Congrats on the NSV, I bet it really made your day! Also, that your Dr is willing to do your TT, but does he usually do TT? Why do you have to lose 20 lbs, first? I know when I had my paniculectomy, (TT without the muscle tightening) they had special payment deals, if you used their carrier you could pay it off in a year at low rates. Don't go down too low in your calories, it could make a weight loss stall. Don't wear yourself out. I bet you will love your body even more after the TT. Excited for you!