Excess Skin Removal Surgery?

[Maryposa]

I am supposed to get my official offer letter and start date of May 2nd with insurance kicking in May 1st since i am a "special case" lol so as soon as I have my info I will be launching my process with the new insurance. Did anyone see a dermatologist for extra documentation? I did not do that!

[Monkee]

Originally Posted by Maryposa

I am supposed to get my official offer letter and start date of May 2nd with insurance kicking in May 1st since i am a "special case" lol so as soon as I have my info I will be launching my process with the new insurance. Did anyone see a dermatologist for extra documentation? I did not do that!

I would. The more you document, the better, I think.

[lisabinil]

Originally Posted by Alfred

Work out and control over your diet is the best remedy for this.Too much medicines or other irrelevant treatments also cause more problems for you.So work out and control over your fat junk and fried stuff.

This is the WLS forum-most of us do not eat "fried stuff" or overeat fats because of our wls. Um sorry but those of us who have been morbidly obese and have lost down to a vastly lower weight have stretched skin. No amount of vitamins and minerals will help this.

[ANGELFIRE80]

Originally Posted by Alfred

Work out and control over your diet is the best remedy for this.Too much medicines or other irrelevant treatments also cause more problems for you.So work out and control over your fat junk and fried stuff.

[Hot Tamale]

Thank you Lisa and Angel for posting those posts. Glad I wasn't the only one who was a bit... disgruntled about it. Not to mention, if everyone knew how much many of us exercise and work at all of this...that post would never have happened.

[Monkee]

I totally disagree with you, Alfred.
If what you say is true, I would have a swimsuit model's body by now. LOL.
I can workout all day long and while it is very beneficial for fitness and even for reshaping my body, it does nothing for the skin. Like Lisa said, too much weight, too much stretched skin. Its inevitable. One can assume that loose skin will result after large weight loss.

[Maryposa]

Just wanted to share a guideline from my insurance. The abdominal portion of the surgery (surgery #2) is not scheduled until december so I believe I will meet all criteria.

Medically Necessary:

Panniculectomy is considered medically necessary for the individual who meets the following criteria:

The panniculus hangs below the level of the pubis (which is documented in photographs); AND
The individual has achieved significant weight loss and reached a body mass index (BMI) less than or equal to 30 kg/m2,as well as the following:
the individual has maintained a stable weight for at least six months; AND
if the individual has had bariatric surgery, he/she is at least 18 months post operative; AND
One of the following:
there are recurrent or chronic rashes, infections, cellulitis, or non-healing ulcers, that do not respond to conventional treatment for a period of 3 months; information must be documented in office visit records; OR
there is difficulty with ambulation and interference with the activities of daily living; information must be documented in office visit records.

[Maryposa]

and for brachioplasty and thigh lift

A. Brachioplasty:

Brachioplasty is considered medically necessary when done in the presence of significant physical functional impairment and the procedure is reasonably expected to improve that significant physical functional impairment.

Brachioplasty is considered cosmetic and not medically necessary when done in the absence of significant physical functional impairment or when not expected to improve a significant physical functional impairment.
Brachioplasty

Brachioplasty has been proposed as a treatment for individuals with conditions related to excess skin and subcutaneous fat associated with significant physical functional impairment. Conditions such as persistent infection or maceration resistant to conservative therapy that pose a risk to an individual's health may be indications for brachioplasty.

B. Buttock/Thigh Lift:

Buttock and thigh lifts are considered cosmetic and not medically necessary when done for any reason.

[Monkee]

Thanks for the info. What insurance carrier do you have?

Even if the butt lift is not covered its pretty awesome that other procedures will.

So excited for you!

[clmoore]

Maryposa: I'm sure you will be very happy with your results!

I don't post much, but read here every day. I'm scheduled this Monday, June 6th, for hopefully my last surgery. I am having arm lift, thigh lift wtih the incisions at the arm pit area and upper thigh areas only -- surgeon is going to pull excess skin up and remove so I won't have the incision all the way down arms or thigs. I am also having me some boobies installed. I am less than an A cup now. I will be having silicone implants placed behind muscle.

As I've posted before, I already went through tummy tuck and butt lift last July and had a lower face/neck lift and brow lift in December.

I'm very nervous about Monday's surgeries, but look forward to this final step.

I'm 5'7" and weigh about 142. Lost 120 pounds from RNY gastric bypass in August 2008.

Please say a prayer for me on Monday!

I love reading all of your posts!

[Hot Tamale]

I sure wish you both success with your surgeries. I do have a question. Do doctors have a limit to how many procedures they do at once? Is it based on how much time they take for each one or how much area they'll be covering? I will need (for sure) a tummy tuck of some sort (meaning it may need more than just a tuck - I have an extreme issue there...), a thigh lift, and a breast lift/fix of some sort. I am also strongly considering having my arms done and having some sort of neck/face lift. Would they do that all at once or will I most likely need 2 different times? Part of the reason I'd want to do it all at once is I have a filter (for blood clots) which needs to be removed before 11/12... A related question, if they will not do it all at once is there a wait time between procedures (say three months or...?)? One more - if you ladies work out/exercise/etc... have you heard or can you tell me how long before you were able to exercise again? Thanks for posting all of your information - I am sure I speak for many when I tell you it is helping me a lot! Thanks and you are both in my prayers!!

