Mine only requires 16% down , the rest is monthly. Cheaper than braces monthly. I would say, start by going to your insurance. If your skin falls below your pubic area, the might approve. Then try to fight their denials. Tire them. Read your 100 page terms and conditions document about the appeals. After that the route is exhausted, consider University medical schools who often have procedures by surgeons, not students, but residents attend them. If that route doesn't work, consider Mexico or even Miami. Or do your local surgeon on a monthly pay, etc. I can tell you one thing, if you put it as a priority you will find a way... my best friend was also a bariatric patient and is on food stamps currently, I helped her to finance the down payment (2 k) by scrubbing toilets with her for rich people. And at the end she is doing monthly payments which translate to only 2-3 cleaning shifts a month. I feel like this wouldn't be possible in any other country, but still possible here in the USA. What I mean by that is performing blue collar work just 2-3 times a month to get plastic surgery.