New to PS Forum and have some questions...

I am just 2 months post op so I know I will not be looking into plastics any time soon but I just had some basic questions.

Is a tummy tuck the same thing as removing all the loose skin from your belly?

Will my breasts sag that much to need a lift?

How many of you are self pay and how many got insurance to pay?

HOW do you get insurance to pay?

How much does it cost on average?

I am 5'4, 314 (highest 367) and my goal is to get down to about 180 or so. At this point, I am thinking that I will only really care about getting rid of the loose belly skin....

Thank you in advance for your replies!

congrats on your surgery and good luck on your journey!.  I am 2 months post op extended tummy tuck..so I can answer some of your questions.
First of all..I would not do surgery until you get to goal and stay there for a good 6 months.
A tummy tuck does alot more than remove the loose skin..it tightens the muscles.  Alot of insurances do not cover that but covers the pani removal (removing the extra fat bulge)..I would absolutely pay the extra for the tummy tuck.  I would not have been happy with just the pani removal.
My insurance did not cover anything..I was totally self pay.  It was worth every penny!  Some insurances do pay...so I can't help you with that one.  Good luck to you on that one...I hope it will pay for you.
I live in California and everything is more expensive here.  I did not look for the cheapest plastic surgeon but the best.  The total cost for my extended tummy tuck and full back lipo was 13,100.

Yes my boobs sag some..and I thought about getting them fixed but decided that in a good bra they look fine and I didbn't want to spend the extra money for it (it was going to cost an additional 11,000 for BA and BL).  The funny thing is since I had my TT, so many people have asked me if I got new boobs!...it is because my tummy looks smaller...so I am really glad I didn't spend the extra money.

good luck to you on your journey.
I hope this helps alittle...you have come to the right place for answers!

Patty

Congrats on starting your journey! A panniculectomy removes just the fat on your belly with no muscle tightening and without a belly button. A tummy tuck goes from hip to hip usually across the front and includes belly button and tightening.

A lower body lift (which I just had) goes all the way around and includes muscle tightening and pulling up the outer thighs, butt, etc. and moving belly button. Mine removed 20 pounds of skin and tissue and I now have a flat tummy and smaller butt and thighs.

I also did a breast lift and implants because I lost quite a bit of mass and I was saggy. I wanted to keep my full look and be perkier, so I got both implants and a lift. I'm very happy with the results.

I also got a nose job at the same time, which I do not recommend having done at the same time as any other plastic work. It made it hard to breathe and made everything that much more difficult.

My insurance would not pay for any body work for me, but I got a discount because I had to have a hernia repair and deviated septum on my nose repaired. So I saved money on OR time. Total for all of my procedures, minus what the insurance paid and multiple procedure discount was 27K. I did pay out of pocket for that.

I started at a very similar weight to you and had the same goal, which is a realistic goal and right for my large muscular frame in terms of measurement of my body fat percentage. I definitely needed skin work and I suspect you will too. You might get lucky though. I've heard that religious use of cocoa butter during entire weight loss really helps. Might be worth a shot for you.

 Is a tummy tuck the same thing as removing all the loose skin from your belly?

Yes - basically that is the goal.  There are several different types.  This site explains them pretty well and gives you a great start on understanding the options.   www.answers.com/topic/abdominoplasty

Will my breasts sag that much to need a lift? 

Maybe. Everyone is different.  Depends upon your age, your skin, history of yo-yoing and genetics. And, of course, it depends on how big the breasts were to start off with.  Some women don't sag so much, but I'd say the majority of us do.  I'm about your height and start weight and at 155, my breasts were below my ribs with nipples pointing down (practically).

How many of you are self pay and how many got insurance to pay?

We don't keep statistics here although it sure would be nice if we did.  Getting insurance to pay can be a challenge but it has been accomplished by some members here.  Those with approval typically get insurance to cover at least some portion of abdominal PS and sometimes a breast lift.  

HOW do you get insurance to pay?

Document any complications you get from excess or hanging skin with your GP.  If the sagging skin on you stomach causes rashes or skin infections have the doc take notes, keep copy of prescriptions used to treat the conditions, have your doctor photograph the problems.  If your sagging breasts cause back pain or skin infections/rashes in the breast fold, have your GP document all this as well. You need to be able to supply the insurance company with a complete and detailed history of any medical issues you may have that could be solved by PS.

