Cosmetic Surgery as Investment

Recently, I received an email from a reader – let’s call her Denise. Here’s her story (edited slightly to remove a few personal details):

Here’s something I’ve been stressing about for a month or so now… I recently lost about 80ish pounds & have a ton of excess skin on my tummy. To “fix” it all is a cool $17,000. I’ve been debt free for several years now but remember clearly when I wasn’t & what it took to get out of it. Your Money or Your Life was a huge catalyst for making that recovery process possible and helping me get my head right about money’s role in my life. I haven’t owned a credit card for over 10 years, bought my first home 3 years ago, paid off my car, and only have about $8.7K left on my student loans. I have a wee little emergency cushion, but no retirement savings.

I know most people consider this a vanity issue, but it seriously effects my self image and my relationships… which is the only reason I am even considering hurling myself right back into debt. It’s really that important to me. But then, so is being able to pay all my bills.

What’s also interesting, of the people I solicit advice about this, most people say “Do it!” However, they all tend to be people who have never had to dig themselves out of serious debt, and/or are people who see how I tend live pretty frugally anyway and just want me to be happy. My “rich relatives” even compared this to the social stigma attached to people with significant overbites, clef palates, “and other disabilities.” As offensive as it might be, their point was that even if I overcome the body
image and self-esteem challenge, the society we live in will continue to make decisions about me based on my appearance which could affect everything from my job prospects to my marriage prospects (I’m 41 and single). They see this as a $17K investment in my future.

I’m interested in hearing a fresh perspective from someone who knows how devestating debt can be, that it can be overcome, and that happiness isn’t about money.

I know this is a highly personal decision, but then, isn’t that the whole point of processing all this? What would you do? What you advise your wife or sister or, in a few decades, your daughter to do?

There are actually a number of simultaneous issues going on here that need to be looked at individually.

First, the surgery itself would have some personal emotional value. No matter who you are, removing a large packet of loose skin from your body will have a positive impact on your self-image. You’ll feel better and more confident about your personal appearance and that can manifest itself in a lot of ways.

I’ve witnessed how a change in weight has completely altered the personality of an individual. I can think of one friend of mine who lost 120 pounds and became incredibly arrogant – she wound up alienating pretty much everyone around her. Another friend of mine lost about 90 pounds and basically went from being a wallflower to being an incredibly outgoing and kind person – it brought her out of her shell. Another person I know gained about 50 pounds but in the process became a happier person because he was no longer “possessed” by the need to maintain a great body, a pressure that he felt he constantly needed to live up to.

Why is this worth discussing? In modern society, body image is intrinsically tied to our sense of self and thus when we change our body (and thus our body image), our sense of self changes as well – and that changes how we behave. If you’ve lost a ton of weight, sit down with a close friend that you trust and ask some honest questions: how has it changed me? A dramatic change in your body and personal appearance can be a great thing, but it’s not worth alienating the people around you or building up a negative personality.

Second, an improvement in personal appearance does affect how others perceive you. Regardless of how you feel about yourself, others do use your personal appearance as a factor in their impression of you. Removing a large amount of excess skin is likely to be an improvement in this area.

In our society, again, such a decrease in weight is a net positive, as would be the loss of the excess skin.

Third, there’s that pesky debt. Obviously, it’s never a good idea to go into debt, but it’s quite reasonable to think that an appropriate cosmetic procedure such as this one does have some significant return on investment.

The question is whether this return on investment is enough to make the surgery worthwhile. It’s only a positive return if the surgery itself is a net positive, and part of that relies on the changes in your personality. Have you personally changed in a positive way because of the surgery, or at least in a neutral way? A two hundred pound person with a positive attitude is much more valuable than a one hundred and twenty pound person with a negative attitude.

Given that you’ve already lost the weight, you have a good indicator as to whether your body changes have affected you positively. Talk to your friends about it. If it’s been a net positive, then the surgery is probably a good idea, as you’re quite likely to continue that positive mindset and have the benefit of a better body. Added together, it will certainly add enough value to your life to make it worthwhile, even through the debt.

On the other hand, if your friends report that you’ve changed in a negative way, listen to them. Don’t blow it off as “jealousy” or something like that, because it’s not – it’s genuine concern from people who care about you. Your best approach is not to gain the weight back, but not to immediately have the surgery, either – instead, seek counseling and work through the reasons why this weight change has altered your personality in a negative way. If you can work through the issues, then consider the surgery.

What about the finances? If you have cosmetic surgery that brings about genuine and dramatic change (removing significant excess skin would fall into this category) and it’s accompanied by a genuine positive change in personality (or at least not a negative change), then, in my opinion, it’s worth it to find a way to finance the surgery.

However, Denise really needs to get on the retirement savings ASAP. Go to your employer and start a 401(k) or 403(b) now, not later. Get it done today – don’t wait another second. If you don’t know what you’re doing, just use the recommendations of the plan’s manager at your workplace – you can change most of this later on.

What about people who need cosmetic surgery and don’t know how it will affect them? Cosmetic surgery should always be accompanied by (at the very least) significant self-analysis – spend time reflecting on the changes it has brought to you and also ask friends and family about the changes they observe. If there are any bumps in the road, a psychologist should be sought out – you’re dealing with a major change in body image and that can affect your personality significantly.

Good luck, Denise! I’m sure the readers will have many more comments than I (and probably a few disagreements, too)!

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  1. savvy says:

    From an emotional point of view, I think Denise should do it. However, from a financial point of view, I think Denise should still do it, just wait until her finances are better.

    IMHO, she should immediately start funding her retirement (at a minimum, to the 401k match or max out an IRA if she isn’t eligible for a 401k). After that, she should bulk up her efund to no less than 3 months expenses but preferably 6 months. Then, and only then, should she consider incurring the expense/debt of the surgery.

    The post didn’t say anything about her current budget/discretionary spending but I suspect she can find ways to cut costs and achieve her goal of surgery more quickly.

  2. matt says:

    My advice is to contribute to a 401-k until you have enough vested that a loan from the 401-k pays for the surgery.

  3. Randy Hunt says:

    The advice you gave started to remind me of a couple of themes Tony Robbins talks about. Those are pleasure and pain, and the power of perception.

    What you choose to believe affects how you perceive any and all external stimuli you encounter, which in turn, grants those things the power to create either pleasure or pain in yourself.

    If this person (let’s call her “Denise”) has not already done so, I highly recommend that she reads “Awaken the Giant Within” before making her decision about what to do.

    If she goes into the procedure EXPECTING to regret the debt that it creates, while HOPING that the result of the procedure will improve her self-image, the outcome will be predetermined. The power of that “pain” will overcast any potential “pleasure” resulting from the procedure and she will regret it.

    On the other hand, if she has a positive opinion of her ability to deal with the debt responsibly, and an excited, optimistic view of the fantastic effect that this procedure will have on her outlook, then it will be a very positive experience… and maybe the improved self-image will create the confidence she needs to find new financial opportunities for paying off that new debt rapidly!

  4. Jen says:

    Denise specifies that she “recently” lost the weight. Is her body still changing? If so, she might want to delay the decision until she has a good idea of where her weight will settle (for lack of a better word) and take advantage of this time to boost her emergency fund and start a retirement plan.

