I am currently in the middle of consultations (or as I prefer to think of it, 'interviewing surgeons'). I've done three so far, but I'm scheduled for eight with one more to schedule. They run through October. I'm planning my surgery for January of 2013.
I am 37 years old, just under 5'8", about 127 pounds, and exercise 6 days/week. I've been training hard to try to get rid of my fat belly, and also in the hopes that lowering my body fat might improve my hormones, as I suffer from adult acne which I only keep at bay with an extremely strict diet (I only eat fruit, veggies, nuts, seeds, and mushrooms. All starchy foods make me break out--bread, rice, potatoes, quinoa, even beans. :( ! It's not a gluten thing). Anyway, I've been having my body fat checked, and after the first time (129 lbs., 26 % body fat, which I think was a bit off), my fat numbers have been low (16-18%) but my belly remained fat! I was getting very discouraged. And then my wonderful husband told me that we could afford a breast lift. Woohoo! I've hated my breasts since I was 11 years old (they grew straight down, then got huge). I started doing tons of research and realized that maybe some of this fat on my belly wasn't actually fat, but excess skin from a lifetime of dieting and then pregnancies.
And about those pregnancies! I have three lovely daughters: a 5-year-old and twin 2.5-year-olds. I have a very hard time with pregnancies--I had hyperemisis gravidarum with both. I gained 13 pounds with my eldest (unmedicated) and 45 pounds with the twins (medicated for nearly 7 months). Prior to my pregnancies, I worked out 6 or 7 days per week, running, biking, step aerobics, functional training when I worked with a trainer, cardio kick-boxing, and yoga. I was strong and healthy and had been working out for about 4 years religiously. I had a little excess fat on the belly then, but not so much I wouldn't wear a bikini (as long as I hadn't eaten). I weighed around 132 pounds.
After the first pregnancy, I lost a bunch of weight through dietary changes. I was 117 pounds and thrilled with how skinny I was (size 0 jeans--couldn't even buy clothes in Macy's or Nordstroms) but I hadn't much muscle left after the pregnancy, since the constant vomiting (involuntary anorexia) caused my muscles to atrophy. The only exercise I had time for was walking with the baby, since I nursed her around the clock for 2 years and 4 months and got pregnant again during that time.
The nausea was even worse during the twin pregnancy, and I dropped to 113 pounds. I feared I would die. And even then, I had fat on my stomach. After the twin pregnancy, I ballooned so that I was in the upper 140s, but with no muscle tone at all, I was like a Stay-Puft Marshmallow Man with two zeppelin-sized breasts (each bigger than a baby's head). I sat 24 hours/day on my a** and tandem nursed the twins, eating to keep awake, eating to stave off depression, eating to mitigate the pain of my C-section. And all of it starches, cause I can eat that stuff when I'm pregnant and for the first 6-10 months of nursing, depending on how much I nurse. At 6 months, though, I went back onto a healthy diet and lost 15 pounds immediately. Then another 3 or 4 more slowly. But the rest wouldn't budge because my metabolism was so low after the anorexia and having no muscles and never moving. I managed to drop down into the low 120s when I got sick or starved myself, but it never lasted more than a couple of weeks.
Gotta go for now...
I am currently in the middle of consultations (or...
I am currently in the middle of consultations (or as I prefer to think of it, 'interviewing surgeons'). I've done three so far, but I'm scheduled for eight with one more to schedule. They run through October. I'm planning my surgery for January of 2013.
Back! Had a little trouble posting, what with the...
Fast forward to April 2012, when the twins were finally old enough that I could leave them with my mom for a couple of hours at a time since they could go a couple hours between nursing sessions. I hit the gym again. HARD. And as I mentioned, got my body fat measured. It's now September--so 5 months have passed--and my latest (professional) body fat analysis came back around 16%. The hand-held meters say anything from 16-19%. But since a healthy percentage is just under 22%, I should be good. I am well-muscled and strong. But this belly!
The Consultations Begin
I'm going to go into these in detail, since I doubt many people will read this anyway, but I'm using this as a diary and want a record of it :). And anyway, if anyone is interested in what consultations are like….
So this past week, I conducted my first three PS interviews (the first really was a consultation, actually). I started with Dr. Samuel Pearl, in Mountain View. He has an excellent reputation, from what I can ascertain, 30 years of experience, his own surgery center in his offices and two nurses who work for him who are down-to-earth but seem competent. Dr. Pearl was not a salesman, but a real doctor, who was more interested in doing what I wanted than in the up-sell. He was also quick-witted. It took him about 5 minutes to suss out that I was an extremely well-informed customer and that he didn't have to dumb-down his vocabulary for me, nor explain things obvious to those of us who have spent literally hundreds of hours perusing RealSelf and other sites, researching our procedures. I disrobed per his instructions, then he came back in and palpated my breasts, measured things, took notes, and noted the extreme lack of tissue in my breasts. What were once two gigantic zeppelins, each larger than a newborn's head, were now sad sacks of empty skin, riddled with stretch marks. The skin is also very thin now, because of all the stretch marks. Poor skin quality, is what they call it. The doctor wrote on them with lipstick, then expertly folded one like origami into a lifted shape and showed me how soft my upper pole would be (not even as hard as weak jello). That, and the fact that small augmented lifts last longer, sold us immediately on the augmented lift.
