2 Consults - 2 very different plans suggested

Okay folks, I am one confused lady after my 2nd plastics consult earlier this week.  I have a 3rd scheduled next week, so we'll see what that surgeon (Dr. Lawrence in ATL) says.

Here's the scoop:

Dr. Lincenberg does a lot of post-bariatric work and speaks at support groups around ATL. He highly recommended a Fleur de Lis LBL and mons lift in one stage and arms, back (bra-line incision) and breasts in another. There was little discussion of a LBL w/o vertical incision as he seemed to take it as a given that the Fleur de Lis LBL would be the procedure I would have done - not really discussing different options. He preferred to do the upper stage first. However, since I went in wanting to pursue the lower stage first, that is what they priced out for me. The consult was pretty quick - maybe 15 minutes. Cost for Fleur de Lis LBL and mons lift was right at $15k.

Dr. Namnoum is Chief of Plastics at St. Joe's in ATL. He does a lot of post breast cancer reconstruction, as well as body lifts. He wanted to do LBL and mons lift first but absolutely did not want to do a vertical incision. He thinks that while I will end up with less abdominal tissue with a fleur de lis cut, I will hate the scar in the long run and be unhappy. If I'd have had an open WLS and already had an existing scar it wouldn't be a big deal, but I don't currently have a scarred up abdomen! He also wants to auto-augment my butt during the LBL from liposuctioned fat. Dr. Namnoum is not a fan of the bra-line incision for back rolls, preferring to use liposuction or an extended incision from the armpit during a brachioplasty, due to the reduction in visible scars. He spent approximately 30 minutes with me discussing numerous possible techniques and is $3k more expensive.

I am now thoroughly confused, because Dr. Namnoum's approach and Dr. Lincenberg's approach seem to be very different and they seem to have philosophical differences regarding aesthetics. I guess I'll see what Dr. Lawrence says next week.

A little about m y body - I have a significant roll above my belly button, as well as a pannus that hangs right to groin level. I have side rolls on my back above the belly button roll, as well. Honestly, I think I do need a vertical incision, but I AM worried that the scarring will be a problem. My scars do not tend to fade and will get purple in color against my very pale skin.

Any advice or thoughts from the peanut gallery? Thanks!

Bethany

Hi there Im in the same boat!!! 2 different surgens one a speaker and very well known in the sac area!! he suggested a circumrential lbl and he told me I'd be very boxy after the surgery and that freaked me out!!! As I have always had great curves and a smaller waist. He said that is because he would pull everything down and lipo the back sides..but still would be boxy!!! He was very expensive...I saw another PS and he said for sure (Fleur De Lis)  anchor cut for me as I have alot of skin and tissue above the belly button and breast bone!!  (which im not excited about the cut down the middle :(  ) ..he is 1/2 the price of the first...However he would be able to pull me in from the sides and then pull down so I would have a small waist again..at the price of a scar down the front!!! Soooo after alot of thought my decision came down to what I'll look like in clothing as we wear clothing most of the time anyway!!! lol  It has been a hard decision and one i dont take lightly but for me I know in the end I will be happier with an anchor...Just be sure to ask how high up the cut will go and make sure its not seen in the bra line between the boobs because I dont want to wear a sexy low cut top and have that showing...Ask to see pics of other people hes done them for and look at their cuts and read on line the differences between the two..good luck Im going in on Dec 7th!!!

Just my experience...had my TT/Fleur de Lis last Monday.

Talked to a couple different surgeons. They were all in agreement that my best chance at having a waist was with the FDL.

I am 48. I lost 167 lbs. I carried the bulk of my weight in the front of my body.

My pannus was huge plus I had a big roll above the umbilicus.

So, I am a week and a half out. Still swollen but happy with the results so far. I have a waist!!

I don't care about scars.
I am hispanic and I scar but I don't intend to bare my midriff.
Just not my style...at all.

My partner has been with me for 15 years. She fell in love with me when I weighed 350. the scars don't bother her.

Plus, I am having arms and breasts done in December. There will be more scars.

It is okay for me.

