This has to have been the scariest surgery for me,...
My surgery was scheduled first thing in the morning, yay, so I wouldn't have all day to be scared, anxious, excited... scared some more. lol We show up to the place where the TT is to be performed & I'm taken back to change & have my IV put in. The lady doing my IV stuck me and said she hit a brick wall (ouch) so she was going to try my other hand. She stuck me in my other hand and said the same thing, wiggled the needle around inside (yah, that felt great) and said that she thinks shes got it. She put a whole bunch of tape on it cause it wasn't dripping right. Then they called my husband back. My IV stopped dripping completely so I asked him to let one of the nurses know, she came over (checked nothing) and said that it wasn't supposed to be because its turned off. Wrong! Anyhow, so then they have hubby leave cause its time to wheel me into the surgery room. As they're wheeling me back the nurse tells the anesthesiologist that we may have a problem with my IV and he says that he can't have a bad IV and that he may need to change it out. Once in the operating room and on the operating table the anesthesiologist starts wiggling my IV around to try to get it working right. He wrapped it around my ring finger and I remember looking up at it and seeing that it wasn't dripping consistently and wanting to just get up & leave. That's the last thing I remember.
I woke up in recovery, everything was great! They said they were going to call my hubby to come & pick me up. YAY! And then it happened.... I started feeling like I couldn't breathe. The nurse tried to reassure me that I couldn't breathe because I had a binder on me... wrong! Then the coughing started. At first I had them hand me tissues to spit what I was coughing up into. It was blood. By the time hubby got there I was couching and spitting the blood into the bowl & they had me on oxygen. Even with the oxygen at 10 my O2 saturation was only at 85! They gave me a breathing treatment and morphine (not sure why they gave me that). A nurse came by and asked the other nurse why I was so sleepy and she said she didn't know why. Then she asked me & I said cause she gave me morphine! The anesthesiologist came in to show me a breathing exercise to make my O2 saturation jump up. He said, now watch the screen, its crazy how much its going to go up. Every time I did it (which he had me do it like 5 times) my O2 saturation dropped.... whoops. Looks like that didn't work! After a while I was able to breathe on my own & released that Friday afternoon / evening.
Once home I couldn't eat much but I made sure I was taking all my pills and still the injections of lovenox (ouch those hurt & I was so glad when I was done with them!). The only pill giving me any issue was the gel capsule antibiotic. It kept irritating my throat and causing me to cough (btw, coughing after surgery is not only not suggested, its really painful!). We called my doc and she said that we could break open the capsule and put it in food but that didn't work, it tasted horrid! Saturday I was doing good, talking on the phone, walking around the house and sleeping in the automatic recliner. Sunday I couldn't breathe again. :( We called the doc and she wanted us to go to the emergency room at the affiliated facility of where I had my procedure done, but I really didn't want to go. I sat for a while on the toilet (just sitting there) and it seemed that sitting in a more upright position, I was actually able to breathe. Come to find out that sitting reclined back in the recliner when I had possible fluid in my lungs / chest probably wasn't a good thing! lol Never had a breathing problem after that!
Went to my first PO appointment where I almost fainted when the doc removed my binder! lol Its so weird to have it removed at first. I suggest laying down at least that first time when they remove it.
Not really sure when I actually got diagnosed with the necrosis but the doc knew pretty much at the first PO appointment that there may be an issue, it was just a matter of my body struggling and the affected area really declaring itself.
Its been a barrage of doctors appointments ever since.
I made it a personal goal of mine that I would not ask for either of my drains to be removed because my doctor told me that I would have them for 6-8 weeks due to my TT being such a large one (almost 12 pounds removed). On July 15th one drain was removed, the doctor also removed the tape (I wasn't allowed to shower so it wasn't coming off on its own) and after consulting with her peer, she did some debridement which is when my first hole appeared.
After more debridement that hole became much bigger on July 26th and we found out why my other drain wouldn't hold suction... it was exposed within the hole so it had to be removed. After that debridement I was told (doing wet to dry gauze, which we bought in bulk because we needed so much!) that I am going to be amazed at how much better this is going to look in 2 weeks.
Just a few days later (Aug. 2nd) I went into the doctors office and left with two huge holes. Not the amazing results I was expecting in the least!
