Hi all,

Well, the scale started moving for me again since I decided to finish up and get my plastic surgery and be DONE with this journey :thumbup:

I'm looking to get PS in December and wanted to have my doc picked in a month or two so it's set, and I have a goal to work towards.

I've met with three PSes in the Philly area and am not sure if my expectations are out of whack.

One guy I liked; he had good before/after of bypass patients, he does a lot of breast lifts/augs and his pictures are beautiful... and although he says he has worked on lap band, he worried me when he made a comment about needing to be careful about not pulling down on my abdomen too much and popping the port off. It sounded like he never dealt with the band before. When I asked him later on if I would be the first Lap Band, he said nope. But I feel like I don't have enough information. I'm still gunshy with him...but out of the three I feel the most confident in his ability, his hospital affiliation, the work I've seen, and his bedside manner.

One doctor was a complete b*tch to me and I walked out of there offended and furious at the treatment I got, as if she looked down on me for being overweight in the first place.

So I thought to check with other doctors, there's a bunch in NY (where I was banded, and who Dr. Ren recommended) but everyone wants $250 just for the consult in NY, and with the cost of gas and driving, this is getting cost prohibitive just from a scouting perspective.

IF I'm going to go to NY for the surgery, I want to consult with the doctor I think can do it. I can't afford to blow $1k just to see who I like best. Well I can, but I am absolutely unwilling to. But these websites make me nervous. There's not enough variations in the people with the before/after. I want to see people with my body type, and the good/bad results, so I can be well informed about what I should *REALISTICALLY* expect.

I am normally not a fearful person, but I am inexplicably scared at picking the wrong PS when I'm self pay. I want to go under the knife knowing I did the best research I could.

I called four other PSes in Philly and when I asked if the doctor had experience with Lap Band, I got answers ranging from "The what?" to "Yes, he's done bypass patients." To which I would say "No, Lap Band. Has he worked with the port with the Lap Band". And she replied "Yes, like I just told you, he's done lots of bypass." It was like a Laurel and Hardy sketch.

Any suggestions?

Am I making too much out of the Lap Band part - if they have experience with weight loss patients, does it REALLY matter about Lap Band?

Sorry for the novel :thumbup:

Kate

Yep! The surgeon I chose was the most expensive of the three I consulted with, but not by much. And of my top two, she was the only one that offers Cosmet Assure insurance, so I think it evens out.

That's another good point. My doctor is also the only one of the docs I saw who includes the "just in case" insurance in his quotes. That gives me peace of mind if anything goes wrong.

That's another good point. My doctor is also the only one of the docs I saw who includes the "just in case" insurance in his quotes. That gives me peace of mind if anything goes wrong.

Hmmm that's the first I've heard of that. Can you elaborate?

The doctor buys an insurance policy to cover complications that would result in additional time in the hospital, i.e. you develop a blood clot, or something else serious that requires hospitalization. In most cases insurance that is not covering a cosmetic procedure will not cover any complications resulting from that procedure. Like all insurance, it just offers some assurance that you won't end up spending thousands of dollars on unexpected bills. I think it adds around an extra $200 to the cost of my lower body and medial thigh lift.

Well I am excited beyond words.

I buckled down and hunted down Plastic Surgeons in PA and Jersey who specialized in post bariatric body contouring. There's a lot of helpful, wonderful docs out there who gave me a referral, who gave me a referral.

I met the last PA doc last night and have two NJ guys in the next 2 weeks. I feel really good about thinking one of these three will be it.

So far, they all have kickass websites (lol, you know that's ridiculously important to me..but hey...it's what I wanted) and LOVELY work. Lots of pics, lots of body types.

The guy I met last night was Dr. David Bottger. I'm totally smitten with his bedside manner. First of all, when he examined me he zeroed in on the one thing I hate the MOST, and why I won't date, which is a chubby mons :confused_smile: He was about to talk about the abdominoplasty and he stopped and said "First of all, I'm going to fix this..." and I started hopping like a mental patient in delight.

"Oh God I am so happy you said that!"

"All I need to do is just lipo this, and I'll pull it up, merge it with the tuck incision...it'll be nice and flat and small."

