I Changed My Mind About Post-Weight-Loss Plastic Surgery—And I’m So Glad I Did

Accepting my body shifts the impetus of maintaining it from self-punishment to self-care.

Today’s Change of Heart: A mind-change essay I originally wrote back in 2018 for The Establishment (RIP), where it’s still archived.

In complete transparency, my mental health got to a place last year where I was contemplating plastic surgery again in seriousness. (Which is not to say you have to have poor mental health to get elective plastic surgery! I just know it’s not actually aligned with my values, so when I start to ruminate on it, something is very off.) It seemed right for this piece to get a second life here on my newsletter as I once again (at least for now) settle into the truth and wisdom of my body exactly as it is, “sagging and stretched and strong and only mine.”

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The doctor had my empty skin in fistfuls, pulling my flesh together at the center of my body. The corset of his hands exaggerated my natural curves unnaturally, making me look wasp-waisted and wrong.

“Just look how pleasing she would be,” he remarked, surprising me with the third person. He was not addressing me, but looking past me in the mirror to meet the eyes of my then-boyfriend.

Pleasing. I remember that word specifically, can still hear it: a word shared between men. Although it was my body he was manhandling, his work was clearly not about me, personally. It was about what I broadcast — the experience of my body from an external perspective. It was about the object I could become.

After a lifetime of obesity — I was fat since I was 4 years old — I lost a significant amount of weight in my early twenties, which took two years and a total reinvention of my relationships with food and exercise. [NOTE FROM 2024 JAMIE: lol it definitely became an eating disorder, oops.] I worked hard to lose the weight, of course, and my body was inarguably different. But I still wasn’t satisfied, still didn’t look as I’d imagined.

At 14, I’d printed photos of bikini-clad women and taped them into a notebook. It was “thinspiration,” a small act of masochism to bolster my daily journaling of bites eaten and steps stepped. The models strode down empty beaches with carefree smiles and almost every inch of skin exposed, their taut tummies and distinct thighs heuristics for perfection — never mind how carefully crafted those images might be, how fake their photographed laughter. Living life as a fat girl in classrooms, doctors’ offices, and school dances had only reinforced my suspicion: If I looked like that, everything would be different. Easier. Better.

At 24, my “new” body could fit into clothes whose tags bore single-digit sizes, but I looked nothing like those women when I wasn’t wearing them. What fat I had left pooled into sags of skin across my belly and inner thighs, which still rubbed together — sometimes painfully. Outwardly, I had achieved thin-girl status, as evidenced by all the strange and problematic things I suddenly began experiencing: Men who’d wanted nothing to do with me before began asking for my phone number; athleisure-clad women beside me in cafe lines commiserated idly about tempting bakery cases, their wares assumed verboten. But in my brain, I was still a fat girl, and my unclothed body corroborated.

Naked at the mirror, I’d pick up the deflated bag of my belly and let it fall, or hoist the flab of my thighs like loose leggings to see the strong muscle I’d developed underneath. I had come so far and put in so much work to meet our society’s ideal, and I couldn’t shake the feeling I was being denied something — something I’d earned.

So I called the surgeon’s office and made the appointment.

My phone rang a week before my surgery date, which was set for early December. It was my anesthesiologist. He wanted to triple-check my health history for the many risk factors of general paralysis; I’d be under for at least four, and up to seven, hours.

I’d planned to take the four-week winter break of my senior year in college to get through the worst of the recuperation. Along with all the risks of the surgery itself, a full tummy tuck involves weeks of brutal recovery; patients can’t even sit upright, let alone walk properly, for several days post-op. Bulbous drains are inserted bilaterally into the wound to catch the lymph and blood the body weeps for even longer, requiring regular, stomach-turning maintenance. The incision site can remain swollen and tender for months after the procedure, all to say nothing of the basic, gut-level grisliness of the thing: a hip-to-hip gouge, a triangle of flesh lifted from the abdomen like making the mouth of a Pac-Man.

