When should you have PS (especially if you have a LOT of weight to lose)?

I guess the subject line says it all.   I started at 360.  I got sleeved in December of 2011.  Now I'm at 250 and still losing.  My goal is to be around 200 pounds or less.

Since I've lost over 100 pounds, my stomach sags, my breasts sag, and my bat wings are pretty bad.  I think these are all areas I wil want to eventually address with PS. Oh, I'd also love a neck lift too!  My weight loss is starting to slow, but I do hope to make it to 200 pounds, so I still have 50 to go to make it to that goal.

Would a PS work on someone who is 200 pounds and 5'7 - that is still overweight, afterall. 

For those of you that started as SMO, what was your BMI/weight when you did plastics?  Did you have problems with surgeons saying you needed to be in a normal weight range first?

Thanks!!!

I see no reason not yo go for a consult and get a feel for what is available prices and emotional compatibility.
Check with your HMO plan and insurance what their rules are as to medical coverage. Document everything - if you have rashes/fungus are any skin condition due to hanging sagging skin. Many PS hold you have to be stable and maintain weight-loss certain amount of time. Many morbidly obese as they lost weight did have Plastics early to help with mobility but knew they would Katerina need revision as more weight was lost.
Mikimi in Israel

It is my understanding that you'll get your best result when you are closest to your goal weight. I know how hard it is to wait, but I encourage you to keep going on your weight loss journey and spend some time at a stable goal weight before taking on the excess skin. It takes time to adjust emotionally to your new body and to get into the routine of maintenance. I didn't have weight loss surgery so it took me about 4 years to lose my weight (125 lbs). I've been at my current weight (give or take a few pounds) for a year and am having my procedures on July 13th. I spent the past year saving money, researching planning. Now, I'm 110% that my body and mind are ready for the final step.

Congratulations on all that you have accomplished so far and best of luck moving forward. I hope you can appreciate every step on the journey.

Most people when they are at the end of their Honeymoon phase 1-11/2 years out. When you bottom out on the weight loss is the time to do it in my opinion. I waited 21/2 years and have my regrets now cause I gained back 25 pounds and it shows.

I think most any surgeon would still operate if you wanted them too but better to be at an ideal weight first. BMI is a bunch of hokey. I've lost 300 pounds and am still considered morbidly obese so you can tell what I think.

Good luck,

I'm 5'7", too. My highest weight was 339 and I had my lbl/bl when I was at 140 (BMI=22). I had been maintaining my weight for about 18 months at that point. I think most surgeons want you to be maintaining your weight for a certain amount of time. A small loss or gain can really mess up your results.

Good luck in your journey!!

Laura

PS I will add I had my arms done as soon as I got to goal. They bugged the bejeezus out of me!! 

I started out as a SMO person.  I had my first round of ps after the 200lbs loss due to back issues and mobility.  I returned to do my face due to sleep apnea related to the excess skin occulding my nares while I slept on my side.  It was bad.  I plan to not return for the rest of my surgery until I am at goal.  I paid cash for my ps so I was able to get it done when I had to - my insurance wouldn't pay for any of it.

I wish I could have waited.  I will pay twice what others paid and my result suffered due to further weight loss, but my mobility improved and I know longer had any back issues.  They were all resolved.

Some ps won't operate if your BMI is greater than 30 since the complication risk increases.

A few thoughts --

I had one consult where the Plastic Surgeon said that he would not do surgery (in most cases) on anyone whose BMI was above 30 --- not sure where yours is

If you have plastics and then lose more weight, you may not be satisfied with your end results and may want/need to revise.  Depending on your budget, that may force your decision.

I was self-pay (for my WLS and for my plastics), so I decided to wait until I got to within 20 pounds of my goal for my arms/breasts.  My surgeon and I agreed at that time that the additional weight was not going to come from my arms/breasts.

I waited until I was almost 1 year at goal before I had my tummy tuck.

Ask your Bariatric surgeon for some referrals (or your local WLS support group if you have one) and go in for some consults -- they are usually free or very inexpensive --- and you can get alot of insight from meeting with a plastic surgeon at this point -- and seeing what they think.

Thank you for the very helpful replies!  So it sounds like being at goal and staying at goal for a good while are important, unless I have mobility or other issues with the excess skin... right?

Just to clarify, I am feeling no where near ready for PS right now.  My worry was that my goal was to get to 200 pounds, which is still considered overweight  but coming from 360 and lifelong obesity it sounds pretty good.   I wasn't sure if a surgeon would even consider someone with such a high BMI.  My current BMI is 40 and when I get to my (yeah, arbitrary) goal of 200 it will be 32.

It's hard to know where, exactly, my weight will end up.  But it is very apparant that I'll have lots of extra skin since I already have a good amount now.  My arms are what I am most self-conscious about.  This will sounds silly, but I never thought about spacing out the procedures.  Maybe starting with the one that gives me the most greif (arms) and then waiting a while on the other issues.

When you all say that gaining or losing a little weight can really mess up your results, can you give me an idea of what that means?  Would an additional 10 pound loss, for example, "undo" a tummy tuck?

Is it a good idea to look for a  consult once a reach goal, or should I wait and make sure my weight is stable for at least several months before scheduling.  Because my goal is 200, but maybe my body keep losing after that.  I'm not sure.  The goal number is pretty much just pulled out of thin air, ya know! ;)

Thanks again for your great replies. 

I think a lot depends on your PS and your build.  I'm still about 17 lbs. from goal at 5'4" and am having a face/neck/brow lift later this week.  PS said even losing an additional 25 lbs. wouldn't make a difference there and no reason to wait. 

I had my first consult with this PS when I was at 180.  At that time he wanted me to keep trying to lose at a minimum until my year anniversary before doing any body work.  When I saw him last week for my pre-op on the face, he said I'm now small enough to do the body work as well, although we agreed to wait until late fall (past my anniversary + doing a marathon).  It sounded, though, like being 15 lbs or so above goal would not be a big deal, and that losing an additional 10-15 lbs. after surgery would be okay.  This is consistent with a second PS with whom I consulted as well.  I wil say that I saw before/after photos at my PS's office with height / weight, and ladies at similar height /weight whose bodies look like mine looked spectacular afterwards.  The ladies who were 20-30 lbs more than me...not so much...definitely improved, but not as wonderful as the ones who were a little lighter prior to surgery.  I also had a 3-4" wide diastasis recti from when I had my twins, so skin aside, I know the muscle work is going to make a huge difference.

Thank you, Chana! That was very helpful!!

Good luck with your PS this week. I'm looking forward to hearing your update - particuarly if you are pleased with your neck lift results!.