery for Dummies).

It's both.  There is a lot of stubborn subcutaneous fat that gets removed too.

You're pretty much two and a half years out, you could look into plastics now if you feel ready.  Unless you are willing to change your current eating habits much more, you probably won't lose that much more.  I know that sounds mean and defeating and not nice to say, but it's just reality.  We pretty much lose for 1 year-18 months and not much after that, so there's no point holding on to your body hoping you reach some sort of (possibly unattainable) ideal body.  As long as you a pretty close, you should be able to get a good PS result.

I only had 3lbs of skin and a liter of fat that was lipo'd off my muffin top and some other areas.  The boost to my self-esteem was dramatic with plastics.  I went to Dr Sauceda in Monterrey Mexico.  He's an artist when dealing with previously MO patients.  If you want more info on Dr Sauceda, click on Dr Sauceda in my siggy line for his group here on OH.