Thank you all.  I wound up booking with AA.  I appreciate all of the advice and insights.  It's definitely made me feel better.  Hopefully this is the last time I have to worry about this.  

Found it ! Thanks ! I would love to do something by the end of April first of May. 

That's very reasonable ! I'll dig a little more, does it say Mexico bariatric and gastric surgery ? The FB page ?

There were a few things on bariatric pal that were a little concerning about him, not sure how accurate they were though.  Do you know what he charges ?

Hello. I just got off the plane to San Diego for my surgery in Tijuana about 3 hours ago. My BMI is close to 50. I needed a seat belt extender. I quickly asked the flight attendants on both flights (had a layover)for a seat belt extender. They both brought it to me quietly and as discreetly as possible. It's easy to hook on, you can do it yourself, and no one is the wiser. It really isn't a big scene and you won't be embarrassed. The flight was comfortable and I was happy I didn't buy the two seats I thought about buying. Look at this as an option because paying for two seats isn't necessary if the only requirement is you are able to buckle up! I flew US airways and American.