Jolls

Surprised to see me in this forum? I am.....

84 posts in this topic

Plastic surgery is really never something I thought would be for me or I would consider.....and this is really only because I am super frugal and have a hard time justifying spending this much money on something I don't really "need".  I "need" to fix my leaky basement, I will "need" a new car sooner then later....   I don't "need" 20lbs of remnant stomach cut off technically....    that is how my brain works.  Anyway...

I am fine with my body 90% of the time.  I don't like it....but I am fine with it and I most certainly can live with it.   The other 10% I will have random meltdowns about it.  Despite losing 190+ lbs and 22 inches off of my waist -  when I look at my naked body I often feel as if I lost NOTHING because of the huge apron/pannus I have left.....and the mons...hate the mons most of all.   At least a little bit of my waning motivation I think is because of this;  how I often feel as if I lost nothing because I still have this huge mass of a 'stomach' noticeably (in and out of clothes) left.   BF is actually the one that encouraged me onto this process -  he says he knows how hard I have worked/work and it clearly bothers me so instead of saving for XYZ....why don't we look into plastics instead?   And so that little push led me to a consultation today.

I was worried I hadn't lost enough to qualify for plastics (too far from goal) -  worried that I have regained too much and thus not 'weight stable' enough for plastics....  but he said everything was fine and I am eligible.  Of course the less I weight or closer to goal I am is the most ideal/more he can remove;  but for what my expectations/wants are regarding plastics;  he is fine with me doing it now (or when I choose).  And of course I am a one-of-a-kind unique case on top of this we found!  I had open appendectomy like 25 some years ago -  I have two massive scars from it (they couldn't "find" the appendix on the first incision so had to do another).  One runs from pubic area to belly button and pretty much cuts my lower stomach in half so I have a front butt -  a big ol crack with fat hanging off either side.  Insurance only covers panniculectomy as a medical necessary procedure so if he were just to do a panni - it wouldn't address the excess skin above the belly button so it would still overhang the belly button and I would still get rashes.   I just so happened to have a nasty belly button rash right now so it was really ideal for him to see it and for his pictures he sends for the prior-auth because in order to fix my "medical" issue he has to do the panni and the upper tummy tuck to 'free' the bellybutton.  So I just might.....just might.... be able to get both approved as medically necessary.  Of course one would be better the none though;  which is not guarenteed anyway.  Whether I go with just panni or get both done, he can make my mons at least 50% better so I am all for that.  He said he might have to leave some of the one scar because it runs right up to the bellybutton but since I've had it practically all my life, I really don't care.  I litttttlllle bit apprehensive because I am his first case with this type of issue.

So the ball is in motion.  Have to wait and see what insurance says and then just go from there really.  Still struggling with spending this type of money for this and the one thing I worry most about is if I do get this done...hating something else then.  Sure my thighs are melty, my arms flappy, my boobs saggy socks and my back rolls still there......  will I start hating one of those next?  I really don't want to this to turn into a whole body make over.  I can't really explain why cause I don't know....I just ...  hope I will finally be satisfied having this massive front taken care of and finally feel like I lost 200 lbs. 

Edited by Jolls
staraflur, Kim M, Raeme and 6 others like this

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I worked with a woman who had a pannulectomy and nothing else, and she was thrilled with the results. Like you, she was obese at the time of surgery. Sure her body isn't perfect, but it works for her. Good news about being able to lift your mons in the process. You've mentioned that as your biggest pain point before. You are a practical person and have a clear perspective on what you value. You're not going to get scope creep. I would suggest considering paying out of pocket for the upper tummy tuck if the insurance denies it. You don't need to be dealing with a lingering rash problem. But I think your surgeon can go to bat for you with your specific circumstances and would have a good chance of getting the additional procedure approved on a peer-to-peer review.

I'm happy for you.

LeeC and sprocket like this

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Jolls - I'm going to be keeping everything crossed (and yes, saying a prayer) that your insurance comes through for you.

It's wonderful that you've got the support of your your significant other - he's a keeper!

I'm with Wendy for coming up with the cash for the upper tummy tuck if your insurance won't approve that part (criminal if that happens).

chriss likes this

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Good luck Jolls!  Really rooting for you.  And just because you don't think you "need" it, you certainly deserve it.  Feeling good about yourself 100% of the time is a worthy goal.