The doctor then looked at my tummy. The first thing he mentioned was the umbilical hernia, which I hadn't been sure I had, but was pretty sure. My innie BB got destroyed during my twin pregnancy, though I managed to get no real stretch marks (slight marring of the upper ridge of my BB where I had a piercing scar that failed to stretch). Then he had me lie down and do a partial sit-up so he could dig his fingers into my diastasis and allow my husband to do the same. I was very glad of this, because it made my husband understand how I can want to do this surgery. We talked about abdominoplasty, and the doctor said that, unfortunately, he didn't think that I had enough skin to avoid the vertical scar from my old BB. My biggest, ugliest problems in the tummy area are the diastasis that makes me look 4 months pregnant after I eat a meal, and my ugly-a** BB. I asked him if I would need any Lipo, and he said no, there wasn't any extra fat there. I guess cause the part with the fat under it will be cut off. Hah! :)
Then we talked about sizing implants, and that was kind of a disaster, because I want to be small, but it felt like he wanted me to be bigger. He said if he took out 100 cc of breast tissue, that I should put in at least 230 cc. He couldn't make us understand why he thought we should have a net gain when I wanted small breasts.
Overall, we had some difficulties communicating. Sometimes we'd ask a question and he heard some other question (or at least answered some other question). And the whole implant size spiel just seemed nonsensical to us. At one point, when he showed us Before/After photos, I commented that one of the ladies' nipples were still pointing down slightly, and my husband agreed. But the doctor got kind of defensive. I was surprised because I'd said (several times) that I thought the result was beautiful regardless.
Anyway, after spending 2.5 hours with us, until well after business hours, he gave us a quote of about $22k for bilateral mastopexy and augmentation with silicone gel implants, and full abdominoplasty with diastasis and umbilical hernia repair. I almost gasped. I mean, I was expecting close to $20, though I'd been hoping for less, but…. I understand why he charges so much--really, I do. But here is my philosophy:
In a free economy, you get what you pay for; BUT WHAT YOU PAY FOR IS NOT ALWAYS NECESSARILY WHAT YOU NEED OR EVEN WANT.
For example, with Dr. Pearl, you are paying for:
-An artistic eye
-30 years worth of surgical skill and experience dealing with complications
-Two professional nurses on staff, both of whom are older and very experienced, plus an office assistant
-An accredited, in-office surgical suite
-Professional Anesthesiologists (MDs)
-and much more!
All of that stuff is expensive. But I don't really need all that stuff, even if I want it. I do want to pay for an artistic eye (or talent). I do want to pay for some years of surgical skill and experience, but I don't need to pay for 30 years. Perhaps the nurses could be less experienced as well--10 years instead of 30. The surgical suite could be shared instead of private and in-office. Etc. It's difficult to find the subset of things one is willing (and able) to pay for, and map those to an actual PS, but Dr. Pearl is out of our league for sure, and that's that. So even if we'd gotten along swimmingly, we couldn't have gone with him.
The Second Consultation
Our second consultation was with Duet Plastic Surgery in Palo Alto, which is in the interesting position of having a team of plastic surgeons, one of whom is Board Certified and the other not (yet--she is Board Eligible and should be certified by the end of the year). We only met with one of them, as the other was on vacation in Hawaii just then. Also, the assistant went home sick, so it was just Dr. Weintraub there. She was also the one who scheduled me, and answered all of my initial emails. She and Dr. Angeline Lim perform the large surgeries together, and have been doing it for at least 4 years (since 2008). They may have known each other during their residencies--I can't remember that part.
As a side note, I wish that these plastic surgeons would just make it easier to see their CVs. I mean, I realize it may be harder to get people in the door that way, and that's why they don't do it until their CVs are solid, but it really just makes me antsy. I think having to go to LinkedIn in order to find out how long someone's been a practicing PS is a bit blah. And if I can't find out even from that, forget it. I will not hire you.
Anyway, back to the consultation. She was great! She heard all of our comments and questions, we understood everything she said. She did not talk down to us. She noticed things and commented. She told us about the process she's been undergoing to get ABPS certified. We looked at books, etc., and saw good results. She didn't seem to think there would be any problem with stretching my skin to get rid of the old BB and avoid the vertical scar. Unlike Dr. Pearl, they do not quilt down the skin, because they have been unable to get good results in the scar that way (it ends up squiggly for them, which could be an experience thing.) The only thing I didn't like (because I found it inconvenient) is that she referred us to another PS at Kaiser because our insurance is Kaiser and because I have an umbilical hernia, she would prefer that a general surgeon fix it, and so it'd be cheaper for us if we had a Kaiser PS handle the cosmetic part in conjunction with a Kaiser GS to handle the hernia under insurance coverage. I'd been putting off the call because I'm biased against Kaiser PSs and because the pics on the website do not represent what I would consider good results (and none of them were this doctor's results anyway). However, I did finally call, but they charge $100 for a consultation AND are already almost completely booked through October (they had only one appointment left for one afternoon in the middle of the month.) Anyway, I need to ask my husband whether he still wants to do it, though I suppose he will, even though it's the most expensive consultation I'll have AND I have seen no examples of the doctor's work. But I digress (again).
The upshot is that the estimate was $17,650, including the silicone gel implants and garments. It's still a good $4000 more than a lot of you lucky ladies have paid for your wonderful transformations, but such is life in the Bay Area. The price would be doable, if we borrowed from the house. Again. The house on which we already owe more than it is worth. *sigh*. BUT, if they get the general surgeon to do the hernia repair, that's an extra $2k. Which brings that estimate up to $20k. For 4 years of experience per PS. I don't know…that's a bit pricey.