I said, "Oh my god I'll have to start shaving my legs again"

He laughe and said "Yeah, this is pretty common, don't worry about it, I'm going to make you look great. This is..." he was poking at the mons

"Doc," I said. "I look like a DEWD!"

He sat back and gave a great belly laugh, that's when I started loving him. He was loling, I swear and said "Jeez you're right, you have this little package going on" and we just snickered to each other.

For some reason, we just bonded. He also told me a couple things I loved.

1. I have enough breast tissue to keep my D cups

2. I don't need a body lift - he says he really believes around back he can lipo hip and back and get rid of my bra rolls :tt1:

3. He said repeatedly I had a good tone on my butt and thighs. He said sure if I lift it a little it might smooth out even more, but I was very lucky that my weight centers mostly on my belly (ok one plus for being an apple shape) because now I don't need a huge scar.

4. He said my breast lift will also not require a long scar underneath, just a small one. omg.

He then showed me like 70 pictures of his work. He showed me girls with similar breasts and his work - OH MY GOD. He does gorgeous breasts! I was so freaking psyched.

We then talked about a second stage - arm lift and thigh lift. I asked him if he would do an arm lift at the same time and he said no way. "Those doctors on extreme makeover do way too much at once. I cold do it all, but you're already at 7 hours of surgery. I can hurry through your breast lift and tummy tuck, but I prefer to concentrate and do it right." PERFECT ANSWER. He was just - awesome. Friendly. That was the click I was looking for. And, his website rocks my socks. He said "Yeah I put a lot of pictures up so my patients can see all kinds of body types...they're looking for their own, anyway." DING DING DING

His staff told me that he's famous for his bedside manner, he calls patients personally post op, and he has a 1 year free revision (his costs, tho hospital and anesthesia are still charged) if I am unhappy.

The only way Dr. Bottger would be perfect is if he worked on ports. He says he had worked on some of Dr. Ren's lap band patients, and is familiar with the port...he said mine is very, very lateral and may not interfere with the sewing of the muscles. But if something did go awry, he does not replace ports. He says that's Dr. Ren's specialty, his is body contouring. I kind of respected that - he knows what he is good at. He said if I chose to go with him, he'd call Dr. Ren and get specifics on my band placement and make sure she was aware in case I needed a port replacement/lower profile etc.

So the only way these Jersey docs could top Dr. B for me is if they were cheaper and had lots of evidence of port replacement/experience.

Thank you guys sooooo much :tt1: I was really despairing. I wasn't sure I wanted to see Dr. Bottger and almost canceled. I'm so glad I went.

Well I am excited beyond words.

I buckled down and hunted down Plastic Surgeons in PA and Jersey who specialized in post bariatric body contouring. There's a lot of helpful, wonderful docs out there who gave me a referral, who gave me a referral.

I met the last PA doc last night and have two NJ guys in the next 2 weeks. I feel really good about thinking one of these three will be it.

So far, they all have kickass websites (lol, you know that's ridiculously important to me..but hey...it's what I wanted) and LOVELY work. Lots of pics, lots of body types.

The guy I met last night was Dr. David Bottger. I'm totally smitten with his bedside manner. First of all, when he examined me he zeroed in on the one thing I hate the MOST, and why I won't date, which is a chubby mons :rolleyes2: He was about to talk about the abdominoplasty and he stopped and said "First of all, I'm going to fix this..." and I started hopping like a mental patient in delight.

"Oh God I am so happy you said that!"

"All I need to do is just lipo this, and I'll pull it up, merge it with the tuck incision...it'll be nice and flat and small."

I said, "Oh my god I'll have to start shaving my legs again"

He laughe and said "Yeah, this is pretty common, don't worry about it, I'm going to make you look great. This is..." he was poking at the mons

"Doc," I said. "I look like a DEWD!"

He sat back and gave a great belly laugh, that's when I started loving him. He was loling, I swear and said "Jeez you're right, you have this little package going on" and we just snickered to each other.

For some reason, we just bonded. He also told me a couple things I loved.

