What do I have my pcp document that will help with getting rescontructive surgery

when I am at goal? I have my annual physical exam on Thursday. Would yall please help me with ideas of what to have my pcp document to assist in getting ps when I am done losing? I don't have rashes but I have huge amounts of hanging skin already at 10 months post op. My upper arms are bad but my upper thighs are worse. My panni is as huge as ever and seems to hang even lower now. I know some folks recommend "making" rashes before a doctor's appointment. I don't feel comfortable doing that but I know I will have to have ps surgery in two years after I am able to go from 423 to 140 pounds. I am open to any suggestions.

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