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If insurance pays both -  I will do both.  If insurance pays neither - I will have to determine if I really really really want this....and if now is the time for it (maybe I want to wait a year and lose a bit more or something).  If insurance will pay for one and I go for surgery;  I will still get both regardless of out of pocket.   I have a decent chunk put away and my mom, whom came with me to the consult, says they can loan me whatever I need.  (as they did for my sleeve to begin with)

WendyH and tmcgee like this

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Jolls-how exciting for a you! Crossing my fingers in hopes insurance pays for both. You are thoughtful and practical in your expectations and I think you'll be thrilled if you can get this done!

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Insurance denied all procedures.  Not surprised as I never expected it anyway.   Waiting for quotes and then talk with BF and go from there.   I could likely appeal but since I only have 1 documented visit regarding rashes, I don't think it is really worth it.   Perhaps it is a reason to wait after all and get each rash documented over the next year or so.....

I have a pro and con list;  perhaps I will post it another time.  Since this isn't something I was really expecting anyway, I haven't REALLY considered it.  So I'll wait for those quotes first.
 

Edited by Jolls

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I'm so sorry that your insurance policy denied coverage for the procedure(s). I understand the difficulties of trying to be at peace with our bodies after going through rapid (sometimes massive) weight loss. It's like a daily reminder of what I allowed myself to become, and that's not a good feeling. I don't have the funds right now (and maybe I never will) to pay for plastic surgery, and even if I did I'd have to try to figure out which area needs it most. Sigh. In the meantime I might try to focus more on the benefits of my weight loss (and there are many). Wishing you the best in whatever direction you take! 

Cheesehead likes this

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So I did go for a 2nd opinion closer to home yesterday.  I got kind of a different response from this one.   He didn't understand why the cities said I needed two procedures -  Duluth considers it one and labels it all as Panniculectomy; taking care of both upper and lower abdomen.  NO muscle work, no lipo, literally just removing the excess skin.  

Now that I have had two different opinions the main difference I glean is the cities would give me a more "finished" result where Duluth would just give me what I need.   I'm not sure which is better.  Obviously it would be nice to be more "done" but since I am so far from goal, still trying to lose and all I ever was expecting even going into this was to get the mass cut off....Duluth is pretty much what I was assuming would be happening anyway.  Duluth doesn't address the Mons as much as the Cities would.   It is snipped and pulled but he doesn't do any fat removal from it during this time so I won't have the gross flappy flap of a mons; just a fat puffy one.  Not want I want BUT still has to be better then what I currently got.

Duluth said he is amazed insurance declined.  He said he has done panni on people who have lost 50lbs and they paid -  I have lost 200lbs and they won't pay?  He was pretty dumbfounded.  So we are going to try and submit again.  I went to my primary today (had a very distinct and clear deer tick, yay me) and talked to her about the rashes since I have ever went into them before.  I luckily had a rash today under the apron (like my cities consult I had a rash in the belly button) so she gave me a prescription cream and documented in my file that I have taken care of rash issue myself for the last 3 years.  And also said if I do decide to wait and get some more rashes on file;  I can just email her when it flares up again and she will mark it down and tell me to refill the cream if need be.   So I feel dumb now for 3 years not bothering to go in cause I didn't want to pay the $200 office call to have  a rash documented.  Anyone new reading -  go in for that rash the first time!!!  Go get that first one documented and talk with your primary and see if for all the subsequent rashes if they will let you do what mine said I can -  just email and tell her it flared up again.  Seriously am kicking myself for being so stubborn and frugal;  I could have had A LOT of rashes on my file in these 3 years with only 1 paying office visit!

I emailed Duluth today with my insurance info and asked for her opinion if we should submit with the little documentation I have;  or if I should way say 3 months and get more rashes on there.  So waiting back to see what she thinks.

My main concern at this point is when to do this.  How long do I wait to get medical documentation noted for insurance when there is a chance they won't pay in the end anyway?  I never really expected them to pay so it is not a determining factor if I do this or not.  The other big issue I now have (I'm over the money thing) is we are trying to get pregnant.  Not full blown counting cycle taking hormones trying trying - but we have been "not preventing" for over a year now and nada.  Do I wait till after a baby to get this cut off?  How long do I wait to see if I ever have a baby?  If I get this cut off and then the next year have a baby, how much does it stretch and 'ruin' what I did?   These are currently the questions I am trying to resolve as to determine when I am going to go ahead with plastics.

