Plastics Consult Update (I'll post it here too!)

Gwen M.
on 2/23/17 4:25 am
VSG on 03/13/14

If you haven't seen this on another board yet, I'll share it here as well.  Since posting I have figured out finances.  The short version is that the promotional rate for Care Credit is still stupidly high (16%) and I remembered (duh) that I already have a low-APR credit card with a high limit that aren't used for much of anything, so between savings and that credit card, I'm all set.  Which means anything my mom wants to chip in is just gravy.  Woo!!!  Now I just need to figure out how scheduling will work with college for surgeries 2 and 3.  

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I got to my appointment at 1:45 which was when I was supposed to be there for new patient stuff. The doc came into my exam room at 2:15 which was when my appointment was and he spent a solid hour with me.

I feel really good about him. He's friendly, good sense of humor, in his 40s if I had to guess, not egotistical but definitely confident in a good way. Super knowledgeable, didn't talk down to me, etc, etc. All good impressions.

We talked for a bit, he asked questions about what I wanted, for some of his questions I just didn't know since I don't know what a normal body would look like or what is possible. But I told him this and he explained stuff.

Then we went to another room with a big mirror for all the poking and prodding. Sadly he didn't draw all over me with a marker - apparently that doesn't happen until immediately pre-op so he knows where to cut.

This part was chaperoned by his office assistant. She was also there to hear him talking about the procedures and order, so she could give me a workup of things afterward. I thought that was a nice arrangement! (And she was super and friendly and wonderful, which is important too.)

This wasn't as awkward as I thought it would be. He moved my skin around, and, the really important part, said that YES, my weight loss is awesome and I'm not fooling myself by thinking I'm ready for plastic surgery now. If I lose 10 more pounds pre-op that's great and no problem either, but yay!

The one question for timing and combinations of procedures was my breasts - I already knew that I did not want implants of any sort because they have time limits and I don't want to need plastic surgery every 15 years for the rest of my life :P But, thankfully, he thinks my breasts will be fine and proportional with just a lift. (The other option would have been to transfer fat from elsewhere in the body to my breasts, but he doesn't even think I'll need that since they've still got volume.. they're just droopy. I'm not going to apologize for TMI since, hey, it's a plastics post.)

So I'm looking at a number of procedures:

Lower Body Lift (This is a circumferential cut around my waist that pulls everything up and down, removes the panniculus which is the hanging skin at my tummy, outside of thighs get tightened too and stomach muscles get tightened. This also includes pubic lift.)

Arm Lift (This removes the excess skin from my upper arms.)

Breast Lift (What it sounds like - removes skin from my breasts to tighten/lift them.)

Upper Body Lift (This is the upper back, since I've got droopy excess skin on my back that will look worse after the Lower Body Lift. It's a circumferential cut about where my bra strap goes.)

Thigh Lift (This is the inside of my thigh - like the inseam and he'll see if he can do anything for my calves at the same time.)

Surgeries combine procedures based on time, since some of these are LONG, and tension direction from sutures. For example, Lower Body Lift and Thighs can't be done at the same time because the suturing pulls in opposite directions.

Sadly, I will need three surgeries for all of this. I knew that was a possibility, but I was hoping for two. This is sad because the first hour of surgery is the most expensive due to hospital fees, so only having two first hours is cheaper than having three first hours. However there is a repeat patient discount, yay.

He prefers 3 months between surgeries, but will go as soon as 2 depending on recovery.

My surgeries will be as follows:

1st surgery - Lower Body Lift and Arm Lift. This will be the longest surgery at ~11 hours. It's also the only one with a mandatory overnight stay.

2nd surgery - Breast Lift and Upper Body Lift.

3rd surgery - Thigh Lift and anything he might be able to do with my calves.

I will have drains for 2 weeks post-op for every operation and I'll need to wear compression garments as well. Follow-ups are one and two weeks post-op for each surgery.

I won't be able to do much but walk for about 6 weeks post-op. He thinks I'll have no problem resuming school at the 2-3 week mark. He said I'll be able to sing right away, but then said no "core work" so I think that non-singers just don't understand how much energy singing actually takes :P

I'll need pre-op stuff from my primary doctor - EKG, labs, physical, and a mammogram prior to the breast lift.

The price stuff. I was expecting 30-35k total for everything so I was a bit shocked when I got the quote for the first surgery. But it's the longest and most complicated, so it's significantly more than the others.

1st surgery = $25,400

2nd surgery = $9,000

3rd surgery = $8,000

So I'm looking at $42,000 total. Once I get back home this afternoon I'll be figuring out finances and then I'll talk to my mom this weekend and see what help she's able to give. (She has offered, but we were waiting to talk specifics until I knew them.)