The third consultation was with a PS who is not ABPS certified. Now why did I schedule this? you may be wondering. Heh, funny story (not really). I was looking for good reviews on Yelp! and he popped up. That was before I knew anything about RealSelf or the ABPS. He had great reviews. I scheduled an appointment, along with several others, and then the weekend before I was going to start the interviews, I did a last check of all the PSs to make sure they were all board certified. He was not. And to make me even more nervous, I was unable to find anything reliable about him! He didn't even have before/after pics on his website. And when, in a fit of desperation, I called his office the day before my appointment and asked for a copy of his CV, the secretary did not even know what a CV was! And then she said for patient confidentiality, he didn't give out that information. And then I explained, very slowly, that a CV is like a resume and doesn't include patients' names or pictures or anything. Then she said they didn't give out that information over the net, and that I'd have to come to the office. I was LIVID. And very angry at myself. And scared. After hours of web research, the only thing I could find is that he is a real doctor in California and that he used to work with a female PS who got one excellent web review for a gender reassignment surgery. And that he's published a couple of papers in neuroscience a long time ago. OMG, I was shitting bricks. And HATING Yelp! It's too easy to fudge there. I even joined Angie's List to see if they had anything on this guy. Nothing, and $12 wasted.
My husband was getting kind of impatient with me because I was freaking out. The consultation was free, I wasn't committing to anything. "It's like you think this is some kind of test you're going to fail," he said. *sigh*. He was right. "As long as you're not angry about losing half a day of work for this, I'm fine," I said, and then I was.
The consultation was interesting. The doctor came into the room talking a mile a minute. And that set the tone for the rest of the interview. Him talking almost non-stop, not hearing us, not even hearing himself (and sometimes mis-speaking). It took 5 times of asking him the same question at one point before he heard us. He had a spiel which he could not deviate from. He kept repeating things we already knew going in, and could not modify his presentation to fit an audience that was well-informed and well-educated. We got some good information and I learned something new about the anchor lift (it's a small technical detail but I'd been missing it). He also seemed to think my skin would reach to avoid the vertical BB scar, but it was difficult to ask exactly. There was exactly one point at which I had the time to ask about why he's not ABPS certified, but it was just before I was going to take off my clothes, and I thought there'd be time later. I never got to ask it. He talked his way out the door 90 minutes later, late for lunch, and I guess I'll never know, now. There's no nice way to ask something like that over email or over the phone. The doctor sent a nice thank you card, (hand written) and the estimate for the full shebang (bilateral breast lift with gel augmentation and full abdominoplasty) was $14,590. His before/after pics were fine--nothing stellar, nothing worrying--just like the previous two. He uses the exact same surgical suite that 5 of the other PSs I'm interviewing use, and he has more experience than Duet. There were some boxy breasts but I think that comes with doing post-bariatric body lifts and, frankly, he may be willing to take some clients someone more experienced and expensive would refuse because they may not get a perfect result. Anyway, the guy was nice, and I think that for someone who clicked with him, he'd have worked out fine. We had a lot of stuff in common, actually--both personally and educationally--but in the end, my husband and I are desperate for someone who communicates well with us.
The difficult part now is that I have to wait over a week until the next appointment, because my mother is away and I have no childcare.
Talked surgery dates with Duet yesterday, (not...
Adding some pictures from long before. There's the...
Dr. Commons canceled my consult that was scheduled...
I've decided to tweak my exercise program as well. I'm going to start learning barbell lifts. I'm making great improvements with my bodyweight strength routines, but I'd like to add some really heavy lifting. So we'll see how that goes. I pulled 102 lbs and did a set of assisted dips at 102 as well, so I'm pretty stoked. And I did so many walking lunges and supported pistols yesterday that my entire lower body is burning. I just realized today, that working out is one of the very few things in life I actually enjoy doing. I willmiss it after surgery. Wondering whether I really want this TT. The BL is what you'd call a no-brainer.
Talking to my husband today and mentioning that I...
Buuut then I drink a glass of water, or eat a meal, or heck, even stand around too long, and I look pregnant again and reminded that I want to enjoy my late 30s, not wait 20 years to see if, possibly, my stomach will fix itself and all my hard work will pay off.
I've gained a pound or so, and my period is due in the next few days, so now I think I need Lipo, too. Thank goodness I start up consultations again tomorrow, because I am just thinking waaay too much, and not at all productively. Dr. Greenberg, here I come!
Can I just say that I am a little neurotic? Due to...
Soooooo, just interviewed my fourth Plastic Surgeon today! Her name is Lauren Greenberg, MD, and she practices in Palo Alto, CA, which is only about 30 minutes from where I live and so, very convenient.
We arrived very early because, for once, I got to decide when to leave and my husband managed not to slow me down too much. And then we didn't hit any traffic, much to my surprise. The first impression was bad, because we were followed by a parking security guy from our car, halfway to the building, when he actually stopped us and asked us where we were going!!! WTF???? We told him which building we were going to (which was right in our path, by the way,) and then he gave us the OK to continue on our way. Ugh.
Then we got inside, and were turned off by the receptionist who seemed rather sure she would like to be elsewhere. This did not affect her job performance, however. She just wasn't as friendly and effusive as every other receptionist we've met on this journey so far (4). I'm pretty sure she's actually a practice manager or office manager or something, not just a receptionist, but that's neither here nor there.
The doctor was exactly on time, which is good, because I was exactly on time filling out my forms. We went into the tiny examination room and she went through the questionnaire with us, including one that the receptionist left out, actually. Then she talked to us extensively about mastopexy and her philosophy regarding them and drew us diagrams of the anchor versus the lollipop that she prefers, and talked about how the internal breast tissue is reshaped with sutures and pedicles and lots of other stuff that my husband didn't know and a little stuff that I didn't know. In fact, she says that I can get a pretty good (read, not stellar) result with just a lift and no implant. This is not so different from the other PS's we visited. However, she told me that if I do get an implant, I will definitely have to return for touch-ups, because what will happen is that the implant will remain in its position until it breaks or whatever (which would also be a reason for a touch-up) but the skin will sag under it! So I'll be back to kind of where I am now, where my bulging pecs form a bump waaaay above the remainder of my saggy-ass boob (grade 3 ptosis, BTW, she was kind enough to tell me, in case y'all couldn't tell from the pics!) So I decided that if I go with Dr. Greenberg, I will be getting a mastopexy only. Which is my preference philosophically, just not aesthetically.
After all this, I get undressed and she comes back in and takes a look. Cause she didn't want to talk about TTs until she'd seen what we were working with. So she measures my saggy boobs and gives me the ptosis verdict, and does the origami thing to show where the breast would end up with a pure lift, and then we talk about the belly. The good news is that I don't have a lot of fat, so not a whole lot of lipo would be needed, but the lipo I would need she just throws in for free with the rest of it since it's minimal. I told her that my thighs rub together and she said no problem, as well as the mons pubis fat. And when she gets in there, if she needs to get rid of some flank fat, she'll do that, too. Hard to know at this point. We determine that I definitely need the full TT because of the diastasis and hernia repair and because I don't want a low belly-button, etc. etc. The other good news is that she, like most PS's, it seems, is willing to do the hernia repair herself. The bad news is that the bra-line spillover I thought was fat and that could get lipo'd out along with the lift, is actually just extra skin, and so cannot be fixed without cutting :(. She said that I hardly have any belly fat, and then showed me these weird ridges and stuff that I could feel when I pinched my belly fat skin together, and she said that wasn't fat cells (like I'd thought) but actually blood vessels and fascia and other stuff that I'd not be able to feel if there was fat there. Huh. Even more reason to do this darned TT. I am now no longer at all torn about that. I should not have 17% body fat and feel like I'm fat because of my belly. It's just wrong.
She showed us a drain, and I asked why she doesn't quilt down the skin. She explained that she is more worried about tearing stitches and having to go into the hospital to fix that than she is about minimizing drainage.
Well, I forgot to ask about the recovery from the TT, mostly because I already know so much about it from all of you guys. But she did show us some before and after pictures of breast lifts and TTs. And I got to see a super-keen slideshow with pictures of people's insides drawn on and the like. I've watched so many BL and TT procedures on the YouTube that it no longer even makes me feel uncomfortable. I actually quite enjoy it. I'm so excited to see my own cut open pictures!!!! That was pretty-much the end of the interview, except we also discussed some the possibility of switching insurance so that we wouldn't have to pay for the umbilical hernia repair. It may or may not be worth it, we'll find out in the next few weeks.
The bottom line: I really liked Dr. Greenberg, and if I had to choose someone right now, she'd be it. Her estimate so far is about $13,600, with billing insurance for the UH repair. It's siginificantly lower than my other estimates mainly because of the $4k discount from not buying the implants and the lack of UH repair. Otherwise she'd be right up there with everyone else.
That's it for now. Tomorrow I see the famous Dr. Steven Williams of 21 Jump Street fame (just kidding--that's a different Steven Williams) over in Dublin town, and I hope he is as awesome as his reviews and his status on the RealSelf lead me to believe he is.....
Firstly, I got the remainder of my quote from Dr....
But mainly, yesterday was the day I had my consultation with Dr. Steven Williams, of 21 Jump Street fame! And right before I was to go in, 30 minutes early, BTW (my husband has decided he can no longer do consultations with me because he was missing too much work, which means that it's my timetable and that means I'm at least 15 minutes early to everything,) I open my bottle of BCAAs mixed with water and the stuff explodes everywhere! I'm wearing black jeans, a black jacket, and a bright orange shirt, and this stuff is white. Like, toothpaste white. OMG. I'm sitting there for 5 minutes trying to rub it out with water and it's doing NOTHING. I look like a hobo. So I decide to just go in and try to fix it in a bathroom.
The place is beautiful. The building looks brand spanking new, all green glass and California concrete (that interesting orangey or yellowish adobe type substance). Very slick. PAMF is right there, too, so it's all high class. Anyway, I go up to the third floor and don't see a bathroom, so I went in to ask the receptionist. She looks like a million bucks, just like the rest of the place. And it's spacious, too, out here in Dublin Town, where land is cheap! I decide to fill out my paperwork first, then go to the bathroom. It was a much nicer questionnaire than any of the others--redone specifically for them. So I fill it out, then go to the bathroom...which has no paper towels. Sigh. So I resorted to excusing my appearance with the doctor once we shook hands. But I'm getting ahead of myself.
This is my first interview without my husband, so it felt like I waited a long time before he got there. But when he came in, I was pleasantly surprised. He wasn't as tall as I'd imagined. In fact, he was a very calming, soothing presence and voice all around. He had an air of knowledge and trustworthiness. And yeah, all the diplomas from Yale help.
Anyway, we talked a bit and then he went out and left me for a LONG TIME while I got undressed. I waited and waited, and I don't know if it just felt like a long time because I was alone but boy, it must have been at least five whole minutes. Usually they leave for like two, max. He came back with a camera and the patient coordinator. They took pictures (relax your tummy, we have to tell everyone that,) and then I got my clothes back on while he left for another really long time and printed out the photos. From then on, all references to the surgery were made to the photos, instead of on my body. I did not prefer this, but I assume some more modest ladies would.
Anyway, I have to make this short now, because I've forgotten a lot of it already since it happened YESTERDAY, and that's a WHOLE DAY AGO. *sigh*. Still with the mommy-brain. The important thing is that we had a long discussion about breast lifts and anchor scars and implants, and his take is that it's scar tissue, not suturing soft internal breast tissue, that gives a lasting lift. So certainly no modified lollipop lift with him. The awesome thing, though, is that he runs the drainline through the TT incision. In other words, no snake-eyes in the public mound. Fabulous!! Still, I left utterly depressed because of this feeling like I'd need to do implants again. Overall price, $13,550 pure mastopexy, $15,550 with implants. Best price yet, totally explained by location.
Today, I went to see Dr. Seung K. Kim in Palo Alto. He is much older than I remembered, though he still looks great, of course. He has decades of experience and they say he has 'golden hands'. They have very short consultations, though, so things were a bit rushed. That I did not like. Also, I didn't feel the same warmth from the patient coordinator as I've felt elsewhere (better than Dr. Greenberg's office). I guess they mostly feel just very professional, as opposed to comfortable. The doc, however, was so hands-on that it didn't matter. The only thing I didn't like, was that he never made eye-contact with me. And I suppose that might have something to do with me standing there naked from the moment we met (no initial clothed visit here, it was straight into the gown, and no knock before entering, either). Indeed, this was the first place I've been with paper gowns, and mine tore. Sooooo, did a lot of the interview in my panties. I'm not modest though, so no problem for me. In fact, I prefer not to wear a gown.
Okay, so the basics with this one, he also would do an anchor lift on me, and the scar lines would stop just short of the midline and possibly go to the armpit. He would do a relatively short scar on the abdominoplasty because he doesn't like the scar (it stretches out, unlike the breast one, since it's under so much tension.) He also doesn't do a whole lot of internal shaping, because he says that the more he opens up the breast, the better the chance that sensation is changed or lost. He was reluctant to do any lipo to my inner thighs, because he says with so little fat, there's more of a chance it'll end up lumpy. But he said we could do it. I didn't even mention the mons pubis because I felt like he was in such a hurry, and if I choose him, then we'll be able to talk at the pre-op. He also explained about TT scarring. My C-section scar is beautiful--barely noticeable and in a couple of places, invisible. He said, though, that it's not a good example, because it heals completely without tension, whereas a TT scar will be under tension no matter what. Once you stand up, even if it's mostly healed, it will still stretch the scar, unless it's placed very high and there's no tension on it. But who wants that??? I want it low and tight! So it'll be a very visible scar. But it'll be much less visible toward the sides, where it's most likely to show in clothes. Makes sense!
My overall impression was very good, and I'd certainly not hesitate to choose him if I had no other great candidates. His price for the whole shebang was $16,205. That's the second most-expensive so far, but still pretty do-able for us, as far as taking more money out of the house goes *sigh*. The bad news: I forgot to look at pictures!!!! WTF??? How could I forget that? I called back later to get an appointment and I have to wait two freaking weeks just to see some goshdarned pictures. Ugh, what a ditz I am!
I then went back to Dr. Greenberg (virtually) and asked some followup questions. The bad news: she does not run her drains through the incision line. She uses the crease between the crotch and leg, which is the same place she does the lipo from, so it does double duty. It's better than the pubic mound, though, and probably it's not a deal-breaker. She doesn't think the internal breast origami affects sensation noticeably for most of her patients, either, and I'm going to go in to see more pictures of breasts like mine and the kinds of results she can get with a lollipop lift on them. Once you choose one kind of lift, it has to stay the same, because the pedicle is different and you can't switch pedicles, so it's a big decision, deciding between her and the Williams/Kim complex.
So I'm still waffling tremendously. I think Dr. Commons has gotten some great results with breasts, so I am fairly excited to meet him. I was very excited to meet Dr. Hoffman as well, but I noticed today that ALL OF HIS BL PICTURES ARE OF BL+A patients. So I have NO IDEA what his pure lifts look like, and that makes me less interested. Though his TTs look great. We'll see.
BUT...I'm kind of depressed. Because I just realized something today while I was undressing for the shower. My bodyfat is very low for a woman. Last time I was tested professionally, he measured just over 16%. I assumed he'd f**ked up the measurement, so I've been going with the 17-18% number because that's pretty consistent on the scales and other bio-electrical impedence tests. But either way, under 20%. And I look in the mirror every day, and see all this fat obscuring the muscle I work so hard for. Today it finally sank in: it is skin. It is not fat. I cannot diet it away. I cannot train it away. I cannot even return to the amount of excess skin I had after my first, singleton, pregnancy. The 39 weeks of carrying twins, plus 6 months post-partum bloat, was long enough for me to make excess skin from my inner thighs (I had that already, but still) all the way up to the top of my breasts. All of that body is covered by excess skin. And getting to 15% bodyfat will not allow me to look like a fitness model. And the worst part? Most of all of this will not be touched by the TT or the BL. They cannot fix the bra-line without leaving a scar around my whole back. They can't even fix the love-handles I have without giving me and extended TT (around to my back), because there's no fat to lipo. It's finally sinking in that this twin pregnancy did more than destroy my breasts (totally worth it, BTW!!! I already miss breastfeeding) and give me diastasis and an umbilical hernia. And most of it cannot be fixed with this operation. Or, well, maybe half of it. I hope half of it.
But I suppose it's a good realization to have now, rather than after the surgery.
Good night, all.
Sooo...a lot has happened since my last update. I...
Okay, I've eaten now and am feeling calmer. Those...
Last week, evon45 replied to a post where I'd written something. It was someone claiming to be one of Dr. Horndeski's patients and to have gotten good results. It was one of those posts where people basically just write a review and include no photos or anything. It's the kind of review where, like, ten people had written asking for pictures, but the person had never responded with pictures. These kinds of posts I generally consider useless, because they could be written by anyone. They are what you get on Yelp! and are not what we love RealSelf for. Anyway, someone had posted that they thought that this person was a shill for the doctor and it wasn't a real post. I had agreed. Then evon45 wrote in that she had done research on Dr. Horndeski and that he was legit and it was mean to write stuff like that about him. She's right, of course--it _is_ mean. But it's also completely useless to write such an unverifiable review. Anyway, I wrote, basically, that, in reply. We got to talking--evon45 and I, I mean. It inspired me to look up those out-of-town tips I'd asked for from Dr. Horndeski's office back in July. Also, the person who'd written the abandoned and unverifiable review suddenly was back and offered me pictures if I sent her a personal email. So I did. And got no pictures. So still a completely unverifiable review.
But I did look up those out-of-town tips and, lo-and-behold, they do Skype consultations! So I emailed and asked if they could do FaceTime and started sending them pictures of me posing naked with my sad sacks held up by my littlest twin (who still cannot see mommy's breasts and not want to mess with them....granted, she's not even been weaned 3 months yet. Feels like FOREVER.) They said YES! So the next day we tested the FaceTime and Jana, the sweetest sweetheart in plastic surgery officedom, set me up with a consultation for today at noon. I filled out paperwork and faxed it to them. Then I waited the weekend.
Today at noon, Jana rang me up right on time and I had my consultation with Dr. Horndeski, who is the nerdiest, most adorable doctor ever. I sure hope he's good at plastic surgery, cause Mr. Personality he is not. But I'm used to nerds because I trained in Computer Science. And also, I'm a nerd. In case you couldn't tell by my anal spelling. Luckily, I'm very good at making incomplete sentences so my writing doesn't sound like I have a stick up my a**. But I digress, again ;)
Right, Dr. Horndeski. He talks REALLY fast. If I weren't a native English speaker, I might have had trouble with it. But it's not like he's trying to pull a fast one or anything--it just kind of feels like that's how fast his brain is moving. He has a bit of the engineer's disease--this total belief in science's infallibility. This idea that if you plug the values into the equations, the answer will be right. ALWAYS. And being from a science background, I understand where he's coming from. The problem is that humans, (like economic systems and, well, nature,) are often too complex to measure correctly. And if the measurements are off, then your answer--even in a perfect equation--will be off. And, of course, creating models (the equations) is also extremely difficult. So...I'm not quite as certain of the entire thing as he is. But he is the only one who is confident that he can make a firm breast without implants that won't droop too significantly too quickly. All of the other PSs are basically saying I'll end up with weak Jell-o in the best of circumstances and I'd rather not have implants for my breasts to hang off of in five years. Anyway, the best part is that he doesn't change the nipple nerve and blood supply at all, so a better chance of preserved nipple sensation.
He had me there.
More tomorrow...G'night, all!
Soooo, today I just spent $129 on new bras to wear...
The good thing, however, is that today I finally allowed myself to think about the possibility of having a GOOD results and what that would mean. I've always just allowed myself to think of a bare minimum result I'm hoping to meet--where my belly button no longer looks like a third nipple growing from my midsection; where I regain my core strength because of the diastasis repair; where I no longer have a huge belly every evening, nor do I have a gigantic gut whenever seated. The things that would happen almost for sure, assuming I don't die, which is kind of a necessary assumption. But TODAY! Today I thought about all the outfits I'd be able to wear if this goes well!
First, I should probably explain something--since I have already shared far too much with you all already. For me, these operations have always been more about how I look naked than about how I look in clothes. I can always find something at Lulu Lemon that makes me look great, and I have one pair of jeans that are doable for when I need to go out. When my husband and I have a date night, (which hasn't happened in 5 years,) I wear a corset, and that fixes everything! Did I mention we live in the San Francisco Bay Area? San Francisco values, that's us! So one of my dreams has long been to be able to wear pasties. Or paint-on latex. Yeah. So today I allowed myself to think about the possibility that, after this surgery, I will be able to go out in public wearing pasties and liquid latex. On special occasions, of course. Also, superhero costumes. I love superhero comics, and have always wanted to wear one of those tight, full-body numbers. After this....OMG. I am so excited now! To go to Comic Con for the first time (yeah, I've only been to local cons so far) in an actual costume? What a dream come true. Yep, I'm 37.
The other super-awesome thing is this: Now that my boobs will be self-supporting, it'll be so much easier to take my measurements and make my Elizabethan costumes, because you don't wear a bra with those, and my boobs were hangin' so low, they interfered with my waist measurement!
Huh, and I wonder why my littlest is always stripping and running around naked. Maybe it's something genetic she got from me. I certainly don't do it anymore now, that my angels have torn me up inside :D. Wow, they are so cute! I wish I could show you guys, but I think my husband would have a fit if he knew I was posting pics of my kids in a public forum.
Enough for now, ladies!
Today is 13 days till we fly to Sugar Land, and 15...
At home, I've been busying myself with freezing down extra food for hubby and the kids. So far I have six large containers filled. So four more to go. For me, I have two small containers filled. I need at least three large containers more, I think. I can't lift anything for a month, but I should be able to make a salad before then. Usually my diet consists of salads and veggie-mushroom stews I eat over kale--everything else I eat is just unprepared food--like nuts and fruit--or smoothies. I'm a litlle nervous I won't be able to get a full meal into myself after the surgery, though, so i'll bring nuts and protein powder to make protein "milk"-shakes. I'm vegan so I make cashew milk most of the time.
