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Michael D. Cohen, MD
Board Certified Plastic Surgeon
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Compression band

Hello. I'm posting this picture of my favorite compression band to reduce swelling. Someone wants to see it... And this is the only way I can figure out how to post it.

Make that 1 year, 5 months, 8 days since my life began...

Hello, everyone. Happy Wednesday evening. As promised, I'm going to tell you everything that has happened to me for the past 15 months, give or take, in a nutshell.

There are events that divide our lives into "before and after." For instance, there was "before" I became a Christian and "after" I became a Christian, and it was the same before and after for my mother and father's death, my beloved little dog, Bobby's death and so on. And that we remember our befores and afters so well and continue to be affected by them is proof that the event and our response to it was and is significant. My surgery, the re-construction of my body, hence my life, really, is one such event.

Where I left off in my previous posts was just three months after I had my makeover. I can remember writing that post because three months seemed like an awfully long time, at the time. I was very happy with how I looked but I wasn't quite "me" yet. I still had significant swelling, looked a little "thick" (for lack of a better work) and my entire stomach was quite numb. So numb, in fact, it felt like someone else's stomach. I had been told (and read here at RS) that it takes time... Time, of course, is relative and I thought, heck, six weeks out I should be good to go. Noooooo.

As time goes on, I find that I am at once used to the new me, yet still surprised by it. I remember a nurse telling me when she was prepping me for surgery, that she had had it done and the biggest adjustment she had to make was how to deal with a bombshell body. That stuck with me and in fact my daughter tells me that it is all I wanted to talk about while coming out of anesthesia. Just what did she mean by that,? I'd asked over and over again.

One day in the very recent past I just had the overwhelming realization that I just feel so good. I mean, I FEEL wonderful! I can wear jeans, I can wear shorts, I could wear a crop top if I were so inclined. But beyond that, I FEEL so good. And that got me to thinking, why? More activity? Less fat? Drinking more water or eating better? Is it because of these things or in spite of these things? All I know is that there is truly a whole slice of my life that has simply been re-set and it is a beautiful thing.

We've had a lovely summer in Maryland. The nights now, though, are becoming cool and the days shorter -- the unmistakable signs of a waning summer season. It makes me nostalgic because this is my first summer as ME. I know that sounds very dramatic but it is how I feel. In a previous post, I had written about how just before my surgery in April 2014, I had a running dialogue with myself as the date approached. "This is the last time I will... (clean house, dust, do the wash, grocery shop, wash the car)... looking like this." And as the sun sets on this beautiful summer, I find myself doing again, my first summer as a whole person. Comfortable in my skin for the first time, possibly ever.

Here are some (very) random things I do, have noticed, or want to talk about:

1.) Scarring. I hardly notice the scarring any more at all. I have been very fortunate in that regard or perhaps it's not all that important to me. I was given Mederma cream as part of my pre-op build up to start using (if memory serves) after the scab comes off the incisions. As everyone knows, Mederma is expensive as all get out and the little bottles contain about a pins's head worth of product. So I didn't use it for long but I have to admit that I think it worked. If you look at the picture I posted yesterday, you can see a little "divot," visible right at my pants line on my left side (MY left side, not the picture's left side). That little area is where the incision ended and could be a very mild "dog ear." My point is, there is hardly any scarring.

Another area of scarring is my right areola. I had some mild areola necrosis on my right side after surgery. It hurt like the dickens but in the end it did heal nicely and that little area, maybe 1" or so is "out of round." In the big scheme of things and considering some of the horrid necrosis pictures I've seen, I'm very pleased and very lucky. It is almost impossible to imagine that they cut the areolas clean clear off your body, set them aside ( guess) and then PUT THEM BACK ON! I mean, seriously? So, yeah, I'm lucky.

2.) As I mentioned before, I feel, now, that I am mostly healed. It's been almost a year and a half. So when you are told to be patient, that is not a suggestion, it's a fact. I think it's important that people heed that. I am only VERY recently experiencing much less pain, well, discomfort, along my abdomen mid-line. I am very recently able to push down a window. (Post-op ladies, am I right?) I don't know what that mechanism is, but pushing down a window or anything requiring that motion was ridiculously and annoyingly difficult. The long time lapse of discomfort really alarmed me because I was afraid that not exercising for abdominal and core strength could affect my surgery benefits. At my one year post surgery followup, however, my surgeon told me not to worry about that and that it is important to let my body guide me. Not lie to me. Guide me.

3.) I still wear my compression garment every single night. I love it. I'm into my third one and I cannot imagine a when I would not cocoon myself into my garment at night. I feel as though I am secure and can get a restful night's sleep with it on. It's most likely psychosomatic and since I'm a nut, that makes sense. In all seriousness though, I firmly believe that it reduces the swelling that I had issues with early on. My stomach is very, very flat in the morning.

4.) I want to stress again that I followed every single rule and directive that was given to me, to the letter, and I believe that to be why I had such a positive outcome. When I didn't know I asked. When I did know, I did it.

5.) I don't love love love my breasts. My doctor opted to use the textured implants. His theory was that due to my age and small frame, I might have some sagging over time with the regular untextured implants. From what I understand, the textured implants work a bit like Velcro, adhering to tissue. The up side is that they stay where you put them. The down side is that they stay where you put them. I can literally feel them, the outline of them. They LOOK great, they feel awful. The top of my breast is soft and pliable, the underside is, well, not. I guess one way to explain it is that the textured must be placed precisely because it stays there, it doesn't slip around like a smooth one apparently does. It can be a bit odd when lying on one's back, one's boobs are sticking up in the air, especially given that pre-surgery, one's boobs were laying there right beside her.