1. I have enough breast tissue to keep my D cups

2. I don't need a body lift - he says he really believes around back he can lipo hip and back and get rid of my bra rolls

3. He said repeatedly I had a good tone on my butt and thighs. He said sure if I lift it a little it might smooth out even more, but I was very lucky that my weight centers mostly on my belly (ok one plus for being an apple shape) because now I don't need a huge scar.

4. He said my breast lift will also not require a long scar underneath, just a small one. omg.

He then showed me like 70 pictures of his work. He showed me girls with similar breasts and his work - OH MY GOD. He does gorgeous breasts! I was so freaking psyched.

We then talked about a second stage - arm lift and thigh lift. I asked him if he would do an arm lift at the same time and he said no way. "Those doctors on extreme makeover do way too much at once. I cold do it all, but you're already at 7 hours of surgery. I can hurry through your breast lift and tummy tuck, but I prefer to concentrate and do it right." PERFECT ANSWER. He was just - awesome. Friendly. That was the click I was looking for. And, his website rocks my socks. He said "Yeah I put a lot of pictures up so my patients can see all kinds of body types...they're looking for their own, anyway." DING DING DING

His staff told me that he's famous for his bedside manner, he calls patients personally post op, and he has a 1 year free revision (his costs, tho hospital and anesthesia are still charged) if I am unhappy.

The only way Dr. Bottger would be perfect is if he worked on ports. He says he had worked on some of Dr. Ren's lap band patients, and is familiar with the port...he said mine is very, very lateral and may not interfere with the sewing of the muscles. But if something did go awry, he does not replace ports. He says that's Dr. Ren's specialty, his is body contouring. I kind of respected that - he knows what he is good at. He said if I chose to go with him, he'd call Dr. Ren and get specifics on my band placement and make sure she was aware in case I needed a port replacement/lower profile etc.

So the only way these Jersey docs could top Dr. B for me is if they were cheaper and had lots of evidence of port replacement/experience.

Thank you guys sooooo much I was really despairing. I wasn't sure I wanted to see Dr. Bottger and almost canceled. I'm so glad I went.

Honestly it sounds to me like you found your doc . If you like this guy that much ,,,, would you sacrifice price for a doc you did not like as much ?

I personally would not ? My lap band doc was a little more than some other docs i could have gone too ( and he's still on the cheap side) but his bedside manner and his personality fit me so well I did not care.

Have you considered asking your band doc if she can come in DURING The plastic surgery to do the port replacement ? A lot of times docs will do that or you can have a separate surgery to replace the port, its usually not very expensive .

But really you get what you pay for and Price is not everything !

mindy

Hi Mindy!

I already made the appts with the last two docs, and I want to visit them. They are in Northern Jersey and probably have worked with the ports themselves. PA just doesn't have the depth of experience in Lap Band surgery OR post band plastic surgery that NY does.

My surgeon is in NY and I couldn't ask her to come all the way to Philly just for me. However I did just schedule a fill with her on the day of my last PS appointment so I will bring it up with her then. She's the kind of doc who would give my PS instructions on what to do and when.

The NJ docs may be more expensive, but they also have to be just as friendly with that instant click as me and Dr. Bottger. All the pieces have to fit...frankly I will pay whatever I have to pay for the emotional assurance and physical evidence of a doctor's skill!

So no - I would NOT sacrifice the rapport I have with Dr. B for a cheaper price. He was cheaper than all of the other PSes I've seen, and none of them had Lap Band experience, or his huge range of body types he works on. He even gave me a discount for having it all done at once...nobody else offered one :rolleyes2: I dunno, you just get the impression he cares.

I'm kinda hoping these last 2 PSes make the choice easy and I'm not agonizing over two or three REALLY awesome docs, LOL.

in other words, I hope they're JERKS. hehe. but not likely. there are rave reviews all over the web on the last two.

Hi Mindy!

I already made the appts with the last two docs, and I want to visit them. They are in Northern Jersey and probably have worked with the ports themselves. PA just doesn't have the depth of experience in Lap Band surgery OR post band plastic surgery that NY does.

My surgeon is in NY and I couldn't ask her to come all the way to Philly just for me. However I did just schedule a fill with her on the day of my last PS appointment so I will bring it up with her then. She's the kind of doc who would give my PS instructions on what to do and when.

