starting stuff - names of surgery/types - timing/when to start, order - any cost advice?

I did bypass 15 months ago and lost about half my weight. I'm at average BMI and really happy with my body for 5 months now. 23.3 BMI Flappy skin better than fat but I'm not normal even though I'm normal weight, finally! So, can my peeps please help with some basics? No one plans to fail but I think it's honest to say we all fear it. I'm cautious and vigilant now but it's also very new. I walk almost two hours, six days a week. I can function with the skin and hide it well except with Significant Other and swimming. We aren't rich so this is a nice to have and we will not be buying a car and giving up other things to make this happen, but we have enough that we can pay.

1. How do you know if I should even have plastic surgery?
2. How do you know when to have surgery?
3. Words/names: What are the usual surgery names? I think I want to fix my thighs and my butt needs to move up two feet. Bat wings are a maybe. Hospital + recovery times interest me too.
4. Costs: Any ballpark costs for some of these surgeries? I know they vary but it's like saying a car varies. Sure, but tell me $25000 for a new cheap car. some guideline?
5. Insurance:I was told Kaiser Colorado covers no plastic surgery period ever except as required by federal law. Do some people get coverage? I can wait and pick the right one.
6. Pain!:With RNY, I can't have pain meds right? Well, tylenol. What do you do?
7. Medical Tourism: Any places, doctors to avoid? Bad outcomes? State the obvious. I like travel but I care about the anesthesia and the surgeon.

Hi there

I'm sitting at home recovering so I have time to reply lol.

I think it first depends on where you are from to help determine what's covered. I'm from Canada so here, in Ontario specifically, sometimes it will be covered (Pannilectomy) but that is just removing the "apron" with no contouring or muscle repair. It also depends on the size of the panni (part of the stomach that hangs down) and if there are medical reasons for it's removal (rash, infection, etc).

1. You will know if you want/need plastic surgery. No one can answer this question for you in my opinion. Speaking with surgeon's about what bothers you and what you want and what they can do with the outcome will help you decide. It's important to be realistic about your expectations but a good surgeon will explain all of that. Asking these questions and research is a great start!
2. Most surgeons (in my experience) want you to be at a stable weight for 6 months to 1 year min. Hopefully at your goal weight.
3. There are many thigh lifts (medial thigh lift, etc), bracioplasty (I think this is the arm lift/bat wing removal) and then there is the lower body lift (lower belt lipectomy) that's what I just had done. It cuts you all the way around your mid section below the bikini line and pulls everything up (this helps the butt lift and thighs) and pulls everything down (helps with saggy stomach skin and tightens the back and sides) plus muscle repair (stitching the muscles together to tighten them). I had this done at a plastic surgery clinic - 2 surgeons, 1 anthesiologist and many nurses. I didn't do it at a hospital. My surgery was about 3+ hours and I stayed at the clinic overnight and went home the next morning.
4. This procedure cost me approx $19,000 (CAD) I also had fat transfer to my butt included in this cost. No part of my surgery was covered, I had to pay myself.
5. I'm from Canada - can't comment on this, sorry
6. I also had RNY almost 2 years ago. Make sure you go to a plastic surgeon who has a lot of experience dealing with WLS patients. Mine does and won't prescribe NSAIDS but I was given pain killers/narcotics.
7. I see a lot of people go to Mexico and there may even be a page dedicated to this but I'm not certain.

Good luck with your journey!

Nikita,

Thank you for replying to the original poster. I never thought about item #6 and it totally makes sense.

Whenever I wind up in the ER, you can see the freak out factor in their eyes once I mention GB.

Haha! I know right :)

How do you know if I should even have plastic surgery?

Very few people need plastic surgery. Those I'd put on the need spectrum are those who can't control rubbing and skin infections from overhang or those who can't do what they want to do in life because of the extra skin. But I think even if yiu don't have those issues it can still go a very long way to helping with mentally feeling whole again after the damage from obesity.

How do you know when to have surgery?

My PS says once you are at a stable weight for 3 months you can consider it.

Words/names: What are the usual surgery names? I think I want to fix my thighs and my butt needs to move up two feet. Bat wings are a maybe. Hospital + recovery times interest me too.

Lower body lift/360 body lift/circumferential lift are synonymous. You're cut all the way around the middle the excess is removed and the edges are sown back together with a lifted rear/hips and a flattened stomach. Many also have their abdominal muscles sewn tight too and some will do some kind of butt improvement with auto augmentation (using your own tissue to enhance projection) or fat transfer.

