Questions on surgeon choice, operation choice/drains? and how long to wait? I'm feeling...

Momofthreeinwis
on 4/11/17 9:00 am
VSG on 05/04/16

Hello everyone!

I am 11 months out from my VSG and down about 123 lbs. I am looking at a TT and breast lift. My initial consult was with a doctor I had seen for a possible breast reduction before I lost all the weight. He said he would recommend doing just a TT with no muscle repair. He said I would have drains for 2 weeks at least. He also said he did not do more than one procedure at once when I asked about the breast lift. I like him but don't love him... He is just okay.. He kind of insinuated that I took the easy way out and won't be able to keep the weight off, but he did have a nice demeanor and was kind. He operates in a hospital and it is an outpatient surgery. The second doctor I saw I was extremely impressed with his work but his personality I did not like. He seemed more like a salesman to me...just kind of ****y and over confident..is this normal? He has done thousands of the surgeries I want and is board certified. His operating room is accredited. (he's is very well reviewed and I know one of his patients personally and have met another that had the same procedures I am considering who looks amazing). The second doctor does everything in his private clinic. He would do the TT, breast lift, MR, and lipo all at once. No drains at all. He is more expensive. I am looking for feedback on these proposals. I am leaning toward the second guy even though I don't necessarily like him because of the quality of his results and the fact that I could do it all at once. The things that make me nervous is that he operates in clinic (which he says is a plus because he works with the nursing staff all the time and less germs) and he seems so confident/****y/salemanny. Like when I told him I was scared he said ..."I have been doing these since you were 7, you will be very happy" The other question I have is how long did you wait/would you wait to have these surgeries done? I am still losing just not as quickly as before. Any feedback or information you can provide would be extremely helpful to me!!

Chris "Thick-to-Fit" T.
on 4/11/17 12:25 pm - FL
VSG on 05/26/16

I cannot provide a lot of input since I've not had plastics... but for me, I know that I do think bedside manner is important, but results are more. If the guys an asshole, but does the best work I can get/afford/etc, then I would choose him personally. I'd rather be happy with the end results, then like someone I'm not going to ever interact with again after the situation is done, you know?

Just my thoughts :)

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Gwen M.
on 4/11/17 2:25 pm
VSG on 03/13/14

For me, I would want a surgeon who had done tons of these surgeries on formerly morbidly obese people AND who I liked. Since there are surgeons who fit both of these qualifications, I'd keep looking.

I'll be 3.25 years post-op when I have my first plastic surgery. I'm not quite at my goal for plastics, but I'm close enough and the timing is right.

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)

AggieMae
on 4/11/17 4:56 pm
VSG on 10/25/16

For me skill would win over personally every time. There are several plastic surgeons I know who I go out for drinks with and like but wouldn't want two of them near my saggy belly even if they waved their fees.

Surgery without drains or staples is getting more common and reduce infection so it's one of the things I am definitely looking for in a surgeon.

sonnieN
on 4/12/17 10:17 am - grand rapids, MI

I have reservations about both surgeons you mentioned. The first one not sure why he wouldn't do the muscle repair. My surgeon said I really didn't need it as I had good muscles but since he was there he'll do it to give just a slightly better contour. I do somewhat understand not doing things together but depends on the reasoning. Just because he doesn't isn't a reason. My surgeon didn't want to do the BL/BA w/ my LBL since it would be too long under (he does it by himself). Other combos he didn't like for other reasons that made sense. He did do LBL and arms and Thighs and BL/BA together.

The second one I'm suspect on for the fact that he said he doesn't use drains. I've never heard of a surgeon who doesn't use drains for a tummy tuck. There is a lot of fluid that drains out (at least from my experience) in the first few week at least that if not drained could accumulate and cause problems. Bedside manner isn't a big worry for me since other than the day of the surgery it's the staff that you'll see and work with more often than not. Experience is the biggest thing for me.

Leslie W.
on 4/12/17 11:58 am - Cobourg, Canada

You want to make sure whoever you choose works with WLS patients. Our skin heals very differently, having been overstretched etc... it requires experience not just any PS.

My surgeon no longer uses drains for the majority of TT procedures. Some procedures can be done together. It all depends on the amount of work that needs to be done with each. Everyone is different.

Having confidence in your surgeon and liking him is very important. Healing can be challenging. I have an excellent relationship with my surgeon. Can call anytime, he called me at home when had issues to follow up. Saw me on weekends etc...

I had a couple of procedures done in hospital and the rest at surgeon's clinic. I prefer his clinic. 1-1 care, not rushed to be discharged, better pain control. Nurses not having to look after multiple people etc....

    
Referral: August 2010 Orientation TWH: May 25, 2011  NP: June 8/11, f/u sleep clinic June 7, abd u/s June 14, SW: June 28/11  Nutrition Class: July 5/11, Dietician Aug 09, Psychologist Aug 25 Surgeon Sept 16th Surgery Date: Oct 11/11 HW:287, Opti wt: 260 SW: 242
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grayC
on 4/12/17 4:03 pm, edited 4/12/17 9:04 am
VSG on 05/01/13

OK, just MY opinion but,

from what I devised by your screen name

you, like me, have three kids, that being said

I think muscle tightening is of upmost importance..

those kids have reaked havoc on your muscle structure,

And my surgeon told me I would not like the outcome

without it (I happen to be in total agreement with him anyway)

also with a weightloss of over 100lbs have you looked into

a total body lift? Longer and I think a little harder of a recovery

but imagine your front totally flat then your saggy, baggy backside..

thats what made me go for it, and I didn't want to have to revise

if I was totally unhappy..

just MY thoughts, take what you want, leave the ones you don't...

edited to add...also find a Dr you love, bedside manner and a sense

of trust is very important, don't settle, do exactly what you want to

do..

   

        
AggieMae
on 4/13/17 2:42 am
VSG on 10/25/16

I have six kids and my abdominal wall is intact and will just need abdominal skin removal.

My husband is a reconstructive hand surgeon in a 6 dr plastics practice. Three of the doc's are body guys only one routinely uses drains.

The issue of drains and staples will on the short list of my pre plastic surgery interview questions when the time comes.

Momofthreeinwis
on 4/13/17 6:18 am
VSG on 05/04/16

Do they operate in the office or at a hospital? This is my big fear right now. For some reason, I can't help thinking if it is safe to operate in the office. What are your/your husband's thoughts on that? I never even thought of the staples question. Is that something you don't want? Are you not wanting drains?

AggieMae
on 4/13/17 3:55 pm
VSG on 10/25/16

My husband is a hand specialist micro surgeon, unless it's emergency/trauma surgery to stop bleeding done because the patient has other, more life threatening injuries, that need to be dealt with, he uses tape and or glue.

I want to avoid drains because drain outlets are the most common sites see for post operative infection. My husband feels that if a surgeon scrupulously ties off or categorizes ever blood vessel these shouldn't be much bleeding and drains wouldn't be needed.

There is always a chance I could need drains but less so with a surgeon who's goal/intention is not to use them. I think the method is called "progressive tension suturing".

Though I had five babies at home, I would never have out patient abdominal surgery. My husband's office is in the hospital annex. All the surgeons in his group do their surgery in the hospital OR. I am not going to use any of them for my plastic surgery. Too awkward.

My husband believe that in hospital surgery is safer but tries to get people out of the hospital and back home as soon as possible to reduce the risk post op infection.

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