44 and After 4 Kids Needed Nips and Tucks (Tummy Tuck, BA/BL + Medial Thigh Lift) - Traveled Internationally from Asia to LA
Hi! I'm a healthy, 44-year old working mom of...
First, due primarily to my pregnancies, my stomach had some laxity. Generally, I could wear a bikini and it was OK, but it was a little poofy...It was mainly in private situations when it was hanging down that I would feel embarrassed. My husband never said anything, but I felt like things could be improved on that front...
Second, my breasts had all fullness of before I had kids. I had always been smallish, but when I put on my wedding dress, there is this big empty space where the bust is. Hope my kids have that additional point or two of IQ that I was promised from all those years of breast feeding!
Third, there was laxity on my inner thighs that was visible when I wore a swim suit and in private moments. Again, I think I noticed it more than anyone else...
Finally, I've always liked to wear sleeveless and shoulder-baring tops, and my upper arms have had minor stretch marks and laxity since puberty, and they've probably gotten worse as I've gotten older.
I've always worked full time. I used to work in the US, but now I live abroad in a developed country. You hear all about medical tourism and how the doctors are great and also cheap, but when I did extensive research in my region (Asia), it was clear that the US is the place to go for doctors with experience and expertise in body-related cosmetic surgery. For me, I'd much rather spend a lot more money (including transportation, accommodations, etc.) to go with doctors who know what theyre doing. That's my background.
20 days ago, I had a tummy tuck, BA with lift and thigh lift in LA. Here are some things I wish I had done differently. If you're reading this, you would, by definition, avoid some of these...
1. Do more research.
2. Take more time off from work and remain close to my doctor's office longer.
3. Not plan any travel for at least 4 weeks after the surgery.
4. Wear the compression outfit without the big hole in the bottom/ tell the doctor to provide a compression outfit without the big hole in the bottom - the one I was put in originally had hooks and zippers on the sides and went down past my knees. There were two problems with it. First, the reinforced hole for going to the bathroom was too large and crossed the area of stitches where the tigh lift was done. Therefore, the edge of the hole rubbed against the stitches irritating that area and prolonging healing there. In addition, the compression garment hole in that area made it so that thigh lift area made it so that some of the stitches were under the garment and the there was a bulge of my thigh closer to my crotch that stuck out of the garment resulting in uneven compression for my thigh lift. Second, the tightness of the compression garment below my knees on my calves was uncomfortable and started to give me a rash, particularly annoying when trying to fall asleep.
5. Ask the doctor and pay for a second compression outfit so that I could have one to wear while washing the other.
6. Ensure a good supply of Neosporin, gauze (bid and small squares and rectangles) and rubbing alcohol and band aids and surgical tape. When strange bonobos appear from having your tubes rubbing against you, you get bruises and scrapes and its bice to just slap a band aid on these and let them heal so you can focus on the real recovery.
7. Buy Milk of Magnesia in advance. I didn't go to the bathroom for four + days and was starting to think I needed to go to the hospital. I can't find MOM here in Asia and sure wish I had some!
8. A more supportive bed with one of those stuffed pillows with the arms that you have in college - wish I had gotten one of those!
9. I wish I had taken more "before" photos.
Now, what worked out well? Most of this was serendipity, btw...
1. Really wonderful caretaker away from all children and responsibilities for about 2 weeks.
2. Really understanding husband who took the kids away so I could focus on recovery.
3. Keeping drains in (this is a tbd) but after having three drains in initially, i had one removed in Los Angeles and I ended up returning to Asia with two drains still in. They are a huge hassle and I hate them. I removed one with my surgeon's approval at the 2 week mark. I still have one in.
4. Having one of those name badge cords/ necklaces you get at conferences to hang my drains when I shower or change clothes.
5. Putting Neosporin on weird boo boos, scrapes and rashes that have developed on my abdomen around the top of my rib cage where the top of the compression garment rubs or by the ends of my thigh lift stitches.
6. Buying this oil changer funnel for $1.19 from Walgreens that I still use to go #1.
7. Getting my toes pedicured right prior to the surgery so they make me happy whenever I look down at my tummy :)
8. Taking a 2-4 hour nap in the middle of the day for the first week - turned off all phones, etc. also wore ear plugs at night.
