Serious Body Image Issues - Post-Op LBL

I need to share what's tearing me apart right now before I implode. I feel like only my WLS friends can understand this struggle.  

You might know my less then stellar lower body lift issues (if not, pics in my profile).  I feel like my surgeon totally failed me.  I have excess skin that actually hangs over my pants when I sit as well as a myriad of other positions.  I'm so unbelievably unhappy with my results and he doesn't even GET IT.  Now I just got an "explanation of benefits not a bill" form from my insurance saying that they are only covering $10k of the $31k hospital bill.  To see that I might end up owing $20,840 after this result, I am in a very dark body issue hole along with some sprinkling of financial doom.  

I already suffer from depression.  I had been fat my entire life.  I've always had a huge belly.  But to come so far and this is what I get.  I STILL CAN'T show off my belly.  I'm 35.  I thought that for once in my life, I'd look and feel normal.  I can't honestly live with these results and I don't have the money to fix it.   I'm not sure what to do.  It's consuming me.  I'm strictly focused on it.  Every time I think about my new stomach, I cry.  I feel like I had one shot at this and he blew it.  He ruined it.

I'm sorry if you think I'm overreacting.  I trusted him.  I trusted his work.  It's not something that can be fixed anymore.  I just don't know how to accept this.  I don't know how to see the good.  At least I could faithfully hate my old belly, it was a result of myself, my food choices, my weight, my loss.  

This is actually the first post I have ever posted at this site, and I've been reading this website for about 8 years (I was finally able to get my surgery this year).  I say that because I want you to know how much your post moved me.  My heart goes out to you that you have not gotten the result that you have worked so hard for and really want.  I know that things look bleak for you right now - I wanted to share what I see from the outside looking in.  I see someone who is very beautiful, although I know all you can focus on is what is left of your stomach, the difference with before and after is truly amazing!  I'm not going to sugar coat it and say that your doctor did everything he could to give you the best result, I don't think he did.  What I do want you to know is that may of us who are still losing the weight are green with envy with what your body looks like now.  You are also fairly early out of plastics and everything I've read says that things change and can get better over time, they may not, but it also be your mind that changes as well.  Don't despair! 

As far as the insurance portion, many times when I've gotten an EOB (explanation of benefits) the insurance company doesn't pay even close to what they are billed, they pay a negotiated rate, but that doesn't necessarily mean you will be left holding the rest of the amount. I would check with your insurance what your maximum out of pocket is and what to expect to have to pay for your portion of the bill.  I sincerely hope that's not the case for you!

I don't think you are overreacting, I think you are reacting to something that strongly affects many of us (our relationship with our bodies).  You might consider talking with a therapist about what you are going through to see if talking about it will help as well?  I wish you the best of luck I'm sending skin tightening, healing thoughts your way!

Jessica,

it it must have been a shock to get that letter. Especially on top of your disappointment. Please take a moment to reflect on your journey. You are in so much better shape and we are our own worst critics. As for the insurance letter don't pani****il you have checked with them or get an actual bill. My wls     bill to insurance was huge compared to the amount they paid.  I sure hope you come out of this on top. In the meantime don't be so hard on yourself. Everything will work out. It's a long but worthy road. 

Terry

I totally understand your feelings and can relate to so much of what you have said. I had my gastric bypass almost four years ago, and I have so struggled with similar feelings of disappointment and resentment, for slightly different reasons. At my highest I was 412 lbs, and 392 lbs and in my early 30s on my day of surgery. In the first 18 months, I only lost 130lbs, which is an incredibly slow rate of loss for someone at that starting weight. I tracked every calorie. I worked out six days a week, for multiple hours a day. I obsessed, stressed over it, and cried. The bariatric coordinator at my surgeon’s office said I did exactly what I was supposed to do, more than any other patient they had ever had, but no one could explain why I wasn’t losing more weight. I often avoided going to support group meetings and stopped reading the OH website, because I couldn’****ch everyone around me lose more weight than I had any longer. On top of that, I had some mild unexplained health issues before my weight loss surgery, and they started to get much worse. It’s a very long story, but after two years of being shuffled around to many doctors and tests and being told I was crazy, I found out that I have celiac’s disease and an allergy to whey. All that “healthy” food that I was eating was actually what was making me sick, and what was most likely slowing my weight loss. I was devastated – I felt like I had one chance to have WLS, once chance to lose this weight, and had any one of the doctors for many, many years listened to what I was saying, I could have had these health issues under control BEFORE I had gastric bypass, and not had to struggle so much.

