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BR/TT - Philadelphia, PA, 6 weeks post op!
- updated 1 year ago
- Worth It
- Cost: $6,300
- Joseph DiBello, Jr., MD (Philadelphia, PA)
Will write more soon...need to sleep now ;-) Cost...
- 18 Jan 2012
will write more soon...need to sleep now ;-) Cost reflects that the breast reduction was covered by insurance. Planned this for 10 years, but didn't think I would have a tummy tuck since I thought BR would not be covered. Saved for 10 years and when insurance came through, I had enough to add the abdomioplasty.
After twins, weight gain and my final weight loss journey, I decided I was worth it. Soooo happy and only 5 days post op. Am so thankful I found this site and the wonderful women who have been so supportive and informative.
Ok, a bit more detail. I first checked into a...
- 19 Jan 2012
I had no monet at the time to have it done. So, I told my husband I would start savign and not have it done until I was down to 125 pounds and maybe wouldn't need the reduction part. During the next 10 years, I put away $ every month, but slowly yo-yo dieted enetually ending up at 170 pounds last January. Iwas an emotional mess, not a good mom, had no feelings of self worth, didn't want my husband t see me, much less have intimate relations and my marriage really started to suffer. I turned to food and my nightly wine or cocktail for solace. I also work at a cooking school, so food was the center of my life and cooking the only thing I felt I was good at.
Last January, I decided I had hit rock bottome. I told husband I wanted a treadmill for my 50th BD in Feb and wanted to make a positive change. He was worried aboutht einvestment (I wanted a decent one) and that I would follow my usual pattern. Start something, loose interest and the TM would sit there and gather dust.
Well, being the wonderful guy he is, he agreed. I started using the treadmill lightly in early Feb., got a terrible cold, stopped a few weeks and really got moticated in MArch. I had lost about 3-4 pounds. In April, I learned about a program through Rodale Press called the 400 calorie fix (I think Rachael Ray had tried it and promoted it on her show. I bought both the program book with recipes and the subsequent cookbook. You basically paln your meals around 400 calories. aiming for 3 to 4 meals a day (1200 to quick start and then 1600 calories). I was able to really stick with it since I never felt deprived, keeping up the treadmill. I added more activities like swimming in the summer, walking dogs at park and made a deal I could have a glass of wine only on the days I exercised at least 40 minutes.
By October, I was down 25 pounds and made an appt. with the PS one of my local friends had recommended. I was so shocked when he told me we should be able to get our insurqance to cover the breast reduction, which was also a lift!! Over the next months, we (the billing woman at PS who is a wonderful person) and I did all the hoop jumping the insurance company required (of course I have the company with the most strict and difficult qualifications). Finally, a ltter from an orthopedic doctor documenting my weight loss, upper back and shoulder pain, etc., etc. got the job done.
So, when I first saw PS, I started to ask about the TT, since I had lost 25 pounds and the belly looked almost worse! I decided if I got the BR covered I would also do the TT, since I had enough money saved. My husband was very supportive, even though I thought he secretly wanted a new patio with that $ I saved!! I think he will end up appreciating this a whole lot more ;)
I got the call Dec. 30 that it was approved. The PS knew I needed it done in early January due to the fact I had to be back at the cooking school by Feb 6, so they had Jan. 13th open. I jumped at the chance, put the check in the mail that day and things started to move FAST!
I had pre-admissions testing that following week, then my pre-op with PS two days before surgery. Luckily, I had called earlier to find out what meds I couldn't take, what garments I needed, etc., etc.
I never saw any pictures of my PS's work. They do not offer, was not on website and I felt wierd asking. I had seen my friend's results, but went to that appt. expecting to ask to see just a few examples. I actually chickened out. It felt ungrateful since the office had worked so hard on my behalf. I later found they would have gladly showed me some, but I put my faith in my doctor.
I was very worried about fat pouch above BB. PS said he coulod thin that as much as possible and it would be more evenly distributed over my entire abdomen. He was so goos about setting realistic expectations, assuring me he would do his best and telling me he never goes into a asurgery thinking hewill go have to do more later. He did say he couldn't o lipo in that area because all the cutting. Nerves and tissue could have been sucked away with the fat and it was just too risky. I can go back later for a touch up with lipo in that area if need be, but I really don't want have to do that and felt I don't need perfection...it would have to be so much better than what I had now!
I left for the hospital at 5:00 last Friday morning. I drove myself the almost 1 hour there so my hubby wouldn't have to make 2 round trips that day and could drive down to meet me after and he could come with my Dad, and I could see both their beloved faces and that's how both cars would get home.
Arrived at 6:00, went into pre-op at 6:30. The nurses were great. I was oddly calm at that point. Of course I had gone through a freak out of leaving the kids if something happened, feeling guilty, scared, selfish, etc., etc. But talking with my son and calming his nerves the night before helped calm me, too. I even slept 6 hours the night before surgery (amazing since I hadn't slept more than 4 any night for a week before surgery!)
I was worried about nausea, since I have had several bad experiences with that in the apst. I actually vomiited on the operating table as the twins were being delivered via c-section. Then, the anti nausea medicine (copazine) gave me a terrible reaction. I tremored violently for 3 hours after delivery. To the point my muscles were in agony and I couldn't talk or hold my babies. The anesthesiologists were very responsive to my concerns and my PS ordered zofran under my tongue 1 hour before surgery. My next fear was the IV. I have had BAD IV experiences and learned the reason is rolling veins. A nurse called for an anesthes. nurse to do the IV. She gave me a little numbing shot and decided to put my IV port in my inside elbow area. She got it first time and I did not feel it. Could have kissed her!!
Next, my PS came in and got out the Sharpie. As he marked my breats and belly, I asked about the bromelain and arnica I had read about here and he was very positive about their benefits. So, it was time to go in. They gave me a little IV sedation to calm me. They warned me as we went in the OR that it would be cold. OMG, it was freezing in there. All to keep germs at a minimum, I am sure. I joked they should all wear long johns. Luckily, they did not make me stand and bathe me. I would have froze. Have since read some have that done. Iuded the hibiclens (that of course I heard about here!) the night before and morming of. They put some oxygen over my face, told me what it was and then said I would soon be going to sleep. That was it until I looked at the clock in recovery at 1:45 (so surgery was from about 7:45 until 1:15). The PS came out to see my hubby and dad at 1:15 to say all had gone well and that they could go up to my room to wait for me.
My PS and anes. doc were first to greet me back to the world of the awake and both said I did great. I asked PS how it had gone and he said "really well, I think you will be very pleased". Music to my ears. No nausea and I was sure to thank the anes. doc for that! I was so glad to wake up, know I had come through fine and now I was "on the other side".
I went to my room about 2:15 and had a nice short visit with dad. The dear guy is 83 and was very happy to see his "little girl" awake and doing well. Hubby stayed for about 2 hours and I sent him home to be with the kids.
I loved the delaudid pump in the hospital and was able to eat a little ice cream at about 9 pm. Biggest discomfort was dry mouth I couldn't relieve except by having an ice cube in my mouth at all times. And, my throat was a bit sore and raspy from breathing tube. That and the catheter were inserted after I was out. I
I slept alright, remained comfortable and got the cath ou the next morning after PS saw me. He though everything looked good and exaimined all incisions. He brushed gauze against each nipple to see if I had sensation, which I did in both.
Was able to pee and left hospital about 3 pm. Drive home was the pits. Hard to get in car. Dear hubby didn't think and brought his stick shift, bumpy older CRV. 50 minute ride home was bad. Felt nauseous and every bump. In hindsight, should have asked for anti-nausea meds before the ride. Made it home with no vomitting.
Day 2-3 were a bit difficult. Just ouchy upon getting out of my propped position in bed. No appetite and hard to get in a comfortable position. Was worried about my large dogs jumping on me. They calmed down pretty quick and we bought an extra crate so they can sleep in those at night and I don't have to worry about them jumping on the bed. May be a permanent thing!!
Was nauseous Day 3 and 4, but more food helped that. Day 5 went back to PS and had drains removed. He was pleased with progress and gave me some directions to resolve lack of BM. Poor January tummytuckers forum had had to endure my trials and tribulations over last night and evening, but glad to report everything is fiannly working properly. That was the worst part so far. Next worst was coughing fit and sneezing last night. Tried to be off vicoden and just on tylenol and a little valium, but resorted to a vicoden after that episode.
Posted my pre and post-op pics last night. Haven't received any feedback yet, but the improvement to me is nothing short of miraculous. Jokingly saying I am afraid I might start flashing my smaller, perky boobies to people at the grocery store ;0
a FEW FRIENDS CAME TO SEE ME, ONE A NURSE AND THOUGHT i SEEMED GREAT AND LOOKED AT MY BELLY AND BREASTS AND FELT THEY WERE GOING TO TURN OUT REALLY WELL. wILL BE 51 IN fEB, DON'T THINK a bikini is appropriate at my age, but may have to get one just to look at myself in it occasionally.
Have lots of swelling, some bruising in breasts and along flanks where liposuction was done to contour my new belly into the sides. That's a bit ouch. Hoping my saddlebag swelling in upper thighs goes away soon.
I loved my PS and every person at his office. They have all been wonderful. Am especially grateful to my husband and friends who have brought meals, my kids who are trying to not fight so I can rest and have been doing some chores without the complaints, my Mom and Dad for moral support and the wonderful women in this forum. I would have been so much less prepared without you and have received such wonderful support, information and care. THANK you!!!!!!!
Just want to apologize for all the typos in my...
- 19 Jan 2012
Thinking we should all post pics of us in our...
- 21 Jan 2012
I am adding a new post because there have been a...
- 22 Jan 2012
I was concerned before TT/BR about constipation since a friend of mine said that was the worst part for her. I started drinking tons of water 3 days pre-op (plus I always am a big water drinkeer). Also ate 35 plus grams of fiber per day including prunes and figs. Started sennakot S day before surgery and hoped to go morning of...no luck. I took sennalot S in hospital, but I was alone when PS gave me my discharge info. He said to take BOTH sennakot-s AND dulcolax (2 tabs sennakot, 2X daily and 2 tabs dulcolax, 1X daily). I thought he said "OR". Came home day 2, drank LOTS of water, ate yogurt and not much else and took the sennakot. When I went to post-op visit day 6 and told him about no BM, he asked if I had done both meds, and of course I said no. He suggested at that point to take two dulcolax when I got home and use a dulcolax suppository. Tried that, held suppository for 20 minutes as directed, no luck. By then, I was feeing VERY uncomfortable, crampy and my anxiety level was so high!!! How hard should I push, could I hurt anything, etc. Called PS office and asked if I should do an enema. She said that would be too aggressive and to give it a little more time. About 1 hour later, things started slowly. Then another hour after that I had a little more with some moderate pushing. Then...all hell broke loose (lol). and I was in the bathroom all night with diarrhea. It was tiring and I had painful cramps. But I felt better the next day!!! Oh...and I had eaten prunes from day 3 through 6. In retrospect, should have been taking a softener AND a stimulant together or used Milk of Magnesia (which many on this site swear by). Now off vicoden (a big culprit for BMs), but on some codeine cough syrup for cough (also constipating). Now taking stool softeners 2x daily, 2 tabs (sennakot-s), 2 dulcolax orally, eating prunes and drinking TONS of water). Still feeling like I might have another problem (went a little Day 8, but no luck today and I am eating normally now...actually I have been ravenous). If no luck tomorrow will use another suppository with my 83 year-old dad's advice which was "hold that sucker in there for at least an hour, don't listen to the 15-20 minute directions". Now, he has experience, let me tell you! SO, I will hold it laying down as long as possible and believe me it will get uncomfortable. But, I want to avoid letting it go so long again. Hope that helps anyone having problems. Your doc may recommend something else. This was the worst part for me. I am always so regular, cuppa joe in the am...straight to the bathroom. I like it that way. And, who wants to worry about damaging any of the work that has been done on our new tummies (I asked my PS's nurse and she said that could happen so do not push too hard...but what is too hard??? SO, DO NOT "STRAIN". Just enough pressure to get the "job" done, or get up and wait awhile. TMI, but that's what this site is for, right. Hope it helps!
Forgot to mention "Smoothe Move" herbal tea. ...
- 22 Jan 2012
OK, quick BM update/revision. I felt very...
- 23 Jan 2012
Day 11 post op and I am feeling wonderful! Off...
- 24 Jan 2012
Started taking armica montana a few days ago (ps said 5 tablets twice a day, a little different than other dosages I have read) and I think that is helping with soreness. Still taking bromelain, 500 mg 3X per day for swelling. My upper thighs are no longer swollen. Belly is a little and am hoping my one breast which is more brised than other is also more swollen than the other, accounting for the difference in size. Still worried about being noticebly lop-sided!
Will start to drive tomorrow or Thurs for short distances, since I can get in and out of car with no major discomfort and am off pain killers during the day and only take 1 valium at bedtime.
Also planning on getting on treadmill for a slow pace for 1/2 mile today. Doc wants me walking and it's cold out and there is only so many times you can do laps around the house.
Go back to work (just cooking school, no house cleaning!) in early Feb. and think I will be fine to do that by then.
Still loving all the support from this site. Anytime I have a question, think something is a little wierd, funny, etc. I just post it and get lots of helpful feedback. SO glad I found Realself and the January tummy tuckers forum.
Have my next Dr. appt. Feb 1st. Planning on posting more pics, soon.
Had my 17 day P.O. appt. today and got all...
- 30 Jan 2012
Great day, more shopping for tops that will now...
- 3 Feb 2012
Ooops, just saw I wrote outtits instead of...
- 3 Feb 2012
First night back at work tonight. Work 3X a week...
- 6 Feb 2012
I am adding a post I left for a member on the...
- 12 Feb 2012
"Congrats, Finally! I, too, was told by someone 10 years ago that my insurance co. would never cover a BR...it was a plastic surgeon, my first consultation. I think he just didn't want the hassle of dealing with the paperwork. So, I did not have the money needed and saved about $100 a month and promised myself when I got to a certain weight and had saved enough, I would have it done.
Well, I gained steadily over the next 9 years. I had breastfed my twins (one for too long, lol) and my breasts were so large for my body and so ugly, I think I was very depressed and had such a low self-image. It also affected my relationship with my husband since I was so ashamed of my body. As I gained, the size and position of my breasts of course worsened. Then about a year ago, for my 50th BD, I asked for a treadmill. My husband was nervous, since I was a couch potato for many years and he was afraid it would sit and gather dust!! I began using it and as I did, I felt better mentally and had more energy (I started slowly, then slowly added to my distance and speed and eventually ended up even running!). By then, I started tackling my eating issues and lost 35 pounds over the next 7 months (went from a 38DD to a 36DD and had been a C cup at this weight before I had kids). I was very close to the weight I wanted to be when I decided to get a BR (I had raised this weight from 10 years ago to a number I knew was more realistic for me to maintain long-term and still enjoy my life...I work at a cooking school, enjoy cooking and having a glass of wine or two. I can't imagine food not being an important part of my life...I just learned more about portion control, making better choices as far as adding more veggies and whole grains, logging my calories and, most importantly. making exercise a part of my daily life.
So, I went to a plastic surgeon a girlfriend recommended. I walked in with the expectation that it would not be covered by insurance. After he took measurements, etc. he felt certain my insurance would cover it. Because of my small frame and the degree of sagging, the DD's were too much for my body. The shoulder and back pain, grooves in shoulders, infections under my breasts, having to wear two jog bras to exercise, etc. also played a roll in his determination. So we started the paperwork and found that my insurance is one of the worst in this area.
Over the next 2 1/2 months, the PS's wonderful billing person stuck with all the "hoops" we had to jump through and so did I. Finally, the insurance co. requested a letter from an ortho. doc (I had already requested and letters from my primary care and gyn. physicians had been sent) stating it was a medical necessity and proving that at least 6 months of conservative therapy (core strengthing, exercise,weight loss, muscle relaxants, anti-inflammatories,chiroprators, etc., etc.) had not worked. My family doc recommended a wonderful ortho. doctor and she agreed to examine me, knowing that I was seeking a letter from her to aid in getting insurance company to cover my BR. She did a complete exam, took x-rays,etc. and said there was no way my insurance should not cover it. She wrote an amazing letter explaining my weight-loss, exercise, that muscle relaxants were contra-indicated (I have 13 year-old twins to drive around, that a lower spine curvature that could be worsened by a chiropractor contraindicated this type of treatment, the fact I had taken anti-inflammatory meds for years, wore two jog bras, etc., etc). She also explained that the pain from my arthritis in my lower back had improved with exercise, weight loss, core strengthing, etc., but my middle and upper back had not and worsened as the day wore on. Finally, she asserted that in her opinion, a breast reduction was a medical necessity.