9. Washing hands religiously and using alcohol whenever going close to my stitches or drains.
10. Still on antibiotics until drains are completely removed. No infections (knock on wood).
11. Not going out. I went to work one day after 2 weeks and decided to work from home after that so I could lie down, wear a loose t- shirt, sit on the toilet for an hour to wait for a miracle, etc. I've read a lot of doctor responses saying you can return to a desk job after 10 - 14 days. My experience is that that is not realistic. If for no other reason, it takes a while to get in and out of the compression outfit if and when you go to the bathroom, and you don't want it touching the unsanitary floor or walls of the public bathroom. Also, it hurts / is uncomfortable to sit down and get up, and if you're like me, I'm still hunched over because it's uncomfortable to walk straight up from the tummy tuck. So save yourself some grief and don't push yourself to go to parties or restaurants or the office too early.
12. Letting my kids know in advance that I had a big boo boo so they couldn't jump on me or hug too hard.
13. Drinking lots of water.
14. Using suppository laxatives for the first five days.
15. Video recording the nurse and doctor when they were changing bandages, milking drains and removing drains so I could do it myself later.
16. Picked a surgeon who responds to email immediately so I'm not fretting...
17. This one is my favorite. I asked the doctor for lives references so that I had someone to talk with before and after the surgery. My contact was a great source of support!
Photos are of:
1. How I look after about 16 days post surgery. Still is strained on right leg so that's why it's bent. Also, breasts look uneven because I'm holding the iPad.
2. The handy funnel I bought.
3. The second drain that we (mainly my husband - how romantic!) removed ourselves. Yes- those things are long. From th black stitches all the way to the end of the white rectangular rubber is all inside the body!
Will post more updates and photos later.
Why I Traveled 10,000 Miles to Get PS in Los Angeles - The Good and Bad of Traveling for Plastic Surgery
There are lots of considerations of doing this. You have to have a place to stay. Using AirBNB or something like that is really great and can be cheap and you have access to a kitchen, bath, etc. If you go to a place like LA, there are cheap options. This can actually be a blessing in disguise - you can choose a place close to your surgeon and easily see your surgeon in person if you need to.
You also have to have a caretaker. You basically need someone who can help you get up, walk around, help you with the bathroom (thankfully, not wiping, though that's a challenge, too), and buying you meds, supplies and food (and preparing food) when you need it. If you're going to LA, there is a high supply of service sector folks, and the cost isn't that exorbitant.
In many ways, having this cocoon of time and space to be alone and to recover is ideal, if you can afford it financially and from a time-away-from-family-and-work perspective. Just doing the basic things like going to the bathroom or trying to put your compression garment on are somewhat undignified processes that you may not want your hubby or kids seeing you do. Being by yourself, you can limp around mid-bathroom attempt with your compression outfit half off trying to get that People magazine realizing that you'll be on the toilet for a lot longer than you originally anticipated. As opposed to (now that I'm home with my family) being called upon and having the bathroom door opened about four times while trying to get the trains moving down below...During the first few days, I must have peed all over myself, the bathroom and my compression garment at least once a day. The process of removing the garment, washing the garment, drying the garment, putting the gauzes back on the body, milking/squeezing out the drains, etc. putting the compression garment back on - took about 2 hours. Now - with three kids - I can't think of one situation when I've had two hours to myself without being asked to do things for the kids. Being by yourself (and your caretaker) is just a lot more...civilized. Also, I don't know about you, but being able to ask someone else to take photos of places I can't see (and not have it be my husband) is a blessing, since at the end of the day, part of this process was to increase the "romance" in my life...
Another bonus is that I was able catch up on lots of movies I've been wanting to see for a long time. Since it hurts like crazy to laugh, I have to say that I busted a gut laughing at some of this - but comic humor is good, also!
A final consideration is there's the travel back to wherever you're coming from. For me, having a 24 hour flight back home, it was critical to have an upgraded class for travel. But if I were going less than 4 hours or so, I could have done it in coach. Sitting is somewhat painful, but the meds make it bearable. I've seen questions about traveling by car for a few hours vs. traveling by plane for 1 hour. Honestly, as long as you've had at least a week of recovery time, probably either is fine. It's getting up and down (from sitting position) that hurts a lot. Also, going to the bathroom is challenging. So whether you're driving (hopefully, it's not you doing the actual driving), you're going to be uncomfortable while sitting and trying to go to the bathroom.
