Today we are excited to welcome Frankie as a guest blogger! She has been one of our clients since the beginning and today she is sharing her thoughts and experience with plastic surgery after WLS.

Whether or not to have plastic surgery to remove excess skin is a decision that we are often faced with after weight loss surgery. Whether you’re just starting to consider it, or you’ve already decided on it, it’s not too soon to start preparing yourself for the next phase in your journey.

Prep Your Body

This seems to be a controversial point in some online plastic surgery groups, but it’s a point that my sleeve surgeon and my plastic surgeon made — meet your goal weight first, and then learn to maintain it before you remove excess skin. I listened because plastic surgery is painful and expensive, and I wanted to do it right the first time so I wouldn’t need revisions.

Once I made the decision to have plastic surgery, I took my nutrition and fitness even more seriously. I worked out at least 4 days a week for two years prior to my plastic surgery. I did a combo of strength, running, cardio (I love kickboxing), interval training, stability, and deep stretching. Basically, I did something different every day, which kept me engaged and happy to keep doing it. There are a few things that I did a lot of that really helped in my recovery. Core training was the most important. I couldn’t use my abs at all for weeks, so all the core training I did allowed me to “turn off” my core as easily as I could turn it on. Squats helped me get up and down off a chair or toilet using only my legs. Push-ups and side planks helped me get up from a lying position using only my arms. My endurance running and other cardio helped me with stamina. Yoga helped with flexibility.

Food is just as important as movement, if not more so. For at least a year, I ate a balanced meal plan and was within calorie range and macro percentages on most days. For me, a balanced meal plan is 40% protein, 35% fats, and 25% carbohydrates. I prioritized getting in lean proteins and eating metabolism-revving foods. That is not to say that I ate perfectly–I most certainly did not–but I ate well most of the time. One week before surgery, I increased my protein to 55% and kept it that way for a few weeks. Then I gradually decreased it back to 40%. Some of my high protein options included Greek yogurt, grilled chicken, boiled shrimp, bone broth, and protein shakes.

At our consult, my plastic surgeon said my excellent physical condition gave me an advantage over his patients who don’t work out or eat healthy, in terms of overall happiness with results and the actual physical recovery. He pointed out specifically that my choice to do so much interval training probably helped with fat loss, which meant that he didn’t have to do liposuction on my stomach–which saved me pain, money, and a longer recovery time.

Prep Your Mind

For me, plastic surgery came out of self-image issues that I’ve struggled with as a result of my 140+ pound weight loss. I became an athlete at 41, but the mirror didn’t reflect how strong I knew my body was. I started counseling before my sleeve surgery because I knew this journey would bring about a lot of life change and challenge, so I utilized that when it came to making the choice around plastic surgery.

One thing that I came out with was that it’s really important to know your why. My “why” was both aesthetic and functional. I wanted to see the results of all my hard work as much as I wanted to move freely without having what turned out to be 7 extra pounds of skin around my midriff and hips. I returned to my why over and over throughout the process, when I’d want to skip a workout or if I started to worry about how much it was going to cost. I had to remind myself that it was worth it–that I was worth it.

Since I was dealing with some negative feelings about my body, I wanted to do whatever I could to minimize that, because I saw with friends that those habits can come back even after you have plastic surgery. I had to find ways to love my body that were not related to what I could see in the mirror. I started daily affirmations about my body. This initially was about me recovering from a shoulder injury, but I got more than I expected from it. I started small. My body can do 1 push-up again. I love my arms because they give good hugs. But over time, this grew into a real love for the body that I’d shaped with food and exercise. My legs are amazing because they can climb 90+ flights on the stair climber. My body is strong enough to run three miles without stopping. The most important thing for me was recognizing that what I love most about my new body is how easily I move through the world compared to 140 pounds ago. Recognizing all the gains I’ve made helped minimize negative self-talk.

Of course, educating yourself about the procedure(s) you’re having is a really important mental preparation too. I chose to avoid support groups because I don’t like horror stories, but you may find what you need there. I stuck to the medical literature so that I could learn exactly what would happen to my body, what the risks were, and what I could reasonably expect. I also watched some surgeries on YouTube and a training video at the surgeon’s office. On my consult day, I went armed with questions ranging from how he was going to place my incision line and how many drains I’d have, to when I could reasonably go get laser hair removal or tattoos around my scars. I kept a running list on my phone, so I wouldn’t forget anything.

Prep Your House

Most of your house preparation can wait until the week before surgery. Food-wise, start by making sure your pantry and fridge are stocked, and that any food you’ll need for the first week is prepared, portioned, and ready to eat. You’re not going to feel like cooking, and you may need to enlist some help for the next few grocery trips following surgery.

Your doctor will likely give you prescriptions and over-the-counter options that you can get ahead of time, so put those near your recovery area. Recliners are great for this, but a bed with lots of pillows can also be comfy. You’re likely not going to be able to get comfortable after surgery, so add in things that calm or soothe you, like aromatherapy, music, or books. Also, expect to live in comfy pajamas for at least a week. Jeans are not going to be your friend while you’re swollen.

Depending on the type of surgery you have, you may need to get a walker to help with mobility. But if you don’t, get one of those sticks with grabbers on the end–that’s probably the most useful thing I had on-hand. I used it for weeks until I could bend at the waist again.

One of the biggest things I did to prep my house was to set a bunch of alarms and Alexa routines to tell me when to eat when to walk when to take a sponge bath, and when to take medicine. I also posted a hard copy of my meal plan on the fridge with days and times. That kept the guesswork out of it and helped my care team give me what I needed when I needed it.

Prep Your Care Team

Since I had the 360 lower body lift, I was looking at a surgery with a 12-week recovery time, which included 3 weeks of absolutely no bending at the waist and as many more with severely limited mobility and flexibility. I needed help, and I needed lots of it. Having one person would probably be okay (but exhausting for them), but I decided to enlist 3 people to help with my care–one during the day, one during the night, and one to come and give ME a break from both of them.

It’s important that your caregivers understand the procedure you’re having. We watched some YouTube videos and went over the Q&A that I had with the surgeon. If possible, take them with you so they can ask questions too. At least one member of your care team should also be present at the hospital to be trained on your aftercare. You’ll likely be dealing with drains and incision care, so if they can get in-person training on that from the nursing staff, it’ll help out a lot when you get home.

One of the hardest things for my care team was feeding my bariatric tummy. They’re all really familiar with my eating patterns, but none of them had ever been responsible for prepping a full day of food for me. I sat down with them and went over my meal plan and showed them where everything was in the fridge and pantry. 

Stick to the Fundamentals

Christina and Lindsay talk a lot about keeping to the fundamentals when you’re trying to lose weight. When you’re prepping for surgery, they all still apply. Make sure you’re drinking your water. Eat as cleanly as possible. Move your body. And most importantly, show yourself some love and self-care. You deserve it.