I was angry for a long time, but things started to turn around for me after a conversation with another woman at my WLS support group meeting. I was sharing with her what I said above, and I remember telling her how I did yoga, water aerobics, spinning, and kickboxing every week, but I was still so disappointed with my weight loss. She said, “Wow! You can do all that? My biggest goal is to be able to get up off the floor without help”. It hit me - I was so focused on my disappointment about what I couldn’t do, I never had the chance to appreciate what I could do and how far I had come.

Since getting my health a little more under control, I have been able to take off a few more pounds. I have also had three expensive, painful plastic surgeries, with many ups and downs, including a LBL, and two surgeries just for my thighs. On top of not ending up any where near my goal weight, I had a tremendous amount of excess skin - one doctor told me I had enough skin for three people (I have pictures on my profile). While I am very happy with my lower body lift, my thighs are still quite loose and dimpled. My surgeon did the best she could, but because I still carry quite a bit of excess weight in my thighs, and they just don't look good. I was very disappointed at first. Two surgeries, $13k, and months of recovery just for my thighs, and I can't even wear shorts.

I am having an arm lift on Sept 3rd and my doctor gave me the option of revising my thigh lift at the same time, which would require re-cutting almost the entire length of the incisions. The thigh lift was such a difficult recovery and consumed so much mental energy, I actually decided not to do it, and just accept my thighs as they are for now. I can't wear shorts or a swim suit, but I can wear skirts and dresses without two layers of industrial strength spanx, my thighs look great in the tightest skinny jeans and yoga pants, I no longer have to pick up the extra skin and hold it out of the toilet as I pee, it no longer sets off the body scanner at the airport, and I can run for the first time in my life. Funny thing is, when I decided to accept my thighs, I actually started feeling better about my body as a whole. I have my arm lift all scheduled and I am so excited to finally be able to work out in a tank top. But a few weeks ago I was doing yoga outside in a park in a group class, and it was 95 degrees with killer humidity. I decided I was sick of waiting for my arm lift, so I took off my long sleeve shirt and did my yoga in my tank top with my bat wings flapping and armpits sagging out in public, in the busiest park in the city, in a class of 400 people. And no one even noticed...and I felt normal. Maybe you won't show off your belly in the traditional sense that you had originally imagined, but you can find a new sense of normal that involves not letting your feelings of disappointment prevent you from enjoying your success as the truly beautiful woman that you are (I looked at your profile - you are gorgeous!!). It's a process that has taken me time and I still have to work at, but it can be done :)

Hopefully some of that helps - Angela

OMG YES!!! SAME HERE. Lost nothing after weight loss surgery--NOTHING--not even on the liquid diet for three weeks...because guess what? Turns out I was allergic to dairy. Whey. You know, the protein in the liquid diet. That was likely a major factor in my 1) unexplained weight gain to begin with 2)inability to lose weight even with trainers, nutritionists, endocrinologists, etc. 3) allllll the other health issues (fatigue, eczema, chronic inflammation in digestive tract....the list goes on).

So two years after surgery, someone finally said, hey, i think you might be allergic to dairy. And I was. And once I eliminated all dairy from the diet, I dropped 80lbs. 

With all the doctors and tests you do to get prior approval for these surgeries, it boggles my mind why they don't test for food allergies and do elimination diets. Would have saved so much pain, heartache and money--not to mention my health.

