I've lost 70 pounds... and now I'm starting to freak a little. Help.

In My Humble Opinion
1

I have lost 70 pounds and I’m losing more every day. I’m down to 258. I look remarkably good, all things considered - at this stage I carry my weight pretty damn well and I feel pretty good, even though I’m still obese.

I want to lose more and I am and I will, and I’m not going to let the concerns I’m about to explain make me turn back…but I might let them slow me down.

I’m 47 years old. I am faiirly blessed with a good shape, good natural muscle tone, and good skin. But I’m not superhuman…I’m not a magician. The skin is beginnning to show the damage of years of obesity. Already I’m amazed at the fact that I can grab handfuls of my ass. My underarms, my inner thighs, my poor breasts… its all starting to drip and droop. Not horrible yet, but bad enough and I’m terrified of how I could look in another 70 pounds.

Before you say: “EASY! Get a full body lift! It’s a SNAP! Modern surgical techniques are amazing! What’s the problem?” No.

No: I have a well-documented-in-these-pages HUGE issue with anesthesia. (Had an awareness episode-hell) I’ve had several short, minor operations in recent years that have gone very well, but a full-body or even a tummy tuck or tit fix is a long operation… the idea of going under anesthesia for that long puts me in a total panic on a gut level, and on an entirely well-thought out level, I just can’t wrap my mind around the idea of risking my life in serious anesthesia for vanity.

No: What I’ve seen on TV tells me that the pain is enormous. And the scars aren’t too fabulous, either. Trade saggy for Frankenstein.

No: $20-30-40,000 I aint’ got.

But the idea of spending my life having an ugly fat body, then losing the weight at last and having an ugly wrinkled saggy body is just incredibly depressing.

So… what are all your best, worst, craziest tips for working on, improving, protecting or magically WILLING my skin to rebound…not perfectly, I know, but better than I fear.

Hit me with everything you’ve got.

Thanks!

(And I did not have a gastric bypass…I’m doing it the old-fashioned way, with a little bit of indirect chemical assistance. Overall, very healthy, and I was motivated by the knee surgery I had last year and the recovery that jsut wasn’t happening…then the light bulb: gee, ya think my knee still hurts 9 months later because it has to haul 300+pounds around?)

2

Well, I hate to say it, but I think you’re stuck. If you work out, you can offset some of that sagging skin, but with a huge weightloss, there really is no other alternative than the body lift.

I’ve seen programs on it, and it would be scary as hell for me, and I LIKE going under anesthesia!

There are people who get the sagging skin and those who don’t. If you’re lucky, it isn’t an issue. If you’re not, you have three choices: gain the weight back, get the surgery, or live with it knowing you’re healthier in the long run. Best of luck to you!

3

Good lord, Kalhoun, what the hell is to like about anesthesia??? It’s not like you have cool dreams or anything, and it wasn’t until my DNCs that I finally got an anesthesiologist who was together enough to give me sufficient drugs to prevent the horrible nausea before I woke, insterad of waiting for me to fully come out and beg for something!

And the gall bladder operation…ugh… I felt so fucking awful…between the nausea, the depression, and the desperate need to get the fuck OUT of the hospital…ack. (No pain to speak of, though. Those little holes and cameras are just remarkable. Too bad they haven’t figured out how to do plastic surgery like that. A hundred years from now they will.)

To others who know about this surgery that I’m never gonna get: what’s the deal with the tits? If you don’t want implants (never, never never, yuck!), how do they tighten them up?

4

Doing it slowly has probably been in your interest. From what I’ve read, the best way to minimize it is strength training, which would probably be good for your knee, too. I was in the best shape ever after the 6 weeks of PT I did for a knee injury.

5

From what I’ve seen of my friends who have lost massive amounts of weight…if the weight loss is gradual, and they maintain an increased level of physical activity, the skin eventually gets tighter. You can’t expect overnight results. It takes a few years, in fact. But as the skin regenerates, it more and more fits the new body shape, not the old. You’ll never get the tight skin of youth without surgery, but long-term exercise has worked for my firends. YMMV, of course.

Oh, and congrats! That took willpower.

6

Yep, you might want to slow the weight loss down a bit. Your skin will be able to adapt more easily. I know a woman who used to be 350+ lbs, and she lost over 200lbs. She did it slowly though, and although her skin is not totally smooth and tight, there are no folds of hanging skin.

7

Stoid, I’m no doctor but… I did stay in a Holiday Inn Express last night. :smiley:

Okay, sorry. I needed a joke to lighten things up. But seriously, with a significant loss of weight like that, surgical tucks and nips may be the only way to serious improvement.

Okay, I know what you’re talking about on the awareness episode with anesthesia. But: Did you see that program on health discovery channel about the anesthesia awareness and this doctor who is pioneering a technique to eliminate it? It aired, I don’t know, maybe 3 months ago or so and while these people’s experiences were truly disturbing, this doctor is doing something about it. I think a web search or even archives search on Discovery Health website would turn up the details of the program.

Anyway, so this doctor (bear with me, this is just what I recall) ties a tourniquet-type thing (not a true tourniquet, though) on the patient’s arm between elbow and shoulder to disrupt flow of the medication into that limb. The patient then gets the anesthesia, and the anesthesiologist/nurse/attendant monitors the patient’s arm during the surgery. If at any time the patient moves his/her arm in response to stimulus or moves it spontaneously then the patient is immediately given more drugs to put them under completely.

In the program, they showed video of an actual surgery being done with this technique. Midway through the patient flexed her fingers and they immediately gave her more drugs. There was then no more response to the stimulus and they continued.

I know you said money was an issue too, but if you get to where you consider a surgical nip/tuck, maybe look into this and see if your doctor knows about this technique.

