As many of you know, I often speak at bariatric support groups in New York and New Jersey. One thing that never fails to amaze me, is how many people are surprised at the body changes after bariatric surgery. Many people had no idea that the skin may remain after weight loss and that needing (wanting) plastic surgery is extremely common.

Patients are much more educated now about PS after weight loss - through support groups that sponsor plastic surgeons, through websites like this one, and in speaking with their bariatric surgeons.

There is always room for improvement - especially on the "pre-op" side, so that you know that the weight loss may not always be the end of your journey.

I am interested to hear your thoughts about the way in which you were educated about plastic surgery (or not educated), and whether this occurred before or after your band procedure. This will help me be able to better educate people about this subject.

I know it's a possibility AND my doctor has mentioned it. He even said they would take pictures and work with a PS and insurance to see that it's covered!! (if possible)

Knowing my insurance, probably not, as I was self-pay for the whole procedure anyway! I'm actually hoping I get sores and skin problems so insurance will pay for it... I imagine I will as I have the apron (it's going away now) but I always have to care for that area a lot or I would get very sore rashes before the surgery.

When I lose the weight, if the apron is still there, I will just do what I can to get the surgery. I would love a flat tummy, thin thighs and perky boobs!

i was told not to even consider it until 2 years post banding and that it maynotbe necessary. some people are lucky and skin moudls to new shape, ifound that quite unbelievable.

It's not that unbelievable. When I was younger, my skin always retracted when I lost weight. Maybe not 100%, but enough not to need PS.

However, I'm a lot older now and, at this point, good genes and a lower starting BMI aren't enough.

I really don't understand why all these doctors are saying to wait two years though. I think that's excessive. IME, by 6 months, my skin had retracted as much as it was going to.

We have a PS come to our seminar/support groups periodically and he said you just have to be "metabolically stable" -- which for a bypass or sleeve would be 3-6 months of stable weight and for a lap-bander would be any time. (But they still recommend 3-6 months at a stable weight for bandsters.)

A PS I saw for a consult said the same thing.

My surgeon doesn't have a set talk he gives during the seminars. He hands out info about the four surgeries they do and then takes questions. So sometimes PS comes up and sometimes it doesn't. One time it came up, he said about 1/3 of their practice ends up getting PS. He added that doesn't mean 1/3 need it. Some people chose not to have it even with a lot of excess skin and some chose to have it even with just a little.

I knew I would need it because I needed it pre-op. I really need a breast reduction -- I have a lot of problems with back pain and shoulder pain and now I can't buy bras because the stores assume if you are a 36 in the band, you can't big bigger than a C cup or maybe a D. I did find some 36 DDDs at Macy's, but really I should be in a 36 G.

The only reason I haven't gotten one before is that I was afraid that if I did and then lost weight, I'd be too small.

I'm not sure I "need" the tt. As a 50+ year old woman, I have no desire to have the body of a 25 year old, but I do have a big poof of skin above the waist that hangs down and a pannus below the waist and these are not getting much smaller even as I lose more weight. I already have trouble with my pants being saggy in the butt in order to fit over the rolls in the stomach area. So I suspect I'll get something done about that as well.

Besides, I already have scars in the same places as are placed for a bi-directional TT so, if I do it, I'll actually end up with better scars than I started with. :thumbup:

My bariatric doctor and their staff at the orientations mentioned this several times. They provide referrals upon request too.

After seeing Dr. 90210, I was totally wanting to have my girls lifted prior to even considering having WLS.

Once I hit my goal weight, I am getting the girls back up north where they are suppose to be. :confused:

I think the 2 year wait is a good idea for other reasons than to see what the skin does though.

I know for me, I went through a period where I was obsessing about everything. Take weight out of the equation and my dissatisfication with other things came to the fore, I obsessed over my boobs, over my nasolabial lines, over the dark circles under my eyes, over getting my teeth whitened, heck even over permanent eyeliner?

You know what? 18 months down the track, I dont really want ANY of it. It has taken me a long time to come to terms with being normal weight, with not needing to change. I might get a breast lift, I might not. I could certainly use some liposuction on the last residual pockets of fat. But I'm much more interested in paying school fees and buying a new house at the moment. Its not that I wont do these things or that I'm against them, not at all. But I needed a fair while to settle, to really decide on what truly bothers me, what I think NEEDS to be fixed, and to accept that I'm 41 and cant look 25 again.

but even the one thing I swore I'd do - a breast lift, I dont feel the need to do now. My boobs have shrunk even more to a nice C cup, and even though they're wrecked, yes, they can now be fitted into even a small bikini top, they're saggy unbound, but dont sag in such clothes, becuase they dont weigh much now, require little support to look OK, etc. I need one to look good naked, but who besides DH and I are going to see me naked anyway? I had to run in an ordinary bra yesterday, both my sports bras were in the wash and WOW, I dont even need a super duper feat of engineering bra to run in now. An ordinary one was fine! All that has changed with NO change in weight.

