I sit here with tears in my eyes still. Though I suppose it is better because they are a mixture of a bunch of emotions instead of the overwhelming sense of despair that I was filled with this morning.
You’d think after three sessions of Plastic Surgery I’d be more prepared for what this part of the journey offers me. False. It throws me curve balls constantly. Try having consults with 4 different surgeons and getting 4 different opinions with 4 different prices. Confusion? Trust me a blog on this and how emotionally unstable I feel sorting through the emotions associated with it are coming, but not today, today we are going to be talking about body image.
I hate my body. This is my problem first and foremost. In my mind, I want to look like that girl I always wanted to be and could not be because size held me back. You know how when we are big we joke about the “skinny girl locked inside us.” Well for ME, that skinny girl had a face, a body and I knew what she looked like. And guess what. I don’t look a damn thing like her now that I am slender and it just pisses me right the freak off. True story.
I associate the skin on my body with something terrible that happened to me. I was sexually abused by my step grandfather at the age of four and it went on until my Grandmother passed away when I was eight. I had a family that was emotionally, mentally and verbally abusive. I was raised as a Jehovah’s Witness and I wasn’t allowed to socialize with other kids much outside of school, I became a loner and food became my friend. I was chubby by the sixth grade and for the rest of my life I was the morbidly obese fat girl who was nearly invisible to the world and that very few people thought were worthy of their time and attention. Food stayed my friend, my addiction, my everything and it was a self sabotaging relationship that I felt was completely out of my control and I blamed it, 100% on the abuse I had endured through my life. I was malignantly obese because everyone else had hurt me so much that I hid behind my weight and had a relationship with food. But then I decided to take control back, to take my life back you know why? Because if I followed my line of thinking, I was now 430 lb., couldn’t wipe my own ass to go to the bathroom and was killing myself with a fork and spoon. I was miserable, because I had allowed what they did to me to push me to this miserable existence and you know what FLIP THEM. I won’t let them kill me, I can change this. I lost 260 lb. Then I looked in the mirror and what I saw looking back at me was “Ha Ha, you thought you won didn’t you, but really, you didn’t, I’m still here to remind you that you’ll always be that little abused girl who is somehow broken by what was done to you and no matter how hard you try you cannot get away from that.” – It’s a sad and mentally damaging thing to hear in your head when you look in the mirror, the people who abused you, laughing at you, but that is what I heard. True Story.
This is part of what drove me to exercise and part of why I love it. Because through exercise I feel like I can fight back. Let me throw some kicks, some punches, get out some anger towards those people who pushed me into a life of obesity with their abuse. It was a brand new outlet for my anger and I loved it. The first time my own personal Trainer Suzie Hamann put a punching bag in front of me I felt like I had just received one of the best mental health sessions of my life.
Today I sat here, asking myself what I needed to do to improve my mental head space on this skin issue, because I can’t fall apart and have a mental break down every time I get bad news from a plastic surgeon as I attempt to try to pick which one I want to use and figure out which one I can actually afford. And while I am ashamed to admit it… I was talking to my dear friend fellow WLS and reconstructive plastics patient Laura Van Tuyl, and I said, “I think this morning was the last time I have in me of breaking down and crying over it when it’s not the result I need. I think it’s time for me to stop chasing a dream I know I can’t get to right now and go home and salvage what my be left of my graphics design business.” Laura’s reaction was to ask me why I was considering this, and after hearing what I had to say, ended with this thought “Don’t doubt in the darkness (or the moment) what has been shown to you in the light (of discovery and wisdom).”
I left it at that, there was nothing else left for me to say, I don’t like being in this place mentally and today, for the first time in my entire journey, it had pushed me to a place where I just wasn’t sure I could go forward. I sat in my Godfather’s backyard for an hour crying and trying to catch my breath.
I made a video trying to explain what I was feeling to this community because I’m not sure anyone gets it, heck I am not even sure if I get it yet… and then I looked down and my phone was ringing, I didn’t answer right away, I needed a moment or two to compose myself, so I let it go to voice mail.
The call was coming in from Bobby Whisnand, a Personal Trainer that I met at the OAC Convention in Dallas who has sort of taken me under his wing a little and has been helping me pursue my dream of becoming a trainer. A former Copper Institute Graduate, Bobby was part of my decision to attend the CI Course, he was also, the one that supported me and told me to go when I second guessed myself and whether I should attend the course back in April or wait until June as I had originally planned. I’m a huge fan of Bobby’s “It’s All Heart,” Program, not just because I am a fan of Bobby and everything he has done for me, but because it is the first program I have seen that I truly believe is centered around making sure EVERYONE can exercise, no matter what level of fitness they are starting at, and understands some of the physical limitations that morbidly obese people face. It is also to my knowledge the first program out there that actually has section included on Bariatric Nutrition. I could go on, but trust me I’ll be talking about It’s All Heart a lot when it comes out; the point here is the program is amazing, but Bobby Whisnand, the man behind it, is even more amazing.
