Love My Result, My PS, and Progressive Tension TT- Salt Lake City

First I want to say what a great forum Real Self...

First I want to say what a great forum Real Self has been. I first came here a few months ago and though I have been considering this surgery for 5 years I finally found the courage to schedule for April 8th. I paid the PS two days ago, solidifying my choice and just typing this gives me butterflies to the reality of it all.

I am a 41 yr old mother of 3 fantastic boys 8,7, & 3. I feel younger than the number of my age. I work out regularly though admit I should do more if the time ever permits itself. I usually run a few half marathons each year and last year ran my first full marathon. I practice Bikram and Vinyasa yoga 1-2 times a week and usually add in at least one day of skiing (skate or alpine), biking or something else to keep me moving. I am 5'5 and for the last 3 years have been at my pre-pregnancies weight of 110-115 and recent body fat % is between 14 &17%. All should be good except my belly protrudes out significantly. I have been asked how far along I am. Ouch. My friends who I love and adore have told me with encouragement that I look good but my abdomen is disproportionate to the rest of me. Which I already know but a second (or third) trusted opinion is validating. My husband agrees, but says I still look hot to him and is willing to prove it anytime I want LOL.

I have had 4 PS consults to see what could be done. I researched mini TTs, lipo, exercise programs etc. All PSs, my primary care physician and a physical therapist have told me that I have diastasis (abdominal muscle separation) and a laxed abdominal wall or stretched fascia from large babies and 3 c-sections that only surgery can fix. This created my big dilemma as the cost, recovery time and risk of the surgery would be a burden on my family. For these reasons, I hesitated for soooo long. Yet after reading many reviews and posts on Real Self, I kept thinking "Good for you" in regard the women who had chosen to have the surgery. I then decided I have a long life to live (God willing) and I want to be that Granny in a bikini at the retirement home someday lol. A situation presented itself where my husband is taking the kids out of town for 8 days and a good friend happened to be on hand during this time to be my recovery "nurse". I you to ever read this "M", I love you girl. And my PS had an opening.

The surgeon I chose has thus far been fantastic. During two different consults with her I practically moved in. We hugged the last time I left. She's become a friend. I do want her to "know" me personally since the procedure is so personal. Dr K is also very sharp (no pun intended). I had read about the progressive tension aka quilted TT or no-drain TT and was excited to find out she performs this on her patients who qualified physically. No-drain TT's are supposed to have easier recovery, less chance for infection and less swelling....And of course no lovely drains to contend with. I do know the down side of this method is longer OR time and increased cost. I havent seen a lot of conversation on here about it so will post my experience as it happens. Or if anyone has an experience to share, I would appreciate the insight. Dr K also said she keeps her OR at about 75deg. She said this has proven to drop the rate of blood clots down dramatically. Maybe all PSs do this but I thought it interesting. I also opted to have implants....just a little fill me up of about 280cc's. May even go smaller. After breastfeeding 3 babies I found out that even A's can sag. Its a cruel irony. Now with an option I wouldnt mind a perky small C. I havent decided on saline or silicone. Will talk with my PS one more time before surgery. Still have some aesthetic questions and health concerns I need to address.

I upped the surgery date by one day for personal...

I upped the surgery date by one day for personal convenience. Oh goodness. I have a mixed bag of emotions. The big day is coming so quickly. Im trying to be prepared. I know some people recommended Arnica and something else for the swelling and bruising. Not sure how much and when to take it. Spoke with my PS RN and she wasnt sure. Please let me know what has worked, and whats recommended and how to use it. If you have experience here would love your input.

TT -4 days. Just posted the before pics. Yikes....

TT -4 days. Just posted the before pics. Yikes. Very humbling to have hid this from the world and now am purposely exposing to everyone. Its for a good cause I think. Im doing this because so many awesome women on this site have logged their journeys and photos and they have been sooo helpful to me. Thank you for taking the time to post your experiences. Also the camaraderie and encouragement I find amongst everyone here has given me strength. Yes Im still having the freak outs and WTF am I doing moments, but its nice to know they are normal. I see Dr Keen for the pre op apt. She said one wasnt necessary, but I still want to finalize some questions about the procedures. We havent discussed the specific of the lipo ie how much and exactly where. She had said she would lipo the flanks a little, but there is a lot of room for variation here. Also leaning towards Silicone. Still have some longterm safety concerns. Also worried about the costs & safety of doing the recommended MRI's at 3yrs and 2yrs every year after.

Ok. Most all is doing as expected. Supper sleepy....

Ok. Most all is doing as expected. Supper sleepy. There are just two things i have questions on . I have had some diarrhea and abdominal cramping. Feels uncomfortable to eat and i havent been doing much. Also I have some puckering below my new belly button. Looks like loose skin. Is this normal and will it go away.

Also the morning of surg they weighed me at 107lbs...

Also the morning of surg they weighed me at 107lbs (stress) and now 3 days later Im 120lbs. Im Takining Arnica and low sodium. Is it normal?

Couple of updates. I feel good in so many areas...

Couple of updates. I feel good in so many areas except abdominal cramping. It comes and goes in waves. Even when I eat. I take a bite and wait for the pain to subside before a take another. Also at other times the cramping feels like mild contractions. I texted my doc yesterday and today and she said it could be normal. Has anyone else had this experience. Im also posting the weird puckering below my new belly button. Will this go away?

I am on day 5. Felt encouraged this morning when I...

I am on day 5. Felt encouraged this morning when I went for a short walk in the sunshine and then took a sponge bath. Then I slept from 10-5pm. I feel like i should be more functioning at this point. I go to see my doc post op on Wed. Her RN called twice to check on things but I was sleeping LOL. I also removed the binder as it seems to intensify the cramping. Any advice. Is this all normal and Im just being a wimp.

Im feeling so much better today. I think Ive...

Im feeling so much better today. I think Ive really turned the corner. Still milking the relaxation. Its been years since Ive watched TV during the day. I think Im living it up a little. Im very happy with how the surgery results are coming along. Im still about 10lbs above my pre op weight. I know its all swelling because Ive been forcing myself to eat 1000calories/day. The abdominal spasms have really been effecting my appetite.I dont want to lose muscle and certainly want the protein and vitamins to help in healing so the low calorie intake is counter to my nutritional goal. Feeling better today so hoping to rectify this. Hope you all out there are doing great. Thinking about you all and praying everyone is healing well.

A lot has happened since my last review. The...

A lot has happened since my last review. The abdominal cramping and pain became severe and I could barely move and stopped eating because of the pain. I also had some vomiting and diarrhea. Went to primary care doc and they found blood in my stool which was indicative of an upper GI bleed. After a CT scan and endoscope they found two large bleeding stomach ulcers. Both preexisted the plastic surgery. Probably the surgery and taking the ibuprofen exasperated them but the surgery was by no means the cause. Im feeling so much better and am finally eating again. What an ordeal though. What I can say is that from my PS, primary care doc, ER doc and GI specialist, I had amazing care. I honestly believe their active listening, fast work and treatment saved me from a hospital stay. FYI the Plastic Surgery results are looking good and am healing relatively well in that respect. My PS wants me to increase my protein and carb intake as I became ketonic. This she said will dramatically help my healing. Will post pics again soon. Hope you are all doing well.

Feeling great today. Took a percaset this morning...

Feeling great today. Took a percaset this morning but think Im done with them. Will stick with tylenol from now on. The pain killers gave me some strange dreams. My ulcer is not causing any more problems. Have to stick to bland, low salt, no caffeine and no alcohol diet. Hmmm seem to be on that diet any ways. I feel like Im entering stage 2 of healing... wanting to do more but still needing a nap. Im really happy with the no drain method TT the doc preformed. I am getting more swelling in the lipo areas than anywhere. Dont get me wrong. My tummy does have some swelling and hoping it will look better over time. However Im already happy with it. I saw the TT scar briefly when the PS change the steristrips. It looked straight (good thing), but puckered and raised in places. PS said it will flatten out. I want to see if anyone can recommend a silicone sheeting brand/type. I know they are usually pricey so want to stay economical with my choice. The PS gave me silicone gel which I will wear at night. I thought though the sheeting would stay on better and protect the scar during the movement of the day. Let me know if you have had a great experience with a product and where to get it. I would appreciate your feed back. Thanks

Im back to the basics of my normal routine (minus...

Im back to the basics of my normal routine (minus work outs). More tired than usual. Very little pain. Some occasional discomfort. Im finding that daily breaks are necessary (no time for naps though they would be nice). I cant have coffee, (im an addict), which may contribute to the moderate fatigue Im experiencing. Over all Im just ecstatic about the way my body looks. I went small with the implants but love them and the tummy....Yippie!!! I look at the pics and cant believe Im the same person in the befores and the afters. Im so impressed with my PS. The scar seems small, the quill stitch method reduces swelling, and the lipo seems even and effective. I do notice more swelling at the end of the day on the right side lipo area. Bruising seems minimal which Im surprised because I usually bruise easily. I was taking Arnica but stopped when I found out I had an ulcer. Wasnt sure if it would aggravate the ulcer, but it may have helped with the bruising the first 5 days I took it post surgery.

Day 20. Feeling good. Went out with the girls on...

