Question:
Where do I start ?

I'm 7 1/2 months out, down 90 pounds. Starting weight 256 now at 166 5'7". anyway. I'm was wondering if anybody who has had plastic surgery could shed some light on where to start? Do I go see my PCP first? Do I just go to a plactic surgeon? Who submits the ins. paperwork for approval? Sorry so many ? I just don't know where to start> Thank you all so much AMY    — Amy M. (posted on July 18, 2003)

July 18, 2003
Hi... why do you want to go for plastic surgery so soon?? I am 19 months post op and won't even have plastic surgery... I'm tightening up my skin on my own through batwing/batthigh and pannie exercises. It si a lot less damanging, less pain, less scaring than plastics... but the only draw back is it takes a bit longer... I had well over a 100 lbs more to lose in the beginning than you did, too... email me if you want more info about this... in my humble opinion, the fewer surgeries, the better! :~) Lap RNY, 12-01, down 227 lbs!!
   — Sharon m. B.

July 18, 2003
I agree with the prior poster, you are way to soon to be doing plastic surgery, You will continue to lose till you are about 14-18 mos out, no Plastic Surgeon in his right mind would preform this on you now, please wait! Heather Open RNY 8-15-02 305/187/150
   — heathercross

July 18, 2003
I agree, too soon for plastics. Need to wait ATLEAST a year. Your not done losing and your weight should be stable for a few months before you have it done. I was 17 months out when I had mine done. I also have to kinda disagree with the poster about exercising taking care of all the saggy skin. Yes, to some degree it does help for SOME people. It all depends on genetics, how much you had to lose,if you've had kids, etc. The minute you have stretch marks, that skin is NOT going to bounce back all the way. But to answer your questions, this is what I did. I went to a Plastic surgeon who took my insurance. He would've submitted it to my insurance but he deemed it cosmetic; not enough skin hanging, no rashes or infections. (document any rashes or irritations with your PCP!) I ended up paying 19k out of pocket cause I really wanted this surgeon. He knows ALOT about WLS patients and I had seen his results on people. He was well worth the money. I had an extended TT, brachioplasty and breastlift. I had a total of 7lbs removed and I'm down 10lbs and at goal at 3 months out. I would've not been able to get at goal without the PS.
   — Kris T.

July 18, 2003
Amy, to answer your question: Whenever YOU are ready to begin your plastic surgery research, depending on your insurance company whether you need a referral from your PCP start there. If (like me) you don't need a referral you can schedule a consult with a plastic surgeon anytime. I was not charged a single penny for the consult so that was great. I had my consult last month (9 months post-op) for my breast and arms. Yes, the surgeon suggested that I wait until my weight loss stabilized to get better results, however the consult was still very informative. The surgeon's office submitted my information for approval for breasts and arms and I was approved for both this week. I will be waiting until November to have surgery so that I may lose more weight, but I'm not waiting any longer than that for arms and breast looking like they do now. I will be 14 months out when I have my surgery. I am considering a TT, however I am willing to wait until I'm long out, say this summer, to see if I'm interested in pursuing that. If you have rashes or anything like that having those documented with your PCP can assist in your approval. I do not have rashes and I didn't have any hoops to jump through. I went to the consult with my saggy arms and breast and was approved about 2 weeks after everything was submitted. My surgeon didn't make a decision that it would be denied if submitted, he submitted regardless. He did however tell me that most insurance companies do not pay for the arms, so I fully expected the breasts to be covered and not the arms. Needless to say, I'm ecstatic that my arms will be covered too. I would personally make sure any surgeon submits to insurance regardless of what they think is cosmetic or not. You just never really know what will happen. I realize not everyone is that lucky, but still. Good luck for whenever you decide to begin the plastic surgery route.
   — Click

July 18, 2003
I haven't had plastics, but had to respond because you and I started out at the same height and weight on day of surgery, and you're about where I was (weightwise) at seven months out. I'm 13+ months out now. I continued to lose a lot more weight than I expected fter the seven month mark, and with those last 30 pounds or so that I lost (shooting below goal), my skin changed a lot. My exercise regime, which was always pretty good (as a post-op, anyway), got better as I got stronger and smaller, and my then body changed from all the running I was doing. Uh oh -- Melted Candle Alert! Awhile later, I noticed the skin seemed to be tightening up a little, though I have no doubt that exercise does NOT get rid of excess skin (if I want that to happen, plastics will have to happen). All these changes in just the past six months or so have led me to conclude I ought to wait another six months before taking the plunge, though of course the thought has been on my mind ever since serious weight loss began.<P>I think the most important thing is for you to decide exactly what you want done and how you want it done. It would probably help to do a lot of research, talking to WLSers who've had plastics whose body types are similar to yours. I'd try subscribing to the Yahoo OSSG (obesity surgery support group) for WLS patients who've had plastic surgery. Folks there are generous in posting and/or sharing pics, and referrals. You can see all sorts of different starts and outcomes, and it will help you ask better questions of your docs about what you can expect (and to be realistic about what to expect). Man, if you think there are conflicting opinions about WLS around here, the plastics debates are even harder to follow at times -- different types of TT incisions, different post-op practices, confusion about how and why docs will or won't do certain plastics procedures together, insurance ins & outs, and (most disturbingly) people needing revisions. That way, you're really getting ready for the process mentally, as your body settles into wherever it's going to settle in these next few months.
   — Suzy C.

July 20, 2003
You should start talking to people who have had the same type of procedures that you want to have done. Ask them about the doctor and look at there scars. That will give you a good idea of what you'll look like after. Make appointments at several different plastic surgeons and ask to see pictures and ask how they will handle your surgery. Your PCP can help in sending in a letter of medical necessity but it really should come from the PS. If he won't do that, I wouldn't use him because obviously he's only in it for the money and your care could suffer for it.
   — Patty H.

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