  5. Steve says:

    From a purely financial point of view, has Denise considered medical tourism? SHe can get the tummy tuck for about 30% of what it costs in the US/Canada in India for example.

    She can start her research here

    http://www.tour2india4health.com/

  6. Michael says:

    Does loose skin never go away?

  7. Dee says:

    Seconding Jen.

    I had cosmetic surgery (not the same kind though) and it merits considerable thought beforehand, both emotionally and financially. You have to be prepared for the time off work to recuperate, the possible expenses of complications.

    Also, the surgery alone probably won’t change how you feel about yourself. I would take some time to get myself together financially before the surgery. The base fee may be $17k but it could end up costing much more. You want to be prepared for that.

  8. Kris says:

    “Is her body still changing?”

    Jen makes a great point. I might also ask if Denise has maintained her weight loss for a good length of time. Maintenance is difficult – harder than the initial pound droppage in many cases, and if there’s a serious chance she might re-gain, I might think twice about the surgery.

    BTW, congratulations Denise! 80 pounds gone is a crazy great accomplishment.

  9. Nat says:

    The Economist mag recently had an article that looked at scientific studies that looked at if there was an economic benefit to being better looking – there is!!

    http://www.economist.com/displaystory.cfm?story_id=10311266

    excerpt:

    beauty is a real marker for other, underlying characteristics such as health, good genes and intelligence.

    It is what biologists call an unfakeable signal, like the deep roar of a big, rutting stag that smaller adolescents are physically incapable of producing.

    It therefore makes biological sense for people to prefer beautiful friends and lovers, since the first will make good allies, and the second, good mates.
    —-
    But read the whole article to see if spending to be beautiful really pays off

  10. chris says:

    this sounds like a good thing to use SmartyPig or ING for, save up for the surgery, and let everybody you know help you with it (donations), I’m not sure what fees would be associated with it, or whether her family or friends would like to help. But hey, why not…

  11. Caroyn says:

    Yes to plastic surgery but no to wearing makeup every day (Reader Mailbag #1)?

    I don’t get it. You’re very inconsistent when it comes to personal choice regarding (specifically women’s) issues relating to personal appearance. Is LOOKING good to FEEL good an investment in yourself or an unnecessary expense?

    I’m sure you’ll say (as with all things) that the answer is situational.

  12. Marcus Murphy says:

    The reason why “Denise” has loose flabby skin is because there is still excess body fat there. She may have lost 80lbs but 10-20lbs of that was lean body mass. To get rid of that excess flab she needs to change her diet from “weight loss” to “muscle gain” and start a weight lifting program, especially targeting the areas where there is loose skin. Her body will not change as rapidly as when dieting so this will take patience. It will also take making those small right decisions every day that will make her “successful” in losing the excess skin. Perseverance is the road to a better body.

    Good luck “Denise”!

  13. Trent Hamm Trent says:

    Carolyn: makeup is optional – you can choose whether to put it on for work, for social events, etc. A huge amount of excess skin on your stomach is not optional – you carry it with you wherever you go unless you have it surgically removed. You can’t just take the skin off like you can take makeup off.

  14. !wanda says:

    She should also ask her friends, especially ones who will be brutally honest, to assess how much the loose skin really detracts from her appearance. She probably thinks it’s worse than other people think it is. Also, she achieve the same cosmetic effect of surgery, at least in the workplace, by choosing flattering clothing, so I don’t think the personal appearance angle matters that much. She’ll needs to buy new clothes anyway after her weight loss.

    I’ve always hated how my jaw looks. It’s too steep, and my chin is too prominent. I never let people photograph me in profile. A month or so ago, I went to some orthodontists for a potential tooth problem, and they all said that the potential problem would be fixed by expensive jaw surgery, which would also “fix” my chin. So, I pinged a bunch of people I knew, told them to be honest, explained my problem, and ask them to rate my chin. Only one person thought my chin looked weird; most people didn’t know what I was talking about, which means that my chin couldn’t be that hideous. Based on that, I’ve decided to not get the surgery for cosmetic reasons, at least until it becomes clear whether it’s the only way to prevent two of my teeth from falling out.

    I’d have vetoed the surgery much sooner if it would have plunged me into debt, though.

  15. squawkfox says:

    This thread boggles my brain. Who would have thought Denise would email Trent about her skin situation. At the outset, major congratulations to Denise for dropping the weight. This is a huge accomplishment. I echo other commenters to wait until you reach and manage your weight, save for retirement, and then get the surgery. I would spend the time to find an excellent surgeon, get exceptional referrals from his/her clients, and then do it. Investing in the right surgery with the right surgeon is a key to success in surgery. Good luck!

  16. Jayrengo says:

    She needs to be sure the body comp change is complete. Then, however go for it! All we have is today. In a situation like this where she understands there are other priorities that need to be addressed she “gets it”. Hate to see her miserably save for X years then when she hits her goal she’s too old or gone to enjoy.

  17. Amanda says:

    My mother had twins and it stretched her skin so much that she had a fold of skin on her stomach for years. She eventually had a tummy tuck (not normally covered by insurance) that her doctor kindly filed as a hernia surgery (covered by her insurance). He fixed the hernia and other inside problems and took the excess skin off and it was covered by insurance. You might want to look into that as a possible way of helping to pay for a tummy tuck since excess skin can, in and over itself, cause health problems.

  18. Wendell says:

    Denise,

    Forget putting money into the 401(K) until after the surgery. Carrying the excess skin has side-effects that go beyond people’s perception of you and your perception of yourself. A physical healthy you is just as important a financial healthy you and the two are inseparable. Finish the great job you have started by losing 80 lbs and have the surgery. Sure you will have to pinch pennies again until you pay it off, but you will be more self-confident and that will help you in other aspects of your life.

  19. Lynn says:

    Denise,
    I realize that our world is very superficial. People do look down on others for their physical appearance. However, keep this in mind: different people will ALWAYS find something negative about someone if that is what they want to do.

    Surgery is not the cure-all…besides putting you into debt, you have to still adjust and get your own mindset on the right track. Skin, even at 41, is elastic. Try natural methods of boosting that elasticity and maintaining the weight…see if it drops on its own.

    No matter what you do…make sure the surgery is for *you* and not for everyone else. Personality and self confidence have far more weight than skin flab (or the lack thereof).

    Good luck. =)

  20. devil says:

    One statistic I’ve seen over and over is that 95% of people who lose weight gain (most of) it back within two years. Wait and see where your weight settles…on your body and on the scale. Then you’ll be sure of what you want and need when you visit the surgeon.

    Waiting a bit will also give you time to save the cash for this surgery. Don’t go into debt for this. It’s elective surgery and risky enough without having more debt hanging over you.

    As far as job prospects, well, there are plenty of gainfully employed fat people out there. I don’t see the connection unless you want to be a bikini model – which I’d advise against at age 41. And marriage prospects? Seriously, do you want to have surgery to land a husband? Do this for you and you alone.

