The Third to Last Post: On Plastic Surgery

In Weight-Loss Maintenance on September 18, 2011 at 11:21 pm

As regular readers may note, I am cleaning up loose ends before I move on.  For example, I finally posted the Rules of Engagement page I had drafted sometime Aprilish when we’d had a visit from a concerned but kind self-promoter (some might say “concern troll”) who thought I was presenting an unnecessarily dark (I would say realistic) impression of weight-loss maintenance.  The Rules page is no longer applicable, of course, but to people who come visiting when the blog is closed down and who happen upon the post that inspired it, it will make sense.

I had also meant, shortly after I opened the blog, to say a word or two about plastic surgery.  In my initial post on The Unfairness of Weight-Loss Maintenance, I mentioned the issue of loose skin. 

“Unfairness 7.  You hide a secret under your clothes: your body may be deformed.  Friends say you look great, but naked in front of the mirror you find your pendulous parts and saggy skin discouraging.  Some maintainers may need counseling; others undergo expensive plastic surgery.”

Well, I was one who went for plastic surgery.  I think it is important to talk about this issue openly.  So often it is reduced to a mere vanity concern, and it is not. 

For some people, I imagine radical weight loss presents a pleasing image, if not nude, then in clothing.  For many of us, however, if our skin is not elastic any more, losing radical weight results in a mirror image that we don’t recognize.  It doesn’t even look like a human as we have come to understand it.  The loose folds may conceal the parts that make us sexually capable and deform those parts that we heretofore thought defined us as sexually appealing. 

Many naturally trim people regard fat people as asexual or unappealing regardless, and Madison Avenue does much to perpetuate this notion.  Sadly, many fat people buy into the myth as well.  That, however, was not my experience with my own fat body.  On the way up, weightwise, I became accustomed to my ever increasing curves, lumps and bumps over the years it took to acquire them.  I was joyful, sexual and fully human and, to my thinking, a Boticelli babe.  On the way down it was very different.  Within a period of months, I became a conglomeration of saggy parts.  I didn’t adapt well to this change.  For example, during intimate times with my husband, instead of being present in the moment and contemplating how to please him, I became self-conscious.  I positioned myself so he wouldn’t grab handfuls of flesh. 

In my more mundane moments, as well, my body would remind me of its new predicament.  As I ran or did other aerobic exercise, the loose parts would bounce about distractingly.  Sometimes they would grow itchy from this bouncing, or hurt.  It made me angry and sad.

I decided, because I could, to get plastic surgery.  I won’t go into the details of the process.  Actually, No Celery has produced a nice accounting of a tummy tuck, if you want that.  What I would like to do however, is issue a cautionary note, both to people who are considering plastic surgery after radical weight loss and people who are in a position to support them … or not.

If you are contemplating plastic surgery, you will have misgivings, and for good reason.  I was frightened that I would leave my husband a widower and my son motherless, all because I couldn’t pull my head together enough to live peacefully with my body.  And it wasn’t for lack of support from my husband.  He loved me (enthusiastically) sags and all.  He had also loved me fat and never pushed me to diet.  He says now he would love me fat again.  When I lost the weight, he would reflect my feelings back to me, but he never tried to push me, lest I fail to lose the weight or regain whatever I lost.  He viscerally understands yo-yo weight cycling, and he knew my history did not make me immune to it.   At any rate, at that time, he told me he would support me whatever decision I made with regard to plastic surgery.  (What a great guy!)  I did research on procedures and the area doctors who did them.  I read the scary and the reassuring literature both.  I weighed the pros and cons and went for a consult.  I weighed the information more.  I prayed.  Finally, I called and set an appointment for a bilateral mastoplexy without augmentation (removing the excess skin from my breasts) and an abdominoplasty (tummy tuck).

As the date approached, I turned to a clergy friend for support.  I’d thought she would understand my misgivings without my having to brace her for them.  I told her simply that I was having the surgery and named the date.  She responded, “Oh, I don’t believe in that.” 

I was dumbstruck.  I told her the decision had been made.  She tried to reassure me and convince me to reconsider by telling me how great I looked.  I babbled at her awkwardly.  When she saw I wasn’t going to up and change my mind, she told me she would be at the hospital for me, and I told her I’d rather she’d not.  I didn’t want to have her misgivings present that day, along with my own, and I had another friend with pastoral training who could be there, along with my husband.   The exchange grew ugly.  She is no longer a friend.  She is still a pastor, but not mine.

The moral is, as in so many stories, be careful.  If you are considering plastic surgery then you’ll need supportive people in place to help you, especially during recovery, but not everyone “gets” this.  And people don’t seem to have the social filters in place to restrain their opinions.  Had I been choosing a particular cancer treatment, even an unproven alternative treatment, I’m sure this pastor would have been fully behind me.  But plastic surgery is one of those things you can choose to not “believe in,” I suppose.  I can only think that theologically she must have felt that I needed to deal with what God had given me.  That’s the only logical explanation I’ve been able to concoct for her response.

The moral for people on the other side of this decision, people who have friends or loved ones considering plastic surgery:  be neutral if you cannot be fully supportive.  My husband was the perfect model.  This issue is more complex than mere size acceptance.  It requires the acceptance of a body that you’ve never seen accurately depicted (not even humorously or disparagingly) in movies or on TV.  Leonard Nimoy hasn’t found the beauty in weight-reduced people and depicted it photographically.  These days, as each season of the Biggest Loser ticks toward its finale, the men put on T-shirts and the women cover their sports braziers once the skin starts to sag, and viola, out of sight, out of mind, out of existence.  For me, this is a travesty.

Plastic surgery:  that is this week’s loose end.  I’ve had a couple of readers recently ask me to explain how I came to reconcile Size Acceptance and Weight-loss maintenance.  That’s a simple story, really.  And I’ll try to post on that soon.  Then my final entry.  Thank you all, again, for listening this past year.  You cannot know how meaningful this has been for me.

The floor is open on the topic of plastic surgery and support thereof.

  1. My late best friend had 2 VBGs, and went from 400 lbs to 160 lbs. She had the excess skin removed from her stomach (from just under her breasts to her pubes), but she still had the flaps of skin from her “bingo wing” arms and she still had excess skin on her thighs that surgeons wouldn’t remove (it wasn’t “medically” necessary, she wouldn’t get infections, etc, from that excess skin, therefore insurance wouldn’t pay for its removal and she couldn’t afford to pay for it out-of-pocket). She hated that excess skin and would never wear anything sleeveless, nor did she ever wear shorts, even in the hottest weather.
    That’s one of the main reasons I wasn’t really all that upset that my VBG failed, and why I haven’t dieted or done anything to try and lose weight again (beside the fact that all my attempts failed me) – I really didn’t want to deal with excess loose, baggy skin and have to fight with Medicaid to pay for its removal (at the time, I was on SSI and Medicaid paid for my VBG). I suppose that may sound vain, but dealing with sweat when you have rolls of flesh that’s filled out is bad enough, I can’t imagine dealing with that when the flesh is loose and saggy/baggy and insurance won’t pay for its removal and you can’t afford to pay for it yourself.
    As far as I’m concerned, if someone loses massive amounts of weight and wants to have excess skin removed, it’s their body, go for it if you can afford it or your insurance will pay for it. No way would I force someone to deal with something that I wouldn’t want to deal with.

  2. I have a bit of saggy here and there but at this point have not considered surgery. But my not choosing surgery does not in any way mean that I would condemn anyone else for their choice. We all ‘gotta do what we gotta do’ and (cough, to use a 70s pat line) the world would be a better place if people were just a little less quick to judge.

  3. The reaction you got to your decision reminds me of how my cousin reacted when I decided to have a hip replacement in my mid 40s. She was very concerned and made me feel like I was making a dangerous decision. My surgery actually went very badly and had to be redone, but I did need that hip replacement and it was the right thing to do.

    Now, I`m getting my knee done and it`s been the same thing again. Are you sure? Shouldn’t you wait? Do you have the right doctor? Isn’t it too early? I’m scared enough as it is. She really isn’t helping.

    I think the implication–both for me and for you and for anyone who makes the decision to have surgery–is that we’re not competent to make the right decision for ourselves. That’s what’s so profoundly disturbing. We are adults but this kind of “concern” infantilizes us.

    • As I recall, you postponed your surgery for two months, which gives you additional time to hear all this “helpful,” infantilizing advice. Or maybe it will give your cousin a chance to just DEAL with it! Grrr.

  4. There you are! I’ve missed you. What an honest essay on something that isn’t addressed very often. Hey, it was a BIG deal for me to go through my little hand surgery. Took me 10 years to decide to do it. So a little extra skin? At my age? And single? I’d be keeping clothes over that anyway. Sometimes I wish I could just wear a bathing suit (I wear swim shorts because I don’t like my legs) but that’s still not worth having surgery (to me.)

    And glad you found another pastor. Wow.

    • Ah, Debby, the pastor thing was the most horrible “growing experience” of my life. I got so close and trusting, and I felt profoundly betrayed — moreso than if a friend who was not an emissary for God had hurt me. It’s good that I went through it, however. I don’t wear naivete well.

      Tomorrow, I have to make time to go catch up at your blog. I’ve missed Mr. Monk, especially.

  5. The whole issue of plastic surgery is fraught. Women who have it for any reason are shamed constantly, but the dirty little secret is that if professional women want to stay in the job market, a bit of botox here and there is becoming a necessity after a certain age. Interestingly, teeth whitening never attracts that nastiness – probably because men do it all the time, too.

    I’ve got a wattled neck from my dramatic weight loss and, as soon as I can afford it, I’m going to get something done about it. It’s unsightly and it bugs me.

    Still, anything that women do brings social ire down on their head. Epidurals instead of drug-free childbirth; anti-depressants instead of pulling ourselves together; cosmetic procedures instead of ‘ageing gracefully’ and allowing ourselves to have the career doors slammed in our faces.

  6. Thanks for such an honest account. I’m so sorry you lost a pastor and a friend (although you probably would have run into that judgement from her about something else, sooner or later — this was a painful time to have to see that side of her and not have her support).
    A friend of a friend had plastic surgery after she had her children, and I didn’t understand it for a while — but then I thought that if it made her more at ease in her skin, who was I to judge? It’s reasonable to change our bodies in order to feel more at ease in them — and respecting the courage of people who do achieve that comfort feels right to me.

  7. Love that you are brave enough to share this information. I think HAES, Fat Acceptance, Size Diversity can’t really exist without all the many experiences that people have and are having and shared within a non-judgemental space. We don’t live in an ideal world, our emotions aren’t disonnected from our mind and bodies – we are all wanting to find our own peace. Thanks

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