Angela- I totally get what you mean about just getting frustrated with hating everything about your body and just TEARING that stupid shirt off and flaunting the bat wings! A few weeks ago I went to Zumba in a tank top and dance my butt off. My arms were flapping like I was about to take off and fly and I noticed that... NO ONE GAVE A CRAP! Haven't gotten to the point that I feel comfortable going sleeveless to work, but working out? TOTALLY.

I believe the eob is indicating what your insurance is going to consider payment in full for the procedure that you had.  Good for you that you got insurance to cover your procedure.  The hospital will bill a crazy amount of money for the procedure but the insurance company will pay a negotiated rate and unless you also have a deductible to pay, the remainder is adjusted off of the bill by the hospital.  So you shouldn't have to worry about that large amount of money. 

As far as your extra skin is concerned, and I haven't looked at your pictures, there has to be enough skin left so that you can stand and move around without stretching out what is left.  So as you bend and sit, you will see some extra skin - but that skin is used when you stand.  Now, if there is much more than that, well that is a different story.  Perhaps your surgeon feels that it is too close to the procedure to discuss revision yet.  If it were swelling, well that will go down, but the skin is not going to shrink.  So as you go through your post op visits with him, keep telling him how unhappy you are and that you want a revision.  They should be willing to revise you for a reduced fee - although you will still have to pay for the facility and anesthesia.  I'm curious how this will be handled since insurance covered the procedure - will they pick up the revision?  I guess one of the big decisions is do you want him to do the revision?  If after several attempts at getting him to understand, you can't get him there, I would consider someone else.  You deserve to get the procedure that you wanted unless he can offer a medical reason why it should not be done.  Unfortunately, that means another procedure to recover from.  I had to have some revisions along the way - in some instances they were because it was not good to do all of that work in one procedure, and in others it was little tweaks here and there.  But you have gone this far, don't give up on what you want.  I wish you luck.

I am so sorry you did not get the results you expected. I hope you can find a way to love and accept yourself "as-is". do you have a therapist you can talk to to help you through this?

My tummy looks better than I ever expected after plastic surgery. My thighs are still a hot mess. I have decided to leave them alone and worked on loving myself instead. This summer I am wearing a bikini, despite my legs. I am too old to care about what anyone else thinks about me anymore. That feeling is very freeing.

I hope you can find peace.

You should talk with your plastic surgeon and tell him your unhappiness about your results/bill. Also, have the office resubmit your claims. It may take time but you should be able to obtain results on all fronts!

Dr. Edward Jonas Domanskis is Certified by the American Board of Plastic Surgery 1441 Avocado Avenue, Suite 307 Newport Beach, California 92660 949.640-6324/1.888.234-5080(Ca) Website: http://www.surgery-plastic.com Assistant Clinical Professor of SurgeryWOS-Plastic,University of California (Irvine) Orange County’s Physician of Excellence/America’s Top Physicians/Top Doctors Plastic Surgery- 2005/2006/2007/2008/2009/2012 President,American Society of Bariatric Plastic Surgeons www.ASBPS.org

Non-Toxic, No Nanos Skin Care- www.ORGANODERM.com

 Scar Therapy-www.ScaRxtape.com

I understand and I too suffered for a while. I had the anchor but still have a roll when I sit, some of it is due to back skin and the skin around my bra area. You are  still early out and depression doe**** I am not a person who suffers from depression but after my PS I really struggled, I still do. I feel like you that I did all this and still do not feel normal or skinny. I am just over a year out from my PS and it is much better, and honestly as time goes your body adjusts, not perfectly but it has been easier to loose the 15lbs I still had one me (which then adds to the extra skin issue) and my skin appearance has improved, I feel like my circulation is better and overall I feel in better health.  It has been frustrating to yet again have to search for clothes that fit my new body but it does get better.

Yeah and like you my not WLS friends just done get it, to them I look amazing they dont understand the body issues I have.