You know, you aren't locked into doing all of your surgeries with just one surgeon. I know it's easier to just pick one surgeon, but if you feel one guy will give you a better tummy and one will give you a better upper body, by all means split them up. I can't say much on the upper body stuff because I haven't looked into those procedures. But I am having a fleur de lis TT in less than a month, with a mons lift and some light lipo.

I absolutely did not want a vertical incision and had to fight with myself to accept that it was what would be best. I talked with 4 different surgeons, and 3 of them told me that I'd get the best results with the vertical incision. When I bend over at a 90 degree angle, there are rolls of skin that hang down on my upper abdomen, above my bellybutton. With a regular TT they can pull skin down but can't pull it inwards, can't tighten it in the horizontal direction. I'd still have extra skin. It would just be pulled lower. I went from a 44DD to a 34B. That's 10" lost in the horizontal direction.

I don't doubt that you'll have a smaller waistline and a little less flab if you get the fleur de lis. But the big question is, can you deal with the scar. Your body will never be perfect. Nobody's is. If having that red scar running up your stomach is going to hinder your lifestyle, keep you from wearing the clothes you want or rocking a cute bikini at the beach, make you self-conscious when someone sees you in your underwear (or less), then accept that you'll be fine with a regular TT. I will never look like a Sports Illustrated model, no matter how much money I spend on plastics. That's ok. I just need to get myself to a place where I don't cry when I look at myself naked. There is "perfect" (unattainable) and then there is "good enough". Figure out where that is for you.

Once I accepted the vertical scar, I was able to get really excited about the surgery. I'm not big on bikinis and dont see myself wanting to wear one anyway. I'm young (27) but I can't think of any situation where I'm going to be baring my stomach/abdomen in public. I don't care about it in private. They have scar makeup that I hear works pretty well, some people use it on their arm scars after brachio. But it's only as big of a problem as you make it. If scars bother you, they bother you. If they don't, they don't.

Get another opinion. It raises a little flag with me that the first surgeon only spent 15 minutes with you. Did he seem like he was rushing? I wouldn't go to a surgeon who didn't want to spend the time to thoroughly discuss every aspect of my surgery and answer all of my questions. If you decide you're still interested in using him, ask for another consult. He should be happy to do one, and if he's not, then maybe he's not going to be willing to spend much time on you for your recovery either, and you should steer clear.

Keep us posted!

I had a fairly large muffin top that Dr Sauceda lipo'd before he did my LBL.  I'd asked him about the vertical cut, as most who'd had a muffin top, needed the vertical, but he explained to me why I didn't.  My LBL, BL, arms, and medial thigh lift were what your first PS quoted for your LBL and mons lift.   

You can send pics to [email protected] and see what he has to say.

Only you can tell how bothered you will be by scars.  I personally think scars are no big deal and wanted as much skin gone as possible so I could look the best in my clothes, which are what I spend most of my time in.

Hope the last consult clears things up for you.

Dr. Namnoum sounds like he has similar views as my surgeon, Dr. LoMonaco. After losing 200+ pounds, I was sure I needed a fleur de lis, but Dr. L got me completely flat without the vertical scar. And I still have a waist. I'm still swollen from my lbl, but just got home from shopping and I now wear a size 4 (was 6/8 pre-op). And $3000 is really not much more, if you decide Dr. N is the surgeon for you.

I think a skilled plastic surgeon can give most people excellent results without the vertical scar.

Laura

Bethany, I've been on 3 consults regarding a TT and I'm worried about the vertical incision, too.  I have no plans to wear a bikini, but I could get into the idea of wearing a halter top that would show some midriff. 

The first surgeon I consulted with thought I needed a Fleur de Lis TT.  Second and third surgeons said they don't like to make a vertical cut on someone who has no scar there already.  My upper abdomen looks like  I'm pregnant even though I'm about 10 # from my goal. 
I'm so confused.    We're having similar experiences.

-Jenny

I knew before I saw Dr. Sauceda that I needed the Anchor Cut TT.  I had so much excess skin above my bellybutton.  He agreed and I am thrilled with how flat my tummy is now.  I have no regrets!  I had originally gotten just a TT and when I sat down the excess would roll over my pants.  It was pretty ugly!