pre 'plastics' questions

hi. i am 19 months post VSG and went from almost 300 lbs to ranging between 140 to 145 lbs. i am 5 ft 5 and i definitely have plenty of loose skin. also there is still enough fat on my body that i think getting down to 130 before plastics would be of benifit, so until now i have put the concept and pursuit of consults off.

it has been many months since i have had a significant change in my weight, and i am starting to think 145 might be my new normal, i would like to get to 130 but my behavior has not shown the level of discipline or lifestyle change that it would take to get there, and this makes me wonder if i white knuckled that weight off, could i maintain that weight without struggle. maybe i should accept 145 as my baseline, at least for now and start my consults?

part of my concern is that if i am not at totally ideal weight, will that effect my surgical outcome?  do they just suck and cut more fat off me during surgery (sounds more traumatic physically?).

part of the reason i am asking this hear is because i am not really planning to have plastics done where i live,so pursuing my consults means i am ready to take that next step, due to the effort involved.
i am thinking Mexico,(Dr Saucedo?) or a plastic surgery residency program (LA or U of M Michigan), or maybe if i want to pay a lot, someone who specializes in post weight loss reconstruction.(Dr DiNick Michigan?) none of those options are available for me in Santa Barbara. my family is in Michigan and i would have good post op support. 

has anyone here faced a similar situation, or has your journey given you any insights you think would be helpful for me? any information or ideas would be greatly appreciated.
in the long run i am thinking what i will want is lower body lift/ circumferential tummy tuck, and thighs. while i am at it i should probably do my boobs too, just because not needing a bra and having firm breasts would be nice, and fairly minimal invasive compared to the other stuff, although my smallish not super perky boobs or wobble arms are not a big issue for me. not that they are perfect, but i don't care that much. the thighs however, look like melted wax and my mid section/buttocks are hopelessly disfigured and droopy.

i like that Dr Saucedo does stuff under conscious sedation, and that he would probably do it all at once, but the recovery/mobility/pain/ having a caregiver present would be a challenge if i did something so aggressive, but i would not need multiple surgeries and would need less time off work in the long run.

thanks guys!! again, anything that comes to mind at all, i'd love to hear....
Kathie

 Hello,

Congratulations on doing a great job with your sleeve.

I had plastics with Dr. Sauceda four weeks ago.  I can't rave enough about him as a surgeon and a person.  He has a group here on OH.  Come join us there.

Now about the weight, I was between 149 and 151 for a  several months before plastics.  I ate out a lot the days before I left for Mexico and was at 151.

Now at 4 weeks out, I'm at 140.  I don't know how much will stick because eventually I'll be able to eat more again, but I'm hoping to keep it all off.

Dr. S removed six pounds of skin and lipoed two liters of fat from my thighs that he transferred to my tush.  When I arrived home after two weeks in Mexico I was 145 so that was the six pounds of skn.  I've tried to be very careful to not fall into eating many carbs post op.

Hope this helps.

yes! thank you.
please share much work you had done at once, and how bad was the discomfort afterward?
i am sure part of your weight at this point would still be water, as i understand water retention lasts for months after surgery.

 If you look at my signature, you'll see the procedures. The first surgery was 13 hours, the second was 6 hours for my face.  In the clinic the pain meds were IV for four days then tramadol 2x a day.  I supplemented with 1/4 of a Vicodin a few times a day when I got to the hotel.

I didn't swell too much, so not sure how much might be water retention. Probably not much, but I can always hope!  I honestly had not thought that until you just mentioned it.

i am VERY impressed that you did not need more pain meds than that!

 HI! I am as tall as you are and weighed a bit more to start with than you. I  was in the same position about feeling like Iike I wanted to lose more weight before PS but starting the research. I decided to go ahead and get some consults. 

It turned out that the extra weight that I wanted to lose was really all that lose skin and tissue.  At first I didn't believe the doctors when they told me that I had at least 20lbs of skin and tissue on my frame. I was sure it had to be fat.  I settled on Dr. Lomonaco in Texas and he showed me how much extra skin there really was.  He said that it was a good thing I didn't lose  more before the surgery as my end result now has me looking healthy rather than emaciated.

Don't let the scale numbers mislead you. Get some email consults now and see where you stand.

After losing 14lbs from my LBL/BL, I am sitting at 144. If they take off between 10-15 lbs during your surgery you would be at 130 to 135 after the swelling goes down.

Raven is right, with so much weight loss, you most likely will not see the scale at the numbers you are looking for until the skin is removed. Unless you get really unhealthy.
I am currently in MX recovering from a tummy tuck, boob life w/ implants. A lot less then a lot of people have to do, but it is what I needed for now. Dr Sauceda is amazing, caring, and patient with the million questions.
In all honesty my recovery has been a cake walk compared to most people. I have only taken 2 pain pills since leaving the clinic, both at night after being very mobile durning the day.
My opinion, the more you can get done at once the better. It takes a long time to recover, but it is only one recovery.
My care here has been excellent, you can't beat his prices and his work is highly recommended.
Congratulations on you weight loss, good luck with your PS research.

thank you for the input! have you met anyone who has gone down there and done this alone? how managable does that seem? or should i find a caregiver to come with me?

I am here by myself, and I have to say, I am a pretty strong women and it has been a challenge. It is not the pain or the recovery it is the lonliness.

Am I okay, yes, would I come and do it again, yes. Do I think it is something that everyone should do, no.  You have to know yourself and what your comfort zone is.

I have been fortunate to have another patient here at the same time, she is also alone. We have struck it off great and have been able to hang out, but we also repected each other alone time.

I am not sure if this helped or not, but feel free to ask any other questions. Have a great day.

that was super helpful!!! i have a bit of a loner streak, and think that part won't bother me too much. i have (well controlled) anxiety disorder, and wondered if the combo of recovery, a different country based in a language i don't understand might aggravate my anxiety. i can aways just take a ton of xanax i guess. i had some panick attacks after my VSG, but it was just the first 3 days and i was having very poorly controlled pain at that time.
can you find your way around? hard to do things if you don't speak Spanish? any English TV? if you bring your laptop is there Internet? that alone would probably be the most important 'comfort zone' thing for me...to be able to get online.