I thought that this might be a good place to post questions to me, so that other people can see your questions and my answers. I will continue to answer questions from those of you that private message me, but this is a nice way to share the information with others - since many of your questions are relevant to other people.

I will try to answer the questions as quickly as possible, and include links and pictures when appropriate.

I am obligated to add this disclosure.....any information provided by me is my opinion and cannot substitute for an actual consultation with your qualified physician.

Dr. Schluman- I am 20-30 lbs away from my goal weight and am trying to decide when to get my tummy tuck. I have had a consult with a great doctor and am very excited. My problem is this, my plastic surgeon recommends me to be as close to my goal weight as i can be/want to be before the tuck. which i completely understand. if i were to continue to lose more weight there is the possibility of my stomach becoming loose and saggy again. my thing is that i carry all of my weight in stomach. the rolls are very big and gross and hang all nasty. i have lost 50 lbs and am not not one pant size smaller because of it. the doctor told me if i thought i would be happy at my current weight, just minus the stomach then to go for it. i think i would be. i love my new legs, they are much thinner and toned, same with my arms. its just my belly that i hate now. what would your suggestion be to a patient that came to see you in my situation? like i said, i think i would be happy at this weight, just looking better, but how do i know for sure that would be the right choice? i know that is MY choice to make, i am just seeking advice. thanks.

Moany people never get to "goal" - the main thing is to wait until your weight loss stops. You have to assumet hat you have about 10-20 pounds on skin....and you may never get to goal. I have many people that have a panniculectomy or tummy tuck before they have completed weight loss. If you want to go for it, than do it. Just keep in mind that you will likley loose more weight and you stomach may sag a little again. The need for a revision surgery at a later date will be high for you - but doesn't meant hat you need to have one. Also, focus on body shape and dress size...not the actual number or your weight.

Dear Dr. S,

What a wonderful service you provide!

Me-57, lapband, great health, 10 lbs from goal (which will make me a size 10--at my age, a 6 is not necessary). daily exerciser.

I am scheduled for a Mastopexy and Aug. My surgeon wants to do silicone ABOVE the muscle. Your thoughts on that? Most people seems to get them placed under the muscle.(I am a 38 C going to a fuller C)

I am also having Brachiplasty. Even though I am near goal, my arms are still fat--not just hanging skin, but fatty tissue in the "wings." Will I be happy with the results? Another doctor said lipo should be done first. Can they "sculpt" the arms when there is still fat?

Thanks so much for your knowledge.

In general, implants below the muscle have a slightly lower incidence of complications - infection and capsular contracture. The decision about over/under has to do with many factors that only you and your doctor know. You shold ask your ps why not under, and see if his/her answer makes sense to you.

Brachioplasty is best for hanging skin. In some popel with "fat" arms, a staged procedure (lipo then brachioplasty) will give the best results. Again, this needs to be discussed specificallywith your ps. I am sure that even with a brachioplasty, your result will be significant and you will be happy witht he improvement. The question is "are you looking for just 'better', or are you looking for 'best' "?

Hi Dr. Shulman,

I'm sure you have answered this question before, but there are 27 pages of questions and answers to sort through :smile2:! Your patience and knowledge are greatly appreciated!

I have two quickie questions:

1) how long before reaching goal weight do you recommend seeking consultations for breast reduction/lift and Lower Body Lift?

2) how long is the typical recovery period for those procedures and what can be expected (specifically, how long before I can resume exercise?)

Thank you so much!!

Ideally you should be plateaued for 6 months before having plastic surgery (note that I say"plateaued" not "at goal" because many will never reach goal without plastic surgery). This means that you should start seeing plastic surgeons much earlier. I think that when you get within 30 pounds of goal, or see your weight loss slowing down, yo should start making appointments.

A LBL is the biggest surgery and the recovery can take up tp 8 weeks - this means 1 week feeling lousey, 2 weeks feeling sore and maybe still having some drains, feeling much better at 3-4 weeks (but tired), begin exercise by walking at 4-6 weeks, and back at the gym (without heavy lifting at 6 weeks)....ths is just a guideline and depends on your recovery and your ps. A breast reduction/lift is a much smaller procedure and if done alone, you should be cleared to go to the gym in 4 weeks (with a supportive bra).

Ideally you should be plateaued for 6 months before having plastic surgery (note that I say"plateaued" not "at goal" because many will never reach goal without plastic surgery). This means that you should start seeing plastic surgeons much earlier. I think that when you get within 30 pounds of goal, or see your weight loss slowing down, yo should start making appointments.

A LBL is the biggest surgery and the recovery can take up tp 8 weeks - this means 1 week feeling lousey, 2 weeks feeling sore and maybe still having some drains, feeling much better at 3-4 weeks (but tired), begin exercise by walking at 4-6 weeks, and back at the gym (without heavy lifting at 6 weeks)....ths is just a guideline and depends on your recovery and your ps. A breast reduction/lift is a much smaller procedure and if done alone, you should be cleared to go to the gym in 4 weeks (with a supportive bra).

Thank you sooooo much! Your one reply gave me more information than weeks of research on the internet.

Have a great week!

