I'm by no means an expert but here's what I've learned since my plastic surgery just over 6 months ago.
#1 thing to know. After long term obesity plastic surgery is more about reconstruction than about cosmetics. It can often take us several surgeries to get what "normal" people get in ONE surgery.
Here are some photos of me before plastic surgery.
Lots of loose skin, but it doesn't look too bad.
However the side view is worse.
This is a horrible photo, I know. It was taken the night before surgery and it really shows how bad my hernias were.
I had 5 consultations, including one over Skype and the Phone with a Dr in Beverly Hills and ultimately choose to have surgery locally at the University of Texas in Dallas by Dr. Jeffery Kenkel. He was not only able to put my many fears and worries to rest but took my needs and concerns into consideration at every step of the way. His staff has always been over the top kind and helpful. I truly could not have a better team of Medical Professionals at my disposal.
I had NO drains. This is actually becoming common practice within board certified Plastic Surgeons.
My Dr removed my "panni" or that lovely "apron" of skin and as a result this pulled up my thighs a bit, but he also extended the incision behind my hips so it's perfect for where I was having skin folds
I had liposuction all over my torso, hips and made sure to remove the "fat pad" on my pubic bone/mons area so I don't have a "package".
Several hernia's (4!!) were repaired during my surgery as well as re-fixing an old Umbilical Hernia. Unfortunately this repair left my belly button too weak to chance it so he had to close me up as is and let me heal. Belly Button revision is incredibly common-both to fix bad belly buttons after plastic surgery and does not require surgery. I had one added at my 3 month mark. It was done in the office and took about 45 minutes.
Pain wise things were rough because of the hernias but nothing that wasn't manageable with medication from my Dr. I did have some additional issues that aren't uncommon with nerve pain in my hip bones from the anchoring of the muscles but that's 100% resolved.
Energy levels after surgery have been interesting. I have struggled and while I'm mostly up and around like normal, I tired quickly. Again, it's major surgery so be kind to yourself during healing.
Wear compression garments. The swelling is quite real still and can be incredibly painful. I am still wearing them when I will be standing for long periods or sitting for long periods. No shame in supporting your new torso.
My incision is thin, very fine, barely pink and VERY low. It will be easily hidden by ANY swimsuit or panty. LOVE that!!! But I didn't have any issues at all with it. No bandage changes needed ever. No openings, it's straight. Smooth and lays flat. THAT'S the true sign of a skilled surgeon.
Two days after my surgery. I was incredibly proud to be SO flat from the front but I'll be honest, the swelling on my hips was truly unexpected and sort of terrifying. I knew there would be swelling but what an eye opener!
Three week progression. You can see how quickly the swelling went away.
This is one of my very favorite Before & After photos. SAME outfit. COMPLETELY different legs & NO apron on my lap.
Here's a comparison of before and NOW. My baby abs are starting to peek through and I am loving how it looks!!
Not so final thoughts....
In clothes...and even out of them. I LOVE the results so far. I love not needing 3 layers of Spanx to look normal in clothes. I love the feeling of not having the apron on my Lap and I love how much easier life is without it. I DO still have some loose skin in my upper abdomen. We opted to not do the Fleur De Lis incision. Dr Kenkel said if we do a breast or upper body lift that would take care of the rest of that. But like I said, plastic surgery after massive weight loss is more reconstruction than cosmetic. Not having the hernias to deal with daily has been a big improvement and that was the goal, to make things better. Not just look better.
I still have other skin issues, arms, back, booty lol. But nothing bothers me like the tummy did so I don't know what the value would be in getting more surgery. A breast lift is an appealing option and would fix the remaining skin issues on my abdomen. So it's not on the agenda, but might be on the horizon.