How much does it cost on average?

Difficult to provide an average as each surgery is performed by different doctors, in different areas of the country, and every surgery involves different levels of work.  That means there can be a wide range of prices.  Also, many of us bundle two or more procedures together to save on anesthehia and operating room fees so it is hard to sometimes separate them out.  You can get a general idea either from flipping thru old posts on the board or by checking out www.realself.com.  Be aware that the prices on that webpage are averages of user submitted data and somtimes appear much higher that actual costs that you might incur.

I am 5'4, 314 (highest 367) and my goal is to get down to about 180 or so. At this point, I am thinking that I will only really care about getting rid of the loose belly skin....

Your WLS was a huge step and this next 12-18 months are going to be full of changes and challenges for you. Be sure to focus on your weight loss and nutrion during this time.  Your skin is going to go thru alot of stress and you'll find that after some of the rapid weight loss it takes time for everything to rearrange and redistribute itself.  My skin actually snapped back quite a bit from months 8-12 even though I continued to lose weight at a slower pace.  

Don't stress yourself about plastic surgery.  Lose the weight. Feel good about yourself. IF you do have issues with skin and tissue related to the weight loss, you can deal with it later.

Good luck to you.

I just had a lower body lift, tummy tuck and breast augmentation (no lift) two weeks ago.  I did self pay because there was no health reason involved, I just didn't want to look like a Shar Pei any more.  My surgeon gave me a $2500 "poster child" discount because he was only working with skin & muscle, not fat/lipo, the results are usually better and he'll want to use my before & after photos.   So for the surgeon & follow up visits, facility and anesthesia, and going with silicon vs saline (which is twice the cost), I still paid less than $10k for all of it...and used my AmEx card so I could get the Delta SkyMiles.  Woo hoo!   And I went with what some consider to be the best plastic surgeon in town.   I only talked to him because he's worked with my WLS surgeon and a breast cancer surgeon for 20 years, plus a friend of mine is an OR nurse who worked with him dozens of times.   They all said his work was exquisite and he's good at what he does.  Patients can be finicky, I'll take the opinions of fellow professionals any time.

I will say I'll never do it again, it was much more painful than the WLS surgery and it's a lot to put yourself and significant other through.   The single best piece of advice I can give you is start working out with a trainer 2-3x a week so you've got muscle strength in your legs & core - it will make your recovery so much easier plus I think you'll be happier with the results afterward. 

So for your specific questions - the tummy tuck does indeed involve the muscles, in my case he only did the lower abs that were affected by pregancies, not that I ever had tight lower abs in my life.  Because of the workouts, he didn't need to do the middle or upper abs.

My boobs looked great in a padded bra (but the cleavage was wrinkly), but I looked like a little boy when the bra came off and have a hard time keeping my swimsuits up and in place.   I didn't have the lift and the verdict is still out whether or not I wish I had done it.  The implants will take some time to settle into a more natural position and it appears to me (could be wishful thinking) that they are looking better with time.  At first, they looked really weird because my nipples are below the mid point of my overall breasts and one of the nipples is still pointing south. 

I talked to a friend who had her arms, breast lift and tummy tuck & excess skin removed a couple of years ago.   Unfortunately she developed some other health issues (some related, some unrelated to the WLS) and continued to lose weight so she still has more excess skin post plastic surgery.   She said the same thing I did - this recovery is too painful, she'll never do it again, so she wishes she had waited longer.  She would love to have the lower body lift and legs done but said there is no way she'll go through it again.  My OR Nurse friend had the RNY 9 years ago and had a "mini tummy tuck" along with a hysterectomy and all they did was remove the skin but didn't tighten the muscles and that's been her single biggest regret related to the entire process. 

And just FYI - I'm 5'9" at 150# (started at 280#).  My body fat a couple of months ago was just over 20% and I consider myself big boned.  I wear size 10 shoes and 8-1/2 to 9 rings.  I'm also 51 so gravity is starting to win the war!   Good luck with it all.

Thank you all for your responses, they helped me ALOT. I am fairly young (30) and havent really yo yo'd much and have always had big boobs, so hopefully I will be okay in that department. I do work out 5-6-7 days a week and will continue to do that, so hopefully that will help! I guess I will just wait and see what happens and go from there.

Sublimate, thanks for your stats also - my DR told me my goal was "unrealistic" and I cant wait to prove him wrong!