I'll make this as clear as I can, but it's a lot clearer in my head than it will be on "paper" -- methinks.

My skin is a joke. While I don't necessarily NEED plastic surgery, it's definitely my only option for something that resembles a human body. I have 40 - 50 pounds left to lose before I'm at my target BMI. When I look in the mirror, it looks to me like there's a lot more than 50 lbs of fat left to lose. This isn't just a distorted body image thing, I really do have a huge stomach, thighs, top part of my butt, etc.

I've been looking at various PS websites and a lot of the time when I see someone's "befores" I think -- wow, they're still pretty fat, I wonder why the surgeon didn't make them lose more weight first. Then they lose 11 lbs from surgery and are a sz 6.

When I see some of the befores in this forum, I think -- wow, they look kind of like I do, and I'm nowhere near ready for PS yet (in my own mind), I have too much weight to lose. (That's nothing against the pictures here, it's just my frame of reference). Yet the people have their surgeries and look great.

I guess I'm just surprised, because sometimes people still look pretty chubby -- like the pannus/abdomen/arms/whatever is still holding quite a bit of fat. I always thought that when I was ready for PS, I would look like a normal person who had a ton of completely flat/deflated skin litterally just hanging off me.

Here's an example of what I'm talking about. I see a lot of "after weightloss, before PS" pics that look like this (I don't know if this one is before or after the WLS, but let's use it as a representative): http://www.makemeheal.com/pictures/large/3443

To me, that person's before picture looks like they still have a good bit of weight to lose, and I see a lot of pics like that. Yes, the skin is loose and you can see it hanging, but it's not the utterly flat droopiness I associate with being ready for PS. It looks like there could still be a good bit of fat under the skin (I know some fat is removed too, but that's not the point). The after picture looks great.

Alternately, this is more the picture in my head of being ready for PS: http://www.makemeheal.com/pictures/large/227. You'll notice there's a huge difference in the "fullness/emptiness" of the skin.

So how did you guys know when it was time for your PS? Was it a matter of reaching some number the PS gave you as a target? Was it deciding on your own that you were ready, and if so, was there a particular "look" (droopy, etc.) that told you that you were ready?

I'm not ready for PS yet, but plan to have it. I think the person in the second picture might have lost more overall weight than the first person.

Maybe person 1 lost 60 pounds and person 2 lost 120 pounds. Not sure, just a guess looking at it.

It could also be a matter of where they carried more weight. For me, I doubt ( don;t expect) to get to a "normal" BMI. For my height, I'd have to be between 100 to 125 pounds to be "normal". Even as a young adult, I never weighed less than 128. so I will still be "chubby" when I get my PS. I will probably look more like photo 1 than photo 2, but I'll still consider myself ready for surgery.

And my thighs already look more like photo 2, so that's why I think it's where we carry more weight that matters.

Not sure, just my observation. So hard to make these decisions, isn't it?

I'm still trying to figure out what will be the biggest priority to fix.

I kind of look like an in between of both of those pics, I have a rounded tummy, but I also have the saggy droopiness of the stomach and hips that the second pic has. When I went to see the PS I asked him if I needed to lose more weight before he would do a body lift on me considering I may want to lose another 20 pounds or so. He said no, that he could pull every thing so tight and cut off a fair bit of the fat that was left so that if I did lose weight after everything wouldn't get loose again. He even sort of hinted at "why do all the hard work losing the weight when I can cut it off for you".

I think its possible that the woman in the first photo might have gotten her PS because her stomach and pannus was affecting her ability to exercise and live a "normal" life (like buying clothes and feeling good about her weight loss etc). Where as it looks like the second woman may never have been that overweight (she's not a WLS patient is she?) and might have had a couple of kids and wants things to look smooth again. They probably carried their weight differently and for different lengths of time as well.

I think you'll find that most PS will be flexible to help the patient, but you just have to be prepared for the kind of results you'll get at the stage of weight loss you're at when you get your PS. Pic one looks great, but I bet once pic 2 had lost her skin, she looked 20 years old and like a bikini model, it would have been more of a cosmetic procedure than a reconstructive one.

I thought the PS might laugh me out of his office when I went, but he was talking about booking me in for the following month! The only way you're really going to know what is possible is by actually talking with a PS about your expectations and what he is capable of giving you. Ask them to show you pics of someone in a similar situation to you that they've worked on. The PS I saw had pics of a doppelganger of me [same age, weight loss and before pics could have been me] and I was sold that he could do what I wanted.

I kind of look like an in between of both of those pics, I have a rounded tummy, but I also have the saggy droopiness of the stomach and hips that the second pic has. When I went to see the PS I asked him if I needed to lose more weight before he would do a body lift on me considering I may want to lose another 20 pounds or so. He said no, that he could pull every thing so tight and cut off a fair bit of the fat that was left so that if I did lose weight after everything wouldn't get loose again. He even sort of hinted at "why do all the hard work losing the weight when I can cut it off for you".

I think its possible that the woman in the first photo might have gotten her PS because her stomach and pannus was affecting her ability to exercise and live a "normal" life (like buying clothes and feeling good about her weight loss etc). Where as it looks like the second woman may never have been that overweight (she's not a WLS patient is she?) and might have had a couple of kids and wants things to look smooth again. They probably carried their weight differently and for different lengths of time as well.

