Pannus Concerns

Greetings Everyone,

I have been reading these forums for quite a while and I have began the process for my WLS and one question I cannot find a solid answer for and no one is seemingly willing to help me find resources for is the post-op pannus. I have elected to have my surgery early in life as I am relatively healthy and without any comorbidities. My BMI is 42 so according to my insurance I only barely qualify.

My concern with this pannus is no one can tell me based on my size/shape what I can expect a year or two down the road. While my insurance covers the WLS (VSG specifcally) they will not cover the panniculectomy except in very extenuating cir****tances and real plastic surgery is out of the question on every level due to cost. I'm an EMT and make just enough to get by.

Is there anyone that can give me some guidance or insight to how a 25 year old male is likely to react to WLS and what can be expected?

Thank you,

Andrew S. 

Now of course, everyone is different, and the loose skin is not something that can be predicted or prevented.  With a lower BMI and your youth, odds are on your side.  My BMI was 46, and I had my DS at 35, and my stomach is ugly, but easily concealable.  It could be worse.  Now I know a man who was of similar size and today has the sexiest rock-hard abs as a post op with absolutely no plastic surgery whatsoever.  He was only MO for less than 2 years, though, so that's a huge difference, too.

I understand that loose skin is inevitable I'm just hoping someone could share some experience because it seems 95%+ of all the stories i have read the patient decides to pursue the pannulectomy or some form of plastic surgery. Others simply don't mention anything or are too new to the post op world to provide this insight.

I can share with you that after losing 145 lbs, I have not had any plastics.  Would I like to??? If time and money came together at the same time, I'd love to look like a "hot mama" that I never had the pleasure of feeling for real.  I still consider myself lucky.  I'm don't have a rock hard body, but I put off a darn good illusion thanks to a couple of lycra undergarments.  Also, being over 40 no, I pretty much look like other women my age losing their elasticity, so I'm not overly self-conscious about it.  I look relatively normal, and I'll bet that you will too. 

Thanks for the quick replies.

I am sure this may seem very conceited but I'm am really worried about this because to put it mildly my love life is non-existent. In 25 years I have never so much as dated and I believe that I blame my size and lack of self-esteem.

It wouldn't be such a problem if guys my age (yes I'm gay) were not so stuck up. I wi**** was different but so far the only interest I have ever drawn is from guys much older, and larger then myself, and that is just disheartening.

Well, you're in for a lot of changes and it's quite the roller coaster ride.  Don't wrap yourself up in conceit, for it doesn't matter what side your bread is buttered on - if you choose it to be, there is so much more to sex than just.....sex.   Even being gay is more than sex.   I've had this same conversation with my son, and it has no gender-preferences:  Take time to get to know someone on a deep level before jumping into bed with them.  If you wait to have that deep level of non-sexual intimacy, then the experience is so much deeper than the superficial physical part.  Your physical flaws are so minimal at that point, for it's the connection and sharing that is occurring, and the feeling is astounding before the "act" even occurs. 

So yeah, as I said, your youth and low BMI are on your side for skin elasticity, but whether you have a slightly loose pannus, or rock-hard abs, take my advice to heart.  I'm older and a bit prudish, but I really think the experience of love and life is so much more meaningful if you take the effort to make it meaningful.

Most insurance companies will cover surgery to remove the excess skin from your stomach if it is medically necessary.  For instance, if you get rashes under the skin that don't respond to other treatments or if the skin hangs so low it gets in the way of walking, they will usually pay for it. 

How much loose skin you'll have depends on so many factors, it is hard to predict what your experience will be.  I was 37 years old with a BMI of 47.  I would not look so good in a bikini but I do not have so much excess skin that I want to undergo surgery to remove it.  Since you are younger than me and your BMI is lower, I'd say there is a good chance you will have less loose skin than I have.  If that's true, your insurance would not pay to remove it because it would not be medically necessary.  Whether or not you would be satisfied with it as it was or want surgery to remove it, I can't say.  All I can tell you is I don't think I need plastic surgery.

I have read that insurance companies may be inclined to pay given a number of conditions are met. However I'm just being honest if I were to say that if my pannus were ever to extend low enough it interfered with walking or caused rashes I am not honesly sure I would know how to cope with that.

I think another issue I am running into is that I am finding very few, if any, others that have done this surgery at my age. A friend of mine had it done and we are about the same age but she was nearly 150 lbs heavier then I am and has only just recently hit my weight but there is no way that her pannus is going to be conperable to what mine would be.

I'm still at least a month away from my surgeon meeting and so far the dietician is pushing a comprehensive diet plan instead of surgery and the physician monitoring my progress is full on-board with me having the VSG.

I'm just not sure who/what to believe. If I diet and have any success I disqualify myself from WLS.

Most, but not all, insurance companies base their decision on your starting weight.  Check your policy.  If your insurance will disqualify you for going under a 40 BMI, you will need to be very careful not to lose too much during your diet.  On the other hand, some surgeons will reject you if you gain during the diet.  It's a really tough balance.  Also, at your age and BMI, my guess is a panniculectomy will not be necessary.  And if any potential partners aren't interested because you may have a little sag, they're not worth your time anyway.

If you don't have stretch marks you have a good chance of the skin going back nicely given your age and bmi.  You need to turn into a work out machine and I bet you will have the body you only dreamed of.  I had an extended tt with muscle tightening at a teaching hospital years ago, but it was the best 4k I ever spent.  If need be drive a piece of crap for a few years and invest in your body.

Good luck.