Plastics Consult Update! (cross posted)

I got to my appointment at 1:45 which was when I was supposed to be there for new patient stuff. The doc came into my exam room at 2:15 which was when my appointment was and he spent a solid hour with me.

I feel really good about him. He's friendly, good sense of humor, in his 40s if I had to guess, not egotistical but definitely confident in a good way. Super knowledgeable, didn't talk down to me, etc, etc. All good impressions.

We talked for a bit, he asked questions about what I wanted, for some of his questions I just didn't know since I don't know what a normal body would look like or what is possible. But I told him this and he explained stuff.

Then we went to another room with a big mirror for all the poking and prodding. Sadly he didn't draw all over me with a marker - apparently that doesn't happen until immediately pre-op so he knows where to cut.

This part was chaperoned by his office assistant. She was also there to hear him talking about the procedures and order, so she could give me a workup of things afterward. I thought that was a nice arrangement! (And she was super and friendly and wonderful, which is important too.)

This wasn't as awkward as I thought it would be. He moved my skin around, and, the really important part, said that YES, my weight loss is awesome and I'm not fooling myself by thinking I'm ready for plastic surgery now. If I lose 10 more pounds pre-op that's great and no problem either, but yay!

The one question for timing and combinations of procedures was my breasts - I already knew that I did not want implants of any sort because they have time limits and I don't want to need plastic surgery every 15 years for the rest of my life :P But, thankfully, he thinks my breasts will be fine and proportional with just a lift. (The other option would have been to transfer fat from elsewhere in the body to my breasts, but he doesn't even think I'll need that since they've still got volume.. they're just droopy. I'm not going to apologize for TMI since, hey, it's a plastics post.)

So I'm looking at a number of procedures:

Lower Body Lift (This is a circumferential cut around my waist that pulls everything up and down, removes the panniculus which is the hanging skin at my tummy, outside of thighs get tightened too and stomach muscles get tightened. This also includes pubic lift.)

Arm Lift (This removes the excess skin from my upper arms.)

Breast Lift (What it sounds like - removes skin from my breasts to tighten/lift them.)

Upper Body Lift (This is the upper back, since I've got droopy excess skin on my back that will look worse after the Lower Body Lift. It's a circumferential cut about where my bra strap goes.)

Thigh Lift (This is the inside of my thigh - like the inseam and he'll see if he can do anything for my calves at the same time.)

Surgeries combine procedures based on time, since some of these are LONG, and tension direction from sutures. For example, Lower Body Lift and Thighs can't be done at the same time because the suturing pulls in opposite directions.

Sadly, I will need three surgeries for all of this. I knew that was a possibility, but I was hoping for two. This is sad because the first hour of surgery is the most expensive due to hospital fees, so only having two first hours is cheaper than having three first hours. However there is a repeat patient discount, yay.

He prefers 3 months between surgeries, but will go as soon as 2 depending on recovery.

My surgeries will be as follows:

1st surgery - Lower Body Lift and Arm Lift. This will be the longest surgery at ~11 hours. It's also the only one with a mandatory overnight stay.

2nd surgery - Breast Lift and Upper Body Lift.

3rd surgery - Thigh Lift and anything he might be able to do with my calves.

I will have drains for 2 weeks post-op for every operation and I'll need to wear compression garments as well. Follow-ups are one and two weeks post-op for each surgery.

I won't be able to do much but walk for about 6 weeks post-op. He thinks I'll have no problem resuming school at the 2-3 week mark. He said I'll be able to sing right away, but then said no "core work" so I think that non-singers just don't understand how much energy singing actually takes :P

I'll need pre-op stuff from my primary doctor - EKG, labs, physical, and a mammogram prior to the breast lift.

The price stuff. I was expecting 30-35k total for everything so I was a bit shocked when I got the quote for the first surgery. But it's the longest and most complicated, so it's significantly more than the others.

1st surgery = $25,400

2nd surgery = $9,000

3rd surgery = $8,000

So I'm looking at $42,000 total. Once I get back home this afternoon I'll be figuring out finances and then I'll talk to my mom this weekend and see what help she's able to give. (She has offered, but we were waiting to talk specifics until I knew them.)

I put $1500 down to reserve my surgery spot for the first surgery. And I know we've got enough in savings to pretty much cover the entirety of that first surgery. And, while I'd like to do these all in the 6-9 month period at the end of the year/beginning of next, I CAN space them out farther if I need to for financial reasons.

My first surgery is scheduled for June 5. I have my pre-op appointment scheduled with him for May 16. I figure the night before surgery I'll get a hotel room close to the hospital like I did for my VSG so I don't need to stress about traffic, etc. I've told the guys that I want one of them to be there for my entire hospital stay, but I don't care which one and they can tag team the time and they said they'd figure it out. It'll probably be two days of time to cover between the hotel the night before and then I assume I'll get released in the afternoon of the Tuesday.

