My (Male) Plastic Surgery Journey So Far PS#1: Decision Phase

[bergamini]

I had my VSG in November of '12 and have gone from 298# to 178#. Those who see my other posts here know that I am an exercise fiend and that has helped my rapid weight loss. My primary concerns for the surgery were health, I'm 41 and seeing the generation ahead of me battle diseases that were lifestyle created was a big warning to me. I foolishly thought that I was young enough, worked out a lot even before surgery and had good enough genes such that loose skin would not be a problem. I was wrong!

I'm not going to post pictures until just before my operation, but I will tell you how my body has fared and start with the good. Keep in mind I do Pilates 5-6x per week, run 25+ miles per week, bike 30+ miles per week and play tennis 6+ hours per week, so I am doing what I can to tone my body. My arms are stunning, they are nearly perfect. I have big veins running all through them, I have contours around the biceps and triceps and they overall have a nice appearance of light definition. The only sagging is only on the outer edge just above the underarm where there is a bit of laxity in the skin but it is not sagging or anything like that, that lax is maybe 2"x2". My legs are amazingly defined. When I put them together there are open ovals between my thighs as well as upper & lower calves. There is, like the arm, some laxity on the inner thigh but the skin doesn't sag or make me feel unattractive. My upper chest is my proudest feature. The pecs are lifted, there is clear definition between sides, there is no leftover fat or loose skin. Lots of planks helped that!

I then have some areas that I consider neutral in that they aren't perfect, but I can live with them. My butt is too small. I had wanted some fat transfer to it but because of my surgical / location choices, and that I don't have much left to lipo, that isn't going to happen. It doesn't sag or drag, but it's just too small for my body. My back is fine but I wish it had more definition like my chest/pecs.. Except for my abdominal region, the worst stretch marks I have are on my underarms but they don't make me feel unattractive and I'm not going to deal with fixing them.

Then we have the areas that I hate. My abs (esp. lower) and my pubis area. Ugh. The midsection has this sort of flap of loose skin that extends flank to flank (front only, fortunately) and in the center (belly button) there is a bunch of crinkled / stretch mark skin that just hangs. It makes a flapping sound when I run, if I do an inversion in Yoga or Pilates it flips upside down and it is just this bowl full of jelly loose skin. As I lost the weight I felt it go from skin/fat to just loose skin, less and less dense, with the flanks thinning out first and the belly button area thinning out last. In my darker moments, I knead it like bread and pray for it to go away...lol. I also hate the pubis. Yeah being fat wasn't awesome but at least my pubic area had some lift and volume. Now it just sags, there's nothing I can do to improve it and I feel less attractive sexually at 178# than I did at 298# as a result.

I started getting quotes this summer from doctors in Mexico because I had such a good experience there with my VSG. The prices ranged from $3900 (Fuentes - tummy tuck only) to $9000 (Gongora / Genesis and a whole LBL). Many of them required stays in recovery clinics which coupled with the flights, pushed the costs to $6K-10K. I most seriously considered Dr. Niebles because of the obvious good work he has done on Christy. Most of the MX quotes were around $5-7.5K and involved a full tummy tuck with lipo of either the back or stomach to hopefully harvest enough fat to do transfer to the butt and give me the volume I wanted there.

At my mother's pleading, I did get some local quotes and consults. Years ago I had some laser procedures at the University of Wisconsin Plastic Surgery clinic (called "Transformations") to repair acne scars. This were major procedures where I was in sedation and looked like I had my face burned off for a month after, not spa laser treatments. I was very happy with the results so I asked the facial PS who did those if he recommended anyone. He advised that Dr. Venkat Rao was his preferred body contouring surgeon, so I booked a consult with Dr. Rao and it was the best of my consults and visits.

Dr. Rao didn't mind that I would only be nearly 11 months out from surgery (I picked 10/9 because I'm running a half-marathon the week before) and said that there might be some improvement but that it was clear I carried my fat abdominally and an earlier surgical intervention would enhance the natural tightening that is occurring. He felt I did not have enough fat to lipo and do a fat graft or LBL, and he said my backside looked good and was going to continue to look better. He said that they do 3 types of abdominoplasty or Tummy Tuck procedures. The mini-tummy tuck only addresses loose skin above the navel and since the pubis was a major concern, that was not an option for me. The full tummy tuck is what most of us think of think of and goes hip to hip. The extended abdominoplasty also goes all the way to the flanks ("love handles" with some mild hip/buttock improvement).

