My bat wings

Hi all. I have lost almost 250lbs since I began my journey and my bat wings are making me crazy. It is so bad that I cannot wear a short sleeve shirt without the skin poking out of the bottom. They literally look like old wrinkly ********s. I originally told myself I would not do surgery, because I cannot afford it basically, but now I think I will have to. Honestly, I cannot even shave my armpits because when i raise my arm my armpit becomes a cavern. It is gross! Sorry for all the TMI :P 

Here are my questions:

1. When is a good time to get surgery, once you are in maintenance? after a certain amount of time? etc? 
2. Does it make sense to do arms and boobs at the same time, cost wise and pain wise? 
3. How badly does it hurt?

Thank you for your advice! 

You want to be at goal and stable weight for t least 6 months. would not want to go through ps then lose or gain.

I did arms with masteoplasty. pain wise managable. swelling and arm limitations the biggest isssue.certainly would d both together

If this skin is that extreme, are you having any problems that a doctor could document to try and get insurance to cover it? Rashes, pain, etc?

Cost wise it definitely makes sense to get both done together and it also eliminates the risk of having a "dog ear" or area where the skin doesn't taper smoothly from the scar under the arm eventually meeting the scar from the breasts if done separately.  The pain should be pretty manageable since you're already going to have one surgery to recover from, and the arms are worse anyway mainly just because of the limited range of motion.  Many people get arms and breasts done at the same time, so it's quite common.

Depending on your body and how much you have to lose, arms and even breasts might not change as much once the bulk of the weight is off.  If you're not done losing, you can always at least consult with a surgeon now and they'll be able to give you feedback on whether you really need to wait until you're done or not, and if you don't, what the impact would be if you lost more.

Go consult with several surgeons and get their opinion on whether you're ready or not.  I don't think minor weight fluctuations matter as much with the breasts and arms as with the tummy tuck, but surgeons might disagree.

I had both done at the same time.  Recovery-wise, it wasn't too bad.  As someone has said, doing them at the same time allows the surgeon to make one continuous line from breasts to elbow, so no dog ears.

The skin on your breasts and arms are different.  Breasts tend to heal and scars fade much faster than the arms and legs.  And you WILL have a scar on your arms -  but it sounds like you're willing to trade off the skin for the scar.

I was not exactly at 'goal' when I had plastic surgery, but I was not losing a lot 2-3lbs a month maybe. I actually reached goal the day of my first PS. I also lost weight after my surgeries- not that much from the skin but just from general post surgery eating less...'cause I just had surgery...

While I lost 220 from WLS my total Weight loss from the highest in my is probably more like 270lbs... so I had huge batwings too...it has been amazing having them done. What a difference.

I think having arms and breasts done at the same time was good- the suture line connects between the two through my armpit---so excess gets removed there too. Unexpected Bonus for me (although this doesn't necessarily always happen) is I no longer have underarm hair...no shaving required. Honestly this was the easiest of my recoveries. There was some suture line irritation between the industrial bra they give you and just general rubbing against each other between arm and side boob---- so I would use silicone scar tape just to protect certain areas, and it worked really well.

Combining surgeries does reduce cost. Your surgeon may charge the same fee but the Hospital OR time and anesthesia fees are reduced...as first hour in the OR is the most expensive.

Honestly I think the best thing to do is get a consult with a plastic surgeon... nobody thinks they are ready. I know you are in AZ but I still recommend my Doc in DC- he will do a free phone consult-you send pictures. I met a woman at OAC conference that traveled from Texas to use him. He did a phone consult with someone in Italy the same day as my phone consult...and they booked him too. Obviously you might not want to travel that far, but I highly recommend getting multiple consults- because even though it is the same surgery, each surgeon has a little different take on it, also go to someone who specializes in people with massive weight loss- It will make a great difference. The quality and the quantity of our skin is not the same....

I reached goal at 14 months out and had my arms done a month later. Mentally, I could not handle the old lady arms. The rest I could hide with shapewear. I figured even if I lost or gained more, my arms would not change much.

If cost is an issue, see if there are residency plastic surgery programs in your area. They are often a fraction of the cost. I know people here that used one and were very pleased.

Good luck! Plastics is the fun part!!

I know what you mean about the pain of bat wings.  I was afraid that if I feel asleep and lifted my arm over my head that I would sufficate from my bat wing. I only wore long or 3/4 sleeves.  I did not own any short sleeves.  There is a name for the armpit cave- it hallows for most people who lose alot of weight.  During the surgery, so much skin was removed that I have no underarm hair to shave anymore - all the hair follicles were removed with the skin.

Based on a recommendation from another OHer I had a consult wit Dr Joseph Michaels in the Washington DC area.  I had consults with other drs, but did go with Dr Michaels - he operates at a Johns Hopkins hospital and  I had such a horrible experience with facial PS, that I needed a reputable location.  He operates in their main operating surgical floor - not a outpatient facility. If needed, the hospital will keep you overnight - for $1000, but if you need it you need it.

He does phone consults based on photos you send him.  He specialized in our population when he was a resident, so he is no johhny come lately and understands how skin that has been stretched for years reacts.  If he saw your pictures, he could prob give you a good idea of when PS would be right for you.  It sounds as though you are about 200 pounds now - but the time could depend on your height and % body fat as well as your long term goals.  I had my first consult in December and my armlift surgery the following July, so you are getting close to being ready for your first consult.

I cannot tell you how great my arm lift/breast lift with fat aug went.  Really great - my pain was treated and I was tapering pain meds after a few days and off totally in 2 weeks.  My pain was never out of control (as opposed to my facial PS where my pain was at AGONY level for days and days). 

I had to sleep sitting up and I recommend that you get an electric recliner.  I got one from Craigslist for $40 and steamed cleaned it.  This was the best $40 I ever spent. 

I had gotten pretty close to my "goal" and my weight was stable for six months prior to surgery. I had a breast lift, arm lift, and lower body lift all at once. A skilled surgeon should be able to join multiple procedures.

The pain wasn't too bad actually, I was mostly just uncomfortable. It's hard to get around after having all of that done.

It will always be cheaper to do multiple procedures in a single surgery so that you don't have to pay separate OR costs. Sometimes the surgeons themselves will also give discounts to have more done at the same time.