So of course, now I'm starting to doubt my PS. I think she's in over her head. I did some more research on necrosis & debridement because at this point I just didn't want to be cut any more! Come to find out... that is not the answer at all. The debridement actually helps to speed the process up even though it seems like you're going backwards and not healing, all this bad tissue needs to be removed so that the good tissue down under it can multiply and fill it all in. During my research I discovered wound vacs and I brought it up to my PS who agreed that we should look into that. We went to a wound clinic on Aug. 8th. Not actually having the wound vac yet, Edith, at the wound clinic took measurements and packed my wounds (the two holes & where my belly button was supposed to be) with Hydrophera Blue. The very next day my hubby was laid off. :(
Time for the wound vac! On Monday Aug. 12 the wound vac came in and off to the wound clinic we went to have it put in. For the most part it's not painful but there is this one part that hurts so bad! It feels like I'm being stabbed in my open wound with a hot soldering iron! Lately the sponges have been getting stuck in my wounds because my body is healing that fast! The results from the wound vac are amazing! I've had it on for almost 3 weeks and everybody can tell that there's a huge difference in the size of the holes. We do sponge changes on Mon, Wed & Fri and those are the days that I get to shower... yay! Much better than the 52 some odd days I went without a shower before getting the wound vac!
Not sure how much longer I will need it (Sara from KCI, the maker of the wound vac, thinks mid to end of September but Edith at the wound clinic thinks end of October or November!) but I'm hoping to be healed by Halloween, my favorite holiday and my birthday is the next day. I am drinking my greens daily where I get 24 servings of fruits & vegetables and trying to keep my protein at 90 grams a day to help healing. The protein proves difficult at times due to it taking up so many of my allotted calories each day but I've recently found a protein powder that will give me 30 grams of protein for 125 calories... not bad! Oh, and its supposed to taste good too, looking forward to trying it.
Oh, and even though hubby getting laid off was a bad thing, it couldn't have happened at a better time. Dorothy at KCI said that we qualify for 100% of the wound vac charges to be free! This could have cost us $50 a day even with our blue cross blue shield insurance!
3 weeks with the wound vac / just over 11 weeks PO
I was a tomboy growing up and played sports my whole life. AYSO soccer from age 5 all the way through my sophomore or junior year of high school. Played a couple of years of indoor soccer during the outdoor off season and then my freshman year in high school I lettered in Tennis, Soccer & Softball. Sophmore & junior year it was just Tennis & Soccer but I rode my bike to & from school and lived in my parents pool in the summer. After high school I played some roller hockey but shortly thereafter I became pregnant with my daughter. I had pre-eclampsia so I gained a lot of weight and never saw below 200 until she was about 16 years old!
Through diet & exercise I lost nearly 100 lbs, so this surgery was my reward for all that hard work.
4 weeks with wound vac - just over 12 weeks PO
I don't know if its not quite as painful on my left or the fact that I've been the one taking off the tape & sponges on that side. It does seem to hurt a bit more while the wound vac is actually on though, but just every so often.
We used up the last of the white stuff we put in the holes (I call it Permagrin cause I couldn't understand what the wound clinic girl was calling it) before the sponges today. :( We're supposed to go to the wound clinic this Friday but I'm not sure whats going on with that. Last I heard from them they were calling because our insurance didn't go through... duh, hubby got laid off. We told them that. So they mentioned doing a cash in advance thing for visits... that's not gonna happen with how much we shelled out for the surgery, prescriptions, gauze and supplies for all this recovering after the surgery that we didn't anticipate!
So we shall see. The PS doesn't seem worried that we won't be going back to the wound clinic but I'd like to continue to see them. I think that a lot of my healing success is due to them. They're just more experienced with healing big wounds like mine than my PS is. We're doing all the sponge changes but we don't know what to do as it get shallower & shallower. At what point do we stop the wound vac?
So I'm hoping to see them a couple more times.
Just trying to figure out what happened...
Also, when looking up necrosis it always says midline below belly button is the place that it occurs, yet mine wounds are on either side of that.
I'm wondering if this could be a complication from my drains?
The left side (which was removed last at just over 6 weeks) was removed because my drain wouldn't hold suction because it was exposed in the hole. My right side was supposed to be ok and the PS had said that the area that was struggling was just skin deap, no holes. That drain was removed first at 4.5 weeks.