I put $1500 down to reserve my surgery spot for the first surgery. And I know we've got enough in savings to pretty much cover the entirety of that first surgery. And, while I'd like to do these all in the 6-9 month period at the end of the year/beginning of next, I CAN space them out farther if I need to for financial reasons.

My first surgery is scheduled for June 5. I have my pre-op appointment scheduled with him for May 16. I figure the night before surgery I'll get a hotel room close to the hospital like I did for my VSG so I don't need to stress about traffic, etc. I've told the guys that I want one of them to be there for my entire hospital stay, but I don't care which one and they can tag team the time and they said they'd figure it out. It'll probably be two days of time to cover between the hotel the night before and then I assume I'll get released in the afternoon of the Tuesday.

I think this is all the information I can think of? It's a lot, I know.

After the appointment I had dinner at Silver Diner with my previously unmet OH friend and that was great since she's done all of this with Dr. Michaels herself and could talk to me about her experience. She actually did consults with many plastic surgeons and chose Michaels! Pretty cool :)  She is also totally awesome, and I'm so grateful she suggested we meet up so I had someone's brain to pick!  

I feel super positive. A little sticker shock at the price, but I look at this as an insurance policy. Studies have shown that people who have plastic surgery after massive weight loss have a much higher rate of maintaining their weight loss AND, seriously, after spending 42k on this you can bet I'm not going to want to waste that money by regaining weight!

The one thing I still need to ask about is what happens if there are complications post-op. Will insurance cover those? Like if I have an infection?

And that's about it! Ask any questions you have, I'll answer them to the best of my ability OR I'll know I have more things to ask the surgeon. :) 

If you made it this far - wow. You deserve a high protein/low carb cookie :D

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

ladygodiva1228
on 2/23/17 4:31 am - Putnam, CT
Revision on 02/04/15

That is awesome news.   

Dr. Sanchez Lapband 9/12/2003
hw305/revision w280/cw197/gw150

Revision from Lap Band to Bypass on 2/4/2015 by Dr. Pohl

    

Gwen M.
on 2/23/17 4:36 am
VSG on 03/13/14

I am so freaking excited!  

He did say I should work on getting 100g of protein a day too and at first I was thinking, "but protein is 9 calories a g, so that's 900 calories just of protein a day, eeeek!"  But then I remembered, "wait, no, that's fat."  Derf.

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

ladygodiva1228
on 2/23/17 4:42 am - Putnam, CT
Revision on 02/04/15

You know you're going to do great right?  And you are so dam good at following your doctors orders so I know you will have no issues getting the required protein in.  So excited for you.

Dr. Sanchez Lapband 9/12/2003
hw305/revision w280/cw197/gw150

Revision from Lap Band to Bypass on 2/4/2015 by Dr. Pohl

    

Gwen M.
on 2/23/17 1:11 pm
VSG on 03/13/14

Aw, thanks.  I better do great - or else!!  Too much money to throw away.  And time.  And everything else too!

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

Liz WantsHealthForAll
on 2/24/17 3:58 am - Cape Cod, MA
VSG on 03/28/16

High protein makes a big difference in how fast you heal. My plastic surgeon recommended the same and I really did recover quickly.  Best of luck to you on your PS journey!

Liz 5'3" HW: 219 SW: 185 GW: 125 LW: 113 Desired maintenance range: 120-123 CW: 120 (after losing 20 lb. regain)!

Citizen Kim
on 2/23/17 4:59 am - Castle Rock, CO

Such an exciting time, Gwen, so happy for you x

Proud Feminist, Atheist, LGBT friend, and Democratic Socialist

Gwen M.
on 2/23/17 1:11 pm
VSG on 03/13/14

Thank you so much!!  I'll drive you all crazy babbling about it - if I haven't already ;)

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

rocky513
on 2/23/17 5:09 am - WI

I've had my panni removed.  I would love to have my arms done someday.  I'm self conscious and never wear sleeveless tops.  I'm just not sure it would be worth it at my age.  I don't think I look too bad with clothes on!  LOL!

HW 270 SW 236 GW 160 CW 145 (15 pounds below goal!)

VBG Aug. 7, 1986, Revised to RNY Nov. 18, 2010

Gwen M.
on 2/23/17 1:14 pm
VSG on 03/13/14

I waffle between caring about my excess arm skin and not caring about it.  :/  Some days it really bugs me, most days it doesn't.  For me all the plastics are a comfort/mobility thing.  My bouncing skin prevents me from doing some things I want to do altogether, and other things the skin just causes a lot of discomfort.  So.. yeah.  I don't care so much about how it looks as how it jolts and jounces around.  

VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)

Age 42 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170

TrendWeight | Food Blog (sort of functional) | Journal (down for maintenance)

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