[Colleywobbles30]

Does anyone know how long after surgery you can start considering PS? I am mainly concerned about my tummy ( of course) and my breasts. The thigh area is a mess but I can live with that and as far as arms go, I think with a lot of hard work I can make them "acceptable" July 24th will be my one year anniversary and I was hoping to possibly have the surgery in the Fall (Oct/Nov) which would put me at 14/15 months out. I know that my insurance will pay for the panniculectomy (spelling) with prior authorization.. I'm assuming that most plastic surgeons would know the ways to get through to the insurance company? Also, when doing the panniculectomy, what all do they fix? Do they take off skin around the lower back? Also, for us women ( sorry men) do they fix the pubic area -- it's hard to explain but I'm sure many or you know what I'm referring too -- the area where your pubic hair grows that tends to deflate as you lose weight? Last set of questions, will surgeons let you do the boobs AND tummy at the same time? When you get a lift and augmentation, do they help with the hanging skin on the sides of the breast, what I like to call my 2nd boob?

Sorry for all the questions, hope someone can give me some insight.

[DocSanae]

If it is just considering, you can start any time
If you mean the time frame of when to schedule surgery, then the recommendation is 18-24 months post op at the earliset, and at a stable weight for 6 months. Generally, your skin will shrink some more even after your lbs loss has stopped, so it's better to wait until then.
Most PS are NOT covered by insurance. If you have skin irritation or back pain due to the excess skin, then, it may be covered as medical necessity. In this case, you need to have it documented, so have your dr record such issues. Also, what type of procedure is covered in these cases is limited, so, if you want to have extended reconstruction beyond that, that will have to be out of your pocket.

The process of consultation and getting surgery will take at least a few months to 6 months, so, if you are over a year out, and your weight loss is really slow, you can start planning ahead and start consultations to see what the surgeon says, check out the costs, and make a go at insurance approval, because probably by the time surgery can be scheduled, you will have gotten to the time frame when it can be done.

Check other threads up in this section, go to the index page of this section and read what others have posted about their surgeries.

[not quite Barbie]

As Doc said, most PS want you to wait until 18-24 months and at a stable weight. A lot will want you to be stable for a year, not just 6 monts, but of course you can find some PS that will do it earlier. Is it in YOUR best interest? No.

Most insurance companies will pay for a panni if you can prove medical necessity. You need to document any/all rashes by visits to your PCP as well as showing that the rashes return or are not responding to treatment. THey will also pay if the "apron" is hanging low enough to get in your way of walking. Or if you have a hernia that needs repaire. You should contact your insurance company and find out what they require to prove medical necessity and then start documenting it.

THe panni is the simple removal of the part that hangs down. There is no pulling down/up of any areas, they don't do any muscle tightening or lipo or anything to contour - simply lop it off and sew it up. Most PS will give you a quote for a full tummy tuck and the panni and you have to pay the difference if you want the tuck. A standard TT will go from just inside your hip, down to the top of your pubic hair, and end just inside the other hip bone. An extended TT can wrap around your side to nearly reaching your back. THere's also a procedure especialy for WLS patients where they go all the way around, bascially a butt lift and tummy tuck. Some PS will do enough pulling to have some effect on the pubic mound and raise it some. Discuss this with the PS, though I'll warn you that mine said I would get a mons lift with the TT and there was no lift. Grrrrr

Most PS want to avoid turning the patient over during surgery, which means they want to work on just your front or just your back. So yes, they will do a TT and a BL/BA at the same time. They don't like to do the arms and the tummy at the same time because you use your tummy muscles to stand up/sit down and when you can't do that you use your arms to lift/lower you. If you get both areas done then you can't get your self out of a chair.

As with TT, there are multiple approaches to breast lifts. And by the way guys, this isn't just for the gals, they remove "man boobs" too. There are procedures that will address the skin on your sides (side boobs) but a BL/BA isn't the procedure that takes care of that area. I think they do that when they do the arms, or they can do like a reverse tummy tuck where they make the cut at the bra line and pull the skin up instead of down.

There are lots and lots of ways to remove the skin, it's all going to depend on the individual. Where you have the most loose skin, what's bothering you the most, and unfortunately, how much you can afford. Most of the PS will do a free consultation so call around and start setting up appointments. You'll get different opinions and you'll have to decide which approach you think is best for you.

My best advice: don't rush it. Wait as long as you can, make sure your weight has been stable for a long time, give your body that year at a stable weight to do it's thing because some of the skin does shrink in the second year. But go ahead and start researching, getting prices, figuring out what you can afford and how you're going to pay for it, and documenting rashes.

[Nurse2B]

Nothing more to add, just good luck. I'm in the process of saving for PS.

[judijo]

I know one woman who had PS 18 months out and she regretted the decision. She wished she had waited until 2 years after reaching goal.

I am "old" so I am not considering PS unless it is a medical necessity.

Doc is right...start considering now, but wait for the actual procedure.

[BreeChick]

Everyone has such good advice on it!

The most important thing that everyone is saying "don't rush it!" listen to that part!