The first thing Bobby said to me was ‘Pandora I want to tell you something and I want you to hear me out.” Which was exactly what I needed right then because I could hardly talk without sobbing. I listened as Bobby explained to me in great detail, how much he personally believes in me and in what I want to do, and be, and how much he is willing to help me get there. I wish I could tell you word for word what Bobby said, but honestly my head was spinning. What he said specifically isn’t as important as the message though, it was very clear to me after the call from Bobby, that whatever doubt I was having about where I am and where I am going, need to be gone. That is the one solid thing I have right now. I may never be ok with my body and what I see in the mirror, that is something I have to figure out for me and a very difficult part of my weight loss journey. But I do need to separate that from my future as a personal trainer, because I know that the only person doubting whether I can be a trainer or not because of how my arms look is me, and I’m not doubting my ability, I’m doubting my self-confidence.
I do not know how it is that I have been so blessed that on the days when I have fallen, and I mean fallen hard, on the days that I am so close to giving up, throwing in the towel and curling into a ball and screaming “you win, you win” to those nasty little body image demons that haunt me so much, I have the most amazing mentors in the world to reach out to me, take my hand and pull me through the darkness back into the light.
This excess skin, body image issues and my mistake of associating my body image with something unhealthy is a battle for me, I am fighting it hard, and I’ve had the blessing of having some amazing people there to pick me up and help make sure I “fall without failing” – people like Chris Powell, Heidi Powell, Bobby Whisnand, and some of the women in this community, I am a very lucky to have such an amazing support system filled with people who somehow know just when they need to reach out a hand to me.
As sad as this is, as I sat outside crying over this today, there was a moment where I felt sorry for myself and the thought entered my head that maybe I believed in my potential far too much, I mean what qualifies me to become personal trainer, I don’t have a normal BMI, I’m scared to take the test because I don’t believe I know it and I don’t think I have studied enough, I’m not a YouTube Superstar or a Marathon Runner, and then I looked down and there was Bobby Whisnand calling me. Alright Universe, I’ve heard the message.
I don’t know what lies ahead with this reconstructive surgery thing. I have a couple good ideas of where I am going, and right now, I think that includes right back to my own surgeon for an honest one on one about how confused I am right now. But what I do know, is that I am going to Dallas for a month where I am devoting 100% of my time to studying for my test, working with Bobby, and making sure that I utilize all the tools I can to pass this test, because what I want more than anything is to be a personal trainer and help others in their weight loss journeys. The excess skin and the surgeries to correct that might come before, during or after, but like my Father used to say, I will cross that bridge as I come to it. The next part of my journey is a month in June in Dallas focused on my future, and who knows, maybe when I am back in Texas, the rest will work itself out, my journey has a way of putting me in the right place at the right time and when I started second guessing this trip my mind was changed fast.
Next stop Dallas, next goal PT Certification, everything else I turn over to fate, destiny and whoever out there I am so blessed to have watching over me. This is my fist victory over my body image issues, it’s a small one, but I’m claiming it. My body image issues vs my Support System. Them zero, us, one.
This is likely one of the hardest blogs I will ever write for you, even as I do it, I am nervous, I am scared and I am self-conscious, but I feel that there is something we’re not talking about out loud in the WLS community and that is, the realism of results and success of body contouring and reconstructive plastic surgery to address the sagging skin that so often occurs after we have successfully lost a good amount of weight.
I get so many questions from readers and fellow Bariatric Surgery patients about plastics; but the thing I get asked the most is, “Can I see your before and after pictures?” I’ve usually quietly avoided the topic; I mean who in the world wants to show someone some of the most unflattering pictures of you ever taken, pretty much naked, with a bunch of extra skin hanging off your body?
The Before Part of Plastics from the Patient Perspective:
Let’s talk about those before pictures for a moment. I hate them. I hate everything about them. For me personally, the skin hanging off my body was worse than the weight ever was. At 420 lb it was very easy for me to look at myself in the mirror and say “I’m cute, if you don’t think so flip off.” That got harder and harder for me as the skin started showing itself. I’d find myself standing in front of the mirror trying to see the 195 lb body that was underneath all that skin that was left behind and I was more self-conscious, more unhappy and found myself more unattractive than I had ever before.