Okay, time for more cooking!
I've been thinking about that whole question of...
I've been thinking about various reactions people can have to the news. In my case, no one could ever look at my boobs and say I don't need a lift. I mean, they can say it's unnecessary, in the sense that, say, a Corvette is unnecessary when you can drive a Spark. But they can't say I have beautiful breasts now, and that I look great. For my tummy, they could definitely say that I look fine, and to that, I say 'Thank you!', but, of course, I don't want to look 'fine'. I don't work out as hard as I do because I want to look fine. I want to look smashing! I want to be proud of the body I've achieved, and not have to explain to others why I should be. Now, if people see my arms, they can tell I work out. But if they saw my stomach, I'd have to explain that I was an overweight adolescent, which means I'll never get a flat stomach, and that I've had twins, so that's why I still look pregnant, and have a hernia. I mean, even I didn't know about the extra skin thing--I thought it was fat--so why would I expect random people to know that? I didn't even believe the personal trainer taking my body fat percentage when he said it was skin.
Anyway, I think that in terms of breasts, most women probably don't love their breasts unless they've paid for them. I mean, women are just kind of taught to dislike their bodies, and the fact that everyone doesn't walk around naked means that the only breasts we have to compare ourselves to regularly are the perfect ones in print. Those of us who go to the gym may see more, and those of us who nurse in public will show ours more, but people tend to try to avoid seeing breasts in those situations, so it's easy to feel like most women have nice breasts like we see in advertising. I personally have no idea, but when I look through the RealSelf before pictures, I see that most women have nicer breasts than I do. I have also seen a few poor souls who have breasts larger than me--like, my whole body (yes, an exaggeration, but not enough of one.) I think anyone looking at one of those women would give her the right--that yes, she needs and deserves a breast reduction. She is not being vain or silly. She is not making life harder for other women. She is doing something medically necessary. In fact, I think that generally, women are happy to hear that someone is getting a breast reduction. Partly this is because it's medically necessary and obvious; but I think that partly, this is also a selfish feeling--entirely unbidden and subconscious--that the operation will not make her a greater threat in the attracting men department. BTW, the medically necessary thing is also the reason, I think, that people never begrudge cancer survivors breast reconstruction surgery, even though it could be considered vain. (You don't NEED non-functional breasts--you can't breastfeed with them, after all! *eyeroll*)
Breast augmentation and tummy tuck, however, are a different story. I think they're fraught with issues and implications. Both procedures are ones that are generally medically unnecessary (hence my constant reference to my "diastasis and hernia repair" instead of my "tummy tuck") and both leave the patient with something better than most women naturally have. There are very few very thin and fit women who have large breasts, but men's magazines love that look and, so, men love that look. If you don't have the money or the desire to go under the knife, it is very unlikely you will achieve the look. I think women resent feeling like they will always lose, and that what they were born with will never be enough. And rightly so. BUT, I think that we also need to take control of ourselves a little bit. Just take a step back. We don't have to resent others for doing what they want to do. We can each make these decisions for ourselves. And the thing that most women don't truly understand (even if they know it) is that men are dogs...and for straight women, that's a good thing! (For queer women it hardly matters :)) Men love how those women look in FHM or whatever. But man, they love how all of us look, if we're theirs. Because a woman in your bed is better than a woman in a magazine any day of the week. So women don't really have to resent other women for getting these operations. It's not really going to make a difference in the grand scheme of things. What's important isn't that woman A got these operations and now has a perfect body. What's important is that woman A got these operations and now FEELS BEAUTIFUL AND HAS CONFIDENCE. Any woman who feels beautiful and has the confidence to seek out men and enjoy sex with them, will be irresistibly attractive to men. I think if women knew that, they'd be less judgmental about what surgeries we were having and more happy with their own relationships. It think it's the same thing that happens with dieting--women get pretty upset if they think you're thin and still dieting. I get that all the time. For some of us, it is easy to feel beautiful and have confidence, no matter how we look (oh how I envy those people!) For some, what they need is external. My mom, for example, needs to have a really nice car--much nicer than she can afford. With that car, she feels like a million bucks. Without it, she feels like a farmer mouse everyone looks down on (she did actually grow up on a farm.) For most of us here on RealSelf, we need to buy parts of our body--they'll look better, but I also think that paying for them gives us a certain kind of permission to love them that we wouldn't have normally because we're taught not to love and be proud of our bodies.
The other thing, though, is just ignorance. People are pretty ignorant about things like breast lifts and tummy tucks. But they both leave crazy scars, and when people find that out, I think they feel a little sympathetic pain, and also feel like--wow, that's kind of extreme! And that little subconscious monster thinks, "Will I have to cut myself up like that to be beautiful, too?" and they balk. "But you look great!" they say, meaning, 'If she looks that good and needs to go cut herself up, then I have no hope at all.' "You don't need a tummy tuck!" they say, meaning, 'Please, I don't want a tummy tuck.' So then we who are undergoing these surgeries have to scramble for things to say. Sometimes, "Thank you!" works. People are so surprised, it just ends the conversation. But most of the time we try to explain why this or that happened and that's why we have these rolls of fat or skin or whatever. But it just doesn't work with some people, because they're not interested in why we're doing it, but why they don't have to do it.
I have one friend who gets angry when I mention diet research at all, not even to her, but on FaceBook--even if it's not for me. Her shut-down phrase is always that people shouldn't have to be beanpoles and that it's an unhealthy goal. You better believe I won't be telling her about my surgeries, and if she finds out, it will be ALL about the diastasis and hernia repair, and the fact that my boobs applaud (loudly) whenever I walk down the stairs without a bra on.