For me, PS wasnt a financial option at this particular point in time. But if it had been I think I would have done a few things I'd now be maybe not regretting but certainly didnt need to waste money on. Waiting has been a good thing for me.

Edited January 27, 200917 yr by Jachut

I brought it up at my surgery consult, my surgeon sort of dismissed it as, let's get through this first... I am really concerned with the sagging skin issue, he didn't seem to view it as a big deal.

I brought it up at my surgery consult, my surgeon sort of dismissed it as, let's get through this first... I am really concerned with the sagging skin issue, he didn't seem to view it as a big deal.

He does have a point to a certain extent.. i mean think about ti.. it is a lot healthier to cary around some extra folds of skin rather than carry around all the excess weight!! but still he should warn you about the possibilities

I'm not yet banded but here's something to boggle your minds:

I lost 80 pounds on my own. over 2 years. I still had 60 to go. my skin (thighs, tummy and boobs) were already starting to show clear signs of needing to be tightened up.

My INSURANCE will NOT cover PS if I lose weight on my own. IT WILL cover PS if I have WLS (of any kind) and my sagging skin is a direct result of WL due to a procedure THEY paid for.

I was below 40 BMI when I noted the sagging skin. I've gained 40 pounds and now I'm eligible for WLS again.

Yes I'm having it and yes I will be having PS as soon as I can get that.....

I'm not yet banded but here's something to boggle your minds:

I lost 80 pounds on my own. over 2 years. I still had 60 to go. my skin (thighs, tummy and boobs) were already starting to show clear signs of needing to be tightened up.

My INSURANCE will NOT cover PS if I lose weight on my own. IT WILL cover PS if I have WLS (of any kind) and my sagging skin is a direct result of WL due to a procedure THEY paid for.

I was below 40 BMI when I noted the sagging skin. I've gained 40 pounds and now I'm eligible for WLS again.

Yes I'm having it and yes I will be having PS as soon as I can get that.....

Lucky you.... i just found out my insurance wont approve the procedure!!!!!!!

I was informed when I went for the psychological evaluation prior to my wls surgery when the psycologist asked how I would feel about it. I have been overweight my whole life and now, 35 pounds down, am already seeing that my skin is not going to bounce back, so I'm all for it!!

I also found out, via my bariatric surgeon, that he can and is helping document the rashes and painful shoulders in an effort to help get insurance to approve it. Further, he said he usually plans to be in the OR when I have ps to replace the port with a low rise port and move the port to where he can get to it for fills. He is super supportive and a strong advocate of after care and support group!!

hi

common-sense wise....i knew about the extra skin before surgery. i actually took this as a challenge and worked my butt off (exercise-wise) to avoid PS.

well low and behold.....the exercising definitely helped.....but not to the point where i felt comfortable.

i'm 16 days post PS. i did it 2 years and 2 months after lapband.

my main concern was a tummy tuck. so while i was doing that i decided to get "the girls" lifted. i LOVE, LOVE, LOVE my boobs. and this was a surprise since i wasnt so concerned about them beforehand.

in fact when i was still on the post-op drugs...i was showing everyone ha! i'm normally a shy irish girl.

josie

My surgeon told me on my first visit that I could expect to have redundant skin, that I might want to consider plastic surgery, and that it is not a covered benefit (Kaiser). I started putting extra $ aside each check before surgery, assuming that after 3 c-sections and 130 lb. weight loss, I would need some work! I am actually suprised that I don't have as much skin as I thought I would.:eek:

I went to several seminars and it was usually never mentioned. The surgeon I chose only touched on it briefly. She showed a picture of one of her patients and said he was hooked on plastic surgery now that he has lost so much weight and that he has had PS numerous times. That was about it. I would have thought that sagging skin would have been a subject that would have been discussed more.

I have not yet been banded, but the possible need for plastic surgery was mentioned briefly at the info seminar I recently attended. The surgeon indicated that they are happy to refer to excellent plastic surgeons in the area who he'd trust with his own family.

That said, I was researching plastic surgeons well before WLS was even a glimmer in my eye. I've long known that, should I reach my weight loss goal, everything is going to need to be put back where it belongs!

I hope that careful documentation of skin integrity issues, as well as pain (neck/shoulder from pendulous breasts, lumbar from pannus) will help offset some of the cost of repair, but am prepared to pay, if necessary. (Well, not PREPARED prepared, but will save for the procedures.)

Isn't it cool that we can emerge from this life-saving process, like butterflies from a cocoon, and claim a new life?!

Ten months since surgery and down 90 pounds. Thinking about the possibility of PS in the future, but hoping to limit the need as much as possible. It was touched on at the beginning but I didn't bring up a lot of questions myself. :bored:

Ten months since surgery and down 90 pounds. Thinking about the possibility of PS in the future, but hoping to limit the need as much as possible. It was touched on at the beginning but I didn't bring up a lot of questions myself. :bored: