BlackBerryJuice

Hello all, I recently logged back in after a two-year hiatus to ask some plastics-related questions and figured I might as well post an update after seeing a few familiar faces. I am not going to answer any questions about my surgeon, details of my post-op recovery, post-op diet, etc, since I think this information is readily available from other posters who are less far out from their operations. When I first joined here, there was a dearth of VSG veterans on the forums, so few of us had any idea what to expect after the honeymoon period is over. I am hoping my post will help people wondering about the long term. PLEASE DO NOT PM ME WITH QUESTIONS. I am happy to respond to questions posted here. I don't really have time to address individual questions in private and I think it's best to ask and answer questions publicly so as many people as possible can benefit. My stats: 25 at the time of my VSG, 5'5", highest weight 228 lbs, weight on day of surgery 208 lbs. Post-op goal 150 lbs (BMI 25), lowest post-op weight 136. That weight required significant effort to maintain. I settled around 140-13. I then started Crossfit and put on a lot of muscle mass. I am now sitting right around 150 lbs. My surgery: Aug 9, 2010 in Mexicali, Mexico by Dr. Aceves. I self-paid, surgery cost around $8700 and then I had to pay for the flight. Laparoscopic VSG with no complications. Easy recovery. Reached goal weight in less than 5 months. Thoughts about the long term: Reflux: I occasionally have some, it's pretty minor. I don't take anything for it. Part of it is due to my penchant for coffee. I drink about 4-5 large mugs of coffee a day. Complications: other than the mild occasional reflux, I've had none. No strictures, etc. Foods: I can eat anything I want. After about a year out, nothing really upset my stomach anymore. I don't get nausea, sliming, or anything like that. I have always had a sweet tooth, and I still find many sweets a little too much for me. That said, I did go on a Haagen Dazs spree last week. But food just doesn't hit the spot like it used to. I don't really get major cravings anymore. I can easily keep ice cream and chocolate around the house and not eat it. When I do decide to have a treat, it's more like, "It's so hot now, ice cream sounds pretty good. Maybe I'll have some, it's pretty yummy!" rather than "I WILL SELL MY FIRSTBORN FOR A BIG MAC NOW, GET OUT OF MY WAY, NOTHING ELSE WILL SATISFY ME" like it was back in the day. I can eat pretty decent amounts of food now. I still occasionally get comments about eating too little, but I think that has more to do with other people eating way too much, to be honest. For reference, I can eat a McDs cheeseburger and a few fries without a problem. I can force an entire Big Mac down my gullet, but some of it definitely sits in my esophagus. Scarring: you can barely see the tiny divot from the scar where Dr. Aceves removed my stomach. I showed it to a few general surgeons (I'm a physician myself) and they couldn't believe the results, they thought it was just from a small mole excision. I don't think a layperson would even notice it. You can't see the 3 scars from laparoscopic instruments at all. Esthetics: I have maintained the same overall bodyshape (pear). I have a very small amount of loose skin on my stomach that does not preclude me from having 6-pack abs when I closely watch my diet and exercise. It hangs slightly when I hold the plank position, but I honestly don't care. I think of it as insurance against stretch marks during pregnancy in the future! I have some loose skin over my butt and upper thighs. My breasts are still a D cup, but they are quite droopy, and when I really watch my diet, they get very flat and dumpy-looking. I worked very hard on my fitness the last few years and have come to the conclusion that I've probably gotten within 90% of what's achievable for my body with exercise, so I am having a breast lift with augmentation and lower body liposuction next week. I was originally curious about a lower body lift, but both plastic surgeons I saw felt that the improvement in my case would not be worth the scar as my situation is not that bad. The plastic surgeon believes he will achieve good results with lipo, although of course I will never have a super-tight rear end like someone who's never been overweight at all. I can deal with that! (continued below)

Wow. Calmed down a bit and reviewed this, and yes, this is 100% true, funeral is tomorrow, there are posts on the official page of the hospital where he worked. Sounds like he was piloting a Cessna back to Mexicali and had 5 passengers on board, the plane crashed by a beach somewhere. 3 people died, 3 people survived. Terrible! I'm not an emotional person, but I definitely have a little something in my eye right now. This man honestly gave me, and so many others, a new lease on life. I can't think of any single other event in my life short of maybe getting into medical school that had such an immense positive impact on me. I have never had a single regret about having my VSG, or having it done by Dr. Aceves. It sounds like he left a great mark on medical education by training the next generation of bariatric surgeons. I hope his staff and family can be comforted by the fact that his life made a lasting impact on countless others.

OMG!!!! Nooooo!

Hello friends, Some of you might remember me from before, I had my VSG almost 4 years ago, but I haven't really posted for the last 2 years. For those of you who have never met me, I went from 208 to 136 (highest-lowest), and 208-149 overall. I have worked hard to reshape my body with weight training and I guess I have been very successful, BUT I am still plagued by lower body flabbiness, so I came to the conclusion that surgery was needed if I wanted any more improvement. I went to see two plastic surgeons in regards to a posterior-lateral body lift. Both were 100% against doing a medial thigh lift on me even though my inner thighs are certainly an area of minor fat accumulation and laxity. Both have talked me out of the lift because they felt that my problem was not bad enough to warrant the massive seagull scar in the back. One didn't offer anything else, but the other said he can do a lot of contouring for me. He said he can do fairly aggressive lipo on my knees and could do gentle lipo on my thighs to smoothen them out a bit. He said he will be careful in those areas due to the concerns about creating sagging skin after. He's Harvard-trained and was strongly recommended by my GP who has 30 years experience and says she sends all patients who want excellent results to him. I am travelling way out of town and paying extra for him over a different surgeon. Because of his training and excellent recommendations, I am, of course, tempted to trust his expertise, BUT I can't help but wonder how good lipo will be in areas where I already have some laxity. It's very difficult to find stories online from people who had lipo post-WLS, it's mostly just lifts. So, long story short - has anyone here who reached their goal weight and was lean had lipo? Did you like your results? Did you end up with more cellulite or with more loose skin than before? Thanks!

Just wanted to check in, I had my breast lift/augmentation and lower body lipo last Monday - 6 days ago. Everything went great! I got 325 cc subglandular anatomical style gummy bear (silicone) implants, right now my chest measures about 1" bigger than it was in a supportive bra pre-op. They look huge and round naked, but in clothing, you honestly can't tell I had my breasts done. I went to a party last night and wore a pretty form-fitting non-stretchy dress that I have worn in the past and it fit just fine! Obviously, my size will probably go down a bit in the next few weeks, but I expect to either remain a D or maybe go up to DD after this. I'm glad I won't have to buy a whole new wardrobe. But I bought a very basic sports bra yesterday and had to go for the L even though I would normally wear an M because of my ribcage width. In regards to lipo, he removed 1500 cc total, the majority of it actually came from my hips/saddlebags, which is interesting because both of us were expecting to get a lot more from my inner thighs/knees. He even seemed a bit hesitant to go into my hips/saddlebags because he thought it was more loose skin rather than fat and he didn't want to worsen how I looked, but evidently, both of us were wrong! I'm obviously still quite a bit swollen, but it's coming down nicely. I have lost 3.8 lbs in 5 days since the surgery even though I certainly have overeaten for a day or two. Right now, my hips, inner thigh crease, and knees are already the same measurements as pre-op, and my mid-thighs are *drumroll* 2" smaller!!! I went shopping at H&M the other day and had no problem fitting into their pants - before, the cut wouldn't work for me at all since their pants are cut for straight, lean legs. My surgeon said he was very conservative with lipo-ing my inner thighs because of the loose skin, but the results have certainly been great as far as I'm concerned! The bruising is gnarly and I have a fair bit of pain first thing in the morning, but I've been taking Percocet for sleep and a Tramacet here and there during the day, and I'm doing fine. I've been doing all my regular activities save for working out. I went back to work today, after preloading with some Tramacet, and it was ok! My first pre-op appointment is the day after tomorrow, so I'm looking forward to having the dressings removed and seeing how my breast lift turned out.

Well, there you go!

Yeah, that hasn't been a problem, as evidenced by some weight gain in the past, haha. It will be more difficult in the first year, but now, I don't have a problem. I would like to go through a bulking cycle this fall, which combines heavy weight training with overeating to help grow muscle, and since I find that my regular caloric expenditure is quite high (I maintain on about 3000/day when I do Crossfit), I suspect it will be a challenge for me to get 3500+ calories consistently with healthy foods. I'm planning to eat more foods like protein shakes with full fat milk/bananas/peanut butter or tuna melts with cheese and mayo. But not being able to eat enough to fuel my workouts certainly isn't a problem.

So true. Note the comments about getting "cosmetic surgery." It is NOT cosmetic, although there are certainly appearance-related benefits.

