**Absolutely everything you want to know about abdominoplasty Read Chapter 1 **
Eliminating Excess Skin and Fat after Gastric Bypassï»¿
Fast forward 7 years… my sagging skin and fat were increasingly bothering me, not only cosmetically but also physically. An apron of skin and fat hung down a few inches below my abdomen. My pubic area was terribly disfigured – or at least that is how it appeared to me. I had to wear control briefs that contained spandex to hold everything in place. And I had to carefully choose pants and shirts that were loose in this region to hide my deformed tummy and pubic mound.
When I jogged, my apron of skin and fat would flap up and down and smack against my abdomen unless I wore the control briefs. You would actually have heard the slapping of skin if you were jogging next to me! What is more, an unpleasant odor would form pretty quickly between the folds of skin even with showering regularly. And to top it off, I was having problems with continence! As for my pubic mound, it had always been grotesque and a great source of embarrassment to me. The bottom line: I simply could not take it any longer.
Similarly to my hesitation on the plastic surgery, before I had had my RNY gastric bypass surgery in 2003, I had considered it for several years. I even chickened out of my first surgery date and cancelled it! Fortunately, I went through with the procedure 6-months after the cancellation. After finally undergoing the gastric bypass, I wondered why I had waited so long to have it because it completely transformed my health and had profound impact on my life in ways I’d never imagined.
So, I predicted that I likely would feel the same way about my plastic surgery. And off I went to meet with both of the plastic surgeons whom I had met with in 2006 - only this time I would follow-though with a tummy tuck (abdominoplasty).
Choosing a Tummy Tuck
I decided to start with a tummy tuck rather than to get all those surgeries on my wish list. My reasons were as follows:
- I am not “sold” on the large incision scars left from the arm lift and inner thigh lift surgeries, especially since they are visible to the world. So, I crossed those off the list.
- A lower body lift is a combination surgery that includes a tummy tuck, and buttock and outer thigh lifts. I do not have flabby buttocks or deposits of fat on my outer thighs. So the tummy tuck meets my needs and it is a less costly and less invasive procedure. The recovery is quicker and there is less complication of risk.
- I will judge the results of my tummy tuck and weigh this against the pain and cost of the surgery to determine if I would like to undergo any additional reconstructive surgeries in the future.
Choosing a Plastic Surgeon
I had interviewed three plastic surgeons originally. I quickly ruled out the surgeon in Mexico. When it comes to healthcare, I strongly believe in going to the very best (a career in the pharmaceutical industry can have that effect on you). As such, I just was not confident in going to a developing nation and a surgeon 2600 miles away.
The plastic surgeon I met with in Bucks County, PA, accepted health insurance coverage for removal of the excess fat and skin (panniculectomy). This would save me a few thousand dollars assuming that my health plan would approve the procedure as medically necessary. However, tightening the abdominal muscles, a key component of the abdominoplasty, is not covered by health insurance as it is considered cosmetic rather than medically necessary. Neither is liposuction or correction of the pubic mound covered.
Upon examination of my tummy, the plastic surgeon told me that the insurance company would not deem the procedure medically necessary for me. Typically, documented history of a rash beneath the apron of skin and fat or chronic back pain from the weight pulling on the back are reasons that a health plan would consider a panniculectomy medically necessary. Bottom line, the surgeon would charge me $8500 for the abdominoplasty and would need a second surgery to fix my pubic mound.
The plastic surgeon I met with in Bergen County, NJ, has an excellent reputation within the bariatric community. In fact, he has done more “body work” on bariatric patients than has any other plastic surgeon. He did the reconstructive surgery on my bariatric angel, Kristin Szilagyi and it turned out amazing. You may read my interview with Kristin in which she talks about her weight loss and plastic surgeries.
Anyway, back to the surgeon: His calm and concerning manner and all of the time that he took to speak with me, combined with his excellent reputation, instilled my trust in him. This was huge as I am inclined to toward critical judgment - few people impress me but he surely did. And the truth is, he was the one that I had wanted to perform my surgery all along. I only had consulted the other plastic surgeons owing to the potential cost savings. But plastic surgery is not the time to price shop; you must select the surgeon with whom you have the most confidence.
The bottom line, this top plastic surgeon would charge me $7100 for the abdominoplasty. He also would fix my pubic mound and do a little liposuction on my lower back fat. My choice was easy to make. I asked him to do the surgery the following week because I was reloating out of state at the end of the month. And miraculously he had one opening!
I was scheduled for April 18th! There was no time for me to chicken out!
Living life well-fed,
My Bariatric Life
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