I tell patients before surgery: you will lose hair. They nod politely and sign the consent form. Three months later, they call me crying. The nod meant nothing — they didn't believe it would happen to them. So now I tell them three times. Once during consultation. Once the day before surgery. Once at the first follow-up. Three times, because once isn't enough for something this emotional.

The second thing patients underestimate is vitamins. I don't mean "take a multivitamin for a few months." I mean: vitamin supplementation is lifelong. Not optional. Not temporary. Not "until I feel better." Your body's absorption changed permanently with the surgery. You will take specific vitamins — B12, iron, calcium, D3 — for the rest of your life. Miss them consistently, and your body will tell you through fatigue, bone loss, and neurological symptoms. This is not negotiable.

The commitment after surgery is permanent. Your stomach is smaller. Your absorption is different. Your relationship with food is fundamentally changed. This is not a phase you go through — it's a new set of rules your body lives by. The patients who understand this before surgery are the ones who thrive after it.