Plastics excess skin removal after WLS

spfldpam

Plastic surgery prices: This is the list of prices for the procedures at the Bari Plastics program in my town if you are a WLS patient and have been referred to that program
Bilateral Mastopexy (2 breast lifts) $6692
Bilateral Agumentation Mammoplasty/Mastopexy with implants $12,098
Bilateral Augmentation Mamoplasty with implants $6566
Barchioplasty (Bilateral Arms) $6232
Body Contouring:
Abdomnioplasty: $8052
Thigh lift: $6892
Hip/buttock lift: $6292

Mini face lift $6327
Full face lift $9389

The above prices are estimates and could change. The price includes the surgery fees for the surgeon, anesthesia and hospital charges (including 23 hour observation stay if needed). If a hospital stay is longer than 23 hours there is an additional $450 charge per night for this. What do you think of these prices? I know you can get it done cheaper in Mexcio doing medical tourism but that stuff kinda scares me. This program is familar with WLS people and their skin and are experienced at working with them on plastic surgery.

I added up if had my upper arms, boobs, tummy, upper thighs and hip/butt done and it would cost me $34,034! UGH! They will combine procedures up to 2 as long as you arent' knocked out for longer than 7 hours also. I would be self pay as my insurance wouldn't pay for any plastics. I have to get a hernia repaired that they found along with the hital hernia they did repair when they did my sleeve so I would have the hernia repaired too if I did have any plastics done. This might save me some $, maybe!

rlshopp6

I haven't looked into any plastic surgery (yet) so I have no idea whether these are reasonable prices or not, though I agree going to another country for cheaper surgery would be scary to me.

I am curious, if you don't mind sharing, how long have you been at your goal weight? I'm within 5 pounds of mine, but I've heard that the skin can continue to change (getting back into place) up to one year after reaching goal, and to not worry about/think about the loose skin until at least one year after achieving goal. Plus, I'm lifting weights and continue to hope that will help and that I might not need surgery. I'm not sure what kind of look I'll end up with, if I don't want to consider plastic surgery. There's definitely still some problem areas where the fat seems to be the last to want to leave (hips/back of legs).

Best of luck, whatever you decide to do.

spfldpam

My WLS program doesn't give people a goal weight number but I met their "goal" back in Nov of 2012 and my own personal weight goal of 130 or less I made in April of 2013. My program will refer you to a Bari Plastics program if you have maintained your weight loss for 3 months and have remained caffine free, alcohol free, smoke free, gotton all labs and attended all post op appointments with they. They will vote as a team if this has happened and then refer to the Bari Plastics program with is a group of plastic surgeons they work with that work with WLS people and worked up a list of prices at a somewhat discounted rate. I asked about it at my one year post op apt in June 2013 and got the paperwork end of June. My appointment with plastic surgeon is next Monday, 7/29/13. I don't know if I will even have plastic surgery but is a informational appointment where they find out what is bothering you the most and go through with you the process and costs and stuff. I have heard things do move around for a year or more after at goal weight too. I have been working out with weights and other strength training at gyms since Jan 2013 and at home workouts before that. I have been obese all 48 years of my life so my skin isn't gonna snap back as good as others who were just fat for a certain amount of time in their life plus I am 49 almost 50 years old too. The appointment cost me $100 to do and not covered by insurance. If I do any plastics they won't be covered by my health insurance either. I don't have any skin irrratations either that would help insurance covering it either. My upper arms bother me the most cause I have great muscle definition on them now from lifting but there is still all the loose skin underneath that bothers me so if I had anything done it would probably be that.
My legs still do not look thin though. I think they will always look heavy, granted not as big as they were with me at 270 pounds but still thick looking. I have muscle definition in them but still fat looking I feel.

I haven't looked into any plastic surgery (yet) so I have no idea whether these are reasonable prices or not, though I agree going to another country for cheaper surgery would be scary to me.

