I've never watched her, I have been watching Alexandria Rodriguez though, and I know a couple of women that have had them while still obese. They look ridiculous and I can spot one a mile away. This is especially so if they have a Fluer Di Lis abdominoplasty (edit to add, Sarah's is not a Fluer Di Lis) where the fat is also taken from the front of the upper torso. It isn't normal to have a flat tummy, with large thighs, big breasts and back fat. I don't know what Sarah's reasoning was but Alex claimed hers was medically necessitated by rashes. A very real issue for these obese women is post surgical weight changes. If they gain the fat distributes unevenly, and if they lose weight then they'll just need another abdominoplasty. It's why most reputable surgeons won't perform these surgeries on folk who haven't lost most of their excess weight and maintained that weightloss for at least a year. What an absolute waste of money.
WOAH!!!! Just checked out her video and this standard abdominoplasty with lipo (no cutting) of both upper arms is going to cost her US$38k (plus the cost of 2.5 weeks accommodation) ... and she's still morbidly obese after having had a lapband previously and a lapband removal...sounding just as stupid as Alexandria Rodriguez. At least it sounds like Sarah has at least waited until after having her kids for this lunacy. Her line about plus size people deserve and have earned tummy tucks too, quite frankly is laughable....what exactly have they done to earn a tummy tuck when they are at their highest weight ever.
ETA: I should haven't skipped the last few minutes before editing... She does want more children. This is lunacy at its finest.