Day 20. Feeling good. Went out with the girls on Friday to celebrate friends bday. I took it easy. No drinking and mostly sitting and talking. I didnt get home until midnight. The next day my body was exhausted. Mentally I was fine, but I could tell my body needed to rest. I also started oozing a little in the center of my incision. I havent oozed for over 10 days. I took off the steri strips, cleaned with soap and let it dry. I noticed there was some white puss present and showed my husband who is a physician. He recommended that after cleaning I let it air dry and then apply a breathable but protective medical gauze. It looks so much better now. I still have steri strips on the other wound areas but will remove and clean upon next shower. Ive noticed more sensation coming back into my abdominal area. It feels strange. Before there was no sensation and now it feels a little numb and tingly. There is a difference LOL. Ive also noticed that Im VERY tight every where and am doing some mild stretching with yoga breathing. Pre surgery I could touch my head to my knees. Post surgery its takes 20 min of stretching before I can touch my toe comfortably. Im also very tight through chest area. I have been doing all my normal activities and picked up walking for as much as a mile. I noticed more swelling below belly button than the week prior. It could be because of more activity or increase salt intake (ham for easter :) Loving my result over all. My belly button looks tiny though. Will ask my PS on Thurs (3week PO) what she thinks. What a difference a week a two makes. For all you 1 week of less Post Op TT's out there, things get better quickly. Hang in there. I know the first week is rough. Also a word of advice. Take it easy on the ibuprofen. Surgery + not eating as much/regularly + NSAIDs like ibuprofen increase your risk of ulcer or dispesia. I hope I help some one from my experience with this side effect. All the best to everyone. God Bless.

3 week 5days. Things are going well. Still not...

3 week 5days. Things are going well. Still not 100%. Im doing all my normal activities except working out. My PS said I can resume all exercise, but just listen to my body. Yesterday I ran a mile out at an easy pace and walked it back. That was enough. The week before the surgery I ran 9miles at an 8:30 pace. Still feel I have a lot of heeling to do. I am also starting to stretch more using Yoga breathing and poses. Im very tight through my shoulders, back and hamstrings. The TT scar looks good. I tried twice to apply the recommended silicone gel, but each time a little white suspicious to infection section formed in the middle of my scar. It recovered with in a day of washing and drying out. I guess Im not ready for any lotions yet. I was also surprised when I tried to go with out my Spanks for a day. The swelling got to be as bad as week one, which wasnt terrible but definitely noticeable. The spanks work. My weight has also dropped quite a bit (about 7lbs) from my pre op weight. I dont think I look that much lighter, other than not having a big belly and love handles. lol Im eating normally so I think its just a result from the surgery and now my middle section matches the rest of my small frame. My waist size I am happy to report went from a 27/28 to a 25/26. Very happy with the 25 :). Im not regretting having the surgery. I do miss being and feeling 100% strong and healthy and able to push myself in the gym and during a run. I know it will come. Just need to be patient. Best to you all. xo

5 & 1/2 weeks post op. Feeling good. The...

5 & 1/2 weeks post op. Feeling good. The occasional ackyness and fatigue I would get is gone. I still get a little swelling, but honestly the swelling through this whole process has been very minimal. I was in my pre op clothes the first week out. The swelling I do get is a little puffiness below the belly button which is most noticeable on the days I run. If any one reading this is consider a TT, ask your PS about progressive tension or quilt method TT. It really minimized swelling. Research also shows it reduces seromas, and promotes healing and the result are viseable faster. I love my spanks too. I wear them constantly. They seem to protect the scar from rubbing and help with the puffiness I spoke of. Wish I had 10 pair. My scars have gotten darker/redder especially the one on my belly button. I have started using the silicone gel my PS gave me and am doing the scar massage at least once a day. I am also going to order Scar Away Silicone Sheets. I will let you know how they work for me. There is some puckering around the vertical scar that I am a little disappointed with. My PS said it should go away or she would do a revision. Im not sure what a revision entails. I dont see her again until 8 weeks PO. Will try to post pics on thursday for my 6 week PO celebration. :) One other thing to note and I want to see if any one else notices this too, my posture is so much better than pre op. Tight abs seem to make for straighter/better posture for me. This is an unexpected bonus that I havent heard anyone mention before. I hope all you ladies are doing well. I like to see everyones posts and updates. xoxo

6 weeks. Im physically feeling almost 100%. Ive...

6 weeks. Im physically feeling almost 100%. Ive been running 3-5 miles every other day and have added some weight training. Ive noticed some of the upper body weight lifting feels uncomfortable, but then I stop if it does. I love everything about my results except the top of the vertical scar is bunched. It will need to be fixed. Has anyone had a minor repair like this would entail. Let me know you experience and thoughts. My scars have gotten darker. I heard this would happen. Am using silicone gel and should get the Scar Away Silicone Sheeting tomorrow. Im hopeful. I also changed the price on my surgery. My op time was scheduled at 4 hours and it ended up at 5hrs 45min. There was an extra $900 charge (ouch). My PS said I had much more muscle repair needed that she thought. Im glad she did what would give me the best results.


It has been a while since Ive been on here....

It has been a while since Ive been on here. Everyones reviews were helpful so I want to keep mine going too. I am now almost 3 month post op. Im feeling great. Ive been running any where from 5 to 10 miles at a time. Everything is heeling well. I still get occasional swelling but its a small amount that only I notice. I do not wear the spanks on a regular basis anymore but notice a difference when I do. They really help with the swelling. My scar has gotten a little better. Ive been using the silicone sheeting on the large TT scar. It has faded the scar but if I go a couple of days with out wearing it the scar seems to darken again. Also I can not get the silicon sheeting to stick to the belly button scar. This scar is noticeably dark. When I go to the pool I apply sunblock (vanicream or blue lizard) and then add makeup/concealer. This hides (and protects) the bb scar pretty well. I have gained some of my weight back. I was down to 106 and now am up to about 113. I dont mind gaining weight as long as it comes back in muscle. This weight seems not to be from muscle. Curious to know why. I eat very healthy and excise often. It seems to stash itself along my flanks. Another thing I noticed is my implants feel like they extend out to the sides too much. Ive been trying to push them together. Not sure how much I can change things now. Will try. I feel like Im being picky because overall I am so glad I did this. I feel so happy with my decision. I think I look as fit as I am. My clothes look and fit better. I will post pics soon.

Im a week short of 4 months out. Physically, I...

Im a week short of 4 months out. Physically, I feel great. Still have an occasional pulling feeling in the abs. General numbness has subsided but not gone. I dont do "abb" work outs yet though my PS cleared me to do so. I think running, weights and normal activity work the abs plenty for this stage. I gained back some weight and am at my pre-op weight. I think its healthy and dont plan to loose it again. The post op loss was partly due to peptic ulcers which are under control now. I do notice my abb area has a more softened look. This seems more natural too me. Its a good thing.

My only discouragement is the scars. I did expect them, but am worried about the BB scar and the vertical section of the TT scar. I dont know if my PS should have done a better job of hiding the BB scar, if Im a poor scar-er, or if Im being impatient.

Overall, Im exstaecstatictic about how I look in clothes. What a difference this has made in my overall appearance. Im confident in the way I look. All those years of hiding that belly are over. My husband has asked me several times if the shirt I was wearing was new because it looked good. Each time he comment the shirts had not been new, I think it now looked good because I was new.

It was a big decision. I was lucky to not have had anything go wrong. I think things were stacked in my favor to have had a good PS but there were no guarantees. I am so happy and grateful to have done this and have good results.

Wanted to say that at 4 1/2 months post op, I ran...

Wanted to say that at 4 1/2 months post op, I ran a 1/2 marathon and came in 5th in my age group. Woo hoo... now thats recovery. lol.

Im over six month out and went to my PS today for...

Im over six month out and went to my PS today for a follow up and to discuss the surgery healing. Over all Im doing great. I feel healthy and like my overall result. With Dr Keen I discussed the scars. They are hypetrophic around the BB and one section of the TT Scar. My PS injected steroid into both spots and thinks this will help. I also noticed that when I do a sit-up the left side of my abs raise more than the right. I thought it was the muscle underneath. My PS thinks it is because the scar is hypertrophic and therefor tight causing tension and thus the raising so to speak. She thought it would get better over time. She also said that there is a lot of healing to be done still. She sees a lot of chances between the 6 months and 1 year mark after a TT.

Another concern I had was that it seems my implants fell a little into the pockets under my arms rather than staying centered. Dr Keen said this can be a unfortunate though minor complication that can occur with implant surgery. Hmmm. I wonder if there was a way to prevent this through surgical method. Not sure. Dr Keen thought that if I wore a band at night I might me able to reposition the implants. Otherwise corrective surgery and additional costs would be needed to correct it. Yikes.

Physically and mentally I feel great. I love the way I look, the way clothes fit, and the strength and support the repaired ab muscles give. Hope you are all doing well out there. Love reading about everyones journeys.
Salt Lake City Plastic Surgeon

Dr Angela Keen is probably one of the most caring and personable doctors I have ever met. My husband is a physician and I had been in the medical field for years. We both agree she is very well trained and very professional. Dr Keen uses advanced techniques such as the no drain method (quilt) in a TT. She also does all her own sutures. I love my results. I love the care I received from her and her staff. If you are looking for a PS in the SLC area, I highly recommend Dr Angela Keen.

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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