Planning Ahead - Help

So this is soon I know.  I just had the sleeve a couple of weeks ago and know I need to do PS.  I made a deal with my huz that if I reach my goal weight and maintain for 6 months we will pay for PS.  I am trying to figure out the costs and have been reading that some of you get it covered by insurance.  I will loose about 100-110 on the sleeve and plan to get a tummy tuck and perhaps a breast lift without augmentation.  I hear that I probably need to deal with the chicken wing arms as well and so I'll probablydo  a  neck lift  also (I'm 40).   

Anyway - I'm just looking for advice for budgeting and also tricks for insurance (which I do not count on). 

You will likely need to be weight stable for one year before a plastic surgoen will do your procedures. Here is an article that will provide some of the answers you seek, and let you know what criteria to look for when selecting a board certified plastic surgeon: http://www.healthcentral.com/obesity/c/276918/162591/intervi ew-capella-plastic-1?ap=831

Are you sure that the advice to be weight stable for 1 year is still accurate?  

I consulted with 5 plastic surgeons regarding skin removal and three of them worked predominately with bariatric patients.  All three quoted a new study by the Mayo Clinic into long term (5 year) weight loss maintenance after bariatric surgery which compared those who don't have PS, those who wait a year, and those who have surgery right away when they hit their goal.  They found that those who have PS right away had much greater chance of long term weight maintenance, so all three doctors said they have adjusted their thinking and would prefer to do the surgery immediately after my goal weight was achieved.

I had the first part of my plastic surgery (TT/Mastopexy) at 10 months after RNY after losing 160 lbs total.

Wow, that is very interesting! Might you post the link to that study? I would love to read it. I am going by what my plastic surgeon told me, and I trust his clinical expertise as he has done more body contouring after massive weight loss than any other plastic surgeon in the nation. He has been doing this for 15 years, I believe... maybe more. Anyway, here is what he has to say about it. Your thoughts?

The ideal patient is somebody who is recovering in an uncomplicated fashion from the bariatric surgery. Or, if weight loss was not from bariatric surgery, somebody who has a diet that is well-balanced. And for both groups of patients, whose weight has been stable and is not in any way creating any metabolic imbalances. Ideally, the patient has not been smoking.

There’s a lot of discussion about when do you operate on post-bariatric patients? Their weight should be stable but they also should be metabolically balanced as shown by their laboratory studies. You want their studies to be normal; otherwise, that would suggest that they’re not eating a balanced diet and they’re still wasting. Clearly, somebody who’s not vomiting if they’ve had a band or some bariatric procedure.

I’ve operated on people who are as little as 12 months out — that’s about the earliest. Take for example a gastric bypass for a woman who may be only 70 lbs overweight — she’ll lose that weight very quickly. And if she’s metabolically stable, there’s not really a problem operating on her. You obviously don’t want to operate on somebody who’s actively still in the weight-loss process because then she’d have more loose skin afterward than she would have otherwise.

http://www.healthcentral.com/obesity/c/276918/162589/intervi ew-dr-joseph-capella?ap=831

I would love to post the link to the study, but none of the doctors provided the link, they just all described it independently, so I assumed it to be fact.  They said the results just came out within the last few months.  

The three plastic surgeons that mentioned the study were all specialists in post bariatric body contouring affiliated with Johns Hopkins.  The two plastic surgeons I had consultations with who did not specialize in post bariatric body contouring were quickly stricken from my list of potential doctors for my surgery.  I found that having consultations with a list of doctors made me realize how different they can be in both knowledge and bedside manner.  None charged me for the consultations.

I am just over 3 weeks out now and everything is going great.  No swelling anymore, and everything is healed.  I was surprised to find I was a size 8 prior to surgery, but a size 4 after surgery.  I am very happy so far with the appearance of the scars. I haven't had to take any muscle relaxers in over a week and I've been back at work for a week.  I see my plastic surgeon Monday for a check-up so I will see if he can provide a link if I remember to ask.  :)

Thanks so much, Lady. I will see if I can find the link. I would like to read the trial and maybe write an article on it. It sounds like your recovery is going amazingly well. But what surgery did you have 3 weeks ago? 

I have consulted with a number of plastic surgeons and agree with you that there is a wide variance in knowledge and bedside manner. Of all the surgeons I saw, one clearly stood out among the rest. 

Congratulations on your VSG surgery and welcome to the losers bench. I wish you luck and very est on your journey. I had two rounds of plastic surgeries (two rounds of panniculectomy). The first panniculectomy surgery that I had was done I also had a ventral hernia repaired at the same time. From that surgery 20 pounds of fat an skin had been removed. Two days later I needed two pints of blood because I was giving to much out in my JP Drains. From the second panniculectomy about 3 pounds of fat and skin had been removed. I did have a follow up with my plastic surgeon that I had this year want me to see him in two years once I have done a total knee replacement on my right knee and both hips. I still need another round plastic surgery around my chest area and my sides. I thing I found out from him that my insurance won't pay for my upper arms, also I have to find out if my insurance will pay for my thighs if not then I might at some point have to find a plastic surgeon (which I have found one already and by that time once I had my right knee and both hips done and a round {which will be my third one} and recoverfrom them and I hop that this plastic surgeon will still be there so I can see him/her so I can have my upper arms and thighs done at a reduced price out of pocket because I am on a fixed income). I don't like the way my bat/chicken wings and thighs look. I myself is on a budget, I also need som tricks for the insurance (same here in which I don't count on). I wish I can help you on any advice for plastice surgery, but the only thing I can say is that ask around if a plastic surgeon in your area can do a reduced price plastic surgery for you.

Congrats on an awesome weight loss!!!!!!!!!!!!!!!!!!

:-) ...thank you.