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Excess Skin Removal

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WLS Plastics from the Patient Perspective

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?

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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:

  1. My insurance covered “complications” of Gastric Bypass so my first approach was that the excess skin was a complication of Gastric Bypass surgery.
  2. 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.
  3.  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.

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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.

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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.

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Its not Masturbation its exploratory

femaleformYes, yes, I am touching myself.

Seriously, it sounds horrible, it really does, of course I worded it that way intentionally to get a laugh out of you, but the truth is, it is NOT that far off.

If you are the type of person that is going to have an issue with the fact that I am opening discussing my private parts, masturbation and body image I highly suggest you stop reading this particular blog post, you won’t like it much, but come back, I’ll go back to the usual post Bariatric topics of flatulence, bowel movements and food issues soon enough I promise.

Okay so imagine this for me for a second. You have been overweight since the sixth grade. Morbidly obese most your life, you’ve lost 260 lb and you’ve had three bouts of reconstructive plastic surgery to get your body closer to what it might have been like if you had not battled this disease we call obesity. However, you have won the fight; your obesity is in remission, as long as you do not fall back into unhealthy behaviors. Your entire body is new to you. It’s been cut in just about every which way possible, you’ve got scars under your breasts, around your nipples, from armpit to elbow, from armpit to hip, from groin to knee and all the way around your body at your bikini line. Everything feels different from how it did before, your body is foreign to you and you have numbness in strange places all over your body where the feeling hasn’t quite returned yet. kissingJordan

Okay now let’s talk boobs. We all have them. Before my surgery mine touched the floor. OK not quite but they hung to my waist for sure.  I can’t remember a time my breasts didn’t hang like that, for the first time ever I have hardly any under boob, I have perky breasts. And my nipples, seriously, night and day difference. Pre Reconstructive surgery I had inverted nipples that hardly ever came out of their shell of boobage, now I have these pert nipples that get hard all the time, it’s cold, it’s windy,  I took my sweatshirt off, I opened the refrigerator door. It’s constant and at first it was actually painful when it happened. That is where the touching thing started. When I told my plastic surgeon how painful it was when my nipples got hard she told me to work on de-sensitizing them by touching them.

Let me pause here and say that I am a very tactile person.  There is something I can’t explain that makes touch a more important sense to me than anything else. I remember as a child lying next to my Grandmother rubbing a scar on her arm that was softer than the rest of her skin over and over again. I’m the type of girl who loves to cuddle and touch and if I find a place on your body that is softer, a raised bump or something like that, I will just rub it constantly, back and forth with the pad of my finger. I’ve had partners that used to smack my hand away after I had rubbed the same spot for so long that it had driven them crazy. I’ve been called a “rubber” on more than one occasion. Even when I sucked my thumb I used to curl my index finger up and rub the tip of my nose over and over again for hours. I can’t explain it I’m a freak.

So I was told to touch my nipples to desensitize them. And I started doing it. Whenever they would start hurting I’d reach in, rub them, and try to warm them up, make them not so hard, and desensitize them. I must say it works. I have less reactive nipples months later. I also, appear to me fondling myself constantly.  I was sitting here at the computer today and suddenly I realized I had my hand down my tank top and was rubbing my left nipple back and forth just like I did to the tip of my nose when I sucked my thumb, just sitting there in thought, idly rubbing my left nipple with my right hand.

When I realized what I was doing I burst into laughter. All I could think of was… crap; I bet my household thinks I’m crazy because I’m constantly touching my body. But it’s all new to me and I am just learning it. I’m not masturbating, it’s not sexual, it’s… exploratory! I can squeeze my whole boob into my hand without having to lift it or anything! My stomach feels flat. I can feel bones and muscles I never felt under my skin before. I can see my muscles move when I do. I can feel them flexing if I have my hand on them as I move.

I’m learning my body and I’m a touch oriented individual. So apparently, reconstructive plastic surgery turned me into Al Bundy only instead of having my hands down my pants in a comfortable resting post I have them down my shirt. Now that I have realized this, I of course, I’m a little embarrassed about it. But then I thought, why should I be, I mean, how the hell do you learn your own body if you don’t touch it.

If I lost my sight this is exactly the way I would learn my body, and for me, seeing it in the mirror doesn’t work for that, not for me, that’s why I take pictures because I see the changes in myself more in photos than in the mirror. And that is why I touch myself and explore my new body with my hands. Because it FEELS different, my skin feels different on me, and my body doesn’t feel the way I expect it to when it is touched, so by touching it myself I am learning how my new body works and responds. I touch my boobs, I touch my sides, I touch my inner thighs, I caress my body where all my scars are on a regular basis.

So yes, I am touching myself.

Yes I am playing with my boobs and learning my body.

The only issue I really see with that is why someone isn’t else doing it for me. I jest. But only a little.

And for those of you that are really uncomfortable with the fact that I am talking about playing with my nipples and fondling my breasts in a Christopher Columbus fashion, well, let’s just pretend I am practicing self-breast-exams and call it good eh? DSSPostSig

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Author: Pandora Williams

Author of Desperately Seeking Slender

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