To plastic or not to plastic ?? - ThinnerTimes - Gastric Bypass Forum, Lap Band Forum, and Vertical Sleeve Gastrectomy Forum

LizzieShell · 02-06-2010, 07:15 AM

I had my RNY on Halloween 2008 so I am nearly 18 months out and I have lost about 105 lbs. I am weight stable and have been for the last 4 months. I typically bounce between 140 - 145 now.

My heaviest weight was 340 lbs about 15-16 years ago and I was 320 lb when I married my DH in May of 2001. I had both of my kids while I was obese (they are nearly 28 & 29 years old now). I was about 245 when I went into surgery. So I have done a number on my body. Of course the worst areas hit is my middle, the belly and upper thigh area.

I have always been "big". When I was in high school, I was built like a brick house, solid but large. I was about 150 - 175 lbs though HS. So at 5'3", I was obese then. So at nearly 49 years old, I am at my smallest right now.

So here is my dilemma, from a lifetime of being fat I have that ugly flap of skin & fat on my belly & hip area that makes tucking in a shirt impossible. When I look at myself in the mirror, I can see that I am thinner. BUT when I look down at myself, it all looks the same to me as it did before the surgery. It's really mind blowing to look in the mirror and see one thing and look at myself and see something else. In my mind I know it could have been worse and I can live with my arms a bit flabby (I am blessed and do not have the "bat wing" problem, just some minor looseness). And I can live with the upper thighs, I'm too old for mini-skirts and "daisy" dukes anyway

But I don't think I can live with the belly flap. I'm still not comfortable in my own skin!

I am not overly worried about the pain, I have a high tolerance and that's what they made pain meds for. I get very sick from the anesthesia, like throwing up sick - took the hospital three different meds to stop my dry heaves after my RNY (as LoriAnn925 said - not fun throwing up with staples in your belly). But I am more worried about complications that insurance won't cover than anything else.

I am a lucky girl that my husband loves me not the outer package. BUT I truly just don't want him to touch me and when he does, I need to keep a long shirt on to cover myself. My DH is very supportive and has been neutral about a TT, so it's really my choice.

My family (5 out of 6 sisters & father) has already said that there is no reason for me to have a TT. I don't have "enough" extra skin. But what constitutes enough? I am going to be in this body for another 20 years hopefully more, so does what they think is "enough" matter? My youngest sister said I wasn't fat enough for the WLS in the first place. She's also the ONLY one who has not said anything about how I look now (strange, huh) And she is about 20 - 30 lbs overweight (and 15 years younger than me) , but she has not been that heavy her whole life only in the last 4 years. So I feel like I can not tell them about this, with one exception - my sister Kelly in California would not be judgmental. She has been my biggest supporter through this whole process so far. I think that she will understand.

I have an appointment for a consultation for a local surgeon that did a co-workers TT about 3 years ago (and arm lift nearly 2 years ago) on March 16th. That way I will have a concrete cost, not just a guess or based on what someone else paid for the surgery. And I can ask the questions about complications and deaths related to the TT in his experience. And what other advice I need.

I can get the money for a TT from my 401K (loan) but it will add to my already tight budget. Is peace of mind worth it? Is self-esteem worth the $6,000 or so. It's it worth the physical risk? Can my transformation from an obese woman to a "normal" woman be complete without the TT. My emotions, my heart and gut say NO, my brain is not so sure. But I know I'm not getter any younger

or any richer, so the time to decide is soon.

Kaly · 02-06-2010, 07:28 AM

I think the answer is in your signature. You already know in your heart what you need to do.

Pink Stella · 02-07-2010, 10:46 AM

Since you asked, here's what I think.

1. You can't take your money with you when you die. You might as well enjoy it now. I would say that there may be better options than borrowing against your 401K when you're so close to retirement, though. I would look into getting a loan from the bank or seeing if the doctor has financing options (many do) because it will cost you less in the long run. I'm sure you know this, but if you take money out of your retirement accounts, you're losing a lot of compounded interest. That being said, if it were my only option, I'd do it.

2. If you really beleive in your heart of hearts that there is something wrong (or at least not right) with you, and you have the ability to correct/fix it, why would you not?

3. Screw your family. And I mean that in the nicest way. They care about you and want you to be healthy, sure. But deep down, each of us thinks more about our own self more than anyone else, with very few exceptions. Your younger sister probably can't acknowledge your success because she's too focused on her own struggles. You didn't have WLS for them, why put off a tummy tuck for them?

4. As for insurance coverage, you should check out your policy. Mine has a clause that says, basically, even if you have a non-covered procedure, any medical complications that may follow are covered. In other words, if I have a cosmetic procedure but have a medical complication, they are going to cover the medical complication. I mean, if you're an idiot and you play in traffic and get hit by a bus, they're going to cover that, so why wouldn't they cover any post-op medical complications?

When I first started this journey, the first real feedback my husband gave me was to ask why I wanted to do this. Once he realized that I was doing it for myself, my own peace of mind, health, and happiness, that was enough for him and he was behind me 110%. It sounds like you have that same support from your husband, too, which is wonderful. I think you know what you really want to do, and I think you should go for it.

MiladyB · 02-07-2010, 07:50 PM

I've had a tummy tuck and breast lift. Like you, I was very uncomfortable in the body I was left with after wls. I'm so glad I made the decision to have the tummy tuck. I felt so much better about myself. It made me feel like I had completed my wls journey and it brought me to a place that I finally felt "normal".

You may want to check your insurance policy. They may cover the tummy tuck. Many of them do as long as you have proper documentation.