I am curious, if you don't mind sharing, how long have you been at your goal weight? I'm within 5 pounds of mine, but I've heard that the skin can continue to change (getting back into place) up to one year after reaching goal, and to not worry about/think about the loose skin until at least one year after achieving goal. Plus, I'm lifting weights and continue to hope that will help and that I might not need surgery. I'm not sure what kind of look I'll end up with, if I don't want to consider plastic surgery. There's definitely still some problem areas where the fat seems to be the last to want to leave (hips/back of legs).

Best of luck, whatever you decide to do.

rlshopp6

Congratulations on achieving your goal, that is tremendous! I think it's good to go ahead with the meeting and get the information. Knowing not just what they would do, but seeing some after pictures of other people (what is the scar like best/worst case scenario is my first question) would be helpful.

I know I've heard of dry skin brushing, and have tried that off and on, but haven't been diligent about it. Once I get to goal weight, and under 25% body fat, and have maintained that for a year I would certainly consider it. But then again it doesn't bother me too much when I'm dressed, but especially on the back of my legs and inner thighs, that has stopped me from wanting to be in public in a swimsuit. I've been lifting consistently for a full year, and definitely have seen a lot of improvement in the last 2 months especially in my arms. There's still that loose bat-wing skin (I'm 39) on my arm, but I still have hope that will diminish.

Good luck with your appointment next week, whatever you decide to do the biggest accomplishment is already done in that you met your goal and are maintaining it!

JillyInAZ

Those look like pretty normal prices for that area. I know my sister had her tummy done after 140 lbs of weight loss and she said it was about 7500-8000 in Springfield. Unfortunately it varies by area of the country. I'm in Scottsdale and it's much higher. I went last week for a consult, though I'm still about a year away from any ps. For the proceedures you mentioned at a total of 34K, it comes to about 44-50K in Scottsdale. And yes, I agree, Mexico or South America would be cheaper, but I just don't think I'd be comfortable in doing it. The surgeons I've seen and heard talk about surgery after massive weight loss have all been very clear that the the tradeoff IS the scarring. You will have it, and it will be extensive. However for me, I'm ok with that. I know the arm scars are the worst, and most visible... but the way my arms are (they are heavy thick arms genetically to begin with, let alone with the sagging skin I have now, with more to come) I wouldn't be wearing anything sleeveless anyway. AND, right now, I'm complete different sizes from my arms to my chest.. if I wear a jacket/blazer, I need a 18 or 20 due to tight sleeves... but I'd actually be able to wear a 16 or 18 for correct fit across the rest of the torso. Right now, I think my approach will be tummy/arms together, first. And then after that we'll see where we need to go next

spfldpam

Those look like pretty normal prices for that area. I know my sister had her tummy done after 140 lbs of weight loss and she said it was about 7500-8000 in Springfield. Unfortunately it varies by area of the country. I'm in Scottsdale and it's much higher. I went last week for a consult, though I'm still about a year away from any ps. For the proceedures you mentioned at a total of 34K, it comes to about 44-50K in Scottsdale. And yes, I agree, Mexico or South America would be cheaper, but I just don't think I'd be comfortable in doing it. The surgeons I've seen and heard talk about surgery after massive weight loss have all been very clear that the the tradeoff IS the scarring. You will have it, and it will be extensive. However for me, I'm ok with that. I know the arm scars are the worst, and most visible... but the way my arms are (they are heavy thick arms genetically to begin with, let alone with the sagging skin I have now, with more to come) I wouldn't be wearing anything sleeveless anyway. AND, right now, I'm complete different sizes from my arms to my chest.. if I wear a jacket/blazer, I need a 18 or 20 due to tight sleeves... but I'd actually be able to wear a 16 or 18 for correct fit across the rest of the torso. Right now, I think my approach will be tummy/arms together, first. And then after that we'll see where we need to go next