The NJ docs may be more expensive, but they also have to be just as friendly with that instant click as me and Dr. Bottger. All the pieces have to fit...frankly I will pay whatever I have to pay for the emotional assurance and physical evidence of a doctor's skill!

So no - I would NOT sacrifice the rapport I have with Dr. B for a cheaper price. He was cheaper than all of the other PSes I've seen, and none of them had Lap Band experience, or his huge range of body types he works on. He even gave me a discount for having it all done at once...nobody else offered one :rolleyes2: I dunno, you just get the impression he cares.

I'm kinda hoping these last 2 PSes make the choice easy and I'm not agonizing over two or three REALLY awesome docs, LOL.

in other words, I hope they're JERKS. hehe. but not likely. there are rave reviews all over the web on the last two.

OH i did not realize they were so far apart. in actuality your doc probably CANT do the surgery with teh doc in PA if she's in NY , she probably does not have privileges at the hospitals in PA . I totally agree with you seeing the other docs. You can have the same feelign with them and I agree i would much rather have someone that has port experience.

Personally I think i am going to have my band doc move my port I just dont feel good about anyone else touching it

Good luck let us know how they go !

Mindy

If your going to NY to have it done talk to Dr. Quetell in Syracuse NY. He is a wonderful doctor, caring very personable and a wonderful surgeon. He did my breast reduction in 2005 and now 3 years later I'm still has happy as the day I had it done.

Girlie, I don't know if you want to add one more to the mix, but Joseph Fodero just did my girlfriend's tummy tuck. Coincidently, he did a presentation at my surgeon's monthly support group a few weeks ago, and I was pretty impressed with what he had to say. It was also pretty interesting to learn that a lot of his staff are WLS people like us and have had PS as well.

-m

Edited May 26, 200818 yr by dancinglamb

Thanks Marisa! I just checked him out - I will see if he can get me in for a consult Friday afternoon June 6. If he can't, I may put him on the back burner. I gotta save my PTO for surgery! lol

Pagan - thanks for the recommendation, too. After this round of surgeons, if I'm still not ready to put my life in someone's hands, I'm going to go for NY consults.

I'm so glad I still went to see the other doctor. I didn't think it was possible to have the same comfort level with Lap Band experience, but I got it all. I found my doctor!!

Dr. Joseph Capella in Ramsey, NJ and his father have a dual practice. His father does bariatric surgery at Hackensack Hospital, and Dr. Capella does body contouring after weight loss.

At my fill visit, Dr. Ren told me that she was concerned Dr. Bottger (previous champion of Kate's Excess Skin) wanted to talk to her about moving the port.

"It's ridiculously simple," she said. "All he does is remove stitches, plait the muscles, move the port and restitch in the new place. If he wants to talk to me, and says he doesn't "do" ports, it means he's never done it."

I told her I was meeting with another Jersey surgeon who apparently specialized in it, or had a lot of bariatric experience.

"Who is he?" she asked.

"Dr. Philip Wey."

"Hmm. Haven't heard of him. You should go to Dr. Capella in Ramsey. He has tons of experience repositioning or replacing ports. He does a lot of my patients."

!!!!!!! the very guy I canceled.

Why didn't the office tell me that?! They gave me 2 surgeons in NY who wanted $250 just to show up in their office.

I called Dr. Capella's office the second I was out of my fill appt and begged them to let me re-make my appointment.

His resume reads like something straight out of my wildest fantasy.

He's Chief of the Division of Post Bariatic Surgery in the department of Plastic Surgery. I didn't know they HAD that. He is a guru in this area.

He's been on 20/20, The View, Elle Magazine in an article about he and his dad did surgery and plastic surgery on a whole family. He's in Weight Loss Surgery Magazine. As I sat in his office, I read an article about how he appeared in a DVD special on Post Bariatric Reconstructive surgery (instructional video for other doctors on doing a circumferential body lift) with the top 12 docs in the nation. He was one of them. Oh, my, GOD!

He's written three books on plastic surgery after massive weight loss and contributed to like 30 journals.