  21. silver says:

    I’m going to be a naysayer and say that she shouldn’t get the surgery. She said: “I know most people consider this a vanity issue, but it seriously effects my self image and my relationships.” When I read this, it struck me that she has other issues beyond loose skin. I bet that before she lost 80lbs, she used to say that her weight effected her self image and relationships. And that once she has the surgery, she’ll find something else to blame.

    I’m speaking as someone who once did a similar thing. I thought “if I lose weight, I’ll be happier.” And I lost weight, and wasn’t happy. So I lost more, and I still wasn’t happy. I kept doing this until I had a BMI of 16 (for those of you not familiar with BMI, that is severely underweight). Why did I lose so much weight and not get happy? Because weight wasn’t the issue. Weight is *never* the real issue.

    I say she’d be better off spending her money on therapy to fix her self image problems. You could probably pay for 2-3 years worth of therapy (if insurance didn’t cover it–much more if it did) with that money.

  22. Do it now. Put it off, and you will never do it. The returns diminish as you age especially if already in your 40’s. Not quite the same thing but my best investment ever was getting LASIK. It cost me $4000 (which I put on my credit card – LOL), but it was still good and I did it at the right time even though I had tons of debt and any PF advisor would have told me I’m crazy.

    And I second the comment about looking to get it done outside the US. Medical care in the US is a gigantic bloated mess. On the Mexican border (which is short drive from southwestern USA) medical/dental care costs about 1/10’th what it costs here, and there are all sorts of doctors and dentists there catering to Americans, especially for cosmetic procedures.

  23. imelda says:

    First, I want to say that silver makes an excellent point. If Denise thinks that losing the skin will solve her relationship problems, she ought to think again. I really hope she takes time to think this over more deeply, perhaps with a psychiatrist. And Trent, I’m a little concerned that you encouraged her by saying that this surgery will either make her happier or arrogant (and who believes themself capable of arrogance?).

    On a second note, why on EARTH would you get this done in the States and pay $17,000? That’s just insane. There’s a whole world of perfectly safe medical care in other countries, and it’s way cheaper. If Denise is going to do this, she ought to research a cheaper and safe place to get it done, then save up the money for most of it. That will give her time to make sure she really wants it, and will keep her out of debt.

  24. Ria Kennedy says:

    “Denise”, here is some information to chew over. I understand how you feel, but:

    1) Is getting an operation going to improve your life? Is everything else so perfect, that this is really the only thing that still needs fixing? Or should you work on other emotional or physical issues and decide about this when you’re less emotional, more confident and feel better about yourself?

    2) I have had two operations, one considered minor and one considered major. The minor one laid me up for weeks and the large abdominal scar still bothers me years later. Nothing prepared me for the excruciating pain and disability that followed. The next operation almost killed me. I got a raging infection that caused me to be on antibiotics, both IV and off for 2 weeks while in the hospital. That hospital bed, those medicines, the other little things, the food that you can’t prepare, finding help to help you do things like shower or clean — all are costs or issues you need to add onto the price of the surgery. Surgery is a major undertaking.

    3) I developed several drug allergies after taking that many antibiotics and I hope I don’t need one of those medications to save any me from new infection I might get. So although in my case the surgeries were required by my conditions, I would never voluntarily go in for surgery. Too many risks, too many complications and too many permanent problems that can result.

    4) After my surgeries, I had nightmares for weeks, and I still freak out around doctors and medical staff. This may be a form of PTSD caused by the physical, mental and emotional trauma of the surgeries.

    5) Are you contemplating going through all this torture and debt because you think people will like you more? Because you’ll be approved or loved more, or get amazing job offers or find that perfect lover? Because I think most people are not that shallow and offensively judgmental.

    Do not allow anyone to put a stigma on you: you own your life and you are free to do what makes you happy. Do not substitute what would make someone else happy for what would make you happy.

  25. Tish says:

    I couldn’t agree more with Silver. This issue is more than (oh boy, here I go) skin deep. I actually think it’s obscene not only for a person to have zero 401K and even consider cosmetic surgery, but that so many agree with her! And to “catch a man”, which is really what it boils down to, let’s not kid ourselves — tsk tsk. There are many other ways to boost self esteem, losing 80 pounds and getting out of debt single-handedly amongst them. Why hasn’t these accomplishments helped??

  26. Ria Kennedy says:

    PS: when I say freak out I mean getting anxious.

    Also Denise, don’t hang out around people who feed your fears and mirror back your own doubts and worries.

    You need to discuss these issues with someone who isn’t trying to sell you a procedure and who can be neutral and help you figure out what’s really best for you. You need someone who can give honest feedback, but who won’t try to sway your opinion to theirs.

  27. Jean says:

    I have a tendency to redness in my face — sort of a “pre” rosacea. My cheeks next to my nose were red and usually hot. I absolutely hated it. To the point I stopped wearing make up at all, because why bother. I had to wear tons of icky foundation that I hated wearing to look even half way decent.

    Yeah — this took a real mental hit on me.

    I looked for a medical fix and found photofacials. I looked at the ups and downs of the whole thing, for a few years…. and decided to do it — at a doctors office. (This is one of those things that can be done at a beauty spa — but I want a doctor there)

    It cost 2500 bucks total and I had to have five treatments. And there were no guarantees, but the doctor and nurse both felt I was a great candidate.

    Oh. My. The redness is pretty much gone, and I am SO much happier now. I could kick myself I waited this long.

    Do it. BUT — while you’re looking for the right doctor and making the final steps — make those “Payments” you’ll be making anyway into a savings account to help you get a head start on making the payments — this will also help you get an understanding on whether or not you can afford it. (Cosmetic surgeons almost all have some sort of financial planning for this stuff too — another question you should ask)

    Good luck! And I’m excited for you!

  28. I think this will really end up being a personal decision. It wasn’t mentioned in the email, but is $17k the best price she can get? There is an article in the April 2008 issue of Smart Money Magazine (don’t see the text to the article online though)entitled “Under the knife-Cutting medical bills” whiich states that 2/3 of patients who negotiated with their physician reported success. She may be able to find a doctor who will do it cheaper. The article recommends asking for a discount early in the process, paying in cash upfront, doing your homework (checking out http://www.nahdo org to compare prices by state), going at an off-peak time (it even after the summer for plastic surgeons)or hiring a professional health advocate to negotiate for the patient as ways to reduce costs up to 50%. Also, this type of expense could possibly be deductible if she itemizes and exceeds the 7.5% of AGI threshold, but she would need to investigate it.

  29. Lydia says:

    I don’t think money is the real issue here.

    I would seek three people before you go and do anything Denise.

    1) A counselor. there are major body dysmorphic issues going on here. If you have to go around asking ‘rich relatives’ if you should get a tummy tuck that means you don’t have a clear view of what you look like. Talk to a professional.

    2) A fitness coach/instructor. You lost 80lbs and were left with a body you are not happy with. Instructors may be expensive but they know how to give lifelong advice on staying fit. A tummy tuck might not last!

    3) A nutritionist. These people can help set you on the right path towards food that will give your body what it needs.

    So back to the issue of money. !7k is a ton of cash to invest in a procedure that might not leave you happy. It has complications that can be unforeseen and possibly fatal. And who promises it will last? Most websites say that results last with DIET AND EXERCISE.

    However, the people I suggested can come in a lot cheaper.

    Saying you spend 5k on a fitness instructor, 5k on the nutritionist, and 5k on the counseling. That would still be cheaper than the procedure and once you know the basics of fitness and healthy eating you can ditch the pros and do it yourself.

  30. Antishay says:

    Oh my. There is so much being discussed here! I feel I need to give my input. Denise, I am writing to you.

    I think that there’s a lot of discussion here about self image and attitude that isn’t necessary. What you need to do is take a breath and sit on the decision for a month. Don’t talk to your family about it, don’t talk to your friends. While input from those closest to you is important, the end decision is up to YOU – and how can you make a decision when so many people are giving you opinions left and right? I say let the commenting on this post be the last of the opinions you take in and then let it SETTLE before deciding.

    The rest of this is for everyone else.

    The weight thing. What a lot of people here may not realize is that losing 80 Lbs is a TON of weight. I lost 25 Lbs and had a little extra skin here and there but it really wasn’t noticeable, and after two years it was all gone. But with a loss of 80 Lbs (especially if the person is shorter) can mean a LOAD of extra skin on the body. Have you seen some of the people on The Biggest Loser? The excess skin is unbelievable. I would not write this issue of hers off as petty.

    In addition, the money thing. What has been lightly touched on but not completely brought out into the open is the very true reality of appearance in our society and in our self-perception. If “Denise” will feel all the more self-confident if she loses the extra skin, so will everyone else view her as more confident and the cycle will continue… back to her and back to them.

    The funny thing is – the more we feel good about ourselves, the more successful we tend to be. The better we feel overall, the harder we work and the harder we play, and the better our lives become. If the high cost of this will bring about that greater level of happiness, than it’s a wash and must be done to achieve the happiness. If she’s super confident and happy after recovering from the surgery, she’ll likely go on to be more successful and make more money, only making paying off the debt for the surgery that much easier.

  31. Margaret says:

    I read somewhere that it can take 2 years for your skin to catch up with your weight loss. I can’t remember where I read it, but you might want to check with your doctor about that. If there is a chance that the excess skin will mostly retract (is that the right word?) on its own, then I would wait. Even if it never becomes perfectly smooth, you might get to a point where you can live with it. Don’t those two what not to wear ladies who sometimes appear on oprah say (tongue in cheek) not to exercise or get a tummy tuck — just get suck-you-in underwear.

    And congratulations on the weight loss. I would love to hear how you did it.

  32. Jason Dragon says:

    Hello. Well this is a money blog, I was shocked that you never questioned the fact that it would cost so much. For this person, and ANYONE considering any medial procedure that is not covered by insurance I would have to look at being a medical tourist.

    Many places in this world have GREAT medical services, but little to no insurance to drive up the price. Therefore everyone pays cash, and the service is top notch, the doctors are as good as the average American Dr, but they have much more time for their “Rich American” patients. The prices are amazing, about 10 cents on the dollar.

    We have found that Cebu, in the Philippines is one of the best places, mostly because of the huge number of hospitals, and the high quality. 20% of all nurses WORLDWIDE went to school in Cebu (Ask a nurse next time you go to any hospital, anywhere in the world) Last year I paid about $1000 in medical bills, for the same level of service for the same things I would have paid well over $10,00 0 in the US. The cost for airfare was only $900 round trip.

    Jason Dragon
    http://capitalactive.wordpress.com/

  33. Helen says:

    I lost 75 pounds in 7 months in my mid fifties and kept the weight off for two years by being very disciplined. I had wrinkly excess skin on thighs and tummy which slowly improved during the two years. Anyway, it was only visible to people who saw me naked or in a swim suit – the right clothes or underwear meant it just wasn’t an issue in normal social or economic life. (I agree that looking good does improve your career prospects).

    Six years later nearly all of the weight has unfortunately come back on – as it does for most people. I’d be really annoyed now if I’d spent a lot of recovery time and money on surgery, not to speak of the discomfort, even danger, involved. The wrinkles disappeared on my thighs after a weight gain of about 10lbs and on the stomach after about 20.
    congratulations on the weight loss – hope it is maintained!

  34. Martha says:

    I had a friend with in this same situation. Her excess skin was completely not obvious unless you saw her in her underwear. (Though to answer the commenter above, no, it does not go away however you train.) So it will not affect anything but possibly intimate relationships. And by our 40s, we’ve all been through the wars. Even if this gets remedied, other things happen to our bodies, inevitably. The men you meet, Denise, will not be perfect either. At a certain point, let them know about your astounding cool weight loss, which is testimony to your determination and character. Then say, “Of course, there was a little collateral damage!” with a smile on your face. If they want a picture-perfect woman, they’ll have to look in the magazines, because none of us are that shapely in real life. I don’t mean to gloss over the difficulties here. But this $17,000 is really to ward off the rejection of a hypothetical man who, if he’s worth his salt, will not want you to be any more perfect that he is. No one else will be in a position to notice. And I don’t want to be a doomsayer, but like the commenter above, I remember the statistic that 95% of weight loss is gained back. What *if* Denise spent the $17,000 and then gained the weight back? Wouldn’t that $17,000 be better invested, producing income which would be enjoyed for years? Or even spent on something celebratory like a round-the-world trip, if it has to be spent? If you’re determined to spend $17,000, Denise, I vote for spending it on something that encourages your hopes, not speaks to your fears.

  35. I agree with what most people here are saying. I think she should do it, but possibly wait to 1) see where and how the weight settles 2) get her finances in better order. It sounds like she could use some medical and perhaps psychological counseling on the matter as well to help figure things out. Plus, imelda is right, there are other options, out of country, that could still be safe and significantly cheaper. I’m also wondering if she has health insurance. Even though this is cosmetic, there’s a good chance they may pay for a portion of it. It sounds like she definitely needs to give it more thought. I certainly wouldn’t want to invest 17k unless I was certain this is what I want to do.

    Regardless, this is a remarkable feat! Congratulations on the weight loss.

  36. Gayle RN says:

    First of all get a medical examination which can help determine if there are ruptured abdominal muscles or hernias which can and probably should be repaired. This would make it a medical problem, which should be covered by medical insurance. Also make sure you have enough sick time or a cash stash to cover your time off of work.
    As for getting it done overseas, hospital quality can vary wildly. I had to do a medical evacuation of a friend from one of those overseas hospitals to a US hospital. Spending a week actually seeing the inside workings of the best hospital in that particular country was a real eye opener. And BTW that evacuation cost almost $200,000.
    Fund your retirement NOW. Start saving up for the surgery. When you KNOW what you want to do you will have it at least partially paid for.

  37. kenttuckyliz says:

    I lost more weight than that, using South Beach Phase I and twice-a-day rowing and weightlifting workouts, and my body ended up athletic and lean and buff. I think there’s more work to do here. I agree with the other posters about exercise and nutrition.

    Today on the news, there’s a story of an 18 year old high school senior in Florida, a beautiful (and smart!) blonde girl with a big, bright smile. She was as cute as a button! But I guess she felt like her rack wasn’t stacked enough, so she went in for breast implant surgery…and died. It’s a great reminder of the risks of surgery. Is it worth risking your life?

