Tumescent Lipo and Umbilical Hernia Repair
I had tumescent lipo under local anesthesia 5 days...
- 10 Oct 2012
I had tumescent lipo under local anesthesia 5 days ago. The areas treated were my inner thighs, outer thighs, abdomen and flanks. I also had a small umbilical hernia repair. I'm a middle aged mother of two children. I'm extremely athletic and completed a triathalon a week before surgery. Before surgery, I did boot camp training, open water swimming, running, cycling, and step/dance classes about 3-4 days a week. I've had this routine since high school.
I found this website to be very helpful in making my decision to go through with the surgery. Hopefully you will find it helpful too!
Through my life, I've never liked the appearance of my thighs. I loved my tummy, breasts, arms, etc. and had a good body image despite my chubby thighs. I'm very petite and have a very long torso with short legs. No one is perfect. Before having kids, I weighed between 98 and 100 pounds, which is average for my height, and an athletic frame. I've always enjoyed physical activity and never engaged in it for weight loss, but for mental well being and for fun!
After having my kids, I found it very difficult to return to my pre baby state. I knew having children would change my body, but I think I expected to look "better" than I did. After having my second baby, my body would not "snap back" to my goal. The bottom line is that I carried two 7+ pound babies for 42 weeks (yes.... that's 2 weeks overdue with both kids). I was like a walking uterus for 10 months. I remember my first baby breaking through my transverse abdominals. We were on a winter vacation and I literally felt her push through my abdominal wall. I had a huge bruise and weakened skin around my belly button for months. My OB had never seen anything like it. I delivered both babies vaginally, so I had no c-section scarring. Even so, my abdomen was torn apart.
After my second baby was born, my abdomen was a mess. I had strong anti-plastic surgery beliefs and was committed to fixing my body through diet, exercise, and physical therapy. I tried to accept my new body. For five years I worked my tail off. My weight plateaued around 118 pounds. The number never bothered me, but the reality of my new body did. I had great muscle and cardiovascular health. I felt great until I put on a swimsuit, caught a glimpse in the mirror, or tried to find new pants.
To be frank, I had a permanent "front butt". My belly button was cushioned between two pillows of fat that would not budge. It also displayed a prominent hernia that was repaired when I was 8 years old and made a comeback during pregnancy. My delightful front butt would not leave and hardly disappeared with compression underwear. Frequently, people asked me when I was due with my third baby. How demoralizing! I also had two new friendly love handles above my hips. My body grew these new parts to accommodate my children. That's wonderful and I'm so grateful that my body nurtured my kids. I feel very blessed in that regard. They are in school now though, and I want my figure to match my lifestyle.
I grew tired of having my endorphin bubble burst in the locker room at the gym after boot camp. I began beating myself up for eating pizza and beer on Friday nights with my husband. I grew tired of going out because I hated the way my front butt tagged along despite my best efforts to cover her up! My strong body was no longer my friend. She was becoming my enemy. That's not a good road to walk.
Reluctantly, I made a visit to a plastic surgeon.
My husband is an MD and recommended I see one of his colleagues. It took me three months to make that first appointment. The doctor had won top doc awards in my city for consecutive years, did a breast augmentation on a friend of mine, was board certified (of course), and served an a few committees with my husband. He is very meticulous and kind. I was still terrified of him.
The first time I saw him he recommended an abdominoplasty. This is what my OB recommended too. I began researching this procedure. Frankly, it terrified me. I hate hospitals, passed out when my IUD was removed, and can't watch when I get my flu shot. The thought of having drains and a long recovery was something I just couldn't wrap my mind around. I talked with three friends who had tummy tuck surgery and said the recovery was hell. One friend said it wasn't worth it. They both needed additional surgeries. One for excessive bleeding and the other for an infected drainage area. The other friend had no complications. She's a friend from my gym and runs marathons. She couldn't stand up straight for 3 months! I know myself well. Three months without any rigorous exercise would throw me into a depression. I wanted a shorter recovery and something less invasive. I gave up and once again decided to embrace my body as it was.
