Since you've had children already (my girls are roughly the same ages as your kids...3 years & 7 months) you can either go with the NuvaRing or the IUD.  Personally I have the Mirena IUD and LOOOOOVE it!  No muss...no fuss...and good for up to 5 years.  I had an IUD inserted when my first child was 4m old and had it for a year.  Had it pulled and the month after it was removed got pregnant with my 2nd child.  When she was 4m old I had reinserted again and so far...so good!  Either way it's up to you.  As far as breakthrough bleeding with the IUD it can cause funky periods for a short time but it's not bad.  I had mine insterted in early April, had a period for about 2 weeks...then 2 weeks later had another one.  Then the next one came a month later and then about 2 weeks ago I spotted for about an hour and that was it.  I don't expect AF to come anymore as that's what happened with my last IUD.  Anyway...you really don't want to go a route of birth control that has to do with intestinal absorption as there is the possibility of it not being absorbed all the way for it to be as effective as it needs to be.

Good luck and if you have more questions about the Mirena IUD just ask!

 Yes I have checked it out and that is the surgery I want. I go to a seminar on the 24th of September. I have a local doctor that will do it. I hear he is just awesome! So, Lord willing my insurance will accept it.

It wouldn't hurt to do a lot of research about the DS and the RNY and then figure out what you think is right for you.

I had the DS specifically because of my PCOS and I'm only about 100lbs overweight.  Within days I got my period, which I have never gotten without the help of BCPs or progesterone.  For me the choice was about how the insulin issues are fixed with the DS and the metabolic component.  My surgeon referred to the change rate of DSers with PCOS as 'astounding'.

I'm sure you have a great surgeon and I understand why you would want to trust and stick with him, but I would consider talking to someone who specializes in the DS.  So many surgeons know very little about it and poo-poo it because they are not skilled in that particular surgery. 

I'd just suggest you know ALL your options - the stats for the DS are stellar.

since someone here just asked me, I had IPL laser treatments in 2004. It included my sideburns, mustache, chin, neck (full beard area). In total I had about 8 treatments total.  It prolly ran me about 2,000 bucks.  This was during a period of  18 months.  Today I have about ten to twenty stray hairs. I just pluck those and sometimes shave cuz I hate the peach fuzz on my face. I am so used to shaving.  I used to spend about 30-40 dollars a month on shavers/cream. This doesn't include the makeup I would buy to mask 5 o'clock shadow (some of you know what I mean). The laser treatments have practically paid for themselves already in the savings from shavers/cream/etc.  No one has asked me if I did anything special to my face, they just used to comment that I looked younger and did I just come back from vacation. Unless I look at my pre-laser photos, I don't remember what it was like unless I see a female with the telltale beard growth. If you're in New York, I recommend the lady that did mine, her name is Shizuka.

Nothing should happen to it since once a hair becomes what they call "terminal hair" it is permanently that way.  The only way to permanently get rid of terminal hair (or any hair) is by electrolysis.  Laser is also good but may regrow. I personally had laser treatments on my beard area about 5 years ago and am sooooo happy with my results.  It really changed my life.  The only thing I could see WLS helping with is preventing our vellus hair from becoming terminal (thick) hair.  Some people experience head hair loss after WLS.  Don't know if it impacts the growth cycle of facial hair. If it did, it would be temporary just like the head hair loss is temporary.

There is a prescription cream called Vaniqa. I never tried it but it's supposed to help with slowing down growth of already terminal hair.

Mimi