First Plastics Consult

So yesterday’s plastic surgery consult was with Dr. Albear, who comes highly recommended from the OH board for my state. He’s also the only local plastic surgeon that will even try for insurance coverage for these procedures. On top of that, he’s really the only surgeon I’m looking at who has a specific case history of massive weight loss patients: everybody else is your basic breast implant, mommy makeover type of surgeon.

So those are the plusses for Dr. Albear, and the reasons he had been pretty high on my list of possibilities to start out with. The one down side is that he operates in Tampa, which is a good 2.5 hours from where I live. That’s a pain for the drive home the day of (or day after) surgery, and it’s a bit of hassle getting to his Lakeland office (1.5 hours) for follow up appointments. But I’d travel as far as necessary to get the right person to do my procedures!

So I walked in knowing (1) I need a brachioplasty, and (2) I need my boobs fixed, whatever that entails.

Lee came with me for moral support, and because he’s 100% behind these surgeries. He knows I’m miserable with my arms, and I know he’s miserable with my boobs! We assumed I would need implants to get some kind of reasonable size, but more on that later.

When Dr. Albear walked in, he began with a schpiel on what he requires out of massive weight loss patients:

  1. a prealbumin level in the range of 18-40. Prealbumin measures hepatic protein levels, which is basically protein in the blood, which is essential for healthy healing. If my first blood test is low, he would recommend protein supplements. (hahaha! I’m the queen of protein supplements!) I haven’t had prealbumin tested on any of my previous labs, but my protein total, albumin, and albumin/globulin ratio were all in normal ranges, so I don’t expect any problems with this.
  2. a hemoglobin level greater that 11. Since many (most?) of us weight loss patients develop anemia, he wants to make sure I’m not anemic before surgery. On my most recent labs, hemoglobin was 13.8 so again, no problems expected with this.
  3. a reasonable BMI. He explained that better results and better sculpting come with a lower BMI. He doesn’t like to do procedures on a BMI of 3o or more (I make the cut! I’m 29.9!)
  4. since many massive weight loss patients need multiple procedures, his rule is no more than 6 hours in surgery. He said that he can begin to get tired after operating for 6 hours, so his rule is no more than 6 hours in the operating room at a time.

Now. Everything is cool until the 6-hour rule. I understand the philosophy behind it and I respect the reasoning, but this would mean two separate procedures for my arms and breasts. Which means two recoveries. And it also means the expense of two facility fees.

Then again, safety first!

Dr. Albear explained that for massive weight loss patients, he usually performs surgery in the following stages: midsection first, since most people are most troubled by their belly. Then arms, maybe breasts, and only then on to thighs. He explained how much he hates thigh surgeries–healing is poor, wounds reopen, and this corresponds with every horrible thing I’ve heard about thigh lifts on the OH boards. So he won’t do thigh lifts until the very end when he knows exactly how a patient heals, and he never performs thigh lifts in conjunction with any other procedure. So that’s good to know for future reference.

Anyhow, I explained that I’m not interested in working on my midsection now since Lee & I are probably going to have kids within the next 4-5 years. I’d rather wait until all that is done before addressing that area.

Lee left the room when it was time for Dr. Albear to examine me. He didn’t want to have to watch the doctor “caress my breasts.” I tried to explain that there wouldn’t be any caressing going on, but Lee didn’t believe me!

So see left, I put on the paper gown, and Dr. Albear and his assistant came back in. Let me just say this: if you realize your skin is jacked up at home, just wait until you see in the lighting of a doctor’s office! Just wait until you see it contrasted to all the beautiful “after” pictures of procedures all over the place. Man, I looked a mess. Totally embarrassing. Getting the pictures taken was such a reality check!

So anyway, Dr. Albear examined me, and no surprises there. We talked about doing my arms first, and then a breast lift 6 weeks later as long as I’m healing properly. That he can’t guarantee a cup size, but that I’d probably wind up a C cup with my own tissue during a breast lift (I’m wearing a D now). Etc. etc. Dr. Albear explained that they would submit the procedures to insurance, they’d be prepared to walk me through an appeal, and then we’ll see what happens. Sounds good to me! I don’t expect insurance coverage, but if they have a way to make it happen, I’m all for it.

Then I went to speak with the financial planner, who detailed more of the insurance process. I did ask for self-pay prices in case insurance doesn’t work, and she provided that.

Now, before I give you numbers, my hope was $8,000 total. Lee and I know we can handle that. My nightmare was $13,000, since that’s what I half-way expected after reading what everyone else has paid for similar procedures on the OH boards.

Their price for the May brachioplasty would be a total of $5,265. With a second surgery discount, the late June breast lift would be $5,400. That’s $10,665 total.

Now that’s more than expected, for sure. But having it in two stages would mean two extra months to save, which means it just might be okay. Lee says don’t worry about how much it costs, just get it done because it needs to happen. That’s my boy!

So I’m left with the following thoughts:

  • Would another surgeon be able to do both procedures at one time, saving on facility fees? And two separate leaves from work?
  • Lord, please work a miracle and have insurance cover this!
  • Can I really handle two surgeries 6 weeks apart? That sounds insane!

So my plan is this:

  • Get the labs done that Dr. Albear ordered so that we can find out if there are any problems
  • Call their insurance coordinator back in 2 weeks to check on the insurance status
  • Reschedule all of my March consults for January/February so I can know what my other options are and make a decision. I hate leaving things open-ended
  • And once that’s done, I’ll work with whomever to establish an actual surgery date(s)

Getting closer to plastics feels really good–like I’m that much closer to having a normal, healthy body!


3 Responses

  1. It all sounds good – but remember – it’s not like you HAVE to do them 6 weeks apart… you can space them out more if that works better for you.

  2. I’m really anxious to read about this journey for you. At 42 years old, I’m not sure plastics are something I want, but if I were still in my twenties, hell yeah! But if I ever change my mind, it will have been good to read through your process!
    Can’t wait to hear about your other consults so…you can compare prices!

  3. […] Plastics Consult Posted on January 13, 2009 by megameggs So my first plastics consult went well, but it left me with some lingering […]

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