For me, the biggest emotional success of my weight loss journey is the fact that I can honestly say that I have gone from being a victim, to being a survivor, to actually living for the first time. For me there were several things I wanted from Plastic Surgery.
- I wanted a body that represented the hard work I have put into it.
- I wanted to remove the excess skin that I saw as remnants of my abusers hold on my life and their ability to still affect my life nearly twenty plus years later.
- I wanted to enjoy exercising more because I didn’t have all this skin swinging off me when I moved.
- I wanted to feel pretty again, or to be happy enough with myself at 195 lb that I could look in the mirror and say “I’m cute, if you don’t think so flip off.”
I did my research. I looked at before and after photos. I consulted with two different plastic surgeons and I selected my surgeon based on which one’s staff was more willing to work with my insurance. I had spoken to my insurance company several times about the possibility of Reconstructive Plastic Surgery after losing 260 lb and I had several ideas, tips, hints, and suggestions about how I might get the skin removal surgeries covered.
My approach was three-fold:
- My insurance covered “complications” of Gastric Bypass so my first approach was that the excess skin was a complication of Gastric Bypass surgery.
- My insurance company had told me that they would consider anything that was “Medically Necessary.” With the amount of extra skin I had on my body, I still had skin folds and rolls of skin on my body that allowed for things like rashes, infections and sores and removing the skin would alleviate these issues.
- I have a diagnosis of Discoid Lupus. It is a skin disease that causes rashes and legions on your body, usually in sun exposed areas. For me however, with the excess skin, instead of just the normal photosensitive Lupus issues, I developed Lupus symptoms in the skin folds, in places where my skin touched skin, under my breasts, under my arms, under my stomach. Because of this diagnosis, the “Medical Necessity” of my plastics was even more prevalent.
Getting the insurance approvals on the surgeries wasn’t ever difficult. Of the three surgeries that I did, the insurance company denied only the second one the first time we submitted and that was largely due to the fact that we had included a breast augmentation and implants in the paperwork. All it took was a letter from my Plastic Surgeon clarifying what was medically necessary which was sent the day after we got the denial and just a few days later we had an approval.
We had the insurance approval. We were ready to get started. I was elated… and I had completely unrealistic expectations.
The Hardest Part of all: The Recover, Recoup, Re-cut Phase
There are so many things about this phase of Body Contouring after plastic surgery that I feel I should share with you I am not even sure where to begin.
First let’s address one of the other questions I get all the time. “Was it painful?” – Yes. It was by far the most painful thing I have ever done in my entire life. I’ve had my tonsils pulled out, my wisdom teeth yanked, my appendix removed, I’ve had a hysterectomy, I’ve broken bones, I use to be a self-mutilator who liked to cut myself and I’ve been physically abused by people a lot stronger than me. NOTHING has ever hurt as bad as reconstructive plastic surgery. Was it worth it? Yes a hundred times over. But did it hurt? Yeah it sort of felt like I had been hit by a truck, severed in half and sewn back together.
And it wasn’t exactly easy on the emotions and feelings either. There were phases that were so difficult. Between surgeries I would hate the parts of my body that were not fixed. I’d stand in front of the mirror grabbing my skin, yanking and pulling on it to trying to envision what my body was going to be like when it was gone. I stopped going to the gym and swimming because I couldn’t handle how much skin was on my thighs and how horrible I felt I looked. It was amazing to me, at 420 lb I had no problem putting on a bathing suit even though I knew people would start at the size of my thighs in astonishment of their girth; but now, I couldn’t handle having anyone see all the skin hanging from them, it embarrassed me and humiliated me more than being heavy ever did. This is hard for a lot of people to understand and wrap their head around, so let me help you…
The hall was crowded, kids bustling around as they rushed to their lockers to get their books for their next class. She stood at her locker with her back against it, cradling her books to her chest as if she were protecting them. Her right foot moved slightly as she readied herself to leave but it halted as a frown appeared on her face. Standing in front of her, blocking her way was one of the more popular girls; one of the “mean girls” if you will. “Awe look at the little fat girl hugging her books because nobody else wants to hug her. Stop eating Ding Dongs and Twinkies and you might not leave high school a never been kissed virgin.” The blond-haired girl clutching her books as if there was safety in them, took a deep breath and even though her voice cracked as tears threatened to stream down her face, she responded courageously, “I might be fat, but I can lose weight, you’re just ugly inside and out and you can’t ever change that.”
