What would you do?

Many of you may have read that I was ready to have surgery in Dec but our insurance changed and I no longer had that coverage.

I meet all the medical criteria and I have been told by 3 different surgeons that I have more than 20 pounds on my stomach area that is skin/tissue.

Fast forward..

I have had several consults and quotes. Anywhere from 8k up to 16k for a anchor cut. And an amazing quote of Dr. S in Mexico for much more work, but thats in Mexico and I am unsure.

Today a doctor that I trust very much has offered to help me because of my cirumstances. He is my weight loss surgeon. He has done many PS and although he is not board certified he is board elgilble. It's odd because before I lost my insunce I was going to use my doc to do my surgery anyway, but I now I am at odds. Its not that I don't trust him, its just that this is a really big deal !

Anyways...

He has offered to do the pani ( all inlcusive) for 5k. This would be outpatient at a surigcal center not a hospital.  After I have healed up and I have more time to be away from school and work he will do my tummy tuck ( muscle work) remove any skin that is left and do my hernia repair. He has offered to do the tummy tuck for free and only bill insurance for my hernia repair.
 So, my out of pocket expence will be 500 ded. to the insurance. I will stay one night in the hospital for this operation.

Or, I can use him have everything done at once and  pay 8k. ( This is a very dicounted rate due to self pay and because he wants to help me)

I am not sure what to do. What would you guys do if it were you. Here are so of the pro's and con's I am thinking about ( I am sure there are tons more)
I am still considering other doctors as well ...


Here are the pro's

No T cut. One cut along the bikini line ( second surgery will be along the same incision line)
3k less
Experienced with WLS plastics

Con's
Surgery Center instead of hospital ( not sure about this, because of the amount of skin I have)
Two surgeries = two recoveries
NOT board cerified

I really value your input and advice!

I'd go to Doctor Sauceda.  Oh wait, I DID!

Here's why.  He specializes in PS for Massive Weight Loss Patients.  He has been doing it for seven years and has tried many ways of doing it over the years to discover what works best for our stretched and worn out skin.  He does multiple surgeries at once which means one recovery.  He used an epidural and twighlight sleep for my body which kept me comfortable for several days.  He used local and twighlight on my face.  I could listen to the conversation in the OR for the last hour.

Best of all was that I was in a clinic with 24/7 skilled nurses for several days, then I moved to a hotel where he came to visit me daily.  Not only that, but his skilled nurse came to the hotel for two hours daily to bathe me, wash out my garments, dress my incisions, remove drains and incisions and get me back into my garments (two very expensive sets of garments included with my surgery cost).  I didn't have to be a worry wart because I was taken care of daily.  The price of my $400 airline ticket was covered by Dr. S.  When I arrived at the airport his driver was waiting for me.  When it was time to return to the airport in a taxi, Dr. S paid for it.  The pain meds and antibiotics I took at the hotel were included as was all the gauze, tape, antibiotic creams etc.  The hotel has a big breakfast (free) daily and a happy hour with food three nights a week.  I had a fridge in my room to keep yogurt and fruit from the breakfast bar in my room.  It also has a free shuttle service to take you place. 

In the hotel parking lot there is a McDonalds and Starbucks, I didn't go to either but I went to the Italian and the Applebees.  Both had good food.  Applebees delivers.  Next door to the hotel is a small mall with a big HEB shopping/grocery store.  A movie theater ($2.10 a ticket) and a food court with a huge selection. 

All of those things, along with the rave reviews (two people who live in my area) and the fact that it was 1/3 the price of Kaiser with 1 instead of 4 recoveries made it a really easy choice for me.

were you ever concerned that if you had complications once you got back that you would not be treated? that is one of my main concerns. what if i get an infection or want a revision. can't do that when my doc is in mexico. and will insurance cover any of that.

Nicole,
I think you were asking Lee. But I will say it does concern me. I can't afford to go back and forth to Mexico. And my insurance won't cover anything that occurs due to plastics.

 I got an infection behind my ear.  I have a friend who is a doctor that wrote me a script for antibiotic cream.

If anything more serious were to happen, I would go to kaiser ER.  They can't turn away a member.

As far as revisions, talk to Dr. S and find out his policy.  If I need a revision later I want him to do it and take care of me.  His service can't be beat.