If flying - getting wheelchair assistance curb to curb was essential. I called the airline in advance and got their reassurance. Limping slowly into the terminal made it easy for the people at the counter to come running toward me asking me if I needed help. The manager of the check in counter personally wheeled in my 200+ lbs of luggage and took care of me. The airport wheelchair assistance took care of all of me and all of my carry ons (which included a garment bag and huge carry on). They were all very service-oriented. You get to short cut all of the lines (although sometimes it takes a while anyway).
Hope this helps for those considering traveling for surgery...
Last Drain is Out! Bride of Frankenstein is Feeling Less and Less So...
It's been 3 weeks and 4 days since I had my tummy tuck, breast augmentation and lift and thigh lift. Since I didn't do it before my surgery, I now read realself at night on my iPad trying to get to sleep. I think that if I had known all the complications that can arise, I would have chickened out! I have to say, I think that it takes a lot of courage for those women who have had complications to share everything - their emotions, their feelings about their decision, etc. It's a big decision, your body is really important, how you feel about yourself...
So I didn't take many "before" pictures, but I dug up some befores that I had sent to doctors when I was first looking into this. I had always thought that my body was "cute" and attractive - a little worn out from life and pregnancies - but cute enough. Fortunately, my husband agreed (or he said he thought so). Just today, he was telling me that my body was really cute before, and that he's looking forward to my new body, also. (What a champ!) Then, I looked at my old photos, and thought - Oh my God - I had some serious droopy and lopsided boobs and muffin top. Is my husband delusional (or an amazing liar) or just really really really nice? Believe me, I'm not an heiress or anything, so he really doesn't have to lie. It's a good thing I believed him and that I didn't spend a lot of time looking at my own pictures, because I would have been a lot more self-conscious! Here are some before pictures, and then the ones in the bikini are the afters. Bear in mind, for those of you who have visions of Jo-Lo or Kim Kardashian dancing in your heads - that I actually like my square-shaped body, minimal bust and flat butt. (My husband loves those big butts, but that's just not me...) So I had to repeatedly tell Dr. Hughes about that - and he kept his promise to not make me something that I'm not...
Also, the big news is that I got the doc's OK to pull the drains! Again, I can't say enough about Dr. Hughes' responsiveness. I write an email, and I usually get a response within a few minutes (I'm in Asia, so I'm not usually writing during California business hours when he's supposed to be working). The email goes directly to him, so there isn't a gatekeeper receptionist who slows down the response time.
Other than that, breasts and tummy are really getting there. I started massaging my breasts last night, and not only is it kind of fun, but it does make a difference in how they feel in the AM. The thigh lift incisions are still healing. I'm still moving slowly. Worked like a demon this past few days trying to meet a deadline. Came home one day and literally collapsed on the floor and was crashed until I heard one of my kids in the kitchen. Re. travel - I ended up canceling three trips (Cambodia, India and Hong Kong) over the past two weeks because I underestimated recovery time, and the last thing I wanted was to be the dumb American who had to be medi-vac-ed out of Angkor Wat because her plastic surgery stitches split open.
Looking Ahead - and Some Clarifications
I looked at my instructions from Nurse Olga, and I actually started to massage my breasts 2 weeks ahead of schedule, so I'll postpone that process a week or so.
I'm feeling great - this is the first day that I'm cold turkey - off of pain killer and antibiotics! No sweat.
Also, I updated the price that I paid for the procedure - originally, it was $20500, but that was not only for a mommy makeover (breast augmentation, breast lift (and apparently breast re-pointing) and full tummy tuck) but ALSO medial thigh lift. The thigh lift was another few thousand - but then there was a multi-procedure discount, so hard to get the exact itemization...
For posterity, I believe that I had silicon 325s put in me - I could be completely off, but that sounds right. Apparently, they don't make saline that small... I lost the tags for the implants... Also, I seemed to have actually gained a pound or two since surgery. My husband decided to donate our family scale to his office where they are doing a weight loss challenge, each participant pitching in $500 and the winner taking about half of the prize. The rest will go to a steak and margarita dinner for all to celebrate their triumphant efforts. Only problem is, according to my husband, everyone has actually gained weight. I told him to bring back the scale...
I read some items about "what do you tell people?" I tell nobody nothing! Only my husband knows. Everyone else knows that I had surgery to deal with "female stuff." So that'll get nearly everyone, especially senior management, off your back! Even my kids know I had surgery, but it's "sort of like that (hernia) surgery daddy had..."
So - in a few days I get to graduate to having to wear regular Spanx (as opposed to super tight ones) and then in another two weeks, just Spanx during the day and nothing at night! Woo hoo!
Since my husband and I have spent about 1 or 2 nights together during the past 6 weeks due to the surgery and our work travel, there are some, errrr, things happening. Like my husband decided to gift himself with a present (see Ducati below). I told him he'd probably get to ride her before his other gift (sorry hun, doctor's orders). And I'm planning for my personal coming out party. Choices behind door #1: Maldives. Door #2, Tioman Island. Door #3, Sepang...
Medial Thigh Lift Update - Healing! :)
I've read Q&As about doing a tummy tuck, breast lift and augmentation + medial thigh lift in the same surgical procedure. Most doctors responded from the doctor's perspective, saying it's best to do it in 2 separate procedures since the multiple procedures can result in a longer surgery time so that's more time under the knife, under anesthesia and puts you at higher risk. All makes sense. I would guess the most important thing is going with a surgeon with lots of experience doing the procedures at one time.
From a recovery perspective, from my experience, I had the tummy tuck, breast augmentation and lift and medial thigh lift done at once. I think that my total recovery time is taking about as long as it takes to recover from the single procedure that takes the longest to recover from: the thigh lift. The incisions for the thigh lift are in a place that gets a lot of action (not like the breasts which were fine immediately or the tummy tuck which just sits there). It's at a joint that gets movement incessantly (like trying to heal an injury on your knee). Also, it's right where you go to the bathroom, so there's no avoiding that. The recovery is tough, no doubt about it. I'm relieved that I got the surgeries done at once.
I've been extremely fortunate to have had no complications - and my heart goes out to anyone who has encountered any - because God knows, just recovering is hard enough!
I was concerned about blood clots. I've read that the chances of developing blood clots is higher with thigh lifts and also with multiple procedures. I guess that's one reason why I went with an experienced surgeon. I know that there are a lot of great success stories from traveling outside of the US, but it was very important for me to get the surgery done in the United States. These are serious and complex surgeries. The medical standards, regulations and certifications are much more stringent than anywhere else in the world. And having had family members who have tried to get into med school or pass the boards in the US (and then have gone to the Caribbean when they failed in the US) - I just couldn't take that kind of risk. (Believe me, I'd never want my cousin performing surgery on me!)
Moving around after the surgery and walking around during my long 24 hour flight back home - 11 days post op were also things I did. Finally, keeping the drains in (even though they were a MAJOR pain), taking the antibiotics as long as the drains were in and being religiously clean with rubbing alcohol - probably helped ward off infection. Again, I don't know if any of this had any bearing on not having any complications - but I'm glad I followed my doctor's advice.
Finally, it's been reassuring having chosen a surgeon who is extremely responsive whenever I have a question post op. I happen to live half way around the world from my surgeon. But even if I lived in the same town, when you go through this, you have all kinds of inconsequential questions you want to ask and not feel like you're bugging someone. Dr. Hughes responds quickly and decisively with specific instructions on what you should do - regardless of whether it's the weekend, before 9AM or after 5PM. Clearly, his work and his patients are very important to him. So I was impressed when he was available to talk with me live when I was interviewing doctors - but that shouldn't be surprising - he's trying to win my business. (And anyone who is unresponsive during the marketing/sell phase should be a red flag! Imagine how responsive they'll be when you're having an emergency problem after the surgery! And even worse - what if you're having an emergency problem and they're not in the US and therefore aren't subject to US liability???) Dr. Hughes has been great with answering questions before, during and after the surgery date.
One correction - finally found my breast implant tags, and they are Natrelle Allergan 234 ccs.
Good luck to all out there.
Six Weeks Post Op
- Ditched the compression outfit (is there a place where we can donate these things???)
- Ditched wearing a bra at night
- Traded off Bio Oil for scar treatment with silicone gel strips
- Got a tiny granuloma (where the last drain had been) lopped off and stitched up by a local doc
- Snipping off suture knots I see as well as any I can feel right below the surface (even though they're dissolvable, until they dissolve, they're annoying...) - helpful Olga had given me pointy tweezers and scissors with a hook on them and my OCD loves them...