Brachioplasty: bat wing repair

Breast lift with or without augmentation bepending on your preference and existing tissue

Liposuction of various areas

Torsoplasty/upper body lift: can remove skin from the upper back, sides

Thigh lift: medial thigh lift cuts longitudinally down your thighs to remove excess skin. Crescent thigh lift cuts where your thighs join your body and pulls up

Costs: Any ballpark costs for some of these surgeries? I know they vary but it's like saying a car varies. Sure, but tell me $25000 for a new cheap car. some guideline?

Varies by location. Mexico is an option and cheaper than the US. It also varies based on how much time will be needed for your operation - more damage to repair = longer op = more $$.

Insurance:I was told Kaiser Colorado covers no plastic surgery period ever except as required by federal law. Do some people get coverage? I can wait and pick the right one.

It's pretty rare to get insurance help. Like lotto winning rare.

Pain!:With RNY, I can't have pain meds right? Well, tylenol. What do you do?

You can't have NSAIDS. There are lots of prescription pain relievers that aren't NSAIDS. That's said, I was looking at something that that lists the pain level for various operations and the lower body lift was "severe". Upper body stuff is more manageable I hear.

Medical Tourism: Any places, doctors to avoid? Bad outcomes? State the obvious. I like travel but I care about the anesthesia and the surgeon.

Mexico has some good surgeons. Research is important!

Do check out Realself.com. There some great info on there as well as surgeon reviews.

1. Having PS is a very personal choice. Some people feel strongly about having it and some people feel very strongly about not having it. I personally always knew I would have it.
2. My surgeon said I should be as close to goal as possible and weight stable for 3-6 months. I was at goal for 7 months and weight stable for 4 months before my surgery.
3. I had a Lower Body Lift (LBL) with auto-augmentation that is a combination of a butt lift, medial thigh lift, and tummy tuck. The augmentation means he used my existing tissue (that is already attached to a blood supply) to augment the top portion of my butt. I also had a Breast Lift (Mastopexy or BL) without implants with fat transfer. This lifted my breasts back to a natural position and added a small amount of volume with fat tissue from the skin he removed.
4. I paid $26,000 for my procedures and I went to an expensive surgeon, but he specializes in WL patients so it was 100% worth it.
5. Nothing of mine was covered by insurance.
6. The pain was no joke for the first few days, but after that it was manageable. It's a slow recovery with a pretty high risk of (minor) complications like small wound openings and seromas. I was given Oxy and Valium. I took the Oxy for 4 days and the Valium I took in some capacity for a month (with the last 3 weeks only being before bed and then eventually even few nights before bed).
7. I have no useful comment on medical tourism.

Hiya :)

I recommend scheduling a consult with a surgeon who has experience with those of us who have lost large amounts of weight. Possibly more than one.

1. I can only tell you how I knew. I knew because my excess skin was making exercise annoying and I didn't want to deal with very compressive compression gear all the time.
2. Again, I can only tell you for myself. I knew because I loved my body and would be happy to stay the weight I was for forever. I also figured that the weight I had left to lose wouldn't make a huge difference and that I might need to have revision down the road. I accepted that. The timing for how it fit into my life was good for me.
3. I've never found a "real" name for the thigh lift beyond thigh lift. Arms are called "brachioplasty." I hate the term "bat wings." Like.. could we be more insulting to our bodies? :( The butt lift normally happens with a procedure called the "lower body lift."
   1. My surgeries were lower body lift + brachioplasty, upper body lift + mastopexy, and leg lift. I was in the hospital for one night after the first surgery and went home the same day for the others. Recovery times were 2 weeks of **** and the another 4 weeks of no exercise.
4. My surgeries were 6-8000 per procedure, with the lower body lift counting as two.
5. My insurance covered NOTHING. It's often determined by the employer.
6. I had oxycodone and valium post-op.
7. I recommend traveling to Washington DC for surgery with Dr. Michaels.

Yes, you can have pain meds - just no NSAIDS. Oxy, valium, tylenol.

How about some minor facial cosmetic surgery? did anyone here try that and what did you do for recovery and eveyrthing? I am scheduled to have surgery next week.

You may want to post a separate, new post for this. I know several people have had facial plastics, but I'm not sure they'll see your post at the end of this older one!