Maybe my body rejected the drains? I know many sutures had to be cut out due to them being exposed in the holes. Could my body have been rejecting the foreign objects? I dunno
5 weeks with wound vac - just over 13 weeks PO
Found out that it would cost at least $655 plus doctors fees to go to the wound clinic without insurance... wow, right! So that's not gonna happen. Sucks but I guess my care is in the hands of my PS now. :(
Still hoping to be healed by Halloween of this year. *crosses fingers*
6 weeks with wound vac - just over 14 weeks PO
This Wednesday we go back to the PS and the KCI rep will be there so we can get her take on how my body is progressing. Last week my doctor mentioned skin graft again but said that we're not there yet. Skin graft just sounds so horrific, like I've been in some terrible accident, ugh!
We also have our family pictures on Wednesday. I'm thinking of turning off the wound vac for the pics (I was going to wait until I didn't have the wound vac anymore but we need to also get my daughters senior pictures done and my Groupon is going to expire), but I have to figure out what to do with the tubing attached to me, it can't just hang down out of my dress! lol
7 weeks with wound vac - just over 15 weeks PO
I also found out that my PS read my review and was none too happy about it. It was never meant as an attack on her but it is my honest feelings & take on the situation.
I'm just going to keep on focusing my energy on healing.
Another week down
We had a bad seal from the change out on Friday (10/4) so we ended up doing a change out on Sunday (10/6) which leaves us with changes on Tue/Thur/Sat this week. Nice to kinda change it up a bit and it works out for me taking a shower on Saturday when I have plans that day. yay
My PS wouldn't discuss what was covered as far as scar revision or skin graft, saying that we're not there yet. Sure would be nice to have a game plan. But would I really want / allow that anyhow... who knows.
UGH!!!!! I just want to be healed already! No more complications.... just healed! I don't think I'm being impatient. Look at how long my life has been turned upside down!
On the plus side, we have plans for the whole month of October and they even take us into the first weekend of November! Yay. I love this time of year. (sucks to wear a jacket with the wound vac though, hope I'm healed before it gets too cold)
Another week closer to being done???
As much as I hate lugging this machine around everywhere... I'm not ready to get rid of it... I'm not healed yet! We're trying to come up with ways to make my packs last longer. We don't use all the sponge or tape and the canister is lasting me over a week so really its just the tubing that attaches to the sponge and to the machine. Hope this gets sorted out.
When we went to the PS today it was looking kind of yellow-y (which it had the last change out as well) so I asked her about it. She said its not an infection or anything. She scuffed it up to stimulate granulation, so that's why its bloody in the pic. Hopefully we'll see a boost in it filling in now.
Only a few weeks until Halloween so now my goal is November 12th, only because then it will have been 3 months with the wound vac (assuming that we get more supplies).
I have been sliding the wound vac machine around to the backside of me so it is more out of the way. I like it (and then its not banging against my tummy) but the wider part of the shoulder strap is then on my chest... oh well. lol I ran on my treadmill the other day when it was raining, it was nice to run without having all that extra skin & fat in my way. I'm trying to take it easy with my exercise though until I can start lifting. So really right now I'm more maintaining my weight at around 168 which is down 18 pounds since surgery. I track my calories on myfitnesspal but I'm finding it hard to track on the weekends. I try not to beat myself up about it as that wouldn't be constructive with all the stuff that I'm having to go through.
I just want to be healed.
I got a living social deal for zombie shooting so my hubby, myself & a couple of friends went over the weekend. I'll put up some pics.
Only 10 days until Halloween
This weekend we had the Oktoberfest and Rob Zombie haunted house mazes on Friday. Saturday we had my sons soccer game, the trunk or treat and then a friends b-day party. This coming weekend we have tickets to another haunted house and then it will be Halloween, Knotts scary farm on my b-day (nov. 1st) and the Halloween poker party here on nov. 2nd.
I love this time of year!
I finally did a side by side by side photo. I put it as my profile pic but not sure how well it can be seen. I will attach it here. I was 279 lbs, about 215 & 169, in the pics.
Time for my weekly update :)
We've been keeping really busy and having lots of fun. Halloween is our favorite holiday afterall. So Friday we went to Slaters 50/50 for the first time... YUM!! then we went to Scandia for their haunted house mazes (we had a groupon so it was only $15 for the both of us!) and I gotta say, they were awesome! Saturday we had my sons next to last soccer game (we had half time snack & after game treats) and then that night we went out for a costume contest and won for best couples costume! Looking forward to scaring the kiddies on Halloween and then dressing up in our couples costume again and hopefully wining. Then Friday November 1st is my birthday and Knotts scary farm and then Saturday is our Halloween poker party!