Moany people never get to "goal" - the main thing is to wait until your weight loss stops. You have to assumet hat you have about 10-20 pounds on skin....and you may never get to goal. I have many people that have a panniculectomy or tummy tuck before they have completed weight loss. If you want to go for it, than do it. Just keep in mind that you will likley loose more weight and you stomach may sag a little again. The need for a revision surgery at a later date will be high for you - but doesn't meant hat you need to have one. Also, focus on body shape and dress size...not the actual number or your weight.

thank you for taking the time to respond for me. you are so right about needing to focus on shape and size, not the number on the scale. i have a hard time with that. i am now waiting to hear back from my insurance to see if the will cover a panniculectomy. my regular doctor wrote a letter of medical necessity, so we will see how that goes. thanks again.

Hello. I am curious to know if it would be ok to have a tummy tuck prior to reaching your goal weight? I had LB surgery on Sept 2, 2008 and to date have lost 54 lbs. I have approximately 75 lbs remaining to lose. I carry most of my weight in my mid section and it would just be so much more attractive to have the gut gone. Please advise. Thanks.

How long is the recuperation for a Tummy Tuck and a breast lift. When can you safely resume activities like swimming. I have my surgery scheduled for early July and want to make sure that I will be recovered enough for my vacation at the end of of July.

Hello. I am curious to know if it would be ok to have a tummy tuck prior to reaching your goal weight? I had LB surgery on Sept 2, 2008 and to date have lost 54 lbs. I have approximately 75 lbs remaining to lose. I carry most of my weight in my mid section and it would just be so much more attractive to have the gut gone. Please advise. Thanks.

It is ok to get a TT before yo reach goal, if your weight has stabilized but are still some amount short of goal. It is common for people to lose about 100+ pounds but still end up 20-30 pound short of goal. But your situation is different - you are still actively losing weight and you are not even halfway. If you want to do something sooner, then you can consider a panniculectomy. This will likely have to be converted to a formal TT after the complete weight loss. My advice is to wait it out, but if the hanging skin causes problems for you, consider a panniculectomy.

How long is the recuperation for a Tummy Tuck and a breast lift. When can you safely resume activities like swimming. I have my surgery scheduled for early July and want to make sure that I will be recovered enough for my vacation at the end of of July.

My patients are on restricted activity for 4-6 weeks after a TT. This includes no swimming for a minimum of 4 weeks. You should ask your PS about your planned activities and see what he/she says. If you were my patient, either the surgery or the vacation would need to be changed...

Hi Dr. Schulman I had lipo done (April 3) in my upper and lower stomach including my pubic area, my sides of my waist and my upper sided (under my arm pitts) my question is since I developed this severe itching all over where the lipo was done and I can't seem to find anything to relieve me of it. Why am i having so much itching. Also I also had really bad swelling and burising in the inner thinghs all the way down to my knees but only in the inside of my legs why would this happen???

Thank you!

Hi Dr. Schulman I had lipo done (April 3) in my upper and lower stomach including my pubic area, my sides of my waist and my upper sided (under my arm pitts) my question is since I developed this severe itching all over where the lipo was done and I can't seem to find anything to relieve me of it. Why am i having so much itching. Also I also had really bad swelling and burising in the inner thinghs all the way down to my knees but only in the inside of my legs why would this happen???

Thank you!

swelling and bruising is normal and can be extensive. Because of gravity, the bruises will go "downhill". Also the itching can be a reaction to the prep used during surgery. If you haven't done so already, call your surgeon. You may require steroids if the reaction is bad.

Thanks for your response and professional advice. How much is a panniculectomy?

It is ok to get a TT before yo reach goal, if your weight has stabilized but are still some amount short of goal. It is common for people to lose about 100+ pounds but still end up 20-30 pound short of goal. But your situation is different - you are still actively losing weight and you are not even halfway. If you want to do something sooner, then you can consider a panniculectomy. This will likely have to be converted to a formal TT after the complete weight loss. My advice is to wait it out, but if the hanging skin causes problems for you, consider a panniculectomy.

Hi Dr. Schulman,

Thanks for all the advice you have dispensed... it is priceless! :rolleyes2:

I have read through this entire thread and always check for updates. I haven't seen the one I have, though! So, here is my question: I am in the process of interviewing surgeons as I would like to have a panniculectomy/tummy tuck and breast reduction done the end of August/first of September. So far, I have visited 2 surgeons and have plans to visit 4 more before the end of the month. Both of those physicians submitted paperwork to my insurance for benefit determination, which was approved in both cases. However, is it really necessary for each surgeon I see to submit this paperwork if I am, in effect, interviewing them to see if I want them to do my surgery? If not, how do I tell them not to seek approval until I decide?

Thanks!

Melissa

Hi Dr. S.,

I'm a few pounds away from goal and am considering PS. I've successfully had PS before (breast reduction). I'm interested in a thigh, butt and arm lift as well as liposuction. I'm worried about the scarring in particular the thighs and arms. I don't want to trade one problem (flabby arms and thighs) for another (unsightly scars). I'm less likely to go for the arm procedure because I don't see anything that doesn't produce significant scars, however I'm hopeful that the thigh and butt can be done without the visible scars. I don't want scars on my legs and arms (I don't mind scarring in the arm/leg crease area however I don't want to have to worry about scars if I'm wearing shorts or a sleeveless top. Given these preferences, are there effective procedures our there?

Thanks for your help Dr. S.!

Thank you doctor for you response. The swelling in my legs is finally gone but I still have some bruising on the sides of my legs and on the lower part close to my knees. As for the itching it seems like its finally going away also but I have my days. I am 2 weeks out today and I still have a pulling burning feeling in the middle of my belly I think it may be because he had to redo my belly button because with the tummy tuck it didnt come out right so he fixed it and its still healing.