OK. So. Yeah. Guess who I'm going with?

I found him to be oozing intelligence. He has a fantastic bedside manner and even the staff was raving about him. This one girl said she needed breast augmentation and after being in the OR with him and saw the beautiful work he did, had him do her work, and she could not be happier.

I asked about port repositioning, he says his dad comes in, moves the port, leaves. LOL. ok I'm good with that.

Other things I like about him is his cutting edge techniques. He explained pretty thoroughly that he does not use drains, pain pumps or even binders.

Drains - I asked him what happened to the excess liquid. He said he did it a lot in the past but has been using a different technique for the past two years that has dramatic results. The weeping is caused by the skin being separated from the muscle, and it has to knit back together, hence the needs for drains for a week or so. He found with 15 minutes extra work of suturing the skin back to the muscle in position, he removes the needs for drains completely and the patient doesn't have to deal with it

He also says papers have come out on that, as well as pain pumps, that convince him it's unnecessary and one more uncomfortable thing to deal with that has no lasting benefit. Pain pumps, he says, do not dramatically reduce the amount of narcotic needed, actually. So he prefers not to have extra "junk" in his patients that will affect the results.

Finally, he shocked me with his views on binders.

"Even after a new body lift??" I asked, unable to contain my surprise.

"Binders are used in theory to reduce the swelling after surgery. But that swelling is also sending blood and nutrients to the wounds to heal them, it's the body's natural process. I've removed blood supply from your belly surgically. The blood that will heal that area has to come from your flanks to heal the wound and re-establish itself. Why on earth would anyone put a tourniquet on a wound that needs blood? Imagine you cut the tip of your finger, and you put a tourniquet at the knuckle. It starves that area of blood and delays healing. I tell people if you want to use a binder, do NOT make it tight, and hang your drains from it if you must...but I don't need drains anymore, so now, I tell people to just throw out their binders."

Ha. I love it.

I wrote about my office visit in my blog. And best yet, the quote is actually reasonable. It's only $2k more than a TT and BL.

Finally, he told me I'd be in surgery maybe 5 hours. He does this a lot, he explained, and has gotten very swift. Others told me 7 hours for a lift and tummy tuck!

Nationally-Known Plastic Surgeon Dr. Joseph Capella

I checked out his before and after pictures on the website. Looks like he has lots of experience and does some amazing work. I hope my lower body lift produces results like those.

Good luck and keep us posted on your journey.

Kate,

Your Dr.'s work looks amazing. I too, hope my tummy comes out as smooth and fat-free as his!!!

I don't understand why you had cancelled your appointment with him in the first place. You kept talking about how a good website was important to you, and he seems to have a fabulous website, with lots and lots of photos -- no?

Anyhow, I'm glad you found him again -- he looks like a fantastic surgeon!!! (I also have to love a guy with a good Italian name !)

I think BooBooKitty's PS has the same opinion on binders (if I am remembering correctly) and Losingjusme's doctor in Tx used the stitching technique that required no drains. It's good to get these detailed reports on different techniques and surgeons, so we know the universe of what's available to us.

I am in Montana, so I'd probably be lucky to even find a PS that has ANY post-WLS experience. I live in the state capitol and there is only ONE PS in town. But, I've got another year until I do it and this helps me consider my options. Maybe I can go on a PS vacation to Philly, Dallas, Salt Lake, or Seattle....

Thanks for the info.

Edited June 9, 200818 yr by Foofy

Foofoo - oh that's right! I do remember reading someone's PS didn't use Binders. I liked knowing why Glad the info's useful to ya.

And lol, if you decide to come out to Jersey/Philly, I will absolutely come say hi to you!

Frangi - well, as it happened, I was really in an unusual money crunch. The other NJ doc was complimentary, and it was in my head to still visit Dr. Capella before the actual surgery, but I had only one day off and I wasn't sure I could squeeze in 3 appointments within 100 miles of each other. Once my fill doctor recommended him, I decided I had to see him that day. and fortunately, the money crunch unexpectedly cleared up the day before. That tells me it was meant to be

Becky - thank you!! Do you have a date yet?? I've seen a lot of great docs in Texas, that's for sure.