Tummy Tuck (Full) with Prolapse Surgery: 9/12/11 - Philadelphia, PA

I am a 44 year old mother of two, 5 and 7 years...

I am a 44 year old mother of two, 5 and 7 years old. And, it wasn't until the birth of my second that I really noticed the impact on my body. Prolapsed bladder, uterus...etc. I tried Kegal bio-feedback (embarrassing!; it helped a little, but not that much). I was told by my Gyn that my only option was to have a hysterectomy and I just didn't feel comfortable with that, so I just lived with it. Of course I also knew that my stomach muscles were never going to be the same again, no matter how many crunches or dieting I did, but thought that was just something I had to live with, too.

Then at my last Gyn check-up in February I was told it had gotten so bad (stage 3) I *had* to have the hysterectomy. So, I went from one Uro-Gyn to another until I found a wonderful surgeon in my area, Dr. Michael Toaff, who said that he could totally repair all my prolapses with good long-term prognosis - and keep my uterus! I was thrilled!!
He gave me the names of phone numbers of several women on whom he performed the same procedure. One of the women said that she had a tummy tuck at the same time (saved on having two recoveries and cost -- *the total out of pocket for my TT is: $5,180!). That got me thinking, would I be a candidate, too?
Sure enough, my surgeon said that I would be a good candidate and referred me to the "only PS he would allow me to use!"

Turns out the PS he referred me to is the Cheif of Plastics for all of Main Line Health and I have since heard many good things about him. He does lots of TTs and combined procedures -- and I liked his before and after photos, too. He was just as confident that he could give me a good result (with full TT and muscle tightening), so my DH and I put together the cash and booked the surgery for Sept., after the kids were back in school.

Well, the summer went by quickly and I have been so busy getting ready for the start of school that I just put my surgery to the back of my mind. So, I cannot believe that it is only 1 week away now! The kids go back to school on Wednesday and that gives me just a few days to prepare. Fortunately, my insurance company has approved a total of 5 days in the hospital to recover and I feel really lucky to have that time, after reading so many other people's accounts of being sent home the same day! Then I have after-school care set up for the children for the two weeks following surgery and my DH is sweetly taking some time off of work to help me and take care of the kids, as necessary. So, short of having to pick a few things up at the store (my meds, some big sweatpants and t-shirts to wear that first week or two; already have my compression garments), I think I am just about ready. Still trying to get my head around the fact that this is all really happening now, as my journey here has been several months.
One question for the veterans out there:

My PS has stated that I should only sit in an upright chair with arms, once I get home; and sleep on my side in bed. But, it seems lots of folks are mentioning recliners, pillow-propping and some even have rented medical beds...??? What do you suggest?

I am thrilled that I found this site, it is so informative and everyone is incredibly supportive -- thank you all!!!
P.S. I will post photos once I have some to post!! : )

Angiemcc - thanks so much for your post and the information! Yes, I have read Kimmers Survival Guide and it was *very* helpful! I'll have to check out th FB page. I called about the medical beds and they only need 24hrs. notice, so I'll wait and see how it all goes, knowing that I can call them the day before coming home, if it looks like I'll really need it. Thanks again!
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I'm glad you found us! This will be a big surgery and require some serious patience on your part as far as recovery goes. You might want to start by reading Kimmers Tummy Tuck Survival Guide. It has a lot of great info in it.

We also have a Facebook page called Moms Who Want Their Bodies Back that we'd love you to check out!

I've heard most women say that recliners work really well. I don't think hospital beds are necessary according to what I've read, but some women do swear by them. You definitely won't be able to lie flat on your back for quite some time.

I'm looking forward to following your journey. Thanks for sharing with us here on RealSelf!

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Well, I got my phone call and I have to be at the...

Well, I got my phone call and I have to be at the hospital at 11:00 a.m. Monday! Oh my gosh, I am so nervous!! I have most everything ready to go: the kids will be in after-care, the food shopping and meal-planning for week is all set, I've got my *fat* clothes for swelling and drainage tubes, meds including MOM and Colace, the Palmer's Oil that Kimmers suggested, Vitamins, my bag for the hospital is packed, my recovery area at home all set up... I just have to finish some laundry and make a list for DH of all the little things he's going to have to take care of!! I will be in the hospital for five days, I return home on Friday. So, I will check in one more time tomorrow night and then I am offline until I return home.
Wish me well!!!

Here is my final post until after my surgery...

