Can PS (apron removal) be done before goal?

I'm just curious.  I'm really having a hard time with my body lately.  I can't find pants to fit right and to look at my midsection unclothed....I can't believe I look like this.  I almost have this hatred for my body.  I don't like to go shopping because I know nothing is going to fit right and even if it does, I look like hell.  I still have about 60lbs to lose.  I wondered if a surgeon would make you wait. 

Anyone know?

 

I am currently in the process right now.  My insurance company requires at least a 75 lb loss and I have to maintain a stable weight for 12 months. You may want to check with your insurance company.   I have 2 more months left to complete my stable weight documentation.

ETA: they are paying for the Panniculectomy only, due to scarring due to rashes and skin boils. I am possibly going to pay out of pocket for a tummy tuck to be done at the same time.

I think most PS want you at a stable weight for 6 months prior to doing the surgery.  I would also add that some do the panni removal prior to goal weight if its really hindering your ability to move around and such.  That being said, most people want to be within 20 lbs of their goal and at least a year post op wls before proceeding.  But it also depends on the PS you choose.  The only way to know is to have some consults and see what they will do.

Insurance - whole separate issue!

Yes, it can be gone but check w/ insurance first if you want them to pay...see what they will cover or not cover.  I am almost 4 weeks out from a TT w/ no muscle tightening and had 10 lbs removed of hanging skin in front and it is amazing the difference I already see.  I was not at goal...I started at 373 lbs lost 175 lbs, got pregnant w/ 2nd child and gained about 20 back and couldnt lose that last 10 let alone get below 100 lbs.  I also had a really hard time finding clothes and the pannus hung further since my 2nd child so that was really disgusting to me.  I have excess skin everywhere but my pannus/apron was the worst thing for me and it was causing back/hip/foot pain as well as a feeling of "less then womanly".  I have no regrets at all, I am swollen so I should have a flat stomach (which I havent had since b4 puberty, age 10) no 6 pack just flat.  If I was swollen like this for the rest of my life I could live w/ it much better then the apron...I am loving my new look already and my back pain is about 75% gone and as soon as I can get adjusted by my chiro, I think I will be 100% better.  Best wishes...

It also will depend on how much you had to lose to begin with.  I started out over 500lbs, lost 235, then had my panniculectomy.  I'm still 40-60lbs above goal right now and am still losing.  I had to have my panni removed due to serious back problems because of the skin.  My insurance paid for it due to medical necessity and my surgeon agreed that it was appropriate to go ahead and do that stage of plastics because of the amount of weight I had lost.

If you are not having medical problems from the skin it might be better to wait until you have lost the majority of your weight.  If you are still losing weight, then you may end up with skin again once you reach goal.

Debbi

I will perform a panniculectomy if my patient is suffering serious problems from the overhanging skin.  The downside is that another procedure in the future will be likely.

Yes, it's best by far to be at goal, but some patients have such debilitation from the overhanging skin that it needs to come off sooner than later:

http://www.khou.com/news/health/stories/khou080211_tnt_weigh tloss.b095f429.html

Best wishes,

John LoMonaco, M.D., F.A.C.S.
Plastic Surgery
Houston, Texas

www.DrLoMonaco.com
www.BodyLiftHouston.com

Thank you all for your input.  I really appreciate it.  The downside to all this is that I don't have rashes, but I get boils now and then.  I don't think I have the issues that some probably have.  I guess it's something I'm going to have to live with for a while.  My weight loss has been non-existent for a long time and am having a hard time getting the remainder off.  I have spent the majority of my life at this current weight and the body really likes me here!!

I know it's best to get off what I want before doing this surgery because I'm sure I won't want to do it twice!

Thanks again.....

I am having hernia repair with tummy tuck and panniculectomy next Wednesday. My BMI is around 38 and I've lost 160 lbs but only 20 lbs in the last 6 months, so I consider myself fairly stable in terms of weight. The surgeon estimates he'll be removing about 10 lbs of skin off my belly.

It's gonna be wonderful to be able to bicycle again and move my legs full range of motion at the hips!

The thigh lift and saddlebags will be addressed in 2010 and the breast reduction and batwings in 2011. Gotta save up between years -- and take time to heal between.

Good luck!
Susan

I am 6 mths out and so ready to get rid of the excess skin. I have on again off again skin irritations, yeast infections and major back problems. I fell recently and I think it is due to poor posture. My pcp is recomending I go for the plastic stuff. I am about 20 -30 lbs from my goal weight. If they remove this excess I will be at goal. So do I wait six more months or go and get the snip and chip now?