Thanks Jilly, I remember you messaging me about your sis that had PS done here in town. I just don't think I could go to Mexico by myself and feel comfy with traveling home with all the bandages and stuff kinda scary I feel. A guy in Taylorville a small town near Spfld went to Mexico to have WLS and ended up dying after he got back home due to the traveling with the blood clots a few years ago. Scarey! We have had 2 plastic surgery presentations at our WLS group support meetings in the last 18 months and they do go over cost, time off, scaring and stuff like that and do show pics. The scaring on the upper arms is usually on the insides of the arms so you can't see it as much they said. Luckily I can wear a small in shirt and my bat wings still fit in it! LOL! I didn't think the loose flabby skin would bother me before I had WLS but now that I have lost all this weight it does. I have been working so hard at the gym to tone/muscle up and it is discouraging to see the bat wings and loose skin on tummy and upper thighs. When I do planks in the morning before work in my bra and undies you can really see the loose skin hanging there as I plank. UGH! Scary looking!
Thanks for your comments. I will let everyone know how the appointment goes after Monday.

lee91356

Im about a year out and I am nearing my personal goal and so I'm starting to look into this also. However, given the costs I read about I decided to limit what my starting points would be - tummy first! arms and breasts later if I can afford it. Do know that some doctors wont do more than one procedure at a time depending on the surgery and the expense of it and the recovery time is extensive. Some people in my program have only had the pennectumy (unsure about the spelling) since our insurance covers that and the recovery for that is several weeks.

Have you considered a packaged like an lower body lift (LBL) or upper body lift their its a procedure that target the areas and can include a tummy tuck. The LBL includes some tweeking on the thighs. I'm not sure that the upper body is exactly since I have really researched that.

I want a LBL but after some online research (though I have yet to have a consult) I may need two procedures for my stomach - an "anchor" and then an LBL (talk about crappy luck lol).

PS I found this perhaps it will help you too http://www.obesityhelp.com/forums/VSG/4028452/Going-to-a-plastic-surgeon-what-to-expect/#32657714

spfldpam

Thanks Lee. I will check out the link. The Bari Plastics program in my area only offers the procedures I listed earlier. The will combo 2 procedures at one time as long as the person isn't knocked out more than 7 hours.
I will let you all know how the plastic surgery consult goes after Monday next week!

Im about a year out and I am nearing my personal goal and so I'm starting to look into this also. However, given the costs I read about I decided to limit what my starting points would be - tummy first! arms and breasts later if I can afford it. Do know that some doctors wont do more than one procedure at a time depending on the surgery and the expense of it and the recovery time is extensive. Some people in my program have only had the pennectumy (unsure about the spelling) since our insurance covers that and the recovery for that is several weeks.

Have you considered a packaged like an lower body lift (LBL) or upper body lift their its a procedure that target the areas and can include a tummy tuck. The LBL includes some tweeking on the thighs. I'm not sure that the upper body is exactly since I have really researched that.

I want a LBL but after some online research (though I have yet to have a consult) I may need two procedures for my stomach - an "anchor" and then an LBL (talk about crappy luck lol).

PS I found this perhaps it will help you too http://www.obesityhelp.com/forums/VSG/4028452/Going-to-a-plastic-surgeon-what-to-expect/#32657714

spfldpam

Here are my notes I took from my Plastic surgery consult appointment yesterday. Sorry it's long but I had alot of quesitons!

Plastic Surgeon Consultation 7/29/13 3-4:15pm

Plastic surgery prices: This is the list of prices for the procedures at the Bari Plastics program in my town if you are a WLS patient and have been referred to that program
Bilateral Mastopexy (2 breast lifts) $6692
Bilateral Augmentation Mammoplasty/Mastopexy with implants $12,098
Bilateral Augmentation Mamoplasty with implants $6566
Barchioplasty (Bilateral Arms) $6232
Body Contouring:
Abdomnioplasty: $8052
Thigh lift: $6892
Hip/buttock lift: $6292
Mini face lift $6327
Full face lift $9389
The price includes the surgery fees for the surgeon, anesthesia and hospital charges (including 23 hour observation stay if needed). If a hospital stay is longer than 23 hours there is an additional $450 charge per night for this.