Here is my final post until after my surgery tomorrow. In fact, I am not planning to update here again until after I return home on Friday. The more I imagine this process, the happier I am that the insurance co. has approved the five days in the hospital! I know most people would rather recouperate at home, but I won't have any help at home until the weekend, and this way I know I will be well-cared for.
I did all my cleansing today (M.O.M. and Fleets) - my doctors want to make sure I am completly empty for this surgery, as I am having the prolapses repaired as well. And, only clear liquids all day -- not fun! But, DH took the kids out to dinner so I wouldn't have to smell the food!!
Getting a bit nervous and am hoping that I will be able to sleep tonight. I guess I am nervous about *everything* - the anesthesia, the procedures, the recovery and the final outcome (both the prolapse work as well as the TT). Not regretting combining the two surgeries, but just being realistic that this is going to be a big deal.
I will post before & after photos afterwards...
Wish me luck!!
Hope you're doing well. Let them pamper you in the hospital. Enjoy it!
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I am so happy to hear you are doing well today:)   I read your post in the September Forum.

Keep up the good work.

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What an amazing past four days! First, my surgery...

What an amazing past four days! First, my surgery was delayed, due to the surgery prior to mine taking longer than expected. So, that was a bit much on my already shot nerves. But my anesthetist was *AMAZING*! And, at a little after 2:00 p.m. (I was meant to go in at 12:15 p.m.) I got a shot into my IV, gave my DH a kiss and the next thing I knew I was waking up in the Post Anesthesia Recovery area. Because all my procedures lasted a bit over 5 hours, I stayed in recovery for nearly 3 hours, but I mostly just slept. Then at about 11pm they moved me to the post-surgical floor, where I was given IV Dilaudid. What a great drug -- I never felt any significant pain.
I was lucky, my blood loss was very minimal and I guess I must have a fairly high tolerance for pain and heal pretty quickly. I was approved by my insurance company for a total of 5 days in the hospital, but both my doctors said that I was doing so well, they couldn't justify my staying more that 4 days! So, last night I had to scramble and prepare to go home a day earlier.
I did end up having a medical bed delivered home for my return and I am glad I did. It just makes it so much easier to get into a comfortable position!
So, I have two incisions: the regular tummy tuck, which I got a quick peak at during my final exam in hospital, and one at my perineum (like a whopper of an episiotomy). From what I can see of the TT incision, it looks amazing. He closed me internally with disolvable stitches and then just used surgical glue on the skin surface. You can almost not even see the incision. I do have two drains just below in the pubic area that are a bit uncomfortable, but really not bad. I am hoping to get these out by the end of next week. He doesn't want me to wear the compression garment until they come out. I cannot wait to show you all the before and after photos, but I am too much of a chicken to post the befores without the afters!! I suspect that it will be a big change. Even with the dressings, I am so much flatter!! Oh, when he got in he discovered that my muscles were separated 2"! And, he ended up taking a lot more skin and tissue than he thought he would be able to.
Thank you, again, to everyone here on this site. You all gave such great advice, I felt really, really well-prepared for everything. I am finding that Gas-X is a big help!
That's all for now... Time to take a percocet and a nap!!
I'm so glad you're doing well! Keep healing and keep us updated. ~hugs
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Thanks Kimmers. You are truly an inspiration and your advice has been spot-on. I have the Palmer's Oil ready to go when the incision heals up -- it smells wonderful! I hope I don't use it up on my hands before I need it on my scar!! : )
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PhillyMom you are so welcome:)  I love being here for all of you ladies.  

The oil smells wonderful and I love it!  When you start using it on your scar stay persistent and you will notice big changes quickly.  I use it on my entire body after every shower and my skin has actually improved.  I caution you thought if you have pets.  My dog drives me nuts following me around after I put this on.  Apparently he also likes the smell because he is always trying to lick the back of my calf's when I am getting ready.  Yuck...darn dog!   

 

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I am getting through day 6 post-op and am feeling...

