After weight loss: Lower Body Lift, Spiral Thigh Lift, Breast Lift. San Antonio, TX

Hi all,
I have been benefited by reading all the reviews here. I am planning on documenting my experience to pay it back. I am female, 42 yrs old, no pregnancies and I have been having weight issues all my life. I have lost over 130 lbs and I am now at about 170 lbs, 154 lbs is the lowest I have ever been. I am 5ft 8in and I am pretty fit overall. I like exercising, I run regularly 4-7 miles, have been doing Yoga for 5 years now so I am pretty flexible (3-4/week regularly) and I do weight training, swimming, fitness classes (FIT, TCX) as often as my schedule permits (from a couple of days/week to a couple of days/month). Up to a year ago, I wasn't thinking about plastic surgery just because I always thought that it is for other people without really ever having looking into it. I have quite a bit of loose skin as most of the MWL patients that go through plastic surgery, mostly on my abdomen and my inner thighs. It bothers me quite a bit when I see myself naked, when I try on clothes and especially when I wear "special" underwear that smooth my tummy and hold it in. I look OK with clothes but the two layers underneath ( "slimmer" panties and camies) really annoy me.
So, I started looking into plastic surgeons. A friend recommended very enthusiastically a surgeon in Austin. She is quite young (mid 20s) and she had a tummy tuck and arm lift. I saw her incisions and scars (9 months post-op) and they looked good, still red but straight and well placed, low on her hips. As a result, I started with her recommendation and went in for a consult with her surgeon. My inquiry was for a tummy tuck and an inner thigh lift since these are the two areas that bother me the most. The first surgeon recommended the tummy tuck, didn't think that I need a body lift and was very reluctant to do the inner thigh lift at the same time. The only option they gave me was to get a vertical thigh lift, the one that the incision was down half-way to my knees. I asked about how many thigh lifts they perform per year and the answer was about 5; that explained their hesitation. I thought that the first surgeon was very qualified for a regular patient that hadn't lost a lot of weight and needed a procedure to perfect their body after a pregnancy but I may not be getting the results that I was looking for. The laxity of my inner thighs bothers me quite a bit and I wasn't ready to give up on correcting it.
After hours of looking thorough the pictures and reading reviews and answers of doctors at Real Self, I came across Dr. Peter Fisher located at San Antonio, TX and about 1.5 hrs away from where I live in Austin. I went in for a consult around mid-November. His office setting was more modest and "real" than the first surgeon's, no big windows with city views, designer couches or high end magazines, it felt more like a very nice waiting room for a doctor's practice and I felt more comfortable.
I am a perfectionist and I have worked really hard to lose all the weight but I have no illusions about being a model, I just want the best outcome as close to perfection as it can get... At the appointment, I saw the nurse first and answered the usual questions about how long have I been at my current weight (1.5 years) and how did I loose the weight (diet and excercise mostly with diet pills occasionally from a nearby clinic) plus medical history. Before I went in, I was only considering a tummy tuck since I never had a problem with my butt or my legs and outer thighs. As soon as Dr. Fisher saw me, he immediately recommended a lower body lift instead of jut an extended abdominoplasty. He felt that a Lower Body Lift (LBL) will address my problems more hollistically. He also recommended a spiral thigh lift (without the ugly vertical incision). I am posting a picture of the procedure that he performs from a research journal. He also addressed my breasts and recommended a breast lift. I am a size 34G even after loosing all the weight so I never really felt that I need breast implants or I even want them. He didn't even talk about implants. I asked about my arms but said that they are fine. In all, he recommended the LBL with the spiral thigh lift and breast lift. I was pleasantly surprised when he said that to his experience, after a LBL, most women have a "boxy" look without curves and that his procedure includes transferring fat from the excised tissue (that he cuts out) to the butt so that the butt has more shape. I always felt that my but was quite flat, didn't really bother me (compared to my other issues) but I would take a fuller, rounder, more feminine butt gladly. I was very excited with his recommendation, doing it all at once and I was also very worried about the length of the procedure (7-10 hrs, I think), healing and also I have to admit that I was skeptical about whether I needed the LBL. I was thinking to myself that this all sounds great but it is me who will have the surgery not the doctor and he can be excited and want to do everything but do I need it all? So I did a lot of reading, mostly research articles that I have the advantage of having access to and I will be discussing and quoting them as I write my review. At this point and from what I have read, I think that the answer is that Dr. Fisher was right. I will elaborate more on this later.
I concur with most of the reviews about Dr. Fisher at Real Self. He is very personable, matter of fact, experienced surgeon and much warmer that many of the doctors that I have interacted with. I felt that he had a vision for my body transformation that I didn't haveI and couldn't have had and most importantly that he has the experience to deliver the results that he envisions. I got the feeling that he is invested into his profession and his work and his motivation is not just financial (not that there is any thing wrong with that). Dr. Fisher gave me the impression that he is not into it just for the money and cares about what he does deeply and that to me is very important. I am having a follow-up appointment this coming week and I want to schedule the procedure ASAP. It looks like he won't have anything in December, a bummer for me since I all have time off during Christmas but so does everyone else and I should have really looked into it earlier although I have to admit that I never realized how much ahead you need to plan for this surgery. I am hoping for the earliest date possible, really early January otherwise I may have to postpone until March of May.