How many times have you done plastic surgery on former WLS patients?-10-15 people a year
How many years?-11 plus years

Ask to see before/after pics of patients of my size/frame that lost the amount of weight I have to see results?
Go to Springfield Clinic of Plastic Surgery to see pics.

How long should I wait till I have first procedure? 12-18 months after reaching my personal weight loss goal since weight/fat move around still that long after reaching my goal?
As long as I am at my weight I am happy with and have maintained that weight for 3 months plastic surgery can be done now.

Does abdominoplasty include paniculumectomy?-Yes

Panniculectomy vs tummy tuck vs. fleur de lis Tummy Tuck what is the difference and do they offer all these here?-Yes all offered here but tummy tuck or fleur de lis Tummy Tuck would be best for me. Dr. thinks the fleur de lis might be done for better results. Might do a circumferential tummy lift.

What is the difference between a Bilateral Mastopexy (2 breast lifts) $6692 Just a lift
Bilateral Agumentation Mammoplasty/Mastopexy with implants $12,098 Lift with Implants
Bilateral Augmentation Mamoplasty with implants $6566 Implants only, no lift
He thinks I need both, would do lift first and later do the implants.

Complications and rate of complications?-Not a smooth incision line when healed, Unfavorable scaring, fluid collection, wound opening up, dog ears-These don’t happen a lot but can happen. It won’t be perfect, they try to make it look perfect but there will still be unsmooth lines with the scaring.


Proposed results? Where would incisions be on these procedures?-upper arm-This could be done in combo first surgery since it bothers me the most. Incision would be in inner arm. Would be able to take all loose skin off from under armpit to right at elbow area.

Boobs-This could be done with upper arm surgery in combo surgery. Would just do a breast lift now and do implants later. Incision might be above breast or at nipple and down the center of breast.
Tummy- fleur de lis Tummy Tuck might be best for me or he could do just tummy tuck but would make sure to tighten up ab muscles under tummy or he might do a circumferential tummy lift. Part of surgery combo 2 with hip butt lift. If does a circumferential tummy lift would also lift upper back area too. Incision would be on bikini line and possible an incision up and down too if fleur de lis was done.
hip/butt-Butt would still be flat but wouldn’t be wrinkled would be done with surgery combo with tummy surgery. This would also help with loose skin around lower back area by waist line also. Incision would be along waist line.
upper thighs-Incision would be at leg line would be part of surgery combo 3 with breast implant surgery.
Implants-Would be done separately from breast lift and part of surgery combo 3 with upper thigh surgery. Incision would be along nipple and down center of breast

Will you need liposuction in addition to the skin tightening? Surgeon didn’t think it would help me any so no lipo would be done. It usually doesn’t last that long is why he doesn’t see at as doing it on me.

Drains how many/how long in?
upper arms-2 in each arm/1-2 weeks left in
boobs-no drains for lift or implant surgeries
tummy-2 drains/1-2 weeks left in
upper thighs-2 drains in each leg/1-2 weeks left in
hip/butt-Forgot to ask but probably 2 drains and left in 1-2 weeks

Recovery time? I have a desk job how much time would I have to take off for diff procedures?
Boobs, tummy, upper thighs, hip/butt-Since I have a desk job probably 2 ½ weeks. Have surgery on a Wed and then go back to work in 2 ½ weeks.

Is a pain ball an option for post-op pain? No not usually with his practice or at Memorial Hospital

How many lbs of skin does he think he can remove?-Not as much as you would think, maybe a total of 5 pounds if all procedures were done. Tummy 3 lbs, Back 1 lb, arms 2 lbs, just estimation.