I talked with my surgeon about this during my last visit. He told me that I am noticeably thinner than I was when I initially had my surgery and this could be some of the reason. But he also said that he has had a bit of a change of heart about the textured implants and is not as enamored with them as he had been, for these reasons. He said that we can certainly explore switching them out, a surgery that is not even in the ballpark of the initial surgery. One reason not to do this is, of course, cost. But the other I think is that I know what I have, I realize the limitations of it and I don't hate it. I think for my age and body size, what I have is the best for me. I don't LOVE them. But love is overrated.

Oh, and one more thing. I had significant stretch marks on my breasts. The implant placement and the "wedge" that was cut out to accommodate the lift, has caused a "bubble" of skin. The stretch mark was so long and wide that now there is a bubble of thin skin on the right breast. It's not visible in the photo -- I looked. But if you do have significant stretch marks to your breasts, you may want to ask your surgeon what can be done to minimize the possibility this will happen to you.

6.) The following is a true story: My oldest daughter and I bought an antique store early this year. And in this store, we have surveillance cameras. Whilst looking at the cameras' video clips, I noticed that I tended to walk a bit hunchbacked. What the what?! Have I always done this? Why? I'm not a tall woman so why would I ever want to look shorter? Honestly, ladies, I had NO idea that I did this. Maybe it was just a bad day, I thought, so I pulled up video clip after video clip. I was ape-like in every single one of them. So, about three months ago, I started to make a concerted effort to stand up straight. I MAKE myself put my shoulders back, straighten my back, and mentally "stack" my neck vertebra over my back vertebra. I make a concerted effort to put one foot squarely in the front of the other one, not with toes out like a duck or in, pigeon toed. I try to walk by putting each heel where the other had just been, or nearly so. I literally imagine my spine stacked up like building blocks, not to be knocked over.

So, that said, people have been saying to me lately the following: "Have you lost weight?" "Did you get a haircut?" "There's something different about you." Even my husband, who wouldn't know how to hand me a compliment if it was on fire, said to me, "Why are you so beautiful lately?" AND (I swear this is true!) "I never noticed how tall you are." I am convinced that it is because I am standing up straight. My clothes are hanging off of me the way they are supposed to so they fit better. It probably has nothing to do at all with the surgery, but maybe it does... I spent so much time trying to "hide" myself that it is no wonder I was hunch backed. I was trying to disappear. (I have attached a recent picture, fully clothed. My surgeon told me that one of the best surgery benefits is that clothes fit better. I think that good posture helps so much and that's why I'm attaching the picture.)

7.) It continues to be difficult to handle other peoples perceptions of my decision and motives to do such major surgery. It bothers me. My grandma used to say, "You wouldn't care what people think of you if you realize how seldom they do." (She also said "The only things open after midnight are hospitals and [RS bleep] houses..." but I digress.) What I have been trying to do since my surgery is stand back a bit and really take notice of others and myself. How we talk to others. How we react when we encounter someone overweight, or homeless, or addicted, or unattractive or unkempt. What does it say about me when I stand behind someone at the market who smells like cigarette smoke and I make a mental calculation about the money they spend on their habit, and how much they would have over a years time if they gave it up. I glance at their shoes and then their pants, shirt, purse. What nicer things they could have if they saved their money, I think. Who do I think I am? I whine because women treat me badly when they perceive competition, yet I judge just as harshly and for even less reason. The bottom line really isn't that it isn't nice to judge. The bottom line is, that it's none of my business.

I have said all along that my journey and probably yours, has nothing to do with vanity. This journey has been about so much more than the technical aspects of putting me aright, nor is it about the wish to deny aging and gravity. Through the journey I've learned so much about myself, about facing my past mistakes full on, dissecting them to find the cause and/or motive, and then putting them on a shelf, turning off the light and shutting the door. They are still there, but not a part of my life. To find and examine them again, I need only open the door and flip on the light. For others to discover and expose them, they need only stumble upon them. We can't run away from what we are any more than we can run away from who we are. This surgery isn't for everyone. Many don't need it to feel beautiful or complete (as SOOOO many women have been quick to point out). But for those to whom it is important for, it is VERY important.

At the end of the day, all we can do, really, is trust in God and take the plunge. My grandma also used to say, "sometimes you just have to jump and build your wings on the way down."

My best to everyone wherever you are regarding your surgery. I am always here to talk to anyone about anything, if you'd like to. You can post a comment or send a private message. I'm sorry I didn't write all of this sooner -- but I've been out enjoying my very first summer. God bless.

It's been 1 year, 5 months, 7 days since my life began...

Hello! I have been meaning to write over and over again but I either didn't have the time, or didn't have the pictures, etc, etc, etc.

This will be short because it's late but I wanted to get this picture up and I promise to come back and comment very, very soon. I feel SO good now but it took a long time. This photo was taken about a week ago. I promise you that it hasn't been carved or sliced in any way. It is me, now. The quality is horrible, the reason being that it is 1.) taken with an iPhone and 2.) had to be cropped to get rid of my shield my face and when I did so, all resolution was lost. 3.) It is in the morning and I am in my jammies. But just the same, it is me and it is now.

I turned 56 this past June and as I've said many times, I only wish I'd done it sooner.

I promise to write soon... and it will be such a long post that you'll actually stop reading. I hope everyone that has had the surgery is doing well. I hope you that will have it soon are excited and resolute. And, I hope you that are contemplating will be encouraged to take the plunge.

Talk soon! God bless.

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Board Certified Plastic Surgeon
1427 Clarkview Rd., Baltimore, Maryland
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