(continued) Weight maintenance: YES, YOU CAN GAIN WEIGHT AFTER THE VSG! BUT YOU DON'T HAVE TO! About two years out, I noticed that I could no longer truly eat anything I want at every single meal even if I did work out quite intensely. Mind you, we are talking eating out constantly, Desserts, etc. I also became more performance-oriented, so I started to think more about fueling my body for exercise. Recently, I had a severe back injury that left me unable to exercise at all except walking for 9 months. I was also having major sleep issues due to pain and work stress and was away from my husband and very socially isolated and unhappy for a variety of work-related reasons. I love to cook and was certainly amusing myself by cooking lots. Normally, my husband would inhale most of my creations, but now I found myself eating less healthy and in greater quantities. Together with hardly any activity, this led to a weight gain of about 13 lbs in 9 months. Not the end of the world, but I was certainly worried! Thankfully, I buckled up and once I was cleared to start exercising, I restarted couch-to-5K and then signed up for a 10K race. I lost the 13 lbs in about 2-3 months with only minor diet changes - basically, eating less crap and more fruits and vegetables. I still ate some sort of treat almost every day. I didn't follow any specific diet plan like low-carb or keto, although I do try to limit my carb intake that doesn't come from fruits and vegetables. I am now closely monitoring my diet as I want to get as ripped as possible since I have lipo coming up and will be away from the gym again for at least 4, potentially 6 weeks. I eat whatever I want within reason, but I count my macronutrients, so every day I eat a certain amount of Protein, carbs, and fat. I eat a fairly high-protein diet - 120-150 grams. I have had no problem losing fat on this plan while eating 2500-3000 calories a day depending on my exercise level. SO YES, YOU CAN GAIN WEIGHT - BUT YOU CAN ALSO LOSE IT, AND YOU WILL ALWAYS REMAIN IN CONTROL! DON'T LET YOURSELF GO TOO MUCH! IT'S NOT HARD TO LOSE 5-10 LBS, BUT 25+ IS A PAIN! LAST BUT NOT LEAST: PHOTOS All these photos were taken within the last week. These are my pre-op photos:

(continued from above) Relationships, Life, Emotional Issues: I used to be a major emotional eater. One of the reasons I had the VSG when I did was because of worrying about how big I would get during clerkship (I was in medical school at the time). I was probably the ONLY one of my classmates who actually got into BETTER shape during clerkship. I very rarely emotionally eat. When I do - maybe once every 3 months - I just acknowledge it and give myself a break. I can afford to have 1/3 pint of Haagen Dazs now and we all slip sometimes. I still get occasional flack from my mother about my surgery, because she's an idiot, but overall, everyone who knows has been supportive since. Everyone agrees I look amazing regardless. After spending my childhood and teenage/young adult years being called "fatty," "BBW," fat cow" and having obscenities and insults yelled at me by men driving by, i's very weird to be known as "Six Pack Sally" at my gym and to have multiple people say things like "I wish I looked like you" or "What's your secret? I want your body!" I just thank people and tell them it's hard work (which is true!) I get TONS of attention from men. That was a bit of an adjustment, remembering how poorly I was treated as a fat woman before. I was quite angry about it for a while, but now I just roll with it and use my appearance to my advantage. People treat me so much better and I can get away with all sorts of special treatment. I have to say that I was worried about women treating me poorly after my looks improved, but even women treat me so much better these days. I also carry myself with more confidence. I am a physician and am often in charge of a large team. I have no problem placing myself in the position of authority or confronting someone anymore and people respect me and follow my orders, regardless of what they might choose to say behind my back - I wouldn't know! Part of it is the weightloss, part of it is Crossfit. Interestingly, one of my supervisors recently wrote in my evaluation that I am "a strong advocate for a healthy lifestyle." Imagine that! I was in a serious relationship at the time of my VSG. We continued to be together for about 1.5 years after. As I got into Crossfit and healthy eating, my partner who is a naturally skinny-fat but unfit person became quite upset with me. He would insult my girlfriends from the gym saying they looked like men (even though they are all quite feminine, IMO!), tell me things like "Live a little!" if I said I didn't want dessert, he behaved like an ass when I took him to my gym in an effort to have him meet my friends and hopefully get into exercising regularly, etc. I eventually broke it off because of that and other factors, but his attitude towards my healthy lifestyle and my goals was certainly a major consideration. I am now married to a guy who is a bit overweight but quite built. He really likes exercise and I'm working on getting him to lose weight. (continued)

Thanks for the post. My weightloss stats are quite close to yours and I am having lipo and BL/BA next week, so this is a very helpful and timely post for me to see! Look forward to hearing about your recovery. How much fat did they lipo off of you? I am most worried about the lipo outcome since we all have some degree of loose skin, and I'm anxious about having lumpy/wrinkly skin afterwards.

