"Specialty Plastic Surgeon" too far?

[sillykitty 10,787]

I think the fact the office didn’t return my calls would concern me the most

As far as distance, well it takes 2 hrs to go 40 miles here. Any surgeon I’m considering is at 1+ hour away. So I obviously wouldn’t consider the distance a deal breaker.

I also want the absolute best results possible. PS is a huge amount of money & pain along with time off and down time. There is no way I’m going to go through all that and have any regrets about the results. That’s not something I’m willing to compromise on

[RickM 1,753]

1 hour ago, mousecat88 said:

I am scheduling the arm lift at 13 months post-op. Very end of November. Not scheduling a consult until September. I am not having insurance involved so there's no required waiting period. I am only having it if I meet my goal weight.

It isn't really an insurance thing, as few of us get any insurance coverage for PS, but rather the time it takes for the body to stabilize. Once the weightloss stops, fat and musculature shift around some and the skin can shrink back some as things adjust to the new you, which is why most PS advise waiting up to a year (at least 6 months) after reaching ones goal weight.

Around the time that I reached goal, I started working with a personal trainer along with my wife, and rolling around on a mat doing stretches and exercises, I could feel the skin on my back folding up; a year later it wasn't noticeable - either I had adapted my moves to avoid it, or things had tightened up some (likely a bit of both.) Likewise, around the same time I had new seats for my racecar fitted to me (they're supposed to be snug) but a year later, my butt was loose in it, though my weight hadn't changed, so things had certainly moved around. This is another of those tradeoff things, but may well be one of those things that is second nature to a WLS specialized PS that may not occur to a more general PS. Again, talk to him about it and see what he says - it may or may not be a big deal in your particular circumstance. It may also still be worth the effort to get a consult with the less convenient specialist PS to get his view on your situation, even if you don't intend to go with him.

[mousecat88 2,281]

2 hours ago, RickM said:

It may also still be worth the effort to get a consult with the less convenient specialist PS to get his view on your situation, even if you don't intend to go with him.

I was willing to consult with him, except he didn't return my calls - I feel like there's something wrong with a patient having to chase down a doctor. Like, I'm paying YOU tens of thousands of dollars and you're the guy that's supposed to look out for me pre- and post. Answer the phone?

I have been working with a trainer pretty hardcore starting at 4 months post-op. I talked to him about the skin issue - if I lost more weight after reaching my personal goal. He thinks that since, especially by 13 months, I will have built up significant muscle on my arms that even if I did the arm lift at 13 months if I lost anymore weight, any loose skin would easily snap back, rather than droop. And even if it did, I am not opposed to revisional plastics down the line if it bothers me THAT much. My bariatric office knows I plan on plastics by the end of the year and they are okay with it, since I have exceeded their expectations thus far. Something I will certainly discuss with my plastic surgeon regardless, obviously.

I'm going to consult end of August/September and if I don't get a good feeling or am not 100% confident, I will continue to pursue other options. There is a second "specialist" surgeon my office recommended that is 3 hours away, but they are in the mountains and it would be impossible to reach them during any inclement weather, so that ones pretty much out of my thoughts. I also don't trust the hospital system they are with. At least the 2 hour away guy is in the same hospital system as my local plastic surgeon. I don't know - things to consider in the next few months.

When I had Lipo in 2009 I lived in Baltimore. It was 11k worth of lipo on virtually every part of my body (it shouldn't have even been done). I got very, very ill and had to stay with my mother, two hours away from Baltimore. I had to see the plastic surgeon twice a week because of how sick I was and the four-hour roundtrip was horrific and painful to make. In 2017 I had a breast reduction and my nipple starting rotting off! Thankfully my surgeon was local and I could see him right away and he identified that it was an allergy to Neosporin and I was able to see him quite often and it saved the graft. That's why I have such a preference for someone very close to me. You just never know what insane thing could happen.

Edited June 11, 2019 by mousecat88

[mousecat88 2,281]

Thank you all for your opinions! I am taking this all very seriously, given my history of disasters, lol. I will grill my plastic surgeon and if I am not comfortable, I won't jump the gun. I didn't go through all this to have the end result be a mess. None of us did!

[Stella S 613]

Mousecat distance is huge But also consider where the surgeon has hospital rights. My PS office is in Bethesda and procedure in DC If complications are a concern then perhaps the office is the more important location. Also being able to get in touch have your phone calls returned feel confident that this is going to be done correctly is huge!!!!! My PS does WLS - it is his thing. PM for details. Good to see someone from the area.