Edited by Jolls
Kim M likes this

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Jolls- I'm so excited that you found another option and that you are on the road to good documentation.

I cannot give you the specific advice you are looking for but I can share my friends story. She started around 350. She lost a great deal of weight quickly and was one of those 5-6 mos post op fertility oopsies that assumed she could never conceive. While losing, because she never had children, her skin shrunk a whole bunch better than mine who started 70 lbs lighter but I've had two kids. 

She is now happily post baby and loving being a mommy but isn't dealing well with the repercussions if what it did to her body. She doesn't have the financial means to get either a panni or tt at this point. So my opinion is if you are going to get more serious about having a baby (yes! Do it!) then wait for surgery. 

If you think your skin issues will bother you too much then Duluth panni option sounds like the way to go. Good luck!!

Stephtay likes this

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So great to hear things are moving in the right direction for you! I don't think getting pregnant will necessarily "ruin" your plastic surgery, but it's something to be aware of. I suspect it's dependent on genetics more than anything. I barely have any stretch marks on my stomach and no stretched out skin and I had 4 full term pregnancies (with 8-9 lb babies) in 5 years. If you have skin that's more prone to stretching, it may affect the results some, but it sounds like your quality of life is affected now by your extra skin. I say move forward with getting your documentation and, hopefully, insurance approval. If you get pregnant before you have your surgery, you can rethink things then. Also, I bet pregnancy would be more comfortable without extra skin to worry about. 

Edited by athenarose
Stephtay likes this

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Of course every situation is different, but my plastic surgeon strongly suggested any abdominal work be done post-pregnancy. 

 

Stephtay and azibclc like this

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I think anyone that has plastics is very courageous.  Really hope the insurance covers it.  Glad you went for a second opinion.  When I had my daughter, I was not overweight at the time, the skin just bounced back.  I should mention I was 21.   As long as you don't gain a lot of weight with the pregnancy it might be okay.  Keep us updated.  Good for you.  

I didn't think I was in this court either.  I would love to get plastics.  I feel like a bowl of pudding. I don't have any medical reasons and just can't justify spending that much money when I am considering retirement in a few years.  

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On 6/15/2016 at 11:41 AM, Jolls said:

My main concern at this point is when to do this.  How long do I wait to get medical documentation noted for insurance when there is a chance they won't pay in the end anyway?  I never really expected them to pay so it is not a determining factor if I do this or not.  The other big issue I now have (I'm over the money thing) is we are trying to get pregnant.  Not full blown counting cycle taking hormones trying trying - but we have been "not preventing" for over a year now and nada.  Do I wait till after a baby to get this cut off?  How long do I wait to see if I ever have a baby?  If I get this cut off and then the next year have a baby, how much does it stretch and 'ruin' what I did?   These are currently the questions I am trying to resolve as to determine when I am going to go ahead with plastics.

My experience is with a different body part, but I had a substantial regain after skin removal. I had an arm lift when I weighed 160. Afterward I regained to 336. Further, while I was at my high weight, my former dermatologist misdiagnosed scabies and prescribed topical steroids. Massive overuse of topical steroids during the 6-week period before my allergist gave me the correct diagnosis and treatment resulted in skin atrophy and a whole new crop of stretch marks. After all that abuse, this is the net result of my weight gain after skin removal. All in all, still better than if I hadn't had it removed.

rsz_20160615_151621.jpg

Kim M likes this

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Thanks for that, Wendy!

A lady at my support group had a tummy tuck done and has gained some weight back - not a lot, she won't give numbers but I would guess about 20lbs maybe 30.....anyway.  She said that non of the weight goes back to her stomach, it is all tight and flat yet.  It goes to other places like back and sides now.   I realize a baby/baby weight is completely different, but it gave something to think about.

