Treatment Provider

David L. Kaufman, MD FACS
Board Certified Plastic Surgeon
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I have been on real self for quite some time...

I have been on real self for quite some time before I scheduled my surgeries. Originally, I had no plans of sharing my experience on here since there were so many who do. But I find that I experienced some things that I have not heard mentioned (or found mentioned) and believe it would be helpful for others if I share my experience; things I wish I knew. Rather than going over what so many already have said about these procedures, I want to share what was different for me.

Pictures will come in an update. Please be patient.

My story:

I have been overweight all my life. As an adult I have lost 100lbs twice and now a third time at 49. Needless to say, all this weight and weight loss took a toll on my body and I wanted to live my next 50 years differently than my first 50 and chose reconstructive surgery with Dr. Kaufman in Folsom, CA.

Lower Body Lift 11-21-14:

First off, cosmetic surgery is hard for most of us. I wanted to be sure to mention this since there are some individuals who appear superhuman after major surgery.

It was hard for me to breathe deeply after surgery and found that mindful breathing while sitting or lying still really helped to not only prove it’s possible but also loosen up that tightness over time. That being said, I did have problems for the first three weeks when I walked other than in my home. I had to learn to stop, slow down and concentrate.

I also had a problem with dizziness but it was NOT upon rising. It just happened suddenly and it was usually with activity. Couple with that, my stomach muscles when I was active sometimes spasmed making it hard to breath. In fact, I went to the ER thinking that I had a blood clot. I was fine and a bit too active. It was a combination of dizziness, spasms and overdoing as well as anxiety.

I found that I was overwhelmed after my LBL. It was a combination of pain/discomfort, pain meds, drains, lack of mobility, dealing with colitis and constipation after surgery, leaking from incisions and a lot of time spent trying to get comfortable. I also experience an abundance of different kinds of pain and sensations all due to the surgery and healing. I was prepared for the itching and the electrical types of pains, but not for the crawling sensation, painful pinching, pressure, needle like pain as well as tightness of the incision.

If you are like me and unprepared for the totality of a LBL (even though you read everything you can get your hands on), it can be anxiety producing!!!

I had my drains removed within a week after surgery. It was fine for my right side but not my left. My left was slower to drain. When the site closed 4 days later, I began to develop a painful hard lump in my groin. I went in to the clinic and found out it was hardened blood. Thus started 10 days of round the clock warm packs. It worked. But… What also happened is that I developed swelling in my lower abdomen. It was firm, not painful but lots of pressure type discomfort. I waited almost 10 days to see my doctor (I didn’t tell him about this issue until I couldn’t take the discomfort anymore). He was very concerned. It could be several things… some serious and some not so much. Turns out I had a huge hematoma (My drain on the left came out too soon and though it was slow it was in no way done draining). The first draining of the hematoma, he removed 180 ccs of black blood. The next week we drained 100 cc and week after also 100cc.
I waited 10 more days until my next surgery where my doctor, opened up and drained the pocket (which he mentioned was large) and inserted another drain. This drain was removed a week later. So far, so good. I liked that this complication didn’t mean another surgery; it was done with my second scheduled surgery. Originally, I shied away from staging my surgeries and now thankful that I did.

A mistake I made, however, that exacerbated the hematoma, was taking walks after my drains were pulled. Here is why I made this mistake. I had a hard time being still. Sometimes, all’s I could think is that I am sitting on the couch getting soft and fat. I have not heard many talk about this. After concentrating so long on weight loss, having surgery returned me to a former state that contributed being fat and it made me anxious.

A raised toilet seat really helped for the first week, but that is all. The vital thing was a recliner. I just cannot say this enough. Use old linens and towels because no matter how careful you are, you will leak on something.

I am six weeks out and scar tape loosened the tightness of my scar within a week. I continue to use it to treat redness and minimize scaring.

Unlike most LBLs, I lost weight right after surgery: 8lbs. The reason is most of what was removed was a lot of skin, not fat. That being said, swelling in my stomach, butt and thighs are considerable. I saw a dramatic improvement in 2 weeks and more each week. Until I had my chest reconstruction and arm reduction; then the swelling returned to worse than after the LBL. Remember, swelling responds to gravity it will travel to the lowest spot and in this case, it was my butt, stomach and thighs.

After two weeks of stage 1 compression, I turned to athletic compression garments to help control swelling. I have spent a lot of money getting compression garments that fit correctly, are comfortable that provides compression without forcing the swelling to one point.

CHIN IMPLANT/Neck Lipo

I woke up with a great chin and I could not open my mouth, chew well, my bottom lip was thinner and my speech changed. The whole way my mouth set and teeth met had changed. I had an intra oral incision. I decide to do mouth exercises (a, e , I, o u, oo) and did so too soon. Bleeding on each edge of the implant became hard /swollen/painful and I needed to treat with hot packs.

Each week, things changed: my lip thickness returned, speech improved, it was easier to chew and my mouth returned to its usual.