Seems to be slowing as its getting closer to closing
I haven't been drinking my protein in the hopes that I will start drinking it again and I will have a boost of growth / closure / healing. I am also planning on not drinking when we go out for our weekly night out in the hopes that not only will it help the healing but also I won't want fast food when we come in at 2 or 3 am! lol
Talked to the friend of the family that also had apron surgery and ended up with a wound vac but her case seems completely different. She had about 16 lbs removed so not too far off from my 12 lbs but she had the wound vac because her incision opened up and she only had it for 6 weeks. She lost her belly button but is not worried about it as she's 67 and nobody would be seeing it anyhow. I'm not too worried about a revision on my belly button but I think my other scars and indentations are going to need something. Call me crazy but I'm thinking of asking how much lipo to my back fat / roll would be if / when I have to go under for scar revision. Of course I would want to know what any possible complications could be from it. I've just noticed that now that I'm into a size 10 jeans that it pushes this roll of fat up and with a clingy top you can really see the back fat. ugh!
Last weekend was absolutely awesome, draining but awesome! Now for some weekends of just chill time before we go out camping for Thanksgiving. Possibly going up to my in laws cabin for the long veterans day weekend.
Not sure that I'll be healed by the end of this month with the way it seems to be slowing down.... come on body, you can do this! :)
Not much change so....
I saw my PS on Monday, she suggested that I keep the wound vac on for a couple more weeks and then switch to the wet to dry gauze. She said that with how small my holes are now, most people wouldn't even have a wound vac. She also compared my holes to scrapping your knee. I personally think its a bit more than a knee scrape, my right one is still definitely a hole, the left one is super small but it still has some filling in to do. I like having the option to get off the vac but I'm just not sure that would be the best thing to do right now.
Next appointment, Dec. 9th, I hope to be fully closed and to be able to talk about a scar revision and trying to get rid of this roll on my back.
I made it!
Last night when we changed out the wet / dry gauze hubby actually said that it looked like the floor of the hole had actually come up... and that was just from this morning! Really loving being without the wound vac, I feel so much more like my normal self, just able to jump up and do things without lugging the bag along.
It dawned on me this morning... I haven't named my holes yet, so here's what I've come up with: tweedle dee & tweedle dum, Tom & Jerry, Thing I & Thing II, Wylie Coyote & The Roadrunner. Any suggestions?
Introducing... Bonnie & Clyde!
My husband says that its really filling in using the wet to dry gauze with vinegar. I am concerned about the yellow, especially when we're going out camping but my ps had said that it was fine when she saw it in October.
Anyhow, take a look a the pics... big difference, right!
Yellow every where!
Didn't use the wound vac at all, still not. Thinking about seeing if I can get in to the ps this week because the yellow is every where now. She had said that it wasn't an infection but that it was my body finishing up. I hope that's still true. I have actually felt it when washing in the shower (and oh how I love being able to take a shower every day now!) and it feels kind of rough, like fried egg yolk. Its definitely not liquid-y or oozing.
In October when I set my monthly appointment for November I though I could be healed by then but that didn't happen. I thought for sure in November when I set my appointment for December that I would definitely be healed... looks like wrong again! I don't know whats going on with my healing... its been almost 6 months since my surgery! I'm wondering also, why do we have to wait for this to completely close??? Isn't this all going to be cut away during a revision?
I'm ready to start really working out and lifting weights so hopefully my ps will give me the thumbs up on that.
Hope everybody had a great T-day... now its time to get ready for Christmas! :)
Bye bye yellow
Bonnie & Clyde go their seperate ways
The PS had asked if I could use the wound vac at night so that it wouldn't bother me too much but I'm not one to do things half assed so I'm using it day & night. We put it back on Tuesday night, changed it out Thursday morning and I will take it off either Friday night or Saturday morning. Depending on the progress that Clyde has made, I may or may not put it back on, on Sunday.
Sorry its been a while....
