He has experience with massive weight loss patients. Vast or not? I cannot say, but he has truly done magic with my tummy, like total magic.

As far as my breasts, I was advised by 2/3 doctors I consulted with (one of which is known on these forums for working with massive weight loss patients) that if I wanted to keep my implants on the smaller size and keep as much natural breast tissue as possible, it would be a risk that things may not settle perfectly, due to laxity. But I opted to go for it hoping for a more natural result and feel (less implant, more under-padding).

When i had my inner thighs and upper arms done last month my concerns and desires here limited by anatomy and the surgeons willingness. Mostly, I just didn't want staples or external stitches or needless drains. I did end up with drains in my thighs. The left one was in for three week, and since I had 100cc of drainage every 4 hours in my left leg for days, and over 150 cc a day for the next 10 days, they were certainly necessary.

I'm having my breast done, along with a lower body lift and fat transfer to my flat butt on 12/28 2(20days!) Originally,at 293 lbs and up until I was down to about 200 lbs I planned on just getting a lift. Then my previously firm "C" cups turned into a pair of tube socks with a handful of pennies in the toes...I am about 165lbs now and yikes!

I did some research and decided I wanted textured, tear drop shaped soft "gummy" implants, under the muscle and thought I'd be happy with a full C cup but the consult today has me questioning this. The surgeon discussed the possibility of the contoured implants shifting, but bottom line is he just prefers the round implants, so that's what ill get. The remaining issue is over vs under the muscle, which is up tome and the size of the implants for optimal results. He recommends I should go at least one size up.

I think I would be disappointed if my breast ended up too small but I don't want to be lugging around melons either. I also worry that with my lack of breast tissue an over the muscle implant will look weird or ripple when I lie down so, even though it's more painful, I'm leaning towards having it under the muscle.

Anyone have experience or thoughts on over vs under the muscle? Can anyone share how they decided on size?

Good luck! Is your surgeon someone who has vast experience with people who have lost massive weight?

Thanks for the link to your YouTube chronicling your journey through VSG and plastics in Mexico.

I understand! I'm sure once all is healed you'll be thrilled with the results and it will have been worth it!

I am getting a little nervous about my very minor PS next week (browlift and upper/lower blepharoplasty). I sort of remember being surprised at the pain of my facelift, which was mostly a sustained headache as I recall. It superceded any pain from my TT, Which I had been prepared for being very painful (it really wasn't). Maybe it is all in the expectations?