Kaiser ran all of my pre-op tests for me that Dr. S required, for my $10 co payment.

Another con, your surgeon is not a plastic surgeon and the results will NEVER be as good as with a plastic surgeon who specializes in working on patients who have lost massive amounts of weight. I wanted the best results so I went with the best surgeon.

Laura

Lee,

I have spoke to Dr. S. I feel very comfortable with him as a doctor and the services he provides. However, he is in Mexico. I will not go alone. That means my husband or someone has to come with me. I won't come home until 3 weeks He wants me there at least 12. But my case is more extreme. We have two kids (7 and 3) finding someone to keep them that long would be hard, but not something that can't be done. Dr. S price is fair. I won't say how much but its more than 16k and less than 20k and it is for a lot of body work and my face. I know its well worth every dime. But I don't have that much money and we added it up and figured 2 years maybe 3 .

The biggest thing is I really need the Panni part removed like yesterday. It is very large like I said over twenty upwards to 30 on my entire stomach is a guess from many leading surgeons. 
I will begin my new career in two years as a teacher ( hopefully) and I would like to be done with this part of the journey before that starts.  I really don't think I could handle 2 years of carrying around the skin and all the issues that go along with it. But I am not ruling it out either.  I don't have much fat left on my body. At 215 pounds I only had 40 pounds of fat according the body fat analysis thingy that I needed to lose. I am now 204. And with the amount of skin and everything my body is more than ready.

Laura,

You are right. He isn't a PS. He has done many surgieries( plastics) on his weight loss patients. He is in  he is elgible now he has completed a fellowship. But its still true the results may not be as good. I have seen some bad work by docs that were supposed to be experts though. That's why all of this is so overwhelming. One of the leading Docs here in Florida was asking almost 17k to do a anchor cut on me. I keep going back to this though.. before I lost my insurace I was more than ready to have surgery with my doc.. but now I am uncertain. I guess its because I have done more reading and more obsessing during this time period.

I am scared of a surgical center. I keep thinking if something goes wrong...

Keep the imput coming ! Thanks so much ladies.

I had my TT and brachio done Friday at a surgical center located acrosss the street from an affiliated hospital.  I never once worried about having it at a surgical center.  You have a lot of choices to make, but if you were confident in your surgeon before, your insurance status shouldn't change that.  For body work he may be fine but I would go elsewhere for facial work. I would go for it all at once.  Can't he still file for the hernia and you just pay the diff?  Good luck.  I know that getting rid of your large panni, no matter what else you might have done, will make a huge difference in your life every day.

Lisa,

I trust him very much. He did my weight loss surgery and he has been a tremedous support! The man called me the night before surgery just to check on me. He has an amazing personal touch.
I have been thinking and thinking non stop since Oct when I was told I would no longer have my insurance that I had prior. I know I just need to stop and take some time.

Amy,

I do know its imporant to be board certified and I will be meeting with him to find out why he is not yet certified. I know that he is elgible. He has experience with WLS patients in regards to plastics and he has completed a fellowship. But, I know its not the same as being certified.

The whole surgery center thing is something I think I could and would be ok with once I am at peace with my doctor that I choose.


Money.... I know its not everything. But, I can't help but feel like this truly is a good opportunity. 5k now and 500 later. I can afford that by May! But, I won't make the choice on money alone even if that means a 3 year wait!

I love this website. All of you are wonderfully supportive and I value your input!

I was sitting where you are - in 2009.
My WLS doctor, whom I love and trusted with my life when I weighed almost 500lbs, made the same exact offer to me.  Exactly.  He said he would remove my panni only for the same price.  I also had communicated with Dr Sauceda.  I decided to go with Dr Sauceda and only get my arms and TT done at that time.  The price was much less and those were the things that bothered me the most!  My chronic back pain ended immediately after my TT.  My mobility increased and I was able to work out really hard and lost another 100 lbs to return a year and a half later to Dr Sauceda.
I do understand the time away is an issue.  Do you have a friend or family member who could go with you instead of your hubby?
Removal of the panni only will leave your body very misshapen and the only benefit (which I do not minimize at all!) is that you will have increased mobility! 
Perhaps, you can get less done with Dr S this time around.