At 420 lb I had two things that I could console myself with whenever I felt ridiculed about my weight. I had the control in the knowledge that I could somehow change my situation, and I had the vision in my head of what I would look like when I did that. Those two things are what helped me get through nearly 25 years of different unhealthy levels of obesity between the ages and sizes eleven to thirty-two. Now that was gone. Prior to my thigh lift surgery in November, I wouldn’t wear a bathing suit because I was so embarrassed of my thighs and because with the skin hanging off them, weighing 165 lbs there was no more change that I personally could evoke to improve the situation. No amount of exercise was going to make it better, losing more weight would only make it worse, there was no more control and no more hope and it was an emotionally defeating place for me to be living.
Setting aside the physical and emotional aspects there were the financial ones as well. Now I will say I had some complications after the first surgery, but pretty much my year went like this.
- January – Move Heather here so I had someone to help take care of me after the surgeries.
- February – Reconstructive Surgery #1
- March – Healing
- April – Healing
- May – Healing / Walked a Half Marathon
- June – Healing waiting for Surgeons Release to move forward
- July – Preparing & Submitting for next surgery
- August – Reconstructive Surgery #2
- September – Healing
- October – Healing – Attended the OAC event and spent 1 month in CA with Family
- November – Reconstructive Surgery #3
- December – Healing
Now after the first surgery in February I had some complications that took a bit longer to heal from. But pretty much after each surgery for about 6 to 8 and sometimes even ten weeks I was pretty much a lump on a log healing unable to do much and definitely not working. I was very lucky, in that my insurance covered my surgeries thus allowing me to use a $22,500 loan I took out to pay for these surgeries to pay my portion of the first surgery and then, to live on throughout the year when I wasn’t working to keep the bills paid.
Even doing all that, by the end of the year I ended up $30,000 in debt on top of that on credit cards. But you know what, going into this my Family and I expected to end up somewhere around 60,000 in debt on plastic surgery, we’re not surprised to be here, but that doesn’t make it any more comfortable or less stressful and even though my household makes a decent amount of money, when you’ve been living paycheck to paycheck to make ends meet and you’ve maxed out your credit cards and taken out loans for your body that cost more each month than your car payment, it can be a bit overwhelming. All that said would I do it again in a heartbeat? Yes. I would.
After the plastics: The Realism of WLS Plastics
This was probably the hardest part of the entire journey for me. In fact, I am not sure that I can tell you with 100% certainty that I am beyond this part. What I can tell you is that my expectations coming into plastic surgery, despite what anyone told me, is that I would have a tight, lean body when all was said and done. Now is my body better than it was before? Hands down and I am grateful. But there are still some areas of my body that I would like improved. I would like my arms tighter and more symmetrical. I would like there to not be puddles of skin hanging from my abdomen when I do a push up. I’d like my breasts to be a bit fuller and I’d like there to not be extra skin hanging from my forearms.
These are things I want, and someday, if and when I can afford them, I will do them because they will make me happier. I’m not sure when that will be, but it will happen someday. In the meantime I won’t allow the little things that I am unhappy with myself about hinder where I am, what I am doing or invalidate the hard work and effort that has gone into having the body that I have, even if that body isn’t perfect. The truth is I can never expect it to be. I am never going to have the body of a playboy model or a personal trainer who has never been 260 lbs overweight. What I do have is the body of a woman who used to weigh 420 lbs lost weight and put it back on for years, and finally managed to get to a maintainable healthy weight and is working on being as fit and as healthy as her body will allow her to be. What I do have, is a body that can serve as an example to others who have lost or need to lose huge amounts of weight and give them a realistic idea of what they can expect afterwards so they are not as shocked and disappointed as I was when I realized that plastic surgery wasn’t going to get me the body I first envisioned.
It is with that goal in mind that I am publishing a Before and After Gallery of my Reconstructive Plastic Surgery. If you’d liked to view these photos you can do so by visiting this link. The page is password protected to insure that you realize that the photos you are about to view are for educational purposes, and may be considered offensive to anyone that has a problem with partial nudity. You will need to enter the password: PANDORASPLASTICS in order to open the page. By imputing the password you agree that you wish to view these photos.
Comments are not allowed on the gallery page itself but please feel free to post any comments or questions that you might have on this page instead. Please remember that I reserve the right to remove any offensive comments from my blog. Basically, be kind, I am doing this to help educate people, not to be ridiculed or teased.
Excess Skin, Body Dimorphic Issues, Weight Dissociation, Plastic Surgery, and Unhealthy Emotional Associations are something that I don’t think we talk about nearly enough in this community and that I do not feel there is nearly enough, patient side information out there on.
It is my intention to open the doors of communication here, and to try to be one of the voices that can both answer some of these questions, and, hopefully, advocate for others so that they might get the sort of medical coverage that I did paying for these life altering reconstructive surgeries.