[clmoore]

HOT TAMALE:

I would NOT do all those procedures you listed at once if it were me. My doctor said the hardest surgery is the tummy tuck/butt lift he does with one incision around your whole body. It was my first surgery and I did fine. I was off of pain meds after two days. The sorest part of that was the abdomen muscle repair where they pull your muscles back together.

Next, I had the face and brow lift. I again was off pain meds after two days.

This time, I am having three procedures at once... arm pit cut for arm lift, front and back of top of thigh cut to pull up excess skin, and boob lift with silicone implants. These are the most procedures he has done on me at once and he estimates it will be an 8 hour surgery. My tummy tuck/butt lift was 6 or 7 hour surgery. He said if he had not operated on me before and knew how healthy I am, he would not do these next three at one time.

You have to remember where all these incisions will be and how it will affect your body movements... arms, stomach, head, and how you can perform every day functions.

My doctor is very conservative and he also says some of us with the absorption issues don't always heal as fast as "normal" folks. I have been very fortunate in my healing, BUT, I do get all my protein in and take all my vitamins every day.

Hope this helps.

[Hot Tamale]

Thanks clmoore - good info I am just so ready to look better. I mean, I still have a long way to go but I am trying to plan in my head when I might get things done and how long I'll need for recovery. I'm also good about protein and vitamins - I hope I can have a successful time like you have. Best of luck to you on Monday!!!

[Maryposa]

oops... the pasted info is from anthem blue cross and they are covering my brachioplasty.

[thinr4me]

I wish I had the guts to do my thighs..........

[Hot Tamale]

Trust me - if you saw my thighs you'd understand why it is a no-brainer for me. They MUST be done! Far worse than my arms so far...

[Maryposa]

HT sorry i did not answer but i agree, the procedures need to be done separately. Your surgeon will tell you how much you can handle at once. My first surgery is 5 hours long. The second will be 7 hours long.

[Emerald]

I finally just got my appointment for my consult. It's not until August 23.

[Hot Tamale]

clmoore - How are you doing? Please post when you can!

Emerald - Well getting that appointment is the hardest step! I wish you the best with it!

[clmoore]

SURGERY UPDATE:

This past Monday had thigh lift, arm lift, breast lift and silicone implants behind muscle.

Surgery was supposed to be 8 hours long, but took about 9 hours. Doc said I have some scoliosis in chest (said most people do) and my right side bones stuck out further than left, so he took more time on boobs to get them even.

I went straight home from surgery and my cousin spent first night and most of next day at my house with me.

Remember, he was able to do arm lift and thigh lift without vertically cutting me all the way down my upper arm and upper thigh. He pulled skin up and cut in arm pit and all across groin, under butt cheek crease, and my "mound area" has two vertical cuts on each side. He did laser liposuction around my knee area and my upper arms.

I was and still am in compression garments. The top is one crop top type that stops under my boobs and has 3/4 length sleeves to compress boobs and arms. It hooks up front.

The lower body compression garment they put on me in surgery was SO TIGHT. It went above my waist and down below knees. It was ok except was so tight around my waist that it was cutting me in two and made red marks and I have blisters on my far left side now. I did not and probably could not have taken it off and gotten it back on the first two days. I went to see doctor after two days and he unhooked and unzipped and pulled down to look at incision around groin / upper thighs. Since I didn't really need compression in tummy area, he let me leave that folded down. I did not remove the garment completely until Thursday evening when I took my first shower. Then, I replaced that garment with a pair of very tight Asset brand footless tights after shower.

WORST PART: Until Thursday evening when I put on footless tights, I had been having to try to stand and straddle potty to pee. The garment had a split crotch you are supposed to be able to hold apart to pee, but you know how that goes... I could not control the direction of my pee stream, so felt like I was peeing down my leg and all over the place. I would wipe and wipe off compression garment and me with wet wash clothes and baby wipes, but that was miserable. Amazingly, did not smell, so I must have really been trying to clean.

After I put the tights on, I can pull them down and sit gently on the back of the lower thighs and pee, etc. Then, I clean and clean some more. I am only taking a shower every other day as I live alone and have to have friend come over to help me... mainly because I can't pull on tights by myself at my feet yet because I can't bend over that far without pulling upper thigh incisions.

I only took pain meds until mid morning on Wednesday and only took one every four hours during that time instead of two every four hours. I HATE PAIN MEDS.

I have not been in pain as much as very uncomfortable with thigh incisions and they feel like they are burning.

I drove myself to the office on Friday and stayed six hours!! It feels much better to walk around or lay on my bed propped up with legs streteched in front of me. Sitting down is not comfy.

Of all the surgeries I have had... lower body (tummy tuck/butt lift), face/brow lift, boob implant, arm lift, and thighs, the THIGHS ARE DEFINITELY THE MOST UNCOMFORTABLE.

