A recent question from my MMH forum tells of a woman unhappy with her plastic surgery after weight loss:
The Question:
Hi there! I am 3 weeks PO today and am still seeing loose skin at the top of my abdomen (more on the right side vs. the left side, but definitely enough to grab from each side) I had a TT with MR, breast lift with implants and arm lift with lipo 3 wks ago. I saw my PS on Monday (and was released from all of my garments: abdominal binder, ace wraps for my arms and surgical bra) and he said that he wants to wait at least another month to see how my skin settles. Needless to say that I am just feeling very discouraged. I lost 100 lbs and wanted to see the body that was under all of that skin, but think he could’ve taken more skin than he did because I am still not happy because I still see loose skin.
An Answer:
Hello,
You can’t really expect a surgeon who has never seen you to magically know what happened in your case knowing so little of what happened to you medically. Let me take a shot anyway. You sound like an extreme weight loss patient who had plastic surgery following that weight loss. You had a lot of surgery in one sitting from the sounds of things.
What people don’t understand about plastic surgeons is much of what we do really has more to do with our philosophy than anything else. My philosophy is to do one large scale operation at a time starting with an extended tummy tuck or lower body lift on an extreme weight loss patient. I find that when surgeons do less patients tend to be unimpressed with the results. My way is more expensive and takes more operations to get things done but my results are better. Then again extreme weight loss patients frequently see “loosening” of their results. Revisions in this patient group are not uncommon.
Other surgeons do multiple procedures in one sitting and don’t extend them as much. It is the only way to get through longer operations in less time. This is less expensive and gets things done faster.
At this point you need to have along “sit down” with your surgeon to figure what to do from here.
Best Regards,
John Di Saia, MD
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The training of the surgeon is important as well as board certification by the right board. The philosophy of the practice is also important however and this can be hard to assess. 
