Congratulations on taking control of your life, and choosing to live healthy. This was a difficult path and a great accomplishment that you completed. Be proud! For many people, this is not the end of the journey; it is only the end of the very beginning!
After massive weight loss (MWL), many patients do not feel satisfied. Despite obvious improvements in health, BMI, and appearance, many patients feel they are still “fat”. For many, it is not until the excess skin and fat is removed that they feel “normal”. Fulfillment for these can only be accomplished surgically, and this means a visit with a plastic surgeon.
A consultation with a plastic surgeon may be one of the most daunting propositions for the MWL patient. Perhaps no other specialty has garnered more attention in recent years than plastic surgery. Reality shows on the one hand have brought to the masses what might be possible, but on the other hand, they have emphasized physical beauty and perfection that may not be possible in the real world. Some of the “TV doctors” can also be characters that are intimidating and larger than life.
To make matters even more intimidating, it takes real courage to even make an appointment wit a plastic surgeon when one considers that the consultation must include a discussion and physical examination of your greatest insecurities!
Nobody can predict the future or control a relationship, however simple steps can be taken to ensure that the visit with the plastic surgeon will meet your needs while insuring your maximum comfort. By doing some homework in advance, you will understand the process and be empowered to partner with the plastic surgeon who best suits your needs. Getting what you need is actually easier than you may think, and you already have all the tools.
Although it may seem obvious, it must be said that without you, there can be no “doctor-patient relationship”. Additionally, cosmetic rehabilitation after massive weight loss is a “want” rather than a “need”. Keeping these things in mind at all times gives you great power because you get to decide what you want, when you want it, where you want it done, who you want to do it, etc. With great power comes great responsibility, and that means that you must do your homework and be a good partner to your plastic surgeon.
What to expect, at a minimum
You should expect:
- To be listened too
- To be taken seriously
- To be treated respectfully
- To have your confidentiality respected
The very first step is simply introspection. MWL, generally present with surprisingly few problem areas. The body areas and the surgery most commonly requested in no particular order are: Jowls/neck (facelift, neck lift), upper arms (brachioplasty), breasts (breast lift/reduction/augmentation), abdomen (panniculectomy, tummy tuck, lipo), inner/outer thighs (medial/lateral thigh lift, liposuction), and back/buttocks (360/body lift/back lift/belt lipectomy).
Take a personal inventory of what you like about yourself (don’t forget this important step!), what you don’t like about yourself, and what you want to change, and what your goals are. Understand also that with change comes a cost in terms of risk, recovery, scars, and of course, money. Balance your goals with what you are willing to accept to achieve them.
Preparation for interview- Part 1 Know yourself
What areas bother you; make a list?
- Arrange the list most important to least important
- Understand how the areas bother you, and what will change after surgery
- Compile a list of questions and bring to the interview
- Be prepared to articulate this with the doctor
Armed with this information, it is time to research candidate plastic surgeons. An excellent starting point is simply enquiring of people who have had the procedure(s) you are interested in. Websites like this are excellent for making contacts. Be sure to seek information on plastic surgeons near you to help narrow your search. Get as much information about distant plastic surgeons as well because this may prove to be an invaluable source of additional information.
Be sure to go to each doctor’s site and focus on the doctor’s training, the practice mission statement, and philosophy. If you have particular personal needs, these important sections of the website may give you an idea if this doctor will be a good fit for you in.
Look critically at the photo section. Start by ensuring that the photographic technique is the same. For example, different lighting, shadows, magnifications, “airbrushing”, etc. will produce artificially good results, and raise concerns about honesty and character. Aside from that, look carefully at the results compared to pre-op. Pick the doctor with the results that you like best.
Do your homework
- Consider only board certified plastic surgeons
- Although some non-plastic surgeons are trying their hands at cosmetic surgery, it is always best to use fully trained, certified, and committed plastic surgeons for all plastic surgery procedures.
- Use all resources to get as much information as possible- OH input, patient review sites such as RealSelf.com, the doctor’s website including photos, mission statement, your overall impressions.
- Schedule visits with at least three board-certified plastic surgeons. If unsure after the visits, plan for a follow-up visit, or find a fourth.
Once you have decided upon a plastic surgeon and are ready to move forward with your procedure, schedule your next visit. Your plastic surgeon will listen to you and work with you to establish a reasonable plan to help you achieve your goals with minimum risk. When your plastic surgeon talks to you about realistic risks, benefits, alternatives, and realistic expectations, really listen so that you understand the outcome that you can expect. Understand also the commitments you must make for a safe preparation and recovery!
Understand limits of what is possible
- Understand what bariatric surgery procedure you have undergone-some make large procedures more risky than others.
- Understand that cosmetic surgery after massive weight loss tends to be physically and emotionally demanding, and you may not be a good candidate for every procedure or multiple procedures at once.
Remember, plastic surgery is not magic. “Reality plastic surgery TV” is not your reality. You are an individual with unique physical characteristics and potentials. Work with your plastic surgeon to establish realistic goals/expectations with safety as a primary concern. If you cannot agree, do not have the procedure. If you do your homework, you will find that you will be able to confidently communicate and partner with a plastic surgeon that should be able to meet your physical and emotional needs while accomplishing your goals. This should be one of the most exciting and happy doctor visits you ever have, and you now have the power to make that happen. Congratulations again, and all the best on your continuing journey! Helpful links:
- http://www.plasticsurgery.org/ (American Society of Plastic Surgeons)
- https://www.abplasticsurgery.org/ (American Board of Plastic Surgery)
- http://www.abms.org/ (American board of medical specialties- check to be sure that the “board certification” is officially recognized)
- http://www.surgery.org/ (The American Society for Aesthetic Plastic Surgery)
- Don’t forget local, county, and state medical society websites.