I was unable to continue with the wound vac since last week because the supplies were back ordered but they said they would be here on Thursday. They didn't come until Monday! I had told myself that I was only going to use the vac until Thursday 12/19 but Clyde wasn't as small as I was wanting him to be so I had planned to continue until Christmas morning and then the gift to myself for Christmas was no more vac. Which might have worked if the supplies weren't delayed... ugh! Soooooo.... last night we put the vac on, then took it off in the morning so I could work out and go about my day. We just put it back on about an hour ago. Not sure how much longer I'm going to be able to hang with it so that's why I'm just trying to have it on when its not inconvenient for me or my life.
Still trying to get back the $2300 dollars that we overpaid by because our insurance has a set rate for in network providers and Dr. Kim is an in network provider. Been working on that for 3+ months now!
Ready to start talking revision and get this hole business behind me! My surgery was over 6 months ago and I've been healing from it ever since. WOW!
Bringing back the vac
Clyde is getting smaller, Bonnie is almost gone. So that's good but it just seems so slow going.
Doc said that she like that the scar tissue isn't as hard as it used to be. I've been massaging it in the shower so that must be helping. She also said that I may have my belly button underneath the skin. Still no talk of revision. We were going to talk with Lisa about the $2300 but she was serving on jury duty. Guess we'll have to call about that next week.
Next appointment is about 3 weeks from now. Ordered what I hope to be the last wound vac supplies that I'll need. *fingers crossed*
What to do, what to do???
Lets see where we're at tomorrow.
So I was told today that not only did we pay the exact amount that we should have whether this procedure went through insurance (like we requested repeatedly) or we paid cash like we did but also that she would not be doing a revision because she can't operate on somebody who doesn't trust her. So I'm left with a hole, massive scars going from where my belly button should be all the way down to my incision line, no belly button and that's totally fine with A1 Cosmetic Surgery. WOW! How terrible! Where is the pride in their work, where are their ethics?!?1?
I'm gonna go cry now.
Sorry I haven't posted
All I can hold on to is that Karma is a mother *@%$&. I've been done wrong and those that have done me wrong will get theirs... 10 times over!
On a more pleasant note, it the Temecula Balloon & Wine Festival this weekend. We volunteer at the mainstage beer booth every year, so I'm really looking forward to that. My shirt size is different this year and I don't have to worry about the sweating & heat rash under my apron. YAY! Oh... and I'm down to a size 6. :) Pre-op I was a 16/18.
Update... why yes, I'd love to buuuuuttttt
Clyde is still with me and actually he looks bigger than the last pic I saw of him in a previous review from the end of february. So here's another summer without being able to go in a pool, lake or to the beach!
Went from a 16/18 pre op to a 6/8 post op... I wonder if there's enough tissue to fix this scarring. (I know the answer to this as I'm sure Dr. Kim does as well)
Wish I could share more.
Short version. $18,000 to fix me. My scar tissue has attached to my muscle causing pain. :( My hole is about the size of a quarter but under the unattached skin it's about the size of a silver dollar. This doc seems to think it will take one month to heal but after that quote i doubt we'll be seeing him again. Sad that I suffer and my doctor doesn't even care.
I will never tire of being called the incredible shrinking woman!
Cross your fingers RealSelf!!!!
My daughter graduated this year and turned 18. She was planning to go in the Navy after graduation but that idea seems to have stalled out now.
I will be coaching my sons AYSO soccer team this year so of course I had to get a pic with the Budweiser box soccer guy. :)
Botched on camera audition!!!
My friend said they're going to think I had breast augmentation and they went too big. lol
Surprised at what they're surprised about...
Tonight is my twenty year high school reunion. The contrast between my beautiful cocktail dress and what lies underneath is crazy. Good thing I didn't go to some crazy california nudist school! lol
Headed to the reunion
Working out too hard???
My husband thinks that I shouldn't be trying to lose weight while my body is trying to heal but I was really wanting to get into the 140's. But if that's what is making my body lag on healing... well then I'll just maintain at the 153-155 that I'm at. It's still over 30 down since my surgery. :)
Still waiting for a referral to go through so that I can be seen at a wound care clinic because wouldn't these all be great questions for a doctor actually trained in this field instead of Dr. Google! lol
Thanks for the support everyone! Hope you're all healing well or healed and loving your results! :)
I do have to admit that it hurt quite a bit, over this labor day weekend, to see my family and friends swimming and playing in the pool while I had to sit on the sidelines. At one point I came out of my friends house to see all the ladies bonding together by jumping in the pool together so I went back in her house and had a couple of oreo's. :( Not something I would usually eat but it helped fill the void for the moment.