- Got the hubby mandate to toss and replace my "granny" underwear with a "no limit budget" but now find that my pre-kids La Perlas fit fine (did not seem to object to/notice that they were not new) - as the mother of three boys, I say without disparagement: men are so simple
- Booked a few beach adventures (Langkawi, Malacca, Bali, Krabi) - kids are dying to go to the beach and surf - but pledge to be covered up (lest scars become permanently dark - don't want that!)
- Started to exercise - man, I'm a tub of lard! - goal is the Angkor Wat Half Marathon in December
On the horizon:
- Underwire bras - can't wear until 6 months post op
- Scars fading - like waiting for a pot to boil
- Being more healthy in earnest - my husband has begged me to eat more healthily and exercise more; I should take as a compliment that he'd like me to kick around longer...
Conflicted: I think I have knots under some of my scars that are too imbedded for me to dig out. They are mildly annoying. Don't know whether I should (a) leave them alone - "they'll dissolve eventually in as long as 6-9 months," (b) massage the scars in line with the theory that massaging bumpy scars helps them heal and flatten out more quickly, (c) try to dig them /cut them out of the skin and cut off the knots - there was some doc commentary about desirability of removing pesky knots under the skin... (d) other? I'll ask Dr. Hughes...
Photos of where my daughter and I will spend next week and how things are shaping up at 6 weeks post op; you'll see silicone gel tape and bandage where granuloma was removed.
What I liked about Dr. Hughes: 1. Tons of experience on multiple types of procedures and knows what he's doing 2. Lots of examples of his work 3. Lots of accolades from real people who can attest to his results 4. Doesn't just do one body type or desired body type. For example, I'm a smallish person with a boyish figure. I didn't want to become a bombshell. He respected that and didn't try to convince me to become something I didn't want to become. There are a lot of his patients who want to become bombshells, and he's obviously good at that, too. 5. He listens to what you want and does it. For example, I said I wanted a breast lift. I exchanged emails with Dr. Bruno, who was very nice. But instead of hearing my needs, he recommended that with the bigger breasts, I wouldn't need a lift. Which is not what I wanted... 6. At the same time, Hughes doesn't stay silent if, based on his experience, he'd recommend something else for you. For example, I was interested in an arm lift. He advised me against it and said the scars just wouldn't make it worth it. He said he'd keep the option open and see me in person and reevaluate. When he saw me in person, he confirmed his initial thinking. Also, though he knew I wanted to remain with modest breasts, and I thought the absolute smallest silicon implants would be good, he recommended going one size higher, and I'm glad he did. I'm glad about both of his recommendations. 7. He's incredibly responsive and isn't a "9 to 5er" or "Monday through Friday" type in terms of when he'll talk to you or respond to your questions. When you're going through this, it is all consuming, and you have urgent questions that you really want advice on. Dr. Hughes responds quickly and gives definitive answers. 8. He seems to like what he's doing and care about his patients. When I returned home after a 24 hour flight from LA, I had an email from Dr. Hughes in my inbox asking if I got home safely. That was even before my mom's email! 9. No sweat. He accommodated my schedule for the surgery, pre-op, post-op, etc. In my last visit, I thought, why not get some Botox for good measure? No problem! 10. The results! I almost forgot the most important item of all. I was waiting to make this review until after I had a sense of how the results were turning out. I'm now 3+ weeks out, and I'll say that I'm really happy with how things are shaping up and how I'm looking. My tummy stretch marks are gone. My stomach is flat and tight, and the incisions are healing well. My breasts look great and exactly how I wanted them - better cleavage for wearing bathing suits and certain kinds of evening clothing but not an obvious difference when I'm wearing regular clothing. And the incisions on my inner thighs from my thigh lift are healing, and my thighs look much tighter and sleeker. Equally important, I haven't (knock on wood) had any complications. Hughes told me to keep the drains in, which I think are a big hassle and I hate them, but he warned me of the repercussions of taking them out too soon (the wound opens up and you need surgery again) or seromas which would then require a doctor to aspirate via long syringe) and I followed his advice and am glad. I'm still on antibiotics as long as the drain is in. At the 3 week mark, I turned a corner, started to see past the incision marks and the drain still coming out of me, started to realize that I'm going to have the body that I envisioned (even better, actually) and also started to feel much better physically. Great doc - thanks, Dr. Hughes!