I gazed at the box of post-surgical vitamins in the early kitchen sunlight, peeked inside at the three large bottles filled with horse-sized pills I dreaded trying to swallow. The blend had cost me $90 and was heavy on the arnica. I was about to give my body a serious beating.

I can’t tell which of the many pieces in this braid of hesitation finally made me call it off, but I do know the decision cost me my non-refundable $1,000 deposit. (The total estimate escapes me, but it was in the five figures.)

I wish I could say my entire weight loss effort was healthy and body-positive, but it wasn’t. Indeed, much of it was rooted in a kind of obsessive-compulsive self-hatred that made existing through constant, low-grade hunger and climbing untold StairMaster storeys not just possible, but inevitable. [NOTE FROM 2024 JAMIE: See? told ya.]

But whereas parts of my weight loss effort were distinctly unhealthy and dangerous—psychologically and physically—other parts, like establishing a balanced fitness routine, were good for both my brain and body. By contrast, this surgery could only diminish my bodily health — if not by some complication related to the procedure itself, at the very least by forcing me to give up exercise, which I’d ultimately grown to love and rely on for self-care, for the duration of the recovery.

Paradoxically, this surgery meant to make a body look “fitter” requires that body to give up fitness pursuits to properly mend. Many patients find that by the time they’re healed, they’ve gained much of their lost weight back. It’s not an uncommon irony in plastic surgery; breast augmentations, for instance, carry the risk of loss of nipple sensitivity. The sexually-objectified body part perhaps becomes a more perfect sexual object, but loses its sexual potency for the woman herself.

In any case, the surgery was an undeniably wild expense [NOTE FROM 2024 JAMIE: which my parents, extremely generously, had offered to fund, because otherwise I definitely couldn’t have afforded it] and put my body at significant risk that was in no way medically necessary. I could tell myself I was doing it “for me” all I wanted, but was I really willing to risk my life for something purely cosmetic?

Half A decade later, I’m still living in my imperfect, stretched-out body. Loose skin and stretch-mark trenches confess a complicated history, a life lived across the spectrum of size.

I won’t lie and say I don’t still think about it on occasion, that I never poke and prod my misplaced parts in frustration. Although my gym time is now (mostly) for my sanity as opposed to my vanity, sometimes, I still can’t get past it. I did so much work. I do so much work.

But most days, living in my imperfect body helps me realize how misguided that ideal was in the first place, how arbitrary those visually-based goals can be. I’m in the best shape of my life, eating food that makes me feel good, and always finding new ways to move; I’m strong enough to enjoy experiences — running 30-minute 5Ks, squatting under heavy barbells, hiking steep river valleys — that were out of reach when I was less fitness-focused.

I can’t deny that excess skin has made dating somewhat challenging — sometimes more so than it was to date fat, when my partners knew what they were signing up for from the start. But in some ways, it’s actually a helpful elimination tool (or, as I like to think of it, an asshole barometer). Given that I look significantly different naked than one might expect when meeting me clothed, I’ve taken to having a frank and open conversation ahead of time — and if that honesty and imperfection gives a would-be partner pause, I’ve gained an invaluable data point as to whether I really want to sleep with them in the first place.

The sex itself is also better, by the way. I find I’m less focused on what’s jiggling where, or on how I can better perform for my partner, the movie-reel play-by-play of what does this look like; how I might be, in my would-be surgeon’s words, more “pleasing.” Instead, I focus and insist on my own pleasure as well as theirs; I’ve stopped faking orgasms. Part of it is plain old growing up, but I also thank my decision to allow my body to be what I’ve made it — as opposed to slicing it into something the better to be served up to others.

But most importantly, foregoing plastic surgery has unlocked a new understanding of my relationship to my physicality. Accepting that my body will always be this way — “imperfect” — shifts the impetus of maintaining it from self-punishment to self-care. The effort of eating well and moving lots, I’ve learned, doesn’t have to be about excoriating excess flesh or trying to be smaller.

Instead, it can be a labor of love, a way to respect and retain this resilient machine that moves me through the world — that is my world, sagging and stretched and strong and only mine.