I remember being flabbergasted after watching the program that someone could awaken during surgery (I have never had surgery), and what it might do to them. I am very sorry for the terrible experience you had with that.

Okay, I’m throwing it out there: In all seriousness, would you consider something like submitting your name to Extreme Makeover? I mean, it would all be on national TV, but that could be an option.

8

Found it - it’s called the “isolated forearm” technique.

9

First of all, congratulations! You go, girl!!

Second, I have a silly question… I know they sometimes do rhinoplasties using only a local anesthetic, and don’t they do cesarian sections with only some kind of local or epidural or something? So, based on the location and type of skin tuck you might need, is there any possibility you could find a plastic surgeon who could do it without putting you completely under? And if it’s even possible, is that something you would consider as an alternative?

10

May I ask what chemical assistance you refer to? I’d like to shed some excess pounds, and although I’m eating right and hitting the gym, I’m not seeing the progress I want.

11

Some people are lucky and have skin that “snaps back.” Others of us, no matter what we do, how we lose it, don’t. Good luck, but if you do need the tummy tuck, I can promise you that it is not that painful. I had one after a 100 pound weight loss and it was amazing. I am very, very, very glad I did it. Clothes fit better, I am happier, all that. This is not a vanity “ok, I have a pouchy bit here” kind of surgery. On me, they removed 11 pounds of skin. No way was that gonna snap back. Nonetheless, because they don’t cut the muscles, only the skin, it was not that painful and healed (at least on me) quickly.

12

Stoid, my mom lost a bunch of weight and had the extra skin thing going on. She was told to stay hydrated, moisturize, and have patience. Slow or rapid loss, there comes a point when your skin is just not going to snap back any further. Excercise is always good, but sometimes it can even make you appear a little more saggy (I saw this on Discovery Health I believe, when they documented a young man who’d had the whole body thing done).

Several people I’ve known have had plastic surgery after weight loss. Anxiety right before the surgery can be taken care of with a valium, and your surgeon should be very aware that you may become nauseus from anesthesia and provide meds to help combat it, at the very least. Talk to your surgeon and he or she can figure out a way to make it much more tolerable. Pain varies from person to person, and what you had done. Nobody I know said it hurt so much they wish they hadn’t done it. Adequate pain meds can help a lot.

You also don’t have to do your whole body at once. The abdominoplasty that goes all the way around your waist doesn’t have to be done in conjunction with any other. It isn’t a short operation, taking anywhere from four to six hours. Everybody scars differently and they generally fade and look better than saggy, stretch marked skin, in my opinion. A couple of places where my mom’s scars didn’t look as nice, the doctor re-did them, using a local.

Breasts don’t neccessarily need to have implants. The doctor just removes enough extra skin to fit the breast tissue you have naturally.

I’m trying to remember what my mom paid for all her work. California is higher than the natl average, and her tummy tuck, which went all the way around, was 8 or 9 thousand dollars. Her surgeon was one of the best in La Jolla, a bit higher than some she’d checked, but much lower than some of the status plastic surgeons, too. The good news is that her insurance paid for some of it, which lessened the sting.

In the end, as Brynda mentioned, it was a huge self-esteem boost for my mom. She felt less than happy, after losing all that weight, to still not like what she saw in the mirror, and have trouble finding clothes to fit her peculiar shape. All tightened up, she says she feels like she’s truly met her goal of being the best she can be.

13

Stoid you have lost the equivalent in weight of a 7 year old boy.

That is freaking awesome!

14

Well, I don’t get the nausea (at least I haven’t yet). Then after you wake up, you can sleep really, really well again. I’m a fairly small person, so they seem to have no problem putting me under. I’ve never been aware of what they’re doing. They always knock me way the hell out. I love the few seconds right before I nod off. I just love narcotic sleep. Go figure.

15

I’ve lost a hundred pounds since last August with nothing but diet and one ephedra free Stacker 3 a day. The only exercise I get is the light housework I do around my apartment or at work and a little (and I mean little) walking.

16

I understand that they can do a lift for the breasts without implants - they can remove extra skin and do a “laser bra”, where they make scar tissue, anchor it to your ribcage, and make a sort of internal bra for you. Sounds creepy, I know, but the results I’ve seen on TV look good.

17

Both you and Stoid rock.

18

So what happens if you get the skin removal done and then gain the weight back? Bad stuff?

19

Your skin will stretch and expand with remarkable speed to accomodate weight gain. If it did it once it’ll do it again.

20

I’m sure no doctor, and can’t even watch the Surgery Channel without hypervenilating, so take this with the whole salt mine it deserves…

  1. Skin shrinkage: I’m basing this on a close pal who went through bariatric surgery. She researched the hell out of it first, and her surgeon was a demon for informed expectations, but from what I gather skin’s snap-back ability is limited. It isn’t just degree of stretchage, but also age and rate of weight loss.
    Realistically, I don’t think there’s much you can do by yourself that will shrink the excess skin back to what you want.

  2. Surgery terror: A bitch, ain’t it? All it takes is one truly dreadful experience.
    Unfortunately medical folk in general seem to close ranks officially when mistakes are made but a lot of 'em are still very responsive in direct care with aftermaths. I swore nobody, including emergency workers, would ever get me inside a hospital and keep me there. Dying in a ditch would have been preferable. A really good, responsible doctor who actually listened finally coaxed and vowed me into a critical preventative procedure. He didn’t excuse what happened or minimize my completely justified cynacism/terror. He just promised to throw his full influence, care and vigilence right behind me. He did, and it made all the difference.

Surgery isn’t your problem. It’s one surgeon who did it very badly. So get a better doctor. They’re out there. Just be honest. Surgery is never fun but it shouldn’t be a crawling nightmare either.

Good luck to you.