So I'm engaged and my fiancé and I have been together for over two years now. We've even flown to Europe to meet my family together, we have a ridiculously expensive trip to Antarctica booked this fall, we've lived together for over a year now, etc. But lately I find I'm not attracted to him at all. There are, naturally, some things about him that irritate me, like complete lack of desire to improve his health while constantly complaining about falling apart and what not, but really, the biggest worry to me is that he basically disgusts me physically. I went through a stage where I had no sex drive, so of course, I was not terribly attracted to him then, but now I'm finding that I'm getting lots of crushes on literally every other guy who comes in my vicinity, yet I still have no interest in him. The fact that he's not the greatest in bed does not help. At the same time, I enjoy his company, he has a good sense of humor, and as a person, I definitely like him. But lately I'm constantly thinking about breaking up with him. He's been constantly texting me that he loves me, and I realized I get very annoyed when I get these messages. The difficult part is that he's completely obsessed with me and I have no idea how to handle this. He's a very anxious, high-strung person who doesn't deal well with stress. Last year I told him I was thinking that maybe we could move to a different province after I graduate and he inmediately started crying and throwing up. I don't know what to do. I don't even know what exactly I'm looking for by posting here. Thoughts?

Haven't been here in a while! I still keep getting PMs through my email, so I figured I'd drop by. Been pretty busy with school/work lately (I'm a few months away from finishing medical school). I remember how few people still stick around the boards once they've maintained their weightloss for a few months, and how much the newbies love to see people who are a few years out. For those who are not familiar with me, I joined these boards in June 2010 and had my VSG with Dr. Aceves on Aug 9, 2010 at 208 lbs. I reached my original goal weight of 150 lbs within 5 months; my lowest weight to date has been 135. I'm maintaining around 140 now (I'm 5'5" and have a large frame). I had a fairly simple and stress-free recovery and consistent weightloss with no major stalls. My weight has bounced up on a few occasions since my surgery, but I always catch myself after I notice a few extra pounds and change up my eating. I went through a phase where I ate anything I wanted and maintained my weight, but back in the spring I became interested in the paleo/primal diet - which is actually fairly similar to our post-WLS diets in that it's relatively low-carb. However, you are not allowed ANY grains and NO processed foods at all. The diehards will also avoid soy, peanuts, and dairy. I personally still eat dairy, but I choose full-fat versions. I eat as much meat/fish/chicken/game as I want, all fruits and vegetables, nuts, full-fat dairy, and occasional low-sugar treats such as dark chocolate (80-85% usually), etc. I've completely lost all interest in grains and a lot of treats taste very sweet to me now. pizza, etc just tastes like I'm chewing flour; I found some artisan ice cream that's quite low in sugar, but even that's a little too sweet, so I think I'll be getting my own ice cream maker soon and make low-sugar ice cream. I eat about 2500 calories a day on average. I eat about 7-8 times a day. I can eat enough that no one notices I eat small portions. Today, I ate: Meal 1: 4 strips thick bacon Meal 2: about 1/2 pint strawberries with double cream Meal 3: lamb chop, 2 small cucumbers Meal 4: kohlrabi and apple slaw with homemade dressing Meal 5: 3 strips thick bacon, several squares dark chocolate Meal 6: handful of almonds, cheese curds Meal 7: roasted figs with goat cheese wrapped in prosciutto I took 2 months off from the gym recently because of work, but I still biked about an hour 3-4 times a week and tried to run about 30 mins 2x a week. I'm coming back to the gym this coming week. I do Crossfit, so I have a very varied routine with lots of bodyweight exercises like pull-ups and burpees, explosive cardio such as sprints, and heavy weightlifting. I'm attaching pix of me from the day before surgery and some pix from this summer (I haven't really changed much since).

Thanks, everyone!

I never had a personal trainer. I already had a good amount of experience with working out before I started surgery. Like I mentioned in my post, I did join a Crossfit gym about a year out - it's all group exercise with coaches, so I got some help learning the more technical movements (e.g. Olympic weightlifting, gymnastics, etc). I had 5 incisions. 2 of them are barely visible, they look the same as the scars from when I had 2 tiny moles removed when I was a kid. The other 3 are not visible at all. In fact, I showed my abdomen to a bariatric surgeon and he was blown away by how good it looked. He said he would've never guessed I had had laparoscopy at some point, and he couldn't believe Dr. Aceves was able to pull out the stomach through such a tiny incision - he said he wouldn't have been able to do that himself.

I don't take any vitamins at this point, I stopped after a few months out.

Thanks. I forgot to add that I had an opportunity to spend a little bit of time at a bariatric clinic this spring, and spent about 2 weeks on a bariatric surgery rotation. The physician I worked with was very impressed with me both from a professional standpoint and from the point of my experience with WLS, so much that she said she hopes to hire me once I'm done residency. I'm doing a rotation with her 1 week from now! So I think I might be taking that route with my future career - I have some research ideas, as well, so hopefully one of these days you'll be posting a research article I wrote, haha. Things are coming full circle!

I asked my surgeon to clarify the post-op exercise guidelines and got a pretty detailed list, so I thought I'd share it for everyone's benefit, as some of the stuff was surprising to me. I used to be quite active before the surgery, so this is kind of depressing to me, I was really itching to start weightlifting and running again! Bowling is kind of random, haha.