TIME, Patience and not over doing is my lesson and mantra.

I was given a chin sling that consisted of a pad and Velcro straps. It was totally uncomfortable. It pulled out my hair and made me feel like I was choking. I tolerated it for two weeks until I bought another. This new one was made out of a thinner material (was not as hot), had a flexible support and was easy put on and take off. It is the style that wraps around the neck and top of head. I highly recommend it.

Please see my update for my chest reconstruction/ arm reduction post.

Medial Thighs surgery is on Jan 21st.

Male Breast Reduction and Arm Lift

I had this procedure 12/21/14.

My breasts were severely feminized for sometime and especially effected by weight gain and loss. My arms were not as bad as many other's who have had the surgery but they were cause of embarrassment for me.

I had the surgery one month after my LBL. I am thankful I waited at least that long.

Dr. Kaufman did an outstanding job reconstructing my breast to match my body type. Due to the stretching of my areola and the length of the nipple stalk, I needed grafts. The right graft looks good but the left was dark purple when I got a look them a week later.

12 days later, I went to change the dressings and found that my nipple turned black. The dressings were wet. I called Dr. K and feared the graft was failing. I sent him a picture and he assured me that it appeared to be superficial... to my relief. We discontinued compression and resumed light dressings.

When I first saw my left nipple, I was upset because it didn't look well. SOME of this was all the exposure I had to other's posting pictures and questions about necrotic tissue. It gave me the false impression that blackish/purple flesh means necrotic tissue denoting graft or wound failure. I am glad I checked with my doctor; he put me at ease.

Arm reductions require that the arms are held above the heart and the forearms held upright when at rest and as often as possible due to swelling. I have rarely read this report in other people's account. While it may seem not worth mentioning, keeping my arms up for the last two weeks have proven troublesome; especially when sleeping. Thankfully, as I enter into two weeks post op, the swelling has decreased and keeping my arms up at all times is not as needed.

The incisions are especially painful at the elbow and arm pit. In fact, my left incision feels thicker and harder than the right and can become terribly painful with some movements.

As for the drains, they have been left in for two weeks to avoid the issues I had with the LBL. We are looking for a change from dark red to see through orange and drainage less than 25cc a day. My right has just achieved that; my left not so much. As soon as the drains are out, I will wearing a long sleeve compression top and shorts.

It seems that the worst discomfort from each surgery really began to ease up about week 2; of course, this last surgery was much easier the the LBL.

I look forward to my thigh lift on Jan 21st. Pictures to come.

50 year old post weight loss Male Medial Thigh Lift

The surgery was on Jan 21st. I am approx. 10 days post op. Usually, the hardest part of all the surgeries I had is the thigh lift; but, my vote is for the LBL. It's because of the sheer size of the surgery and muscle involvement. I didn't bounce back nearly as fast with that one than I did with the others. But, that is only my personal experience and it can be different for many others.

I have THE MOST AWESOME surgeon and once again my surgical experience was superior... seriously! Between my diet and fitness level and his experience and skill, my results are simply superior. I am lucky enough to have very few complications.

The only complication so far with this surgery is that I had a reaction to the suture tape... and I mean I had a reaction. Blisters and massive incision irritation. I am not prone to tape allergies though I will get sensitive after continued use, but this is not the case. It was a surprise and of course, a cause for concern. But I have a great team and access to my doctor by phone and email and after surgery, it really helps. It relieved me. Stress doesnt heal but talking to my doctor relieves the stress.

For anyone out there who gets this incision reaction to tape there is help in the form of a cream or ointment and will clear it up fairly fast!

I think the only other thing that gave me problems was the ace bandages for compression. The minute I start walking, they start falling off. After the first week, I bought spanx (yeah, I am man enough for spanx) and have purchased athletic knee compression sleeves because the thighs are a bit short on the spanx.

I could drive short distances within a week. And showers are my friend with this surgery. I have a crescent incision on my inner thigh/groin along with a vertical incision running medially. The groin incisions feel better after a shower and I HAVE TOO wear soft andrew christain boxers with the spanx for comfort. Keeping the area dry is a challenge.

Ok I know I said I will post pictures... see below... I posted one! LOL promise will get before and afters ASAP.

Blessings in your Journey,

Mario

Provider Review

Board Certified Plastic Surgeon
1841 Iron Point Rd., Folsom, California
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Overall rating
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I just cannot say enough about Dr. Kaufman! Him and his staff are wonderful. What stands out, is that the staff made it clear to call anytime, for any reason. It's not bothering them and its what they are there for. I for one felt like I was bugging them, or being wimpy. They reminded me, I was not. I was going through an extreme experience which I needed guidance and consultation on and its OK. They would rather here from me about something that is not serious, than to not hear from me about something that could be serious. They are all up beat, professional, personable and knowledgeable. As a guy, I felt really comfortable. My results are astounding and I am still swollen and recovering. I never felt rushed. All my questions were answered. I felt very supported!