When I first saw my boobs in mirror at my first shower, they look so weird and alien to me. I had less than A cup boobs before and these look so high and big right now, but friends who have had same surgery say they will settle down behind muscle and they will look so pretty that I'll be wanting to show to everyone.

It is Saturday and I have been in the office since 7:00 this morning. It is now 12:40. I can only sit in my desk chair kinda leaned back for so long, then have to get up and walk around.

Hope this helps you all. If you have any questions, please let me know!

[Hot Tamale]

Wow clmoore - great, honest information. I knew it would be hard, and from what you're saying it IS hard. I hope every day you're feeling better; though - and imagine how great you'll look and feel in a few weeks! Hang in there!!! Hugs!

[clmoore]

must say, the cosmetic surgery after weight loss is NOT for everyone. It is not any kind of fun. I am ashamed that I damaged my body so much by becoming morbidly obese. I am now literally and physically paying to repair the damage I did to my body.

This is the last surgery I plan to undergo.

I am concentrating on eating good protein, taking my vitamins, and healing. I plan to take care of this repaired body and hope to never use food as my drug of choice again.

It is a struggle EVERY SINGLE DAY!!

[Maryposa]

wait.... you are already back at work??? My surgeon told me I will need to take a MONTH off after the lower body work... whoa!

[clmoore]

Yes, I am back at work. I am an office manager, so I don't do heavy lifting, etc. I am just walking around my house, so I can do that at the office and have something to do.

I think I tolerate pain well and I have an excellent surgeon. He doesn't pump me full of fluids during surgeries, so there is not as much swelling... thus, less pain.

I am also a determined person and I want to get better fast and I think coming off pain meds as soon as I can helps me heal faster.

I had my lower body lift done last July and drove myself to office about 4 or 5 days later.

[Maryposa]

WOW! Amazing! You are tough

[NanaMG]

Does anyone know whether the doctor can tell how much of your weight is the lose skin. I think my daughter may be at her goal except for this excess skin. I don't want her to keep losing unless she really has fat to lose. She is definitely going to have to have the surgery. I think they make you wait a certain amount of time after reachin your goal to make sure you are stable with your new weight. I'm sure they don't want to do such an extensive surgery if someone is going to just gain weight all over again and undo everything.

[Maryposa]

Originally Posted by NanaMG

Does anyone know whether the doctor can tell how much of your weight is the lose skin. I think my daughter may be at her goal except for this excess skin. I don't want her to keep losing unless she really has fat to lose. She is definitely going to have to have the surgery. I think they make you wait a certain amount of time after reachin your goal to make sure you are stable with your new weight. I'm sure they don't want to do such an extensive surgery if someone is going to just gain weight all over again and undo everything.

She could get a DEXA scan or other ACCURATE (ie not bio-electric impedance on a scale or caliper) method of measuring body fat percentage. If her body fat percentage is 25% or below, she is no longer overfat.

[Bejewelme]

CLmoore= OMG you are so right!!! I am paying for all the damage I did eating myself into such a mess for 20 plus years!!!

I had a bilateral brachioplasty on 4/2 I am getting married in Oct and although not at goal, at that point I had lost 115 pounds, I am now at 130 pounds lost, I am trying to get another 35-40 off and then have a TT and boob lift and possibly the thighs. I am 43 and weighed over 300pounds for 20+ years, the skin just doesnt respond to that much weight loss.

Here was pic of my arm before surgery


This was 4 hours after surgery, it really wasnt painful I took 1 vicodin, my arms were sort of numb and felt funny!


THis was my arm 3 days post op after he removed the bandages


3 day scar, this was scary, man I was questioning if I did the right thing


This was 6 weeks post op


8 weeks in my wedding gown getting married in Oct


9 weeks post op


10 weeks


The scars are fading nad do I care, heck no!!! It was the best money I ever spent on me! $6000 insurance doesnt pay, and I told my fiancee I dont care if I sleep in a car, I am getting fixed when I am done losing this weight, I worked too hard not to.
Is it for everyone? It is up to the person, I am blessed I found a great surgeon, the surgery made me want to work out even harder to make my arms look good, I am working out like mad trying to get my abs and back and core in the best shape possible for the impending surgeries! Not sure yet how I will pay, but I know I am not going to look like sharpei forever and these scars are a constant reminder of where I never want to be again!!!!
130 pounds lost, about 40 more to go, 20 for my doctors goal but I think I can get lower than that!!!! I will be happy to help any of you that have any questions, just email me!!! Over 3" removed on each arm!!!
Amber

[thinr4me]

Holy crap you look great

[Bejewelme]

I think this weekend or next is 12 weeks, I will take new scar pics!!

Thank you Linda!!! I workout 6 days a week at the gym, I am running for a 5k I want to do on my B-day, spinning, trying to do everything, but skin is skin! And there is no fixing it without removal at this point.

There is a great site, makemeheal.com, lots of women share their surgery stories, it was my lifeline through this, me and another lady that had surgery in the UK, became good friends, we email everyday! I recommend that site for anyone that wants PS. Many bariatric patients as well.