Gotta get the kids ready to go now, but I am excited to say: 12 days left to travel day, and exactly 2 weeks till my surgery!
BTW...I didn't mean to make it sound like we do...
Those are just some thoughts I've had. I wonder what others have come up with?
Was looking up Arnica and Bromelain today....
(The following is from Medline:)
Bromelain is POSSIBLY SAFE for most people when taken in appropriate amounts. Bromelain may cause some side effects, such as diarrhea and stomach and intestinal discomfort. Bromelain may also cause allergic reactions, especially in people who have other allergies. If you have allergies, be sure to check with your healthcare provider before taking bromelain.
Special precautions & warnings:
Pregnancy and breast-feeding: Not enough is known about the use of bromelain during pregnancy and breast-feeding. Stay on the safe side and avoid use.
Allergies: If you are allergic to pineapple, wheat, celery, papain, carrot, fennel, cypress pollen, or grass pollen, you might have an allergic reaction to bromelain.
*****Surgery: Bromelain might increase the risk of bleeding during and after surgery. Stop using bromelain at least 2 weeks before a scheduled surgery.
Are there interactions with medications?
Be cautious with this combination.
*******Amoxicillin (Amoxil, Trimox)
Taking bromelain might increase how much amoxicillin is in the body. Taking bromelain along with amoxicillin might increase the effects and side effects of amoxicillin.
*******Antibiotics (Tetracycline antibiotics)
Taking bromelain might increase how much antibiotic the body absorbs. Taking bromelain along with some antibiotics called tetracyclines might increase effects and side effects of these antibiotics.
********Some tetracyclines include demeclocycline (Declomycin), minocycline (Minocin), and tetracycline (Achromycin).
********Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Bromelain might slow blood clotting. Taking bromelain along with medications that also slow clotting might increase the chances of bruising and bleeding.
Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, indomethacin (Indocin), ticlopidine (Ticlid), warfarin (Coumadin), and others.
Sitting in the hospital waiting for my first...
Like everyone else so close to surgery, I'm having difficulty sleeping. I feel good today, though, and had a fantastic upper body workout this morning. I'm up to 4 chin ups. And I can do 4 pull ups if I can kipp a couple. I'm sad that my improvements will be lost with all this time off I'm taking :(. I know it'll be worth it in the end, but it's hard to lose the momentum.
So the surgery will be in less than one week, if...
I do not have all of my lab resuts yet, and I'm also waiting to hear from Kaiser about whether I have to do more mammography stuff or if I can just pick up my results. So far, I know I'm not pregnant and that my CBC and UA are all normal. So now, more waiting (and cooking).
I also just found out that the surgeon recommends following a fluid diet for 24 hours prior to surgery, then fasting the last 12. I don't know if they mean an all liquid diet, which wouldn't include green smoothies, or just that everything should be liquified. I'd honestly have an easier time just fasting the 24 hours, (which is something I do regularly anyway.) My concern is that I don't know how long after surgery I won't be eating, and I don't want 24-hour fast to turn into a 36-hour fast.
Otherwise, things are chugging along here and I'm very positive and excited. When people ask me how I am, I can honestly say I'm doing great, the kids are fantastic, and we are all happy. Novel. Having twins really threw me for a loop, and I'm only now starting to recover, almost 3 years later! We'll see what tune I'm singing after my fitness assessment tomorrow morning.
But for now, I'm singing, "Things are comin' up roses...."
Blah blah abnormal mammogram blah ultrasound...
Sitting under the dryer at the hairdresser and...
It's been extremely busy day. At 7:00 a.m. I had my follow-up fitness assessment. My body fat is about the same, but I've added nearly 2 pounds of lean muscle mass. I gained some fat too, possibly, but since it's all within margin-of-error, it's hard to know. Went from 16.3 to 16.9%, but the test is only accurate to within 4% or so, so yeah. I don't need to worry about my weight more than I already do, is the upshot.
BUT, the good news! Went from 26 (knee) push ups to 40! Went from 46 crunches in one minute to 69! And increased flexibility by 1 inch (sit-and-reach). In two months! I am stoked! On their charts, that puts me at 99th percentile in all but flexibility. Granted, it's non-athletes, but still. Me? Happy. My sub-max oxygen test hasn't improved but it was already 99th percentile.
After I leave here, I have to return to the hospital for another blood test. I haven't even had time to eat breakfast :(. Plus my stomach is upset from nerves over...well, everything!
Okay, gotta go! Later....
*Sigh* Ultrasound revealed what appears to be...
Ultrasound revealed what appears to be a benign tumor called a fibroadenoma. I will have to have a biopsy to be certain, which will likely delay my surgery. I am just so extremely bummed right now, that I cannot even express it. I'm tearing up here in the hospital waiting room. And Dr. Horndeski is in surgery right now, so I can't even confer with his assisstant about it. I am just assuming the biopsy is the way to go because Johnsome went throu the same thing recently and she did the biopsy. So. That's where I am.
(Please go here to read Part 2 of my journey...)
I found out about Dr. Horndeski through RealSelf, in the Ask A Doctor forum. I spent a lot of time looking up information and finding pretty-much only a few raving fans, self-promotion, and other doctors pooh-poohing any new techniques. Since my case is rather dire, breast-wise, I was getting only luke-warm projections for my results from others. Dr. Horndeski's method might be able to get better results. As soon as I spoke to him, I knew I wanted him to perform the procedure (he had me at 'maintain nipple sensation'). Anyway, I hope my result is great and that I can be an advertisement for him in the future!