Kaly · 02-08-2010, 04:29 AM

Quote:

Originally Posted by MiladyB

I've had a tummy tuck and breast lift. Like you, I was very uncomfortable in the body I was left with after wls. I'm so glad I made the decision to have the tummy tuck. I felt so much better about myself. It made me feel like I had completed my wls journey and it brought me to a place that I finally felt "normal".

You may want to check your insurance policy. They may cover the tummy tuck. Many of them do as long as you have proper documentation.

Can I ask, what kind of documentation is necessary for the tt?

LizzieShell · 02-08-2010, 04:35 AM

Quote:

Originally Posted by MiladyB

I've had a tummy tuck and breast lift. Like you, I was very uncomfortable in the body I was left with after wls. I'm so glad I made the decision to have the tummy tuck. I felt so much better about myself. It made me feel like I had completed my wls journey and it brought me to a place that I finally felt "normal".

You may want to check your insurance policy. They may cover the tummy tuck. Many of them do as long as you have proper documentation.

my insurance won't cover it. The panni is not that low (unless you take my belly button out, that's the only thing holding everything up

). I don't have any rashes, or anything like that. I will have to pay for this out of pocket. It's a matter of trying to get all the pieces together now. If I do it, I would like to have the surgery in early May, that way I can still enjoy the summer weather.

LoriAnn925 · 02-08-2010, 06:16 AM

Quote:

Originally Posted by LizzieShell

my insurance won't cover it. The panni is not that low (unless you take my belly button out, that's the only thing holding everything up

). I don't have any rashes, or anything like that. I will have to pay for this out of pocket. It's a matter of trying to get all the pieces together now. If I do it, I would like to have the surgery in early May, that way I can still enjoy the summer weather.

I was in the same situation as you. I did not have a lot of extra skin or any rashes. I'm not sure if I didn't have to have some other procedures if or when i would have decided to get a tummy tuck, but even as I sit here less than two weeks from surgery, I am very glad that I did it.

My vision was a lot like yours. I knew that I had lost weight, but everytime I looked at myself naked, I saw that 300 pounds woman because of my flabby belly. I know in my heart I did the right thing for my peace of mind, and my self esteem.

It went so well, that I will definitely consider a breast and thigh lift at some point in the future.

I wish you luck in making your decision.

Vikkator · 02-08-2010, 07:26 AM

As one who had her surgery 4 days after you (same surgeon and same hospital, no less) and whose starting weight was close to yours, I've been kicking the idea around myself. I had twins 21 years ago and they did a number on my middle and I've always contemplated a TT just to make my road map of a belly (and the resulting vertical scar from an emergency C-section) look better. I too have a lot of hanging skin, everywhere. I too deal with the same issues about covering up.

I talked to my gyno about it recently. I said what the heck, at my age, I'm not exactly trying to look like a super model. But he pointed out to me that I will probably live for another 40 years or so, so why not make myself look and feel good? He said that just because I am an older adult, I shouldn't 'settle' for looking and feeling anything less than my best. After all, I had the WLS to better my life, why not be totally satisfied with the results?

As far as borrowing from your 401(k), we did that this past year to buy an RV. I asked our financial advisor and he said that since the market was awful (when we did it), we'd probably just be losing money anyway, so using the money wasn't such a bad idea. When you borrow from your 401(k) you pay yourself back with interest. It's not considered a distribution, it's a loan. $6k isn't all that much money and you most likely will have it paid off before you get anywhere near retirement. You can have the money (to be paid back) taken out of your pay and you won't even miss it. I say go for it.

MiladyB · 02-08-2010, 07:37 AM

Quote:

Originally Posted by Kaly

Can I ask, what kind of documentation is necessary for the tt?

Kaly, it will vary, depending on your insurance company. This is what mine wanted to see:

pannus hangs below the pelvic area.
3 month documentation of rashes and treatment
stable weight for 3 months
100 pound weight loss

The best thing would be to look at what your insurance criteria is. I took a copy of my criteria with me to my pcp to make sure he was documenting everything the insurance company wanted to see.

dclair · 02-15-2010, 03:42 AM

I was told that if I have a medical issue with the hanging tissue on my abdomen, the insurance will pay for the procedure. The one issue I have is yeast infections. I'm only 6 days out, but this was a problem before surgery. The thing is, I treated it myself before surgery. Now, I will visit my primary care physician each time a yeast infection begins. With that documentation, mine should be paid for. I have Kaiser insurance.

Knowing what a yeast infection is very important. Almost all obese people get them. It is a slightly redded area that is shiny under the abdominal fold (and breasts). If not treated, it will get redder and then have the white yeasty look. What many people do is just figure it's there, and wash the area and keep it dry. If it doesn't go anway on it's own, you can end up with deep red tissue and open areas, yeast will eat tissue. Think about it, have you been there. Well what to do now is see your doctor each time it occurs. They will have you use an ointment or powder to clear it up. The next time you can use the same treatment, but if you don't see your doctor, there is no documented proof of the condition. Look for other issues in that area also. Do you get boils in these areas?
We need to try to adovoacte for ourselves. Take what others tell you as helpful, not as truth. The best thing to do is work with a plastic surgeon. He/She wants your business and wants to be paid. They'll know. and also get your insurance to provide you with[a written protocol on what constitutes surgically necessary to them. This is not easy, but it's worth $6,000 if you can save it, or can't afford it.
So right now I'm doing a "do as I say, not as I do" because I haven't started the process yet. I was told by one of my support team leaders from the insurance that this will work. I have informed my primary doctor that she will now be seeing me with each yeast infection and why. She understands and will be there for me. (I'm going to try to get this to work for a breast lift, but I don't think I'll have success there. It is more popular as a cosmetic procedure)
Good Luck to everyone, and share your knowledge as you receive it.