open RNY with panni removal

Please just make sure that you have talked to him and thoroughly understand the potential health/healing issues that may arise if you choose to do them at the same time (since your body will be taking in almost NO calories after the RNY, healing both incisions WILL be an issue).  Removing a large pannus on someone who is still SMO is pretty serious surgery.

As Lithia said, my original repsonse was NOT intended to put you down... but knowing that you weigh over 500 pounds instead of 300 pounds DOES make a difference in terms of how much sense it makes to even consider the risks of combining those two procedures.  It would be completely ridiculous, for example, for someone who is just over 200 pounds to even consider it.

Lora

Makes sense to me if you have a large panni already.  It will probably reduce your chances of post op infection if it is that large.  I'm sure it will be a painful recovery but not any more than another abdominal open procedure.

You may need another one or an abdominalplasty (tummy tuck) after you have lost your weight.

Best wishes.

I've seen it done.  The patient carried most of his weight in his abdomen, recovery was harder than just an open RNY but I think he moved around better.

You have to be diligent with your nutrition status post op, the above pt did not heal well as he "hated" all protein shakes, refused to take vitamins, laid there and ate crap all day.   I spent months packin his wounds and finally had him court committed as he had Kwashiorkor  (protien calorie malnutrition)  The crud he was eating came back out diarrhea and he wasn't getting up to go.  Ended up laying in his s@it all day, essentially starving to death while eating.

Anyway, long story short, it can be done but you have to follow ALL the rules to heal.

Pup 

I do not know anyone who has had it done.  I would not do both at the same time.  It's tough enough just recovering from the RNY alone.  I think you will lose weight quickly, even without the panni right now.  Why not wait until you lose 100 pounds are are truly ready to be more mobile?  Then you could always have more plastics after you get to your goal weight.

Laura

the surgeon said i will be in the hospital for 5 days and yes there will be a drain. not real sure about insicions yet he explained it to me but by then my mind was going a mile a minute and i cant remember what he said about it . i know he has done them before. but i still havent made up my mind yet ..

Is the same surgeon doing both procedures? Is the surgeon board certified in both bariatrics and plastic surgery? How many has he/she done?

Generally, when they remove a large apron of fat and skin while a person is still obese they do not worry about making it "pretty" (as a plastic surgeon would normally do) because there really ISN'T any way to make it "pretty"... the point is functional not cosmetic, so it doesn't really matter if it is a plastic surgeon who does the panniculectomy...  as long as the surgeon is capable of handling the various complications or healing issues that may come up if the two surgeries are combined.

Lora