Does he recommend compression garments? If so, do they provide them to you in cost work up or do you have to pay for them? Special wraps/binders/Vest/sleeves are given to the person after surgery is done and you were those home and keep wearing them and are part of the cost work out. Eventually he would send me to Macy to buy Spanx or that type of compression garments to wear for 6-8 weeks after different areas of surgery that I would have to purchase on my own.
Very important question is to ask about revisions. Sometimes things don't go as planned and you may need a revision-ask if it's covered by him/her or if you'll have to pay. What if I lose weight after Plastics will revision need to be done? How often do revisions occur with your patients? If revision is done he usually will do it when he is doing another combo surgery of mine. Sometimes an additional cost but it depends. Revisions sometimes happen. Depends on the person and their skin and how it heals up.

Lifting restrictions/working out restrictions, how long?-6-8 weeks for most surgeries. Walking can begin right away but weight lifting and stuff like that has to wait till 8 weeks. Water exercise could start in 3 weeks depending on the activity level.
I have a hernia that needs repaired could this be done at same time and save money if my insurance would pay for that part of it?-Yes it could either Hammer/Icazza could do it or even he could do it when the tummy area is worked on.

How do they go about that with the bill? -My insurance would be billed surgeons time on the bill that would go to my insurance co.

Does your office take care credit?-No
financing options?-At this time, none but they are working on some. He doesn’t know what Memorial Bari Plastics programs offers for financing options so I would need to call them to see if they have any.

Is excess skin donated to Memorial Burn Unit? Discounted cost for this?-No, they use cadaver skin. No most hospitals don’t do this anymore. No discounts either.

23 hour observation stay also included in cost so do you usually go in and stay overnight or come in early in the morning have surgery and leave that night?-The observation stay time doesn’t start till after the surgery has occurred and you are admitted to the hospital

Can your office check to see if my insurance would cover any plastic procedures? I have tried to look it up but gotten no luck since it’s a new insurance is why I ask. -In his experience, most if not all insurance companies will not cover these procedures I am thinking about because it is cosmetic type surgery with no medical advantage to having them done.

Lab work, EKG, Chest xray are all include in Memorial Bari Plastics Quotes also so price is all inclusive unless have to stay longer in hospital.

Complications and costs-many times they have been able to get the person health insurance to pay for the cost of bills if complications. He said to not quote him on this but usually they can get insurance to pay for this.

Surgery 1:
Bilateral Mastopexy (2 breast lifts) $6692
Barchioplasty (Bilateral Arms) $6232
Estimated cost total $12,924

Surgery 2:
Abdomnioplasty $8052
Hip/buttock lift $6292
Estimated cost total $14,344

Surgery 3:
Thigh lift $6892
Bilateral Augmentation Mamoplasty with implants $6566
Estimated cost total $13,458

Total cost of all surgeries $40,726

Right now I am waiting to hear from the Bari Plastics group to get the "firm" prices since these are just estimates. Last night I got to thinking and was thinking of having my upper arms done and tummy done first. Those two areas bother me the most so if I only had one combo surgery that would be it, if they would combo those two areas.
Has anyone had upper arms and tummy done at same time?

HMD7703

Have you gotten a 2nd and 3rd opinion and quotes?

I had my surgery about 1.5 yrs out from my VSG. I didn't wait till my goal weight because my goals have changed over time. I am happy with my results, and glad that I shopped around before deciding on a Dr.

spfldpam

No this was just my first plastic consult. There aren't alot to choose from in my town and I really don't wanna travel too far if there is complications and stuff like that. This was through Springfield Clinic, I haven't checked with SIU Medical yet. That might be it in our town. I will have to google it and see. I am not going to jump into anything right away due to finances also!

Have you gotten a 2nd and 3rd opinion and quotes?

I had my surgery about 1.5 yrs out from my VSG. I didn't wait till my goal weight because my goals have changed over time. I am happy with my results, and glad that I shopped around before deciding on a Dr.

HMD7703

Money held me up, too. I ended up using CareCredit to finance my surgery.

Good Luck.