I am getting through day 6 post-op and am feeling better each day. I am just trying so hard not to do too much. The temptation is really there and I do not want to pop any internal stitches. So, that is my biggest challenge right now. I have to do sitz baths for my *other* incision and am having memories of post-birth care from both my children! Oh boy do those sitz baths feel good. In fact, that incision is giving me more pain/discomfort than the whole tummy area, which is actually doing pretty well. My drains only put out 21.5cc yesterday, so I am hoping that when the PS calls tomorrow and I tell him that, he will schedule me to come in and have those drains removed - yippee!! Can't wait for that -- he won't let me shower or wear the compression garment until then. So, I think that will mark a major milestone for me.
Kimmers -- I found a new use for the Palmers Oil: it gets off all that gunky tape residue from the IV! Worked like a charm, and still loving the scent. : )
Also, I asked my PS if there was anything I could do for my lower back pain (from having to stay bent over) and he said to use a heating pad -- it really helped!
That's all for now... Time for a nap. ; )

You are doing wonderful!   Congratulations..gotta love that Palmer's Oil:)   

Also try the Therma Care patches for your back.  They stay warm for 8 hours and feel heavenly.  Hang in there and keep me up to date on your progress and drain situation.

Hugs to you:)

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This is the end of Day 8 and I am feeling better...

This is the end of Day 8 and I am feeling better and better each day! But, I did end up taking some Milk of Magnesia (MOM) yesterday to help get things moving down there. As a result I was going back and forth to the bathroom all day! So I was going to get my drains out today but my output went back up to 28.8cc (probably the result of so much back and forth to the bathroom!!) and PS and I decided to keep them in another day or two. I have sort of mixed emotions about it -- they had been down to, like 21/22cc. I was really looking forward to getting all my packing taken off at the same time as drains out, so I would finally be able to see what it all looks like. And, of course then I could take a proper shower. But, I guess it is better to wait... as it seems some people get terrible swelling after the drains come out and have to get that taken out with a needle. I'd rather avoid that, if possible.
Anyway, I'll let you all know when it finally happens and then I'll post photos, too!!
Nighty night!

It will be ok.  You needed to get cleaned out and you don't want the drains out too early.   Soon it will all be over and you will get back to normal.  Usually the mom gets you going you get back to normal by the next day.  

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Day 9 post-op and I have good news and bad news.....

Day 9 post-op and I have good news and bad news...
Good news: PS called and I went in to get my dressings off and drains out -- YIPPEE!! I felt no pain, whatsoever and am glad to be free of them and able to finally shower again!
Bad news: As soon as the dressings came off, I saw the look of disappointment in my PS's face. Then, I looked down. The tummy portion of the tuck looks great -- in fact, I am really pleased with how flat it is! But, at either end of the incision (more on my left) there are buckles of...what to call them, *love-handles*. UGGH! He immediately said that he would need to do some revision work in 3 months, once the swelling has gone down.
So, I am glad that he immediately owned-up to the less than perfect results, but I am totally bummed out that I will need a revision. My PS is wonderful and he did say that the revision would be a much smaller/simpler procedure -- not so much of a recovery. But, what can I say, I am disappointed. See for yourself...I finally posted photos, side-by-side before and afters. Check out the ones of my left side, espcially bending and you can see where there is still a roll of skin left in the after.
Has anyone else had this problem? How did your revision surgery go? Were you finally pleased in the end? Thanks!
Thanks Kimmers! I am switching to just one Colace at bedtime, for now!! : )
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Day 11 post-op and am starting to feel much more...

Day 11 post-op and am starting to feel much more mobile. I'm actually using my new, tighter tummy muscles and am not so sore, although the numbness is kind of weird. I tried on some pants that fit berfore surgery and they are still a bit tight. I must be pretty swollen still, so it's sweat pants for now. I guess this is what people refer to as 'swell hell'...definitely not thrilled with it, but this too shall pass.
So, had a great talk with my BFF about the need for revision surgery and I am feeling a little better about it. I guess I can just concentrate on getting back from this surgery and look at the revision as just the finishing touch-up! I made my 3-week post-op appointments with both docs. for 10/3, so I guess I will discuss that with my PS then.
Also, today is my birthday -- so I am looking forward to a nice dinner (take-out) and cake with my DH and kids!
Happy Birthday to me and my new body! : )
Thanks for the birthday wishes -- it was a really sweet, quiet birthday at home with my family. : )
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Happy Birthday to you!!!!
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Happy Birthday! You're always gonna remember this one! Congrats on the good attitude and taking the steps to move forward! Have a great day... Eat a piece of cake for me :)
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Today was day 16 post-op and I am continuing to do...

Today was day 16 post-op and I am continuing to do more and more each day. But, I think I over-did it today -- it is such a fine line between resting enough and pushing myself just enough to keep building my stamina!! So, this evening, after getting the kids to bed, I just felt soooo swollen, I took a Percocet (hadn't taken anything all day) and laid down. Boy did my tummy hurt -- the kind of hurt from swelling. So, I took off my compression garment to pee (hoping that would help) and I was actually surprised to see that I looked a bit thiner. How strange to feel so incredibly swollen but actually look thiner! I plan to try on some real pants (have been wearing sweatpants all the time lately) tomorrow morning and am hoping that I might fit into them again?? My scar is looking pretty good and the surgical glue is coming off in spots. It seems like I could just peal it away but am scared to do that. So, I just gently clean it each day and apply some Polysporin. I have my 3-week post-op appointment on Monday and have so many questions for my PS... What is his assessment of my swelling? Do I have a seroma or is it just normal swelling? When will all the glue come off and when can I start using Mederma and/or Palmers oil? And, of course I want to discuss the revision surgery with him... what he plans to do, just cut away the edge of the scars, or something bigger. The more I look at it I am wondering if I wouldn't benefit from a bit of lip on each hip where the scar ends, to keep it from buckling up...?
That's all for now!

Oops, typo above. I meant, "...benefit from a bit...

Oops, typo above. I meant, "...benefit from a bit of LIPO on each hip..."!

Today was day 18 post-op and I had a bit of a...

Today was day 18 post-op and I had a bit of a reaction to the Bromelain. Maybe I took too much (500 mg at breakfast and again at dinner), but it gave me some intestinal distress (uggh, had the runs!). Anyway, I love that it is helping to reduce the swelling, but think I'd better scale back to one time per day -- will try that tomorrow. I am thrilled with how the incision is healing, and (otherwise) I am feeling better each day. I took some more photos and posted them below. I also made the switch from granny panties back to my old favorite bikini-styled ones, and I am much more comfortable, even with the compression garment over them! I am also really scaling back on the Percocet, just half a pill two or three times per day, as needed.
Again, I am looking forward to my follow-up appt. on Monday! Will write more then.
Good night!!

Today I had my 3-week post-op visit to both docs....

Today I had my 3-week post-op visit to both docs. and all went well! First, let me just say that I did have some difficulty trying to find something other than sweatpants to wear. The good news, my former "fat" jeans actually fit with my compression garment, and they looked pretty good! I am finding that the compression garment really does add to the waistline, along with the swelling. So, now I am looking forward to reaching that next milestone of actually fitting into my normal pre-op pants.... I hope soon!
So, back to the appointments... My Uro-Gyn is pleased with all the work that he did and I have been released, with the caveat of no heavy lifting for a total of 4 months, and no sex until we get to the 6-8 week mark. (I expected that, tho'.)
My PS also thought that everything is looking good -- no seroma, just normal swelling to be expected. We also discussed the revision surgery and he wants me to start dieting and light exercising at the 6 week post-op point, to loose a bit more weight. I go back in another 4 weeks and he will reasses at that time, if I will need a little lipo, or a skin-only removal of dog-ears, or some combination of the two. The good news is that he feels I am 95% there and that this will just be a minor touch-up... And, that I will be able to wear a bikini in time for next summer -- yippee! I haven't worn a bikini since I was in my 20's. Wow!
After my appointments, met my DH for lunch, made a trip to Target to pick up a few things and then met the kids at the bus. I think this was the first day (post-op) I didn't take a mid-day nap!
I am one happy (tired and swollen!) camper this evening. Looking forward to a good night's rest!
Hey girl! I had similar procedures done at the same time as my TT. It definitely saves you money to have them done together only I didn''t get as good of a result as you did. I had the TT with a hysterectomy due to adenomyosis which was fine with me since I wasn't having any more kids and I had already had a tubal done. I also had some prolapse and some stress incontinence so I decided to get it all done at once. My Uro-Gyn was excellent too. its crazy because I didn't even know those types of doctors existed. It makes so much sense. Anyway, how you are looking these days? Did you ever get your revision and how did that go?
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You are looking great! Glad to hear that you were able to get both your surgeries done together. Careful not to overdue too much as you are healing from 2 different things at once. Congrats!
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Wow!!! You look amazing! I'm looking for a doctor at this point.
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Philadelphia Plastic Surgeon

Dr. Larry Jonas is not only an amazingly talented Plastic Surgeon, but also a genuinely nice person! He has spent so much time with me throughout this whole process. He makes you feel that you are his only patient and that he has all the time in the world for you. I would recommend him to anyone thinking about Plastic Surgery in the Philadelphia area.

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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