    When you’re middle aged, you’re dating middle aged men, and they are usually in just as bad a shape as you fear you are. They have bellies. They are in no condition to be picky. LOL

    If I were you, I’d be more terrified of destitution in old age than potential rejection by a hypothetical man because of loose skin. Don’t you have an Inner Bag Lady? I’m 42 and I have six figures saved and invested for retirement. To have 0! OMG that is terrifying.

    I think funding your retirement would be a greater act of self-care and self-love and self-empowerment than the surgery and more debt. That sounds kinda Suze Orman but it’s true.

    If appearance-insecurity wins out over financial-insecurity, at least get extra jobs, work overtime, sell stuff, ask for donations from friends and family, and raise the money FIRST.

    That way you don’t resent ongoing debt payments if it goes horribly wrong and you’re left with ugly scarring (because that can happen too). That would totally suck, to have the slavery of debt and payments with bad surgical results. Yiiiii.

  38. Emma Savage says:

    I have the same problem with loose and flabby skin after losing about 35kg (I think thats about 70 pounds american).

    I am 24 and while my underbody is still overweight, I have maintained it for 2 years and still have the flabby skin on top which I am also considering having removed in the future.

    while it isn’t noticeable when clothed, it is definitely noticable naked and it looks like my skin is melting off.

    At 40 it is understandable bodies have scars but I am surrounded by beautiful young things! Experience has proven that men do care about what’s underneath clothing, and so do I but it’s not as simple as toning up or not getting naked.

  39. Susie says:

    I find it interesting that most people here don’t seem to have had any sort of cosmetic or “optional” body surgery.

    I had a severe overbite and a mild crossbite. I had difficultly smiling because my jaw was all loosey-goosey and thus went all over the place. I had to work hard at enunciating (although people I’ve asked said they never noticed I slurred by words). I think I was teased about it all of twice, so it wasn’t that I was worried about what other people think–*I* didn’t like it, *I* felt uncomfortable. The main reason I went to get it fixed was for cosmetic reasons. I did NOT know it would also fix my chronic backaches, neckaches, headaches, and eliminate my waking up several times a night, in addition to boosting my self-esteem. (I found this out at the first consultation with my orthodontist.)

    Although I was told I needed to have it (e.g., “Either you have this done now or you have all your teeth in back capped in 10 years because you are grinding them all down”), insurance didn’t cover it. So by those standards, it was an optional, “cosmetic” surgery. It cost $5500, plus monthly visits (for two years) to my orthodontist, which was a lot of gas costs and wear and tear on my car.

    That’s substantially less than the 17K Denise may have, but really, if fixing my jaw cost 17K I would do it, simply because I know how it has changed my life. Not only do I feel better, but the physical benefits are *tremendous*.

    There will always be those saying “Deal with what you have” and “Love yourself no matter what” but unless they are in your body, they can’t know just how things affect you.

    And yes, going into this I was in debt (school loans, credit card) and working hard to get out of it. I’ve paid off my jaw work, and have still managed to pay down my other debt. It can be done. Does Denise need to pay everything at once or can she set up a payment plan?

    Either way, congratulations, Denise, and good luck with whatever you choose to do!

  40. PFH says:

    I think, before she has the surgery she should read “Psycho-Cybernetics” by Maxwell Maltz.

    Maltz was a plastic surgeon who noticed two types of patients: One would have very minimal work done (you could hardly tell they’d had surgery) and it would change their life. They’d go on to accomplish great things.

    The second would have extensive work done, look in the mirror after the surgery, and say, “You didn’t do anything.” They would go into a major depression and be worse off than before they’d had the surgery.

    He became an expert on self-image, and “Psycho-cybernetics” is his masterpiece on the subject… it was the foundation for sports Psychology.

    All general surgery is risky, and those risks should be seriously considered before going forth.

    Ultimately, you are who you think you are.

  41. sam says:

    Denise, my best advice is to get a personal trainer and build muscle. You don’t *need* surgery. And you’ll make friends at the gym and find a nice new world to be involved in. Please…don’t get surgery.

  42. Avraham says:

    Every surgery has it’s risks, from either the surgery itself, or from the anesthesia. I would try everything else first before elective surgery. Many excellent suggestions given already. Keep up the great work!

  43. Jeff says:

    This is where “personal finances” get VERY personal. I’m not one for telling someone when they should or should not get cosmetic surgery. I do believe that a persons self-image can affect them in many ways. Denise, it sounds like you’ve worked hard to get out of debt and your “financial smarts” are sound. I only wish you the best of luck no matter which path you choose to take.

  44. Shawn says:

    I can relate to cosmetic surgery as an investment. I am 28 and lost all but six of my teeth and am currently getting dental implants and have paid $13,000 so far and will be paying another $13,000 in the coming months. I have had to make lots of sacrifices in both myoutlook on life and financially but it is a choice that I made after looking at everything and I think each person who has any elective surgery does the same thing. Luckily I have been able to save and budget money throughout the year but will still need to get a short term loan for the remaining $10,000.

  45. Katie says:

    Even though it’s not necessary, or $17,000, I’m using a portion of a windfall (well, a settlement, actually) to bleach my teeth and fix two fillings while I’m at it. I could have that extra $$ in savings, but I’m already accomplishing or almost accomplishing my savings goal with the rest of it, and it’s been something that has bothered me for at least the last 6 years – to me, the $$ is worth it as I know I’ll be more self-confident and that translates to benefits greater than the interest I’d gain by placing that $$ in my savings account, instead.

    In my opinion, the “right” thing to do personal finance-wise is not always the “right” thing to do for your personal life, sometimes you just have to make that financially “unwise” decision to improve your quality of life.

  46. Valerie says:

    Again, congratulations Denise! I am actually going through my own weight loss journey, and it is not easy. Thus far I’ve lost 70 pounds, and when I reach 100 I plan on getting plastic surgery myself.

    I absolutely say, go for it! But I agree with the others, talk to a therapist/counselor first, wait a few months so that your weight is stabalized, and save for an emergency fund should anything happen to you during your recovery.

    Congrats & Good luck!

  47. KF says:

    Get the surgery if you want it, but pay cash. There will always be “important” and self-esteem related justifications for jumping right back into debt. Don’t do it. Ever. You need to draw a line and decide that you will no longer live above your means. So, save up for the surgery you desire and then pay for it. Pretend we don’t live in a world where you can get whatever you want, whenever you want it even if you don’t have the money.

  48. Matt says:

    I would say think about it for six months.

    And during those six months, save 20% of your income in a retirement fund, keep paying off the student loans and other bills, and save as much money as possible for the operation.

    Then decide. I would also try to save at least 25% the cost of the operation ($4,250) before taking out the loan, but that might take longer than six months.

  49. CheapGirl says:

    To all the people saying to get a personal trainer & the loose skin will go away, obviously have never lost a lot of weight.

    Me, I’ve lost 45 lbs with 15 to go & on my small frame that’s a lot. Guess what? I’ve got loose skin. Your body can only accomodate so much stretching before it grows more skin.

    Can training make your stretch marks grow back together into smooth skin? Please. Ask any woman who’s had a few kids. I’d like to see ONE person post pictures somewhere to show that they’ve lost 80 lbs with no loose skin.

    I do agree though that Denise should have at least kept the same weight for a while, maybe a year or more. Just to make sure she doesn’t loose more weight or not be able to maintain. It’s one thing to get 17k into debt to have the surgery, it’s another to get 17k into debt & gain the weight back & waste the surger.

  50. It sounds like Denise needs to go to a medical doctor who specializes in weight loss and find out if there’s a realistic possibility that the stretched skin will recover with time and exercise. Then find out HOW MUCH time and exercise would be involved.

    Given the risks of any kind of surgery, she’d be better off to avoid it if she can. One negative outcome will make the 17 grand irrelevant.

    Also, if the stretching will reduce to some degree over time, she might be able to get the results she wants with less surgery — and less cost? — if she waits, exercises, and watches for a while.

  51. R.Grant says:

    Check out realself.com before you have the surgery. It is a website dedicated to cosmetic procedures and people document their experiences (good and bad) and looking back on their experience whether or not they would do it again. It gave me some real insight on a procedure I am considering. Good Luck! P.S. Price seems kind of high so maybe there are less expensive alternatives

  52. Rachel says:

    I agree with CheapGirl. I’ve lost 115lbs so far over the past year, and still have about 50 to go. I’m 28 and married to the man of my dreams, so “landing a man” isn’t an issue. (BTW, it wasn’t the main issue in Denise’s letter, either.) The comments about how “easy” it is for skin to shrink back up are inaccurate, since it depends on each individual person. Do those commenters really think she hasn’t already tried these things? It’s not like “Go to a trainer” and “do muscle toning exercises” is some sort of revelation! We’ve all heard it before, and unfortunately, it is not the answer for everyone. Some skin shrinks and other skin doesn’t, even on the same body. Unless you’ve been there, don’t dismiss the issues other people face.

    Something that hasn’t been mentioned is the medical reasons behind having the skin removed. Having a sizable flap of skin can cause infections, skin breakdown, and even back problems. This isn’t a strictly cosmetic issue. Most physicians will recommend waiting at least a year after the weight loss to make sure the body has stabilized. The last two months I’ve gone down two pants sizes, even though my weight hasn’t changed. Yes, I do exercise and I am much stronger and more toned than before, but the skin is still loose. My doc estimated that I would go down another two pant sizes just by removing the excess that I have now, not to mention the excess I will have at the end of my journey.

    Since I know that any reconstructive surgery will be a few years down the road, I am saving for it now. I know I will still need a loan to cover the balance, but at least I am getting prepared. In the meantime, I am also adjusting to my new outlook on life. After losing that much weight, getting my finances in order, and generally uncluttering my life, my perspective has changed entirely. The issues in this letter are not about trying to conform or looking for a quick fix. Remember, Denise has done quite a bit of introspection, too, and has shown great courage in putting her story out there.

    Denise – I applaud you. You’ve come incredibly far! Give it time and make sure it is the right solution for you. No one can tell you it is or isn’t; and you should ignore the people who try! Be strong and celebrate how far you’ve come!

  53. Carol says:

    I am embarrassed to say this, but Trent did mention it. I have lost weight before (and regained it) but I did become arrogant and short tempered when I lost the weight. Normally I’m about as far from arrogant as you can get – but I just seemed to think I was better than everyone else when I lost weight. A therapist friend told me she thought I acted that way because I was hungry and she may have been right! I’m now trying to lose weight verrry slowwwly and if I feel some arrogance creeping back in – then forget it! I don’t want to inflict myself on the world if I’m going to be so snotty!

  54. Girlpie says:

    Uh, after taking the story literally, and taking all these smart comments and good advice into account and understanding the planning and considerations,am I the only one thinking:

    “you got rich relations that think you should do the surgery? Have them chip in and buy it for you!”

  55. John says:

    Denise,

    God love ya! It seems that you have a lot of advice already. Give yourself time to assimilate it all. If you give yourself time and watch all from a quiet space inside, you’ll know what to do.
    One of the first books that I read on self immage psychology was by Dr. Maltz a plastic surgeon who noticed that after surgery which was “perfect” some patients lives were turned around dramatically, while others remained the same. The book is called, PSCHO-PSYBERNETICS.
    Why not write Trent again when you have a happy solution?

    john b.

  56. Imho says:

    I agree with Rachel, there are many medical reasons to have this done. “recently lost about 80ish pounds & have a ton of excess skin on my tummy.” Recently is hardly a description of how long it took her to lose this weight, she has lost the weight equal to a kid in middle school so she has a lot of excess skin there. I don’t think she needs the self-help books, she want’s the surgery because “it seriously effects my self image and my relationships” but fears being in debt. I understand this from a personal point of view, I was almost completely out of debt when someone offered to purchase my home necessary for their business expansion. It took 2 seconds to make that decision, I jumped at it, the neighborhood was going down hill quickly, and was seriously effecting how I looked at myself, no matter what I did to the house my surroundings dictated how I felt. Denise’s surroundings (skin) are dictating how she feels, now I can’t tell her to go out and spend 17,000 on a surgery, but I sold my old place and went into big debt to get the house I really wanted, safe neighborhood, small town, large yard. When I walked out of that other house for the last time the way I felt about myself immediately changed for the better. I no longer had the problems assiciated with the downward spiral of the neighborhood, the noise from the newly widened road, the questionable renters, thoughts that constantly plagued me. A load was lifed off my shoulders, I have an investment now (new House) and the mortgage to show for it. Do I hate being in debt when my old house was almost paid off and I would have been debt free, yes. But the emotional payoff far outweighs the debt. Honey you did a great job, to all the people who say it won’t last, don’t listen, it’s your life and you only go around once. So go for it if you are so inclined, I’m 45 and listened to the naysayers, in 20 years I’ll be 65, thats scary, it took this long to finally get what I wanted and they are still telling me I made a mistake. My mistake was doing nothing, you have already accomplished something really big and only you can decide what works for you.

  57. H says:

    the society we live in will continue to make decisions about me based on my appearance which could affect everything from my job prospects to my marriage prospects

    Job prospects? Unless she’s entertaining a career as a middle-aged stripper or prostitute or planning on getting a job less by her qualifications, experience and talents and more by stripping naked for the (sexually interested) interviewer, I rather think some excess belly skin is not a going to be problem. When was the last time anyone you knew went for an interview in the corporate world with their midriff exposed?

    As for marriage …. whatever. If you want to have surgery for your own self and you CAN afford it and all possible financial repercussions from it (such as loss of savings, possible extra medical expenses arising from complications, loss of income from recuperation time) that’s one thing. To do it to make yourself into a more marketable object … ugh. Reminds me of the latest online Libertoonian pastime of estimating one’s mate’s ‘market worth’, something that should make any self-respecting person projectile vomit their lunch. Do what you want to do, but don’t let people who know the cost of everything and the value of nothing browbeat you into thinking no-one will ever love you again if you’re not physically perfect. Of course men who want trophy wives won’t want you – hell, they won’t want me and I don’t have excess skin – I’m just not in my 20s, blonde, skinny or able to simper on demand. The kind of men worth being with won’t reject you on sole account of a bit of extra skin.

  58. Mary says:

    I lost an excessive amt. of wt. in a short period of time and I had a lot of loose, flabby skin. But that skin has mostly shrunk. For me, it took excercise and patientce. I’m not saying this is Denieses case but, we are an impatient, results driven society. We don’t want to put the effort into something. Why do you think there are so many with credit card detbt? It’s easier to have something now than to wait for it. Plastic surgury is not much different. Yu have to accept yourself for who you are. It’s not going to affect relationships unless you let it. and if some guy is turned off by your body then you didn’t need him anyway. BTW, I know many ppl who are severely overweight or are rather ugly or have really bad bodies and they are in reltationships and are happy. I don’t see how it can affect someone’s career either, unless they are a ‘dancer’ or other related “work”. It sounds more like a self confidence/esteem issue. Think of the risks and the fact that your body will never be perfect. You could very well have a scar after the surgury.You will have stretch marks that will fade, to some extent, over time. In any case, if you really feel that surgury is the only answer, save up all the $ before you go thru with it. This will prevent you from going into debt and give you time to really think about it. And if you still want to go thru with t at that point, go in with a wad of cash and try to negotiate the price.

  59. Ann Bartleson says:

    You have lots of great advice here. I just wonder if you have options for a cheaper doctor. Also, have you been very frank with him and discussed the financial situation? Heck, if he just didn’t charge interest or low interest even that would be helpful.

  60. Nancy Juniper Wands says:

    Please do it.

    I’ve spent the last 12 years saving for retirement, working OT and more than one job and denying myself A LOT of other things so I can max out my 401(k), etc.

    Last December for Christmas I spent $800 on Botox and filler. Not an incredible amount of money, I know (I did all the math about how much stock that $800 would buy) and even though I am not a vain person I cannot get over how much better my face looks and even more important how much better my self-esteem is just with this little improvement.

    Something like this should be included in all of the articles about “imvesting in yourself”.

    Just do it.

  61. moonimus says:

    I would pass on the surgery but I would never advise anyone else from getting it if they firmly believe that it would solve some issues. However, I would agree with all the recommendations that Denise really take an in depth look at herself before she makes the final call. There could be other underlying issues that even she may not be aware of.

    Also, check out http://mrlowbodyfat.blogspot.com/ for some inspiration. He’s going through the same issues as Denise.

  62. Dana says:

    Why is everybody out to psychoanalyze Denise just because she doesn’t want to be stuck with massive skin folds for the rest of her life? Why is this a sign of mental illness? Is everyone here sure they would want to live that way themselves? Even if they are, how does that qualify them to look down at her for feeling the way she does?

    I’ve heard that bit about people who’ve lost a lot of weight, only having the loose skin because they have more fat to lose. I don’t buy it. It might be true if no stretching occurred, but if there are stretch marks, that’s never going to shrink back to normal–it’s always going to sag.

    I have almost a hundred pounds to lose and if I pull it off, I’ll be in the same boat. Between two pregnancies and a seventy-pound weight gain after the second baby, I’ve got stretch marks out the wazoo. It’s too late for something like cocoa butter to help me, and although I am Caucasian I have Native American ancestry, and darker white people scar and get stretch marks more easily–the deck is stacked. So I will want to do this as well, and no, it doesn’t mean I’m crazy.

    I like the idea of investing the money into the 401k and then borrowing against the 401k. That would give Denise extra time to make sure the weight stays off.

  63. Dana says:

    Oh yeah, and I’ll chime in on the excess-skin-causing-health-problems thing. I haven’t always been this fat, and now that I am, including increased bust size, I have to be extra careful because going too long without a shower will make me more vulnerable to skin infection. It’s got to be worse when most of the excess bodyfat is gone and there’s less mass to hold the skin up out of the way. Ew.

  64. Margaret says:

    Re borrowing from a 401(k) — I’m not American, but isn’t that your work retirement fund? And isn’t there some rule that if you borrow from it and then leave your job, you have to pay it all back immediately or else face serious tax consequences? It seems to me that I’ve consistently read that borrowing from a 401(k) is risky.

  65. Shana says:

    Even though it involves regaining debt, I would do this. I’ve seen before and after photos of women who’ve done this, and it’s dramatic. I would imagine most people viewing those photos would agree that it’s a good idea. And to the person who said “but can you/have you kept the weight off?” — I think that’s irrelevant. If someone doesn’t have this kind of surgery, I would think they would be more likely to comfort eat and thus gain the weight back. I would be depressed continually if I lost as much weight as Denise but *then* had to carry around all the excess skin.

    Also, why not go to Buenos Aires, which has a huge and good plastic surgery community? People in Buenos Aires are *obsessed* with appearances, and plastic surgery is even covered by some medical insurance plans… It’s far cheaper there than in the US, and they do it well. I know a woman who had facial plastic surgery done there, and it looked great.

  66. Imho says:

    Do you have access to a medical flexible spending account, there is a $5000 limit per year but that money would be taken out of your check pre-tax and if I figured it right at a 28% tax level you would save $1400. You would still have to come up with the rest and you would have a smaller income for a year as they would take out ($5000 – 1400 = 3600 / 24 (if you get paid 2 times a month)) = 150.oo. Someone out there recalculate it for accuracy. The rest would also be a regular tax deduction at the end of the year.
    We max out our flexible spending account every year due to my husbands medical condition and it saves us a fortune.

  67. tightwadfan says:

    I know a few women who had babies and got the loose skin which never went away. So, no, exercise and time may not fix this, and if Denise gets the surgery I think that’s fine.

    However…

    DON’T go into debt for this surgery! Usually the advice on this blog is so reasonable, I can’t understand why so many people seem to think it’s a good idea to borrow $17,000 for elective surgery that doesn’t have a pressing need!

    Like others have said, the excess skin isn’t noticeable under clothes so this really only becomes a problem if you want to wear a bathing suit or if a guy is going to see you naked. The health problems caused by excess skin may not even happen and if they do will take years to show up. This procedure can wait!

    Save the money for the surgery beforehand. When it’s $17000 of your own hard-earned money you’re handing over maybe you’ll feel differently. Maybe saving $17000 will boost your self-esteem more than any surgery could! Who knows what your life will be like in a few years.

    In the meantime do your research. Look at before and after photos. Understand that your stomach will still look kind of funny afterwards. Any guy that would reject you for your excess skin will probably also be turned off by the surgical scar and the cellulite.

    The surgery won’t fix your self esteem or relationship problems.

    People don’t seem to think cosmetic surgery is “real” surgery. It is a serious decision. Any time you undergo anesthesia there are risks, and there is always the risk of infection.

  68. Mrs. Micah says:

    I’d consult with a doctor and nutritionist about it first, find out whether or not the skin will go away.

    I wouldn’t want random skin on me either, but if it could go away on its own through further diet and exercise (you’ve already shown you’ve got perseverance!) then I’d do that rather than risk major surgery, scarring, and so forth. I might also talk to a fashion consultant about the best ways to look good right now as my body continues to readjust.

