Complication rates with Plastic surgery after WLS and what questions should I ask surgeon?

I am looking into having plastic surgery possibly for removal of excess skin. I had WLS sleeve surgery over a year a ago and have been at my own personal weight goal for 3 months now. I have an plastic consult appointment this Monday with a plastic surgeon that my WLS program referred me to from their Bari Plastics. The more I read about plastics the more I worry. I worry about drains and complication rates. It scares me now.  Any information you can give me would be great!

I am making a list of questions to ask the Plastic surgeon at my appointment on Monday.  For those that have underwent Plastics after WLS what questions should I ask.

I will probably have to pay out of pocket for all expenses since my health insurance will not cover it and I have no rashes due to excess skin.   I don't know if I will ever have any work done but I want to find out more information about it.
My upper arms bother me the most. I have worked out alot and have muscle definition and lift weights but the bat wings are still there. Would like to also get tummy tuck, boobs done, butt lifted and upper thighs done too at some point.  

Thanks in advance!

You need to ask about other WLS patients that the PS has worked on, ask to see before and after pics.  You want someone with quite a bit of experience working on post MO patients.  Our skin has been abused by the years of gaining/losing weight.  It's not the same for someone going in for a little mommy me makeover.

If you want to read about several people's experience with Dr Sauceda, click on Dr Sauceda in my siggy line and it'll take you over to our group.  I think there are 3 ladies down in Monterrey now.  If you go back several pages, I fully documented my visit in Jan 2011  when I had most of my body work done and a full neck and facelift, then went back in Jan 2013 for my upper body lift. 

1. You may want to get the book that my surgeon, Dr. Capella, and two other plastic surgeons wrote, Body Contouring Surgery after Weight Loss. It states that many of the surgical procedures performed on the massive weight loss patient are complex and labor-intensive, and that the wide spectrum of body contour deformities that can follow massive weight-loss often exceed the magnitude of what plastic surgeons have traditionally addressed. The book helped me to understand why weight-loss surgery (WLS) patients need to work with a surgeon who specializes in bariatric plastic surgery, as well as other important criteria to consider. I believe that you can get it on the Barnes & Noble site for a few dollars.

Also, Dr. Lomonaco, a plastic surgeon who is active on this forum and whom I respect as a surgeon but have not had any work done by, also wrote a book on bariatric plastic surgery. I have not read it but you may want to check it out.

2. Easy rapport with and access to the surgeon post-op is vital to your safety and well-being. What protocols does the plastic surgeon have in place to provide this much needed level of support? 

3. It is important that the surgeon have board certification by the American Board of Plastic Surgery. Also find out what hospital s/he has admitting privileges at. Better yet, have your surgery performed in the hospital rather than a surgical center - do you really want to be rushed by ambulance to a hospital to be transfused? If you do opt for a surgical center, make sure that they are accredited by AAAASF. Understand that the surgeon who performs in the hospital setting will have to meet the strict criteria of the hospital and is only allowed to perform specific procedures. That is not necessarily true in a surgical center.

4. Review the credentials and certifications of the rest of the surgical team, especially the anesthesiologist who will literally be breathing for you during your operAtion.

I say go for it! I am thrilled with my new body.

Thanks for the replies. My appointment is today at 3pm.  The plastic surgeon I am seeing is experienced with working on post op WLS people and familiar with huge weight loss/loose skin issues after WLS.  I will ask how many people he has worked on that were Post WLS and how many years. He is accredited through many plastic surgery organizations also.  There is a Bari Plastics group through my WLS group that they refer people to post op after they have maintained their goal weight and have done other specific things through the WLS program then the person is team approved to be referred to the Bari Plastics program.  It is for people whose insurance won't cover plastics and will have to pay out of pocket for the surgeries.  They give you a discounted rate and a 23 hour hospital stay is included along with surgeon fees, hospital fees, atheistic fees and all that stuff is in the price. If you have to stay longer than 23 hours at the hospital there is an additional $450 fee per day for that.    I have a 4 page list of questions I have typed up and taking to the appointment today.    They will only combo 2 surgeries at one time and will only keep you sedated for up to 5 hours at the most also.   My upper arms bother me the most and boobs so maybe do those as a combo?  Then do tummy and upper thighs?  I have a saggy butt too and would like that worked on too.   The major issue is paying for it!  Did any one use Care credit or some other type of financing?   I know for this Bari Plastics program you have to pay the fees in full up front also.  I will have them contact my insurance co to see if they might pay for any but I doubt it.  I have a new insurance co since my employer decided to go with a different carrier starting July 1, 2013. I don't have the all the paper work still saying what they will and won't cover. I have called United Health Care 7 times now and ask for them to send out the big book of inclusions and exclusions but I haven't received it yet. 

Have you checked your employers website or the UHG website for the inclusions/exclusions? Please let ne know what you find out because I have UHG. I am planning to submit my bill after the fact just in case they cover something. 

That is a great price on the hospital stay. Mine is more than $1000. 

It is common to do boobs and arms combo.

You cannot do inner thighs and tummy at the same time because they pull the skin in different directions. You can do a LBL which will address the outer thighs, buttocks, and tummy.

Let us know how you made out at your appointment today!!!

I don't think they will pay anything for plastics since it is considered cosmetic. Even the plastic surgeon said most insurance companies will not pay if it isn't medical and even then with rashes and documented stuff the insurance companies don't usually pay.  

I just posted a new message with all my notes from the plastic surgeon consult yesterday.
I am now leaning having upper arms and tummy done at the same time as my first combo surgery but not for sure if they would combo those two.  I thought if I only had one surgery what are the two things that bother me the most and it is my upper arms and 2 rolls of loose skin on my tummy. A bra can hold the saggy boobs up and clothes hide my wrinkled saggy butt and upper thigh area so I am going to see if arms and tummy can be combo'd.

Good luck! That is a very common surgery combination with the plastic surgeon that I use.