PS Consultation and I have a few questions.

Hello everyone!  I am 11 months out from VSG and have lost 114 pounds.  I still have at least 30 pounds to lose but I scheduled a consultation with a reconstructive plastic surgeon because I wanted a professional opinion about how much more weight I need to lose before plastic surgery.  I know they give you numbers for your height and weight, but I wanted someone to look at my body and tell me where I should be.  In my opinion, I should probably lose more then 30 pounds because I still have a lot of fat in my stomach.  I have seen a lot of pictures and most people honestly just have skin with a little fat.  To my surprise the doctor said I don't need to lose any more weight at all.  I am completely shocked.  He said the part below my belly button will be completely removed and  the rest will be stretched down so most of it would be removed anyway.  All I have heard from vets is to get to goal before plastic surgery.  I would love to PM pictures to people so they can give me their opinion.  My second issue is that I need tummy, boobs and arms but this surgeon wants to stage these procedures.  He said being under for too long is more of a risk, which I understand.  I told him I was looking for one procedure, one recovery and to move forward with my life.  Also, I am a single mom of 2 kids (ages 7 and 3) and I can't miss that much time from work.  Also there is the financial aspect of paying for 2 hospital, anesthesia and whatever other charges there will be.  Insurance is going to cover my panni and breast reduction, but I will be paying for my arms.  Also, I have an inverted nipple that he said he could fix and the insurance would cover it as well.  He wants to schedule the panni at the end of next month and boobs later.  This surgeon is a reconstructive plastic surgeon.  He does have great experience with post bariatric people so I am comfortable with his skill, but I'm not sure I want 2 plastic surgeries.  I have seen so many people go in for "the works" and he can't do 3 procedures at once?!?  What I want to know from your experience is: how honestly important is it to get to goal before plastics and do you think panni/boobs and arms can be done as one procedure? 

My doc wouldn't do all at once either (I have seen on here that some docs do, but the norm is that they won't).  My doc explained that the skin would be pulling in opposite directions (boobs pull the skin up, the TT or LBL pulls it down)  which can cause skin healing issues.   Also, with ab surgery, your other body parts need to help compensate for your muscles there.  For instance, I had to really use my legs to get up and down off chairs as well as push off with my arms.  So I can see that if I had done my arms at the same time as my LBL, I would have had a problem.  

I had a belly below my belly button and a muffin top above.  Also saddlebags on each hip.  Those are all gone now.  I had 10lbs of skin and another 3lbs of lipo.  It is totally amazing how much difference it has made in my body shape. 

 

Thank you for your feedback.  I appreciate it  Honestly even if I have to have each procedure done separately and this next step take a lot of time, I will just be so grateful to live without the skin and fat. 

I live in Israel but am an avid reader on this Board and Dr.Sauceda from Mexico.
I had my Panni in Israel under my HMO with appeal and a year later my boobs also with appeal and I am fighting for my thighs and dog-ears on my boobs which even for that the head Plastics of my HMO if all of Israel is giving me a very hard time.
That being said, from what I have read, most PS will operate up to six hours anesthesia and I think only Dr.Sauceda does a twilight anesthesia so one can actually have more procedures done at one time. If I had money I would definitely travel to Mexico from all the wonderful things I have read about him!
I unfortunately have had complication after each of my surgeries. But I wouldn't trade the experience of the flat tummy or smaller boobs!
Good luck on your continued journey to a better body and with whatever you choose.
Mikimi in Israel

Thank you for your feedback.  I wish more doctors in the states used twilight sedation.  I would honestly feel way more comfortable not being put all the way under for many surgeries.  I also have a hard time with anesthesia so that would be incredibly amazing to not have to deal with.  I plan to use Dr. Sauceda for the procedures my insurance does not cover in 2015.  I think he is a very skilled surgeon and have been impressed with the results people have had.  Good luck with your insurance victories!

Is it poss to get panni/boobs/arms at once- yes, but I believe the ps must be VERY experienced. Do you need to get to goal? Depends on how you are calculating "goal". (Also consider that most, if not all, of the best, most experienced bariatric ps do not take insurance- they will submit paperwork, but you pay them and then ins reimburses you. Remember, if the dr is very experienced, he has enough customers and doesn't need to deal with ins. All of the dr on my ins only wanted to do 1 procedure at a time, and then have me come back to do the other procedures. I found that if a dr takes ins, he may not feel comfortable doing many procedures at once because he may not have enough experience dealing with each separately) I felt it was worth it to pay much more out of pocket and have combined surgeries, with a more experienced dr.

I used a well known post bariatric plastic surgeon.He has a team he always works with and does several body contouring procedures a month. He did breast lift, arms, flanks, lbl and tightening with lipo - surgery time about 6 hrs. I am very happy with the results so far (only a few weeks out), but the recovery is a pain. If I were a single mom, with a 3 & 7 yr old I would wait to get surgery until the kids were older, unless you have MORE than one source of VERY reliable help. You will not be able to drive for about 2 wks, no laundry or lifting for many weeks, you will be tired, and the first wk or 2, you will need percocet, so you can not be chasing kids or holding them - you will need to focus on you- and you will be constipated. I cooked and froze high protein food, but think about who is going to reach up and microwave them? I bought a lift chair, had a walker, toliet seat riser, etc and I still needed help showering for at least the first 4 or 5 times. Who is going to help you and bathe the 3 yr old? If you do not take it easy, you will not heal properly. I say, if in doubt wait.  Wait until you are really ready.   I wish you THE BEST, whatever you decide.

also, I will still need additional ps to deal with my neck/face and thighs. So you can't really get one surgery and be done with it anyway. 

PS-. Why do you think you need to lose 30 more? Was that your weight as a teenager or on a chart? If so, don't believe it. Although, skin and fat may not weigh much, your body is very distorted after such massive weight loss, when the skin & fat is removed, your contours will greatly change. After pregnancy, my body "dropped"- the muscle tightening along with the rest, really restored my body.

Thank you for your feedback!!!  I sent you a PM

I had a LBL, BL, arms and small groin thigh lift at one time.  Dr Sauceda uses an epidural and twilight sedation for the longer surgeries.  I was in surgery almost 12 hours.  I have before and after pics in Dr Sauceda's group photo section.  You can click on Dr Sauceda in my siggy line and it'll take you over to group.  Do a friend request and I'll send you the password.  I had a huge muffin top that Dr S lipo'd before the LBL.  It no longer sticks out further than my boobs.

Thanks for the reply!  I am a member of Dr. Sauceda's group and think the man is amazing!  I am going to use him for whatever procedures my insurance won't cover in 2015.  I sent you a friend request and appreciate you sharing your pictures with me, it is so helpful but hard to ask for!

I sent you a link and password.  I think it helps so much to see before and after pics especially those folks who have the same body type.  I was definitely an apple and carried all my weight in my upper body.  I had a huge muffin top and thought I'd need the anchor cut, but Dr Sauceda was able to lipo and pull down with just the LBL.  I did go back and get the upper body lift last Jan.