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Payam Jarrah-Nejad, MD, FACS
Board Certified Plastic Surgeon
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some comments / thoughts for others who are considering this

i posted this as a comment on someone elses journey, but thought i would repost here for anyone in the research stage. (for context, i was responding to another user who was in seattle, contemplating surgery in miami, and her weight was above 250 lbs.)

"some thoughts i had, which are hopefully helpful:

- florida doctors arent required to carry malpractice insurance, and so many of them dont. what that means is that malpractice lawyers wont take a case to sue them, so you have almost NO recourse if things go wrong. its f-d up, but apparently true. keep this in mind when looking at potential factory BBL doctors in florida (and abroad!). implications are even worse for out of state patients, obviously. :/

- since youre in seattle, i would highly recommend you stay on the west coast. there are good doctors in seattle, and there are tons in california, which is a short, cheap flight away if you need to be examined. if you cant afford this limited travel, you should consider waiting until you can.

- the limit for volume removal in california is 5L, but you can legally and ethically be exempted from that limit by working with a surgeon who operates on you at a hospital and will keep you there overnight for monitoring. dr joel beck (in the sf bay area) does all of his surgeries this way. i think his standard BBL is currently $10-$13k, including bloodwork, garments, and the hospital stay.

- do NOT BARGAIN SHOP on this procedure. if they mess you up, youll have to pay for a revision, which is takes longer and even more expensive because surgery with scar tissue is harder for a surgeon to manage. basically, assume that youll have to pay twice for whatever procedure you do, and THEN decide whether you can afford it.

ie - consider a bargain price, and what you would have to pay for revision. then consider going to a doctor who is attentive and has a good rep and would only need to be operated on once. from what i can tell, the flashy factory BBL docs charge $5k-$8k, and the quiet, reputable docs charge nearly twice that at $10-$15k. i know its a lot of money, but consider whether you want your doctor to be attentive and careful with you, and have their undivided attention. plenty of people get great results with the celeb docs who crank out BBLs, but (as you have found) there are also some things to be very concerned about there.

- remember that base price is for the ideal candidate, and its entirely possible your doctor may charge a little more - and if they dont, you may want to be slightly suspicious that they might cut some corners with your surgery or care.... i think of it like a car wash service; they write their fees assuming your car will be unwashed but not have just been off-roading, right? and if you bring your car in caked with mud, most car wash places would justifiably request an incremental cost to cover the additional time and work to get you sparkly washed and waxed. same with your body and with surgery; youre paying for a surgeons time, effort, and expertise. since you are significantly overweight (not to take anything from you on your weight loss, which is awesome, im just speaking pure mechanics here), you may have some special considerations that you do NOT want a doctor being flippant or lazy about. make sure you select a doctor who has experience with heavy patients and has a plan for what you want to achieve with your surgery and for your weight loss future. its hard to imagine that the quick-surgery miami docs would be the best choice for that, although maybe they are.

- do your homework, interview (personally, if possible) AT LEAST four surgeons, and make sure theyre board certified plastic surgeons, preferably with some sort of bariatric or large-volume lipo experience. (even if you dont do large volume lipo, youll be best with a doctor who knows the risks there.)

good luck to you!!"

moved my surgery date

i had a few things open up on my calendar, so ive decided to move my surgery date up - from june 21 to may 6.

holy F -- its so close, now!

did anyone else get cold feet once it started to seem real?!

I have been loosely considering a BBL for a few...

i have been loosely considering a BBL for a few years. given how popular (and so, expensive!) theyve gotten in the last few years, i am kicking myself for not doing it years ago. nonetheless, i have finally decided to pull the trigger and do it now.

i am in my mid-late 30s, 5' 3", and presently about 150 lbs. i havent worked out regularly for close to a year, and i am not really watching my diet at all, so its safe to say that this weight is about as fat as i get. i have started going for walks but i hesitate to get back to grinding at the gym because i want my weight to be stable before my surgery. (i also havent had any children, since that seems to be a large factor as well.) i do think fitness level will have a bearing on my healing, though, so i plan to address that.

my body shape is roughly an hourglass, and my lower section is an A-frame - although i am technically an "apple" (since i carry my fat in the belly/front and not in my ass). my butt definitely has the top-booty juice, and the lower-booty curve, but the mid section is a little lacking and so i can look square-ish at some angles. since i expect this to get worse and not better as i age, i want to handle it now and enjoy it for as long as i can. :)

what i want is a redistribution of where i carry fat: a reduction in the front (and a bit all around my midsection), potentially some lipo of the arms (since i have an athletic frame and they can look a little large if i dont keep my body fat super low), and a "fill in" of the booty midsection. i am not touching my thighs (theyre thick and i like them that way!) and im not seeking a kardashian, donkey, or shelf booty; i already get a fair amount of attention for my body shape (and amount of ass) and just want to improve my confidence about the shape. i also dont intend to add any width, because i like my curves as they are, so i will probably ask to taper the top of my booty, fill in the mid, and leave the bottom as is. i guess thats a teardrop/heart booty? :)

i also really dont want to look like i have had surgery, and a natural-looking stomach (post surgery) is SUPER important to me - perhaps even more than the booty result. this is another reason i selected dr. j.


i live in the bay area and have met with four local surgeons who have all said the same thing: i am a great candidate for this surgery, and can expect good results. i also have done an email consult with dr. j in beverly hills because i really, really liked his results, and have ultimately decided to go with him - even though i much prefer a local surgeon, i am most interested in a doctor who has shown results similar to what i seek. i also really appreciate how accessible his staff (specifically, daria) has been through this whole process. thats a really big deal, to me!

i have just booked my surgery for june, and have decided to spend two nights at serenity recovery house in santa monica. they say one is more than fine, but since i am from out of town, it just makes me feel better to be looked after by pros. its not cheap but is worth it, to me.

then, my loose plan is to have a family member fly in and drive me home to the bay area for a few days before flying back for my 7 day appointment; if the doctor doesnt allow that plan for any reason, i will figure out a contingency option. :)

im super excited for this change but i am also nervous. i have a low pain threshold, and i hate painkillers, so thats not great here ... but i am hoping its worth all the time, money, pain, and energy!

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Board Certified Plastic Surgeon
465 N. Roxbury Dr., Beverly Hills, California
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