  69. DoubleTrouble says:

    I am a big person and know that it is very tough in this world to be overweight. Many (NOT ALL) overweight people find their selection of mates, employment and social opportunities to be limited in scope. Losing weight takes hard work and often one loses weight because she/he wants to participate more fully in life. It is not always about vanity. The cruel joke is that when you lose weight at middle-age you end up with excess skin. At a certain point (age and amount of weight lost) this excess skin will NOT go away “with exercise” and it is not a sign that there is more weight to lose as suggested by others. All the exercise in the world will not remove excess skin. It might pull the skin that is attached to the muscles in a little bit tighter, but the skin will not go away.

    Many potential suitors and mates will recoil from a fat person; this is a fact. There are also a great number who would recoil from someone who has a gorgeous face, scintillating personality and… OMG – rolls of excess skin once those clothes come off. It is easy to say, “Well those types arent worth dating/being with because they are shallow and insensitive, etc.” This might be true, but is certainly doesn’t help someone when a person loves them with their clothes on and then rejects them when their relationship is close enough for a more intimate experience.

    Denise might try to find a doctor that will determine if the excess skin is creating a medical condition that is covered by insurance. If the excess skin is causing chaffing and irritation, infection (as can be caused a draping pannulus over the abdomen), undue tissue injury due to pulling when moving in bed or by clothing then it is possible that this is a medical issue.

  70. Shawna says:

    Wow, I was pleasantly surprised with the response Denise got from The Simple Dollar. I am in an identical position, so am glad that her emotional needs were taken into consideration and not just her finances. I will say this… there is a plastic surgeon in Tijuana who works with a lot of Americans (including celebrities that go there for the privacy). He is very well-known and actually has a practice in San Diego also. Many people choose to go to Mexico for the financial savings and from what I’ve heard from others, the cleanliness of the hospital exceeds the cleanliness of ours here in the states. I’ve done a lot of research and have spoken with him a couple of times and I am definitely heading to Mexico when I’m ready for the surgery! (Which will hopefully be sometime soon!)

  71. silver says:

    “This might be true, but is certainly doesn’t help someone when a person loves them with their clothes on and then rejects them when their relationship is close enough for a more intimate experience.”

    I would argue that a woman who plans to have children should never, ever, ever become involved with a man who would recoil at fat or extra skin. Pregnancy does a number on a woman’s body. It would be awful if a woman’s husband became repulsed by her body after she has given birth to his child. Men who are like that don’t deserve to have wives and children.

    Let’s say Denise gets the surgery, gets married, and gets pregnant. Let’s say that she gains just 25 lbs during that pregnancy–not an excessive amount at all. That 25 lbs isn’t going to be evenly distributed across her whole body. Her stomach is going to get very large. Even if she quickly goes back to prepregnancy weight–which is difficult for many women to do, she may wind up with saggy skin on her stomach all over again.

    I still don’t think the surgery will make her happy. But if she still thinks she needs it, she should at least wait until she’s done having kids, or she risks having the same problem later on.

  72. Keeper Of Stuff says:

    I can tell that “Denise” is agonizing over this decision, and I truly wish her well. I have read most of the replies to her, and would like to contribute my opinions. If they sound a bit researched and studied, there’s a reason for that…

    First of all, I was told years ago by a fitness trainer that I should lose any weight I had to lose by the time I went through menopause (I didn’t). When a woman’s body quits producing those hormones, it has a huge impact on the elasticity of her skin. I lost quite a bit of weight after those years, and my skin is saggier than I would like. However, I switched my goal to becoming healthier and fitter, rather than worrying about how much better I might look.

    Second, in response to those who have suggested she seek surgery in other countries – BE EXTREMELY CAREFUL HERE! Many people have to have post-surgery surgeries to FIX the mess made by the original surgery done by what may or may not have been a “certified” and “qualified” “doctor” in another country. I have personally seen legitimate horror stories regarding plastic surgery in border towns. (One of the patients reported that they had had to get off the gurney to swat flies that were hovering over them!) One exception, other than Switzerland or Austria, of course is India, which is quickly becoming known for its treatment of economy-minded Americans in posh hotel-like hospitals. My thought, upon reading about that, was how very difficult it is to make sure all your medical information is understood and accurately recorded HERE in the U.S. (think of the people who get the wrong kidneys removed). Heaven help you when you don’t even speak the same language!

    Third, let’s talk about PAIN! My best friend has had quite a few surgeries, and she said that her “tummy tuck” involved quite a bit of pain. When she got her “neck lift,” she got an infection and was on antibiotics for weeks, as well as too swollen to work.

    Fourth and final point, although a few have touched on it, no one seems to have stressed it enough. Calling a procedure a “tummy tuck” is a cute name for major surgery. Major surgery is painful and risky. Remember Kanye West’s mother who recently passed away after cosmetic surgery? The woman who wrote the book “The First Wives Club,” on which the movie was based, died recently after a face lift. Also, on a more personal note, a woman I attended high school with was given a desired face lift by her mother as a birthday present in her late 40’s. Guess what? She died that night in the hospital. Talk about guilt .

    If you decide to have the surgery, don’t try to economize by going home too early or having it in a facility not able to deal with emergencies.

    And for goodness sake – make sure your surgeon is BOARD CERTIFIED in the procedure he/she will be performing. It is a rampant problem right now that many varieties of doctors are calling themselves “plastic surgeons.” Why, you ask? For MONEY. Most cosmetic procedures are not covered by insurance or government programs. Therefore, most doctors get paid the full amount they ask for (without a disallowance by an insurance company), and they usually get their money right away (unlike with an insurance company), whether from the patient or the patient’s finance company.

    In closing, I am continually amazed at how much research a person will put into buying a new car or house, and then consent to surgery without having done any at all. Take the emotions out of the equation. Do your homework. Good luck however you choose.

  73. Bri-Austin says:

    Cosmetic surgery – an often unmentioned potential problem for people over 50 is the highly toxic effect of anesthesia on the brain. There are an unfortunate few who suffer significant loss of memory for prolonged periods of time post surgery (of any kind)- possible a year or more of noticeable cognitive problems. For the even more unfortunate few there are some who after the insult of anesthesia to their brain suddenly enter into early onset Alzheimer’s with a steep decline into dementia – over 2-3 years. It is hazardous enough to have to have necessary procedures such as heart stenting or hip repair and face significant cognitive losses. If you have to have procedures try to avoid total anesthesia for extended periods of time, local anesthesia is a much safer venue for your brain. The search for beauty – often with multiple procedures requiring complete sedation — could extract a very high price.

  74. Tiang says:

    2 quick comments

    1) Personal relationships is the reason why we have wealth. If the surgery will improve your relationships, or help you gain more relationships, then you should go for it.
    Read this for more on the rational behind financial success.
    http://online.wsj.com/article/SB120769727703599697.html

    2) Cosmetic surgery is cheaper in asian countries. Korea is probably the safest, as it’s very common for them to do their thing

    Okay, #3 just snuck in. If you’re 41, you definately need to start putting $$ away for retirement. Read up on blog posts on compound interest.

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