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One email I recieved asked the question about plastic surgery which said: "I am considering WLS, and have questions about the excess skin that comes with weight loss. Your blog makes it sound like that plastic surgery is a must for most people who have had WLS - is it?"
There is no way to tell whether or not a person will need plastic surgery. You can ask your gastric surgeon, but I am sure even as many patients as he has seen, he cannot foretell who will need it and who will not. It varies according to the person, their skin type, how long they have been overweight, their age Some people will never be in need of any plastics at all. Others will need it but cannot afford to have it done since most insurances will not cover (they say its cosmetic). Then others will beg, borrow and steal to have surgery because they can't live with their bodies. It all depends on the individual.
For me, I am satisfied with the abdominoplasty (tummy tuck). However, this was not always the case. For a period of months, I longed to have more surgery but could not afford it. I simply had to LEARN and PRACTICE love towards my body in order to accept it. There is saggy skin on my upper, inner thighs. You cannot see it unless my shorts are really high, or if I wear a bathing suit. I've spent a lot of time shopping for a bathing suit with a skirt so that people cannot see the skin issues. There is also some sagging in my arms but it is not noticeable unless I hold my arms up high and wave them back and forth (then I see a roll of loose skin waving back at me!). I wanted breast implants but after taking up jogging, decided it was a good thing to be small breasted. (See, there is a silver lining in every cloud!).
The thing is, you can't know what your skin will look like... if a person has been overweight for a long period of time, its like stretching out a rubber band over a thick stack of papers, and then leaving it for years. Once you take that rubber band off, there is no longer elasticity left... instead, it just stays stretched out. That's how skin is... or can be. Some people's will go back quite nicely, others not so much.
As formerly obese, we have unique skin issues. Imagine doing this experiment. Take 500 pieces of paper and put a rubber band around them. Leave them sit for two weeks, then remove the rubberband. What happens? It snaps right back into the same shape it was in at the time you wrapped it around the sheets of paper. Now imagine taking the same 500 sheets of paper, putting on a rubberband and leaving it for twenty years. What do you think will happen when you come back and remove the rubber band? Most often, it breaks. Or, it stays the same stretched out shape. Very seldom will the rubberband diminish into the same shape it originally was. Why not? Because it has lost its elasticity, just as our skin does after being obese for so many years.
Now, I weigh 130 lbs and am a size 4. Size 6's are too huge in the legs, but more comfortable around my waist/stomach area. Size 4's often times cause my loose tummy skin to come up over the top of my pants which makes me look like I have a muffin top. It is not fat, I assure you! When I lay down on my bed, I can look over to either side and see loose skin floating beside me. It hurts me emotionally and grosses me out because it looks like I am laying on a bed of loose flesh. I wonder if I had a total body lift, what size I would be. Perhaps a 1 or a 2. But as disgusted as I have been with my body, I also try to come to terms with what I have done to it. I realize that no amount of plastic surgery can erase the inner emotional regrets that I experience. That is something I have to deal with, and live with the repercussions of the obesity which has stolen so much from me.
In the meantime, I continue to rely on shapewear garments to hide my flaws, and wear clothing which accentuates my stronger assets.