I shared my story with everybody there and showed them my pics and scars. They all just sat there in awe. Everybody always says that I should get a lawyer, wish it was that easy.
So it's September now... hoping to get that million dollar, you've just won the lottery, call from Botched saying that I've been chosen to be on the show! :)
Happy planning, healing or living life everyone! :)
Got my referral... yay!
I'm continuing to have my protein at 105+ daily and only worked out tuesday & thursday of last week but did get in a hike yesterday. I'm taking Skin, Hair, Nails and Orac Greens from the Vitamin Shoppe and have just added 500mg of L-Arginine. I clean my wound in the shower with dial gold and then clean it with a q-tip and wound wash when I get out of the shower. Sometimes I put Eucerine on it, sometimes I put the brown perscription and sometimes I use the white perscription. So it will be nice to finally be under the care of a wound care specialist who can tell me exactly what I need to be doing and what I need to be avoiding. YAY! :)
Wound care clinic... oh how I've missed you
They were so great! The doctor checked and it doesn't seem that my wound goes under my skin anymore... yay! He set up to see me in a month and says that I should be healed by then. If not, then there are other products that we can look at to help me heal. He also mentioned using a type of skin graft that doesn't come from me but said that would be a last resort.
He said that working out should be fine, just don't do anything that would stress / strain that area. I also found out that I shouldn't have been cleaning it so much or leaving it open. They said each time that you clean it or leave it open, it takes about 2 hours for the wound bed to get back to the temperature that its supposed to be at which delays healing. Who would have known! lol So they gave me a care package of supplies and told me to leave the wound covered as much as possible (2-3 days at a time if possible). Guess I'm back to no showers again... but not as extreme as when I first had the surgery (53 without a shower). I think I'll wash my hair every other day and in between I'll either sponge bathe or shower but keep my abdomin away from the shower water.
I've been piecing together my mermaid costume for Halloween. I mentioned it last year that Halloween is our favorite holiday and we start planning our costumes the day after Halloween. lol We had wanted to have me be a mermaid and my husband be a fisherman (I would be his catch), last year but with the wound vac, open wounds and no belly button... that wasn't happening. lol Hoping to be able to fulfill that this year.
Hope you're all healing well or having fun planning!
Bye bye Clyde!
Thank you all for your support... I'm so glad that this journey is almost over. :)
Journey coming to an end...
Just having some fun. Looks like Clyde might not end up as clean and pretty (if you can call a scar pretty) as Bonnie but nevertheless, I'm glad to see him go.
I still have not soaked in a bath, gone swimming in a pool, jacuzzi, lake or the ocean because I would kick my own butt if it were open just enough to get an infection and cause a set back. But with fall now here, it's less of a temptation.
Halloween is coming and I'm sure I will be healed up in time for that. Come to think of it.... last year when I was hoping, wishing and praying to be healed by Halloween... did I specify which year?!?!?! lol Oh well... live and learn.
I pretty much consider, mission heal my holes, a success. :)
Wound care clinic appt
Not sure how comfortable I am with swimming in the pool at the cub scout family camp weekend in a few days. Would hate to possibly jeopardize my health so close to my revision. Speaking of revision... I've started a revision review so I think it's finally time to not be on this journey anymore but to start a fresh new one with hopefully a better outcome than I ever could have received from my original surgeon. :) Hope to see you lovely ladies over there. :)
Don't miss out on my revision journey
I chose Dr. Kim because I really liked her, I thought that she was a very skilled & thorough surgeon, honest & caring. I do however feel that she was in over her head with my necrosis and that maybe there was a way that this could have been handled before it became this large of a wound. I see now that she is trying to completely blame this wound on me and smoking but find it hard to believe when smoking was not an issue to her or myself prior to surgery or thereafter. I only smoked once a week and when the lady at the wound care clinic told me after surgery that I shouldn't smoke, I easily switched over to a no nicotine e-cigarette because its the hand to mouth motion, not the nicotine that I needed. Due to the tightness I am thinking that maybe too much was taken. If you look at my before & after pics you will see that there was quite a lot removed. I think that Dr. Kim and her office should willing to fix the terrible scarring and lack of belly button as it reflects poorly on her.