Dr. Rao recommended the extended tummy tuck for me because the wider incision will also allow for more lifting in the pubis, that my loose skin does start at the flanks and it will help with that minor loose thigh skin. The cost for this is $7416 and considering the recovery center / flight costs for Mexico, I'm not really paying anymore although I don't get the fat transfer. Dr. Rao is consistently voted one of the top docs in Madison and in '13 was named one of the top doctors in the US Venkat K. Rao, MD, MBA, UW Health, University of Wisconsin Hospital, Madison, UW Health, University of Wisconsin Hospital, Madison

The costs include a pre-op appointment with a PA-C two weeks prior to the procedure for labs, physical, etc., all compression garments, anesthesia, facility charges, etc. It also includes post-op visits, drain removal, etc. The only thing not included are the pain meds which my RX coverage will pay. I go in at 6:30 AM on Wednesday and will go home mid-afternoon. Part of me wishes to be inpatient for monitoring but a bigger part is happy I'm going to be home with my pets and having friends/family come monitor me. Another positive is that if I am unhappy with the pubis area, Dr. Rao will do a revision for me to tighten it even further.

I paid my 50% deposit and booked October 9th. My parents are going to take me and stay while it is done. I'm going to take the next 10 days off from work to recover. I am 178# now, I'd like to be at 173-175# by 10/9 (~ 2 months) and then I'd like the removal of the skin to help me hit my final goal of 170# (I'm 5'11").

Sorry for the rambling post. Not many people post their pre-op journey and I wanted to share mine so people could know about costs, options, etc. I will do 1 more pre-op post with pictures just before surgery and then post pictures regularly thereafter so people can see how I progressed. I hate that vanity is driving a good chunk of this, but it really is just driving me nuts and I had a better body image when I was heavier and didn't have this weird loose skin. There are chubby chasers out there for big people, but there aren't a ton of people who say "yeah I'm into a guy with loose stretch mark skin and saggy pubic region". TMI? Oh well.

Facility: Cosmetic and Plastic Surgery, Transformations, UW Health, University of Wisconsin Hospital, Madison , UW Health, University of Wisconsin Hospital, Madison
Surgeon: Venkat K. Rao, MD, MBA, UW Health, University of Wisconsin Hospital, Madison, UW Health, University of Wisconsin Hospital, Madison
Procedure: Extended Abdominoplasty - Plastic Surgery For Me

[kps317]

Incredible. So much to think about, both before and after surgery. Good luck.

[LisaI]

That is a fantastic price, ESPECIALLY since you do not have to travel out of the country! I'm so happy for you. I long for the day I can get rid of my hanging disgusting gut. Hopefully less than a year.

[~Fawn]

I am happy for you John taking this step! I will continue to watch your accomplishments...

[emotions_of_love]

I can totally relate to how you feel. At 300 pounds I felt sexy and curby. Now at 168 with flat, wrinkly boobs.. not so much! Hubby tells me nearly daily how beautiful I am to him but its so hard to comprehend how he feels that way when I feel so "deflated" and old (I'm only 37!!).

[azladyrider]

Good luck - and just as I said to you in a PM just now while Neibles did get good results with someone else (I speak to Christy often on the phone and she knows how I feel) when confronted with any complications he runs away. If one can afford local then that's far better than a doctor that you have to speak to with a translator. My wished either got lost in translation or totally ignored, not sure which but he did offer to fix (for more big money) and he didn't fix his mistakes anyway then when confronted with the latest fiasco he ran.
Again good luck. I am going to hope to find a local doctor myself or at least a better one in Mexico which I know there are plenty.

Logistics doesn't necessarily mean a good result - the first horrible disfigurement I encountered was from an American doctor in Illinois in early 2000 but she died from her own self induced liposuction.

[bergamini]

Thanks, everyone. Sue, you sure are right -- logistics means nothing. Some of the work I've seen coming out of MX plastic surgeons is AMAZING and if I had more to do (like boobs, arms, etc -- the stuff women get more often), I couldn't afford it in the US. My mother is in her 2nd battle with cancer (good prognosis) but I didn't want to stress her out while she's going through chemo so I acquiesced to get the local consults. I'm glad I was able to find a doc that came in at the right price even if I'm not getting all the procedures I dreamed about. My goal has never been perfection, just a body with which I can feel comfortable. This will get me there.

[HealthyHeather]

Best of luck to you! Sounds like you have worked really hard to get where you are and you deserve to have the cherry on top! I am having plastics done in October as well. Tummy tuck and boobs, so we will be recovering at the same time. Hope yours goes without a hitch and a speedy recovery. You will probably be itching to get back to exercising ASAP. Check out the site RealSelf.com. There are great stories and pics of people who have gone through what you are about to do.

[Harley Granny]

I think it's great that you're sharing this! So many people..myself included don't now what all is involved in this kind of decision.

Wether it's vanity or not it sounds like you're educating yourself and making an informed decision.

One that I'll probably be making in a year or so.

So...Thanks for sharing!