Help....Anyone had a 2nd TT after a revision WLS?

Long story short, I had a TT and breast lift in 2008 after losing 100 lbs with Lap-Band and developed an umbilical hernia in 2009.  Had revision to RNY last year  with removal of Lap-Band, and am at the point where this hernia is getting bigger and causing me pain so I am going to need to get it fixed. 

Having had a "traditional" TT in 2008, and I believe a very conservative PS the 1st time around, I was never 100% happy with my results and still have a "muffin top" and dog ears on my hips.  So, if I have to get this dang hernia fixed, I am seriously considering getting a TT revision done at the same time to I don't know, I guess for lack of a better explanation, finish what the first surgeon started?  I guess I didn't understand it fully back then what to expect and I didn't realize that when a traditional TT was done that I would have to have a second surgery to "fix" my upper abdominal and flank areas.

My breasts are also too small so I am considering augmentation as well.  I'm not really worried about anything else, but if I had to choose, I want a flat stomach!!!!!!  THAT is more important to me than anything!!!!! 

So, any recommendations as I get ready to start this process looking for PS experienced with Bariatrics and PS revisions as well are much appreciated as well as any personal experiences!!! 

Thanks so much!!!! 

Also, I'm in DE, so anywhere on the East Coast is a benefit  but I AM WILLING TO TRAVEL to get the best results possible, I do NOT want to live through the disappointment I went through previously. . .though I do take the blame for that because I should have researched better but I was too blinded by the excitement of getting rid of my pannus and just couldn't see past that. . . .

Although I live in Israel Incan totally relate to your frustration and pain.
Your hernia will most likely be covered by your HMO so ask the surgeon whom he recommends as a PS to revise to work together with him and pay the difference to a real TT. But all HMO coverage is based on medical and not just our being unhappy with out results. Dog-ears are a known "complication" in Plastics and should be easy enough to correct however the muffin top might be more complex.
My HMO only covered apronectomy so my tummy is flat and I had a breast lift a year later so my breasts are boobies that look like half mangoes. But I have dog-ears on the sides I am fighting my HMO to cover the revision which would in my case be Day Surgery.
I wonder if after being so overweight all the years we were, if we will ever be totally satisfied with our end results...
Mikimi in Israel

Thanks, Mikimi 

I did have a "real" TT the first time around, and I have the 24-inch scar to prove it lol.  I just didn't realize that I should have had either a Fleur-de-lis TT or a LBL rather than just a straight, traditional TT. . .and I should have gone to a PS who was more experienced with Bariatric patients, but lesson learned and I AM happy that I don't have that huge pannus any longer so I won't say I am completely unhappy.  I am just not yet satisfied with my body yet though as you inferred, maybe we never will be because we got so used to being overweight and unhappy with ourselves. . .I guess that will be something determined over time!

My RNY surgeon actually now has a PS in his practice so my Bariatric surgeon could do my hernia repair and the group's PS could do the TT for me.  I am going to talk to their office about that tomorrow.  It would be a reduced cost as my HMO will cover the hernia repair so the fees for the anesthesia, OR time, etc will be reduced/prorated for the TT, but I am not familiar with him or his credentials so I will need to look into that.  I actually just found that out today when I e-mailed and asked if they refer out to any Plastic Surgeons in the area.  

Thanks again for the info!

As I reflect on life after WLS I realize that those of us needing and choosing PS seem to have a harder time.
We are unhappy with the saggy flabby rashy body we have and we set out on a GOAL to look better to feel physically better. Some of us have buyers remorse with pain and complications.
I had both, but not buyers remorse - just the wish for money to have been able to pay for more extended excess skin removal than what my HMO provided and without the fact that I have to fight for everything!
I don't think your TT was less of anything that complete however I think even with a fleur de lis or anchor, some if us still have the muffin top. Also your hernia sounds large and I am sure it very much distorts your abdominal appearance! And here in Israel I think all women having a TT after weight loss also get a mons lift.
Breast assymetry is common as is breast falling after a lift although I was told there are no guarantees on any of it. My boobs are wide and flat but not fallen yet the dog-ears are driving me batty!
Continue your research so you can get the best possible medical care for your body. Check carefully your HMO insurance as you might well be entitled to more than you realize.
We may not achieve perfection in our weight loss or Plastics - but most us will get and see vast improvement.
My insights are from what I have read on this Board and Dr.Sauceda and some of my personal experience. If I had money I would go to Dr.Sauceda.
Mikimi in Israel

I am nearing 4-mos post op from my TT and mons lift with Joseph Capella in Ramsey NJ. I wrote entensively about my experience with that here: http://www.healthcentral.com/obesity/c/276918/160586/bariatr ic-abdominoplasty-ch?ap=831 But if you want to read the phenomenal results I had you can start here: http://www.healthcentral.com/obesity/c/276918/162069/bariatr ic-wow-inches-months My results are even better today - I am in size 8 jeans after TT. Before TT my size 14s were tight.