I think this is all the information I can think of? It's a lot, I know.

After the appointment I had dinner at Silver Diner with my previously unmet OH friend and that was great since she's done all of this with Dr. Michaels herself and could talk to me about her experience. She actually did consults with many plastic surgeons and chose Michaels! Pretty cool :)  She is also totally awesome, and I'm so grateful she suggested we meet up so I had someone's brain to pick!  

I feel super positive. A little sticker shock at the price, but I look at this as an insurance policy. Studies have shown that people who have plastic surgery after massive weight loss have a much higher rate of maintaining their weight loss AND, seriously, after spending 42k on this you can bet I'm not going to want to waste that money by regaining weight!

The one thing I still need to ask about is what happens if there are complications post-op. Will insurance cover those? Like if I have an infection?

And that's about it! Ask any questions you have, I'll answer them to the best of my ability OR I'll know I have more things to ask the surgeon. :) 

If you made it this far - wow. You deserve a high protein/low carb cookie :D

Wow so amazing! I'm looking at just doing tummy skin. The rest I feel can wait... at least for me. 

I haven't started the process at all yet, just thinking about it at this point. i'm in Northern Ontario, so I have to account in travel time etc. and I'm a full time student. :)

I am also a full time student!  Fun and excitement :)  I'm hoping to get all of this done between finishing my AA and starting my BSes.  The plan is I'll do a really light course load during the first terms of my BSes that overlap with the plastics recovery.  

I'm not sure what AA or BSes is.... lol. I can't lighten my course load at all. I'm a nursing student and it's kind of all or nothing.

My hope is that part of it is covered at least. Lol... But I will have to wait likely because I don't know how to pay for it all, but I want an idea of what I should have done, and what I will need to save.

An AA is an Associates which is a 2-year degree.  A BS is a Bachelors which is a 4-year degree.  Basically I'm finishing up my first 2 years of college in May and will start in on my second 2 years in August.  

Ahh I get it now, always better to ask then guess. I'm doing BSCN. I'm in year 1 of 4, I have a ways to go yet.

Good progress.  Regarding if ins pays for complications,  Check your ins policy, some do cover them, even if the elective surgery was not covered,

I will be checking :)

GWEN!  This is so exciting!  I am so so so happy for you.  I am glad you were comfortable with Dr. Michaels and opted to go with him.  I know I sound like a broken record, but he is my guardian angel and I could not be more pleased with his work!  I honestly still marvel at my body in the mirror every morning (after peeing and weighing myself!  Gotta make sure I lose those 4 oz before getting on the scale!) and I am with you - having spent the money on my PS is kind of like an insurance policy.

So here is my feedback based on your post (and feel free to take it or leave it!):

1. Wait until after your lower body lift and arm lift to determine exactly what you still need.  I opted not to do thighs since the LBL really pulled my thighs up to an acceptable level - they are still wrinkly and won't ever look like a person's thighs who didn't lose massive amounts of weight, but I am willing to work with it and wear a bathing suit and forego the visible thigh scars.  You may find that you can live with your thighs after Dr. M's incredible LBL.  I, for one, was not planning on doing arms but then once my butt, stomach, mons, and breasts looked good, I knew I needed to do arms (which was a much less expensive outpatient procedure).
2. The same goes for the upper body lift.  I know some people are bothered by the "bra fat" bulge they have, but I found that with my breast lift and arm lift, I can live with the upper back fat.
3. My mom came with me to the hospital, was there hanging with me after the marker mark-up and before I was wheeled into the OR.  She then spent the 10+ hours hanging in the waiting room until I was out of the OR.  She came in and chatted with me for a bit, then took an uber home, and I didn't need her there overnight.  She came back the following morning.  I was perfectly fine hanging ou****ching tv, and enjoying the IV drugs ;)  So you may not need the guys there 24/7 - just an idea.

I am just so excited that you are taking this next step - for me, plastics was the end of this crazy journey and helps me to feel really comfortable, confident, and mentally healthy.  I am so happy for you that this time has come!  You are in excellent hands with Dr. Michaels!!!

I am SUPER excited!!  And I booked my second surgery date today - since that's how I roll apparently :D  That one will be breasts and UBL, I assume I can change that if I decide to after the LBL and arms.  But.. honestly I'd be surprised.  I've got crazy hanging stuff and I think my back will look worse after doing the LBL.  But I will definitely keep your words of wisdom in mind!  

Thanks for the info about having your mom there!  That's good to know.  I'll let them know that they can just tag team during surgery and come back to pick me up.  (I think I told them I'd want someone there for their sake... if you know what I mean.  I'll be fine.)  

I'm so freaking excited.  :D