A Patient's Perspective: Plastic Surgery After Dramatic Weight Loss

Article By: Tiffany Willis

Tiffany is a Bariatric Coach, Bariatric Patient Advocate, and Co-Host of the Life After Fat Pants Podcast. After losing 349 pounds in just 18 months following bariatric surgery in 2012, Tiffany has dedicated her life's work to helping those suffering from morbid obesity disease.

Growing up, I read Glamour Magazine, and my favorite feature was in the back of each issue — that at-a-glance lesson in what not to wear known as “Glamour Do or Glamour Don’t.” There was always an image of some fashion-forward icon pushing the boundaries of style or trying something new. Stilettos with shorts? Sneakers with silk skirts? Baggy pants with tight-fitting crop tops? Black nail polish? White jeans in winter? You get the idea. The question was always left up to the reader — is this a do or a don’t? What I liked most is how the magazine posed the question and let the reader decide. I got to evaluate for myself and make up my own mind. The same is true for post-weight loss plastic surgery.

At my heaviest, I weighed 531 pounds. And, believe me, I still have plenty of loose skin to show for the 349 pounds I lost in just 18 months following my gastric sleeve in 2012. That is a LOT of change, both mentally and physically. Several years ago, I became “plastic surgery curious” enough to go for a consult with a surgeon. Wow! Talk about a vulnerable moment! There I was — standing in front of a doctor and nurse, wearing a fluffy white robe (BTW I was super stoked because the robe felt “big” on me). He opens the robe to examine me and there I was — totally exposed, awkwardly standing with my legs apart and arms stretched out wide. The surgeon started pointing out what all needed to be “fixed.” I started to feel a bit self-conscience and worried about what they were thinking. They were judging me and I was actually asking for it. It was a strange experience because on the one hand, I had never felt more confident about myself and my 349-pound weight loss and yet it was hard to not feel insecure as a perfect stranger explained to his nurse that I have “bat wing syndrome!” The consultation also included other possibilities for how I might “improve” my body with a breast augmentation lift and implants due to the “deflation” of both breasts. Before I could get out of there, he had educated me on a procedure known as a 360-body lift. Say what? It seemed like a lot — because it was! Do I want all of that? Do I really need any of it? Is post weight loss plastic surgery a do or a don’t?

There are so many physical, emotional and financial considerations. Physically, I’ve thought about how much my body has already been through — how much I mistreated it before I lost weight and how much my body has gone through in the process. Is it wise to put my body — the only body I’ll ever have — through even more surgical trauma? After all, no surgery is without risks. Plus, as a single woman, I have to think about the recovery. Who could I rely on for my post-op care? How long will I need to be away from work? When can I get back to walking my dogs?

Emotionally, I feel ready to take on the risks to change my body. For me, it’s not about conforming to some notion of ideal body type. Instead, it’s about getting rid of some of the leftover skin that no longer serves me. In fact, some of my skin is holding me back, causing other health issues (ones I’ll save for another post).

In my case, in the end, it all comes down to the Benjamins.

Q: How much is this going to cost?

A: Too much.

Q: How much will insurance cover?

A: Next to nothing.

Q: Can I afford it?

A: Not unless I win the lottery.

Realistically, I would have to pay private/cash for my “bat-wing repair” because my insurance company classifies that type of procedure as cosmetic. Some insurers have more flexible policies and can pay or help pay for a mini tummy tuck or other skin related issues due to rashes or infections that become chronic from the loose skin. If these things occur, please seek medical help from your PCP or weight loss surgeon. Been there, done that!

So, is post weight loss plastic surgery a do or a don’t? I say — you do you!

Ultimately, the decision to have plastic surgery is a personal one. Only you can decide what’s right for you. As for me, I’ve learned to embrace a healthy body weight and lifestyle — leftover saggy skin and all. Like a scar from an old battle wound, my saggy skin is proof that I survived. And for that, I am grateful. But maybe one day, when finances are no longer an obstacle, I’ll let my bat wings fly away. Until then, nothing is going to stop me from soaring!