[mousecat88 2,281]

Mousecat distance is huge But also consider where the surgeon has hospital rights. My PS office is in Bethesda and procedure in DC If complications are a concern then perhaps the office is the more important location. Also being able to get in touch have your phone calls returned feel confident that this is going to be done correctly is huge!!!!! My PS does WLS - it is his thing. PM for details. Good to see someone from the area.

Unfortunately Bethesda is the same distance as the guy I was referred to. His office is in Fairfax and he is with Inova. My plastic surgeon here is also with Inova Health System, but in Winchester VA... not the Fairfax location.

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[mousecat88 2,281]

I meant to clarify... the plastic surgeon and the hospital are both in Winchester. His office is like 5 minutes from the hospital.

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[mousecat88 2,281]

PS. I was born in Silver Spring and raised in Bowie. Hi! lol!

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[Stella S 613]

Check any before and after for the breast PS regarding patients with WLS A whole ton of vein work and neurological considerations in skin removal. That said I feel tummy tucks and breasts are a PS bread and butter. ANOVA and Sibley are the 2 places I consider for hospitals. Not familiar with WV at all. A note - it is important to me to have 24 hr access to the office and not be sent to an ER. Also I have sent my doctor pics to learn if my concern is justified. And ha - hubby hails from Pointer Ridge.

[mousecat88 2,281]

1 hour ago, Stella S said:

And ha - hubby hails from Pointer Ridge.

OMG me too! I went to Pointer Ridge Elementary! lmao. My dad still lives there.

[Taoz 284]

At 13 months post op and close to goal, I've also started looking into skin removal surgery. It took several months to get in for an appointment with the local specialist plastic surgeon I am keen to go with here, and their waiting list for surgery is 6 months plus.. so I didn't want to wait until after I have been weight stable 6 months before even starting to get the ball rolling. He previously specialised mostly in breast surgery, but in recent years has become really sought after for his fantastic post-weight-loss skin removal surgeries.

If you have short windows of opportunity for surgery dates, and are keen on a well sought after surgeon then give yourself plenty of time to plan your operations.

I have lost 52kg (115lb) and would love to lose up to another 9kg (20lb) to make it all the way down to "normal" BMI, however I have a fair bit of loose skin on belly, butt, upper arms and inner thighs, and my poor once very large boobs are now mostly deflated skin So I'm not sure how much more I really have to lose beyond the skin... I have a lot of upper ribs showing on my chest already at 69kg (152lb) and 157cm (5'2")

[ms.sss 15,814]

12 minutes ago, Taoz said:

If you have short windows of opportunity for surgery dates, and are keen on a well sought after surgeon then give yourself plenty of time to plan your operations.

This.

I am 7.5 months out today, and had my consult with one of those well sought after surgeons almost a month ago.

By the time my scheduled surgery comes around I will be 14 months post-op. It would have been at 17 months post-op, but I got lucky and got placed on a newly opened date.

[mousecat88 2,281]

4 hours ago, ms.sss said:

This.

I am 7.5 months out today, and had my consult with one of those well sought after surgeons almost a month ago.

By the time my scheduled surgery comes around I will be 14 months post-op. It would have been at 17 months post-op, but I got lucky and got placed on a newly opened date.

I've been in touch with my plastic surgeon of choice and they said if I want the last week of November to consult beginning of September. I told them it HAS to be November 20-22nd and they said that's no issue. There's never really a wait period, fortunately. It's just getting the pre-op testing done in between. I am going to go in August anyways. The last week in November is the ONLY week I can do it until like... September 2020.

I should add I live in a fairly sparsely populated area and the demand for plastic surgery isn't like how it probably is in a metropolitan area. When he did my breast reduction I had the consult one month and the surgery the next.

Edited June 17, 2019 by mousecat88

[mousecat88 2,281]

I did call a bunch of other surgeon's in a 50 mile radius of my house and NOT A SINGLE ONE did arm lifts! They ALL just do boob jobs and Lipo and facial stuff. Very weird. And several of the receptionist "never heard of" insurance for a Tummy Tuck and I explained I had gastric bypass and they said "they don't *do* that"... although I probably have less skin on my tummy than someone who gave birth once. Unless he says something totally absurd, I feel good about seeing my guy again.

[Stella S 613]

Rethinking this thread WLS PS patients present so much more vein and neurological considerations Some procedures have conplication rates up to 75 percent. I want my specialist.