I think you'll find that most PS will be flexible to help the patient, but you just have to be prepared for the kind of results you'll get at the stage of weight loss you're at when you get your PS. Pic one looks great, but I bet once pic 2 had lost her skin, she looked 20 years old and like a bikini model, it would have been more of a cosmetic procedure than a reconstructive one.

I thought the PS might laugh me out of his office when I went, but he was talking about booking me in for the following month! The only way you're really going to know what is possible is by actually talking with a PS about your expectations and what he is capable of giving you. Ask them to show you pics of someone in a similar situation to you that they've worked on. The PS I saw had pics of a doppelganger of me [same age, weight loss and before pics could have been me] and I was sold that he could do what I wanted.

Ditto. One reason that I've looked into PS so early is that I KNOW I want it when I get close to my goal weight. I've decided to go for it this fall (around mid-August, hopefully), and I've put it off to that point because I do want to get close to my goal weight before surgery because I'm also having my breasts lifted, and that's a surgery that can easily be ruined by losing too much weight post-surgery. I've promised myself that I'll call and schedule it the day I weigh myself and see 140 (140 is a BMI that is right inside the healthy weight range for my height).

I somewhat agree with what She Smiles' surgeon said, why work my ass off to completely lose the fat in an area that's just going to be cut off anyway? Sort of like, why pay to have the nasty carpet in a newly-bought house cleaned, if you're planning to immediately rip it up and replace it with hardwood before moving in, you know? And to be honest, a person that gets PS when they're still a bit from their goal weight can get results that are just as good or better than those of a person who was at goal. With tummy tucks, in particular, a patient can lose a significant amount of weight after the surgery and still have awesome results, so I don't really see the need to be "at goal" for that surgery. For breast surgeries, yes, but not that one.

im more the first pic (maybe even bigger).

my pics are here -

Plastic Surgery Pictures, Videos, Photos, Pics, Before, After, Cosmetic Surgery

i was 260ish when i had my tummy tuck.

why then?

a few key reasons...

1 - my body was TOTALLY disproportionate..

-chest - 38

-waist - 37

-HIPS (due to pannus) - 53

-thighs - 22

i was at the point where clothes just didnt fit. i had to wear a 20 stretch jeans due to my gut. they were droopy in the waist (im high waisted)

2 - intense exercising with my gut was damn near impossible...

running (my new addiction to replace food) at a fast pace (over 5-5.5 MPH) was impossible due to FLAP FLAP FLAP of the gut. i tried compression garments and they were just too warm/uncomfortable.

i couldnt even fit in one machine (abductor??)... gut wouldnt let me close my legs (talk about embarrassing with a trainer next to you ... :embaressed_smile:)

3 - everyday life

sure, getting down to play with my DD was easier after 150 pounds gone, but it was still such a pain in the ass...

sex ... hmm... when i was really fat (as opposed to just fat) the gut was more filled out and less 'jiggly'... almost like it was FILLED with the fat - squishy but a firm squishy ... with the loose skin and fat, extremely 'jiggly'

i would go somewhere (anywhere really) and people would finally look me in the eye (that doesnt happen when you are super morbidly obese like i was), but after a few seconds, their eyes would just wander down to my gut.. not a good experience... which led to...

depression was setting in. severe depression like before i started losing the weight. i got to the point where i didnt want to go anywhere (including working out)

having my tuck, even only 20 days out and sore and swollen as hell has already changed my life. yup, i know im going to have to have a revision, especially since i lowered my goal weight by 20 pounds. so what? this tuck is going to enable me to not only live my life, but work my ass off in order to get to goal quicker.

plus it didnt hurt finding the perfect PS for me...

no regrets ...

Good question Wheetsin and great responses. It's especially useful to see the pictures for comparison. I never had a flat stomach or nipped in waist - even at a normal weight. I am looking forward to it. It's a great motivator.

I always knew that I would have to have it done. I knew that the way I carried the majority of my weight would result in a trainwreck.

I got to my goal weight before having my tuck. I looked more like your second picture before, with a bit more droopiness. From behind I looked tiny. From the front I looked normal, but without my girdle and clothes I looked like this;

It was starting to cause real discomfort. I had fairly constant rashes and when the skin broke I would get infections. It was time from a medical standpoint.

I was "ready" in my mind many, many pounds before I actually did it. I hung out as long as I humanly could, and got down to goal. I am glad I did, because now, almost 2 years later, I am still flatter than flat.

I know I'm still almost 20 lbs from being in the normal BMI range but I'm actually happy with my size right now - that is without my stomach. My butt, back, legs all look normal and tight but as always I carry most of my weight in my stomach area. I dont' think that if I lose more weight after my tt that I'll need or want another or a revision. I think I'm close enough to goal that it'll look good. I'm not looking to wear bikinis, I'm just looking to fit and feel good in my clothes.

I also feel like the insurance company helped make my decision for me, if they feel like I'm close enough to be paying for this in full - hey, who am I to argue? :thumbdown: