Hello /r/loseit,
I've been a long-time member, mostly lurker, of this supportive community/subreddit. My highest known weight as measured on a doctor's office scale was 338 lbs (153 kg) and I'm a female who is 5'8" tall (172 cm). My method of weight loss was/is CICO via logging calories and using a food scale. It took me a little over 2 years to originally reach a maintenance weight, which for me ranges between 145 lbs to 155 lbs (66 to 70 kg), and I've had a few pregnancies/childbirths/breastfeeding stints since entering maintenance. Each return back to maintenance weight has taken about 1 year after giving birth, as I gained during each pregnancy. Since having my last child, I've nearly returned to a (final!!!!) stable maintenance weight and I thought that others may find it useful if I shared a recent experience with my first of three planned skin removal surgeries.
Truthfully, I was not planning on having the surgeries after initially reaching maintenance weight. The cosmetic concerns with having a lot of loose skin were not enough of a motivator for me to undergo what I had dismissed as potentially risky and expensive procedures. I developed an interest in upping my casual jogging into running regularly, though, and I started encountering challenges with keeping the skin contained in compression gear and free from infection. I decided the surgery was worth learning more about. After some initial consultations and shopping/price comparisons, I was pleasantly surprised to learn that improvements in physical function, which was/is my main goal, was possible. I'm currently 2 weeks post-op and I'm delighted and optimistic at the change so far. I'm happy to answer questions, and here is a quick list of things that I learned and a few things that I wish I had understood better beforehand:
Things I learned:
-Depending upon your age, personal priorities/goals, health status, financial status, and skin situation, it is possible that more than one body area will be recommended to be addressed with a procedure (i.e., more than one procedure may be recommended and these may or may not be able to be done at the same time). Based on my circumstances, three procedures have been recommended. This first procedure was skin removal in my lower abdomen with muscle repair of split abdomen muscles (abdominoplasty with diastasis recti correction).
-Recovery post-op is a serious commitment. I took a lot of work leave, and working from home was not doable for me for the first week post-op, as sitting up straight at a computer was uncomfortable for me for more than a few minutes. The recommended care routines for eating (consuming at or above maintenance calories), hygiene, and compression wear are not optional if you want good results and to heal quickly.
-The price was not as unaffordable as I had feared. If geographically possible for you, consider getting a consultation from a surgeon affiliated with an (academic center) university hospital. There may be discounts that are not readily advertised on their websites for people in certain professions (e.g., military veterans, educators) or those who are willing to have their consults with supervised trainees. My first procedure was $5k, and included all pre- and post-consultations, testing, supplies, and exams. Not cheap, but much less than I expected after googling had warned me to expect a range between $10k and $30k (ouch!) for a United States location.
Things that surprised me:
-How much time the surgery team actually spent with me during consultations and exams. I was truly shocked at this- I expected quick visits and questionnaires, but this team spent more than 2 hours at my initial consultation (of several) and then they took many, many measurements of my whole body, inside and out. They were extremely thorough and I have felt incredibly listened to and safe the whole time. To be blunt, this has been pretty much the opposite of many of my previous healthcare encounter experiences.
-The pain has been less than I expected so far. I was uncomfortable and curled up in a recliner for a few days, but I haven't really had a lot of 'pain'. The team checks on this constantly and also monitored carefully for post-op nausea for a whole week.
-The drains that the surgeons installed to pull off the fluid away from the incision sites are vile to me and have been more uncomfortable than the actual surgery. The drains are necessary and work well, but I'll be honest, make me squeamish. I was hugely relieved to have all but one removed recently but the removal was also a bit...well.. freaky. (Remember that scene in The Matrix when Neo has the bug sucked out of his belly button? Yeah. Too close to that.)
-I can't believe that I actually like the dang compression garment that you are required to wear after surgery. That was a roller coaster of emotions- I hated that thing the first few days as wriggling into a girdle (straightjacket?) on top of the drains was uncomfortable and odd-feeling, and then I started to realize that I had a 'favorite' garment a few days after the surgery, and now 2 weeks post-op I can't hardly stand to be out of the garment for longer than a few minutes without feeling uncomfortable.
-The weight fluctuations. I swelled approximately ~20 pounds in the days following surgery and this was considered well within normal range for my stature. My whole body felt wibbly wobbly and when I made the short shuffles from my recliner to the bathroom on post-op days 1 through 3 I felt that 'slish slosh' sensation of the swelling everywhere. I then began to pee, mightily, around day 3 post-op. At 2 weeks post-op, I'm still about 5 pounds heavier than I was pre-op, but the relief of the swelling going down every day is wonderful. Every day I feel a bit more like me again.
-If you are curious about what they actually cut off, they removed two equilateral triangle-sized swaths of skin with accompanying subcutaneous fat from my lower abdomen, each of which had an approximate 8" side length (math friends- is that about 27 sq inches in area per triangle/flap? please correct my faulty math methods memories). There was no accompanying liposuction. The abdomen before surgery was flat but had heavy skin hanging quite low. The current look is a relatively flat abdomen, pending a bit more swelling that will reduce.
-My belly button had to be cut off in the skin swath removal (it hung pretty low), and then it was re-built with re-located skin from the excised flaps. It is much higher than it was before and it looks natural! I am very excited about this and I had no idea that I was going to be so pumped about having a belly button.
