Hi. Often, I will perform a lower body lift and breast lift (with or without implants) at Stage 1. Stage 2 is to work on arms and legs, plus any touch ups from Stage 1. Hope this helps.

Oh Em, thank you so much! I will read through all that you've linked.

I am proud of myself, in a cautious kind of a way! I feel very confident in clothes, but without them it's a whole different story. I feel love and compassion towards my body, though - it isn't my body's fault that I went through all of that, and despite everything, I remain, thankfully, healthy. I just cannot see comfortably entering a physical relationship looking as I do. Plus, just in terms of my own happiness in how I look, it is important that these things be addressed.

I totally understand the feeling that having plastics adds insurance against ever lapsing back into being so heavy. I know I will view it exactly the same way.

Thanks again for your kind and thorough response.

I don't have a surgeon picked out, but would travel if I had to and was unable to find someone truly top-notch up here. I wish Dr. Michaels wasn't so far away, he sounds pretty perfect. I don't mind traveling as I said for the surgery, it's the follow-up visits beyond the first couple of weeks that would become difficult.

Good to know that it isn't so important to have a face lift done by someone deeply experienced in post-massive weight loss PS. I'm sure I can find a good regular cosmetic surgeon in the greater Seattle area, or I could go to Santa Barbara and have it done down in that area, since I could stay at my brothers, at least until they sell or rent their house there.

First of all, CONGRATS, Cara! You have lost such a tremendous amount of weight. You should be so proud!

Going into RNY, I knew some people had sagging skin but (bizarrely) didn't think that would happen to me. Um yeah, until I got down to 160 from HIGHEST weight 369 (surgery weight, 351). I had the worst deflated tube sock breasts and my stomach was a melted candle, and my arms were bat wings. In my mind, I was going to have a tummy tuck and a breast lift and not do my arms (didn't want visible scars). I had a couple of consults and went with the same surgeon that Cynthia and Erin and Gwen used - he's in Bethesda, MD however...so super far for you. I also had a virtual consult with Dr. Capella in NJ. Their advice and prices varied.

I ended up with Dr. Michaels since he works a lot with plastics and body contouring with clients who have had massive weight loss. Like Laura in Texas said, it's SUPER important to choose someone who specializes in that.

Dr. Michaels helped me see that a tummy tuck would fix the front of me, but then my back and butt would be super droopy, so I needed a lower body lift. He was pretty sure that I could do a breast lift without implants and get fullness by using my own body fat to transfer into my breasts and my butt. I am THRILLED with how it turned out. But once my body was mostly fixed (I don't care about my dimpled saggy thighs - that recovery is something I never want to go through!), I realized I had to fix my arms. Luckily his stitching is so thin and clean that my scars are not super visible.

Plastics did two things for me - 1. They helped me to not be so self-conscious and 2. I feel like they are a bit of an insurance policy. I will be damned if I am going to regain back to 300 lbs after investing that much money into my body!

Here are my plastics posts in case they are helpful :) It's hard to believe I will be five years post-op in a couple of weeks!

Four year surgiversary: http://www.obesityhelp.com/forums/rny/6028857/Four-years-gon e-by-and-RNY-is-still-the-best-gift-I-ever/

Money is an issue for me too, but it is something that in time I can resolve. If I could only have a few procedures is choose a LBL, BL, and facelift, probably. But my thighs really need help, as do my arms...honestly I would like everything done!