PS for high BMI patients?

[lacroixje 1]

Hi all,

I'm new here and would really appreciate advice!

I had the Lap-Band back in 2003. I started out at 515lbs and my surgeon set a goal weight of 350 (expected weight loss for Lap-Band tends to be lower, but the surgery was the right choice for me because I was only 21 when I had it). Anyway, I got down to 295, which I maintained for about 10 years. Most recently I started losing again through food planning and exercise and am now at 279.

Lately I am really frustrated by all the sagging skin. It isn't causing infections or major mobility issues (thankfully), but I would really like to experience how my body moves (and looks) with less of the excess. I know some guidelines say a WLS should consider PS after they've lost 40% of their body weight or 100lbs. I've lost 46% of my full body weight, and 236lbs. The issue is that, because my original goal was so high, I have no idea what my target weight would be to make me a candidate for PS.

I'm mostly interested in a breast lift w small implant, removal of excess arm skin (which is a lot!). I'd also like a LBL or TT down the line, but there's still a good amount of belly fat, so I don't know if that would be an option for me.

I should say that the most beautiful part of this lap band journey for me has been letting go of the idea of ever being thin. I'm 6 feet tall and have a large skeletal frame, and I actually really like my body shape-- I'm just not a huge fan of all the sagging skin. For that reason, I don't really want to have to reach what the CDC recommends as a "healthy" weight for me (which is 136-184lbs) in order to get rid of the extra skin. I don't know that my body will ever reach that range, and I don't really feel like I need it to. I just want to be able to enjoy my body to the fullest now.

Has anyone with a very high starting weight had PS while in the 250lb weight range? And do you know of good surgeons in the NY, Philadelphia, or DC areas who are good with high BMI patients? Any insights welcome!

Many Thanks! Hope you're all having a great weekend!

J'amile

[OutsideMatchInside 10,166]

Most PS won't operate when you have a BMI over 32. It is too high risk.

You are going to get better results with a lower weight.

You are going to have to contact Dr's and ask for consultations. A Dr will decide how much is excess skin and if surgery is safe.

[lacroixje 1]

Thanks!

[Stella S 613]

Best in your journey.

[Nologoz 18]

I know this is an older post, but I think it deserves to be revived for others with the same question.

There are definitely times when a "higher than normal BMI" can have plastic surgery for loose skin. In my case, My high weight was 385lbs. I'm 5' 7".

When I had Tummy Tuck and brachioplasty a few months ago, I weighed about 220lbs (35 BMI)...still firmly in the "obese" category. They removed almost 9 lbs of skin during surgery.

The way I was told how it works with massive weight loss is that they want your weight stable...ideally for a year.

Ideally you should also be as close to goal as possible for the best results. Although I was still 40 lbs from my goal weight, I went ahead with the procedure. I don't regret it. Since recovering, I have found it easier to lose weight and feel great with my new silhouette.

Ask your bariatric doctor for a referral to a plastic surgeon who can handle "body reconstruction". If you have lost a massive amount of weight, it's not gonna be a simple "nip tuck". A reconstructive surgery is very different than the average plastic surgery.

[Wallflower7522 328]

I was really worried my plastic surgeon would be concerned about my weight but he didn’t seem to have an issue with it. My high weight was 340, my lowest weight was just under 200 and now I hover between 215-220 at 5’6 this still puts my BMI pretty high. But I’ve maintained my weight loss for over 4 years. I also have a larger build and a lot of muscle. I would say at least 10lbs of the weight I’ve gained back is muscle. I’ll be curious to see what he says when I go back for my 2nd consult, the first one was to try to get insurance approval.

[ssflbelle 829]

Congratulations on the weight loss. I don't know of any surgeons in your area. I know how hard the excess skin is to deal with but I would see if you can get closer to 200 before you seek out a Plastic Surgery Dr. Your recovery will probably be better. I waited until I had lost 280 pounds before I consulted with a PS. I went from 497 to 217 and had maintained that weight for about 6 months. Because of my 4 herinated disc and inability to walk without assistance the Dr was willing to do a breast reduction on me in June 2017. Sleeve presurgery breast measurement was 70 I. After losing 280 pounds I was a 48DDD. After breast reduction and recovery I am a 42 B.

Just this past March he did a Brachioplasty on me. This surgery was very difficult. I don't know if it was because of my current weight which is still 217 or maybe the Dr forgot to close up a blood vessel. They never told me what happened. I went from 21 inch upper arms to 15.5. However I am still swollen and only 2 1/2 weeks into recovery. Here is the posting on the last surgery I had.

He wants to wait a bit longer until Iget closer to my goal weight of 180 to do my tummy.

[lacroixje 1]

Thanks, Nologoz for reviving this post! And thanks everyone for weighing in.

Ssflbelle, thanks for sharing your story. I'm so sorry to hear you've had such a tough time, but I'm glad things are looking up.

I'm still in the researching stage. I consulted with a surgeon in Philadelphia who had no issues performing my PS, but the two procedures would be quite expensive. I'm planning to continue researching and getting the weight down even further while I figure out the money.

And, in the meantime, I've started working out twice a day and ran my first 5k! Will keep folks posted. Thanks again for sharing your experiences!