If you friend me, you can see my TT before and after photos using the password "capella." He is going to do some revision work, as noted in my photo album, at no charge. He did an excellent job tightening my muscles without doing the anchor TT. I lost 8" off my waist and I don't have a scar running down my stomach.

I have searched high and low for a plastic surgeon. And I firmly believe that Dr. Capella does the best body work on post bariatric patients than any other surgeon, hands down. I love his boob jobs, LOL. His prices are also about the best around and his consults are free (in person or by phone). I've seen some of his revision work and he does a remarkable job.

Like you, I am out of state. He handled my aftercare via phone, text, and email. I will be traveling back to have more body work done with him. In fact, I have a second consult next week.

There are a few other patients on this board who will undoubtedly speak up about their plastic surgeons. I know one patient recommends her PS at UPenn and another *****commends her PS in VA and yet another who had work done in a residency program at Harvard I believe. Check them all out and see who feels like the right surgeon for you.

Good luck to you!

Thanks so much, I sent you a friend request!   I looked up Dr Capella, he is about 3 hrs from me, so that's not too bad.

See, I thought I was getting a mons lift with my TT and I so didn't and I am not happy with that area too, it's a bit prominent, which needs to be corrected.  I can't believe you lost 8" off your waist WITHOUT an anchor incision!!!!  I actually went from having a curvy, coke bottle figure to LOSING those most of those curves and having a much less defined waist, another thing I was unaware of and I was heartbroken over.  

I have significant scarring under my right breast from my breast lift and they took out too much tissue and even though I am a DD, my girls have "fallen" since my lift and all of the fullness is gone out of them which is why I am thinking about implants but I am not sure I can swing a TT and implants both.  I may have to do it separately which I would do if I had to.  I can live with my boobs the way they are.. . .I am really unhappy with my abdomen, especially with the hernia because it is uneven right to the side of my belly button and finding pants to fit is next to impossible!!!!!

Thanks so much for all of the info, I will definitely be checking out all of your links.  I do NOT want to go through this all again.  I had a rough recovery from my last TT so much so I swore I would NEVER put myself through anything like that again. . . but I am unhappy enough that here I am yet again ready for a do-over.  

Best of luck to you as well and I will be looking forward to seeing all of your pictures!!!!

Dr Sauceda in Monterrey Mexico is wonderful.  If possible he hand sews hernia's.  You can see pics of Levittown_Loser (Tom's) hernia in his pics.  Dr S fixed his hernia before doing his LBL.  I had a huge muffin top and he was able to lipo, then pull me flat for my LBL.  I also had a BL, arms and sm thigh lift at the same time. 

We have a group here on OH, click on Dr Sauceda in my siggy line.

Hi and thanks so much for the info!  

Wow, you really had a lot done at once, all I can say is oweeeee and I bet you look fabulous!!!!!!!  I will definitely check out his OH group, I have actually heard of him before, but I'm not sure where.  Maybe in my old Lap-Band life lol.  

Thanks again for the info! 

I had a hernia repaired about a year ago. I had gone to a plastic surgeon to discuss a revision to my Bariatric scar which was open surgery. He took one look at me and said I had a large hernia that needed to be repaired. The good news was that he is also a board certified general surgeon so he could do the repair and fix the scar. He did call in another surgeon for a consult but everything was handled via the plastic surgeons office. I didn't need a tummy tuck at the time but he is a very good plastic surgeon. He is very competent, capable, compassionate, and a great listener. We have spent much time discussing what I want done. He makes sure that we are on the same page and he will tell me if he doesn't think I will get a good result. He has done the hernia repair and a thigh lift along with some other smaller things. We are chatting now about the arms. I would highly recommend that you speak with him if you are willing to travel to PHILADELPHIA. His name is Stephen Kovach and he is with HUP. Prices are also reasonable.

JoAnn

Thank you JoAnn! 

Philly is only about 20 minutes away from me, so that would definitely be doable.  I will look him up.  Being a general surgeon and a Plastic Surgeon is definitely a plus in my situation!

Thanks so much for the information!