Duluth just submitted to insurance today.  I am leaning towards getting it done this year still.  I have a 4 week training coming up for work tentatively in October and if I have to keep this particular date;  than I'm not sure I can do it this year (but not out of question).  I just talked with my super to see how set in stone me having the training in Oct is or if I can move to a later class; so I'm waiting to hear about that as well.   While I do understand it would make far far more sense to do it post-baby...   my frugal mind says "you barely talked yourself into it now - there is no way you are going to drop this amount of money when you have a kid."   I can't get into the gyno until end of October as it is, at which time I was going to talk to her about some minimal fertility help....which I will still do since its so hard to get in and see her;  but something I will wait on for a while yet after healing from this (whenever I end up doing it).   And really knowing how my luck usually goes....   I'll get in for the surgery and they'll run those last pre-op test and then find out I'm pregnant  /roll eyes.  It seriously wouldn't surprise me!  That is how things tend to go for me lol.

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I read somewhere on TT that women who undergo a tummy tuck generally have smaller babies and earlier delivery. I wish you all the luck in the world and I know how precious children are.  But I think it would be safer to make multiple consultations before making a decision.

Best of luck

Caroline

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Insurance declined again.  Basically what comes down to is I need more documentation about my rash issue;  which I don't have.  So I could wait a few months/year and try and get more but decided it is not worth it.  For Duluth the procedure is 6345.00 and my out of pocket is 4500 so waiting long to have insurance possibly pay like two thousand dollars doesn't seem worth it.  If I got it done in the cities where it costs 10,000+ then yeah...insurance to pay a six thousand difference would be a bigger deal.    And I've decided that Duluth will be just fine even though it is basically the "bare minimum" in procedures.  Truly I just want the big mass cut off and since I still want/plan to lose more and/or have a child yet....  having just the bare basic procedure seems the most logical at this time.   I have just over 1/2 of that amount saved, BF will be helping me out and I will likely be waiting till October or later to have it done and by that time I should easily have the amount needed.  I have not booked yet, still trying to hash out with work about the upcoming training buy my hopes at this time is to have it done mid-October.

MarktheNerd, Raeme, Clickin and 2 others like this

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I am so sorry Jolls.  With the amount of weight that you have lost, I find it unconscionable that they would deny you even the basic abdominoplasty.

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I'm sorry your insurance is so stubborn. It's the same in Germany. Getting WLS and/or WHO covered is still like playing the lottery here.

(I'm saving up money already because I don't think I will be approved either.)

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Jolls I really am sorry insurance declined again. It stinks but I'm very proud and happy for you taking the steps you need to take care of yourself.  You have a great attitude and it seems like this is a good thing for you! 

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Indeed, I doubt I would have your patience.

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Sounds like a plan. You can try one last ditch effort to get insurance to kick in. Perhaps your PCP can provide more documentation from the notes in your chart to support your final attempt at getting them to approve the procedure. And hey, we're heading into late summer. Maybe you could exacerbate the problem and get some good photos. ;)

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4 hours ago, WendyH said:

 And hey, we're heading into late summer. Maybe you could exacerbate the problem and get some good photos. 

It's a tragedy that we really have to hope for skin issues (i. e. complications) so insurance will cover the WHOs but I know exactly what you mean. :mellow:

BeachGirl likes this

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I could have stopped at the tummy tuck and been very happy with my results -- and have a lot more money in the bank :-) Good for you on reaching this decision and not giving up despite the insurance hassles! Good luck!

Edited by My Bariatric Life

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I am booked for November 21st  :)     Decided to do it over Thanksgiving as I get a "free" two days off from work for the holiday so that is less PTO I have to use.  (though I have 181 hours of PTO right now so not like I really need to skimp hahah).  

Because insurance is not covering and it is all out of pocket anyway,  we are doing what he is calling 'full abdominoplasty with lipo'.    This basically will be the panni, the abdo without muscle repair, and light lipo in all the areas being worked including the mons which I thanked him like 100x for.  Hate the stupid mons.   Anyway;   because I have not had kids he said I likely would not need the muscle repair but not something he would know until he got in there (as it depends on how you carried your fat internally).  And because I do plan on having kids yet, we have regardless decided to do no muscle repair even if he finds it is needed once he is in.   I am perfectly pleased with this plan.   It was more then I was expecting initially and for far less than the cities and with the no muscle repair recovery will be much easier.   He said I likely would be fine with just a week off and then maybe 1/2 days or every other day after that for work.   I took 2 weeks off officially but likely will try and do as he suggests;  got back 1/2 days that second week -  but of course we will see how I feel when I get there.   Since I work from home - and if I'm just sitting around at home in a recliner anyway - I might as well just be working, is how I feel!

tmcgee, JulieW, bellamoma and 10 others like this

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