The billing person at the PS received her letter, and mailed it to the insurance company along with a receipt for three very expensive sports bras I had purchased two years ago(they would not allow faxes!). 2 1/2 weeks later, they claimed not to receive these items! She convinced them to accept a fax and told them their policy to take another 30-45 days to review the additional info. they had requested was ridiculous. I also called the insurance company to complain as did my husband (his employer contracts with this insurance provider). They finally agreed they would "try to expedite" it. This was Dec. 22 and I knew I needed the surgery to happen by mid January at the latest, since I had to be back at work on Feb 6 at the cooking school (we had the month of January off).
We got call on Dec. 30 from the PS office that it had been approved (yeah!! I sent a thank you letter to the ortho. doctor that same day!) and the PS had an opening on Jan 13. I decided since I had saved a significant amount of money that I would also have a tummy tuck at the same time (the excess skin on my belly from carrying twins and my yo-yo dieting was not going to ever go away with any amount of exercise and weight loss!). I had my surgeries on January 13th and would do it again in a minute. My breasts are now a perky small C cup and finally proportionate to my small frame. I was most excited about the BR, but am also very pleased with the tt, although from a recovery standpoint, the tt has been much more painful and difficult.
I am going to add this super long post (sorry I rambled on, Finally) to my review so that people who might see it know that if one doctor says insurance won't cover it, see someone else. And, if your insurance company denies you or makes you jump through hoops...do it!! And, choose a PS that has someone who knows how to work with the insurance companies and stays on top of the situation and is persistant. I guess I owe that PS from 10 years ago in a way. I wouldn't have saved enough money to allow me to have the TT with my BR. But, I would have had 10 less years of pain and a low self image.
Never think you are "too old" to do this for yourself. Sure...it makes you look and feel better about your body...but it is also a medical issue. I have had NO middle/upper back pain or shoulder pain since my BR. I will be able to exercise so much easier. Congrats, Finally and for anyone reading this who is wondering if their insurance should cover this...if you have pain...pursue it to the max!!
Adding some photos 32 days post op. Belly button...
- 14 Feb 2012
Feeling so much better about my body today. I...
- 15 Feb 2012
Posting some new pics today. Changes I see are...
- 23 Feb 2012
Heading out today for a consult on getting my...
- 27 Feb 2012
I had my two month follow-up today and everything...
- 12 Mar 2012
My Doctor: Joseph DiBello, Jr., MD
I only saw two docs, and Dr. DiBello was the 1st. I was amazed when he measured me and told me I should qualify for insurance coverage for breast reduction, given my size, frame size and symptoms. Turned out I have THE WORST insurance company for getting this approved (Horizon B/C B/S of NJ). The person in his office that handles this was WONDERFUL. I cannot say enough about how she stayed on top of the process, kept me informed, instructed me on each hoop they wanted me to jump through, etc. It was several months and she was with me every step of the way and if not for her (and a great orthopedic Dr. I saw who wrote an incredibly effective letter on my behalf), this never would have happened. Because of this, I was able to afford to get the tummy tuck as well. The rest of the staff is caring, friendly, responsive to phone calls and absolutely professional. Dr. DiBello is reassuring, very matter-of-fact and NEVER rushes you (hence my 4 stars on waiting time...I am not at all bothered by waiting knowing I will soon get the same attention is is currently giving another patient). I felt he was thorough in explaining risks and evaluating if I was a good candidate for the surgeries. He answered every question thoroughly, even if it might have sounded silly. He also does a great job of helping to set expectations. I felt confident I would get great results but knew that perfection can never be guaranteed. But I knew he would strive for it. He uses tried and true methods that might be more time consuming in the OR (he said some advancements are strictly developed to reduce the length of procedures). I was happy for him to take his time when he was doing my surgeries!!! Very highly recommend him. Also have a girlfriend who he had done a TT for a few years back and breast augmentation. She also loved him. Her scars look great and the work he did looks awesome. I am confident I will have the same type of final results.