The straw that broke the camel's back was my injury last spring. I developed a stress fracture in my left leg due to a weakened abdominal core. I was overcompensating and putting too much stress on my knees, hips and legs. I faced 12 weeks of physical therapy that ended up strengthening my core. I felt like a new person! I was standing up straight, running without pain in my knees, and felt great! Even after all of that core work, my little friend the front butt was still tagging along.
Needless to say, I went back to the doctor.
This time I told him that a full abdominoplasty was not an option for me. I wanted to explore other surgeries. He said a mini tummy tuck was a waste of time and he wouldn't do it. He said that his surgeries were like his signature and he wouldn't sign off on bad work. He also said it was a waste of my money. That's when I asked him about liposuction/liposculpture. He thought for a moment and did another exam. I could tell he was jumping to another track as he began seeing my situation with new eyes. He said that we could improve my silhouette with tumescent liposuction to my inner and outer thigh, flank area, and abdomen. I was thrilled! He also wanted to fix my hernia, as he was worried about a later "strangulation" which would be a medical emergency. I was reluctant, as I wanted my surgery to be simple. He did persuade me to fix it because it was medically indicated. I agreed. He then told me that he wanted my expectations for the tummy lipo to be reasonable. The only way I'd get rid of my mommy bulge is to have a tummy tuck. The lipo might help a bit, but it wouldn't "fix" the area. I'm not looking for perfection, just improvement. I reassured him that I understood that fact and wanted to go forward. He agreed. I thanked him and told him that I was still OK with only lipo on my abdomen. A bulge was OK with me. A front butt was not. He was pretty sure the front butt would be smaller, but wasn't making too many promises. This appointment was in March. I booked surgery for the first week in October. He's a busy doc!
I spent those months managing my expectations about my surgery. I did a ton of research. Liposuction can have mixed results and serious complications. While the recovery can be simpler than other surgeries, it's not a walk in the park. The biggest complications are deep vein thrombosis (DVT),blood clots, which can result in pulmonary embolus. Yikes. There can also be infection, loss of sensation, excessive bruising and swelling, skin death, discoloration, surface irregularities, and uneven contouring. The list goes on. I felt it very important to take these risks into consideration.
Despite the risks, I felt that I needed to go on with my surgery. My body image issues were not healthy. I want to be a positive influence to my kids and friends. Hating my body was a bigger risk than a DVT. I decided to take the risk. I wasn't naive though. Any of those things could have happened to me. They are rare, but they happen.
I was terrified of developing a DVT and stopped taking my birth control pills pre surgery to reduce my risk. I also followed my doctor/nurse's orders exactly. My doctor was great and reassured me that they would take great care of me and watch for any complications carefully. He also said that most of those complications happen with active middle aged women like me. He didn't sugar coat the issue. I appreciated that.
At my pre op appointment, the nurse terrified me. She said that the recovery was painful and tough. She said most patients find it worth it, but some aren't pleased. She walked me through what would happen on the day of surgery from my arrival to departure. She told me to be sure to have help with my house and kids for at least 4 days. I was glad she didn't sugar coat it either. This wasn't a trip to the spa!
I left the exam room to pay for the surgery. As I walked into the scheduling coordinator's office, I lost it and nearly cancelled right there. She was great. She closed the door and blinds, handed me a tissue and told me my feelings were normal. She said that they would all take great care of me and that she would have the doctor call me if I wanted him to. She also gave me the option of rescheduling. I pulled out the check book and wrote that check feeling like it was all a dream. I told her to leave everything in place. I was determined to do this. I wanted it and I hated it all at the same time. I hated the fact that I "sold out" to plastic surgery, but I loved the fact that my body could look more like I wanted it to. I hated that I couldn't accept my body, but I felt so lucky to have the opportunity to change it. I was like a roller coaster. Who knows how I'd feel at the end of the ride.
I spent the next few weeks sure I would die. I'm not joking. I wrote letters to my kids, put my will in order, set up a whole financial planning meeting to be sure my family would be ok, and gave my husband orders for my memorial. I told everyone I was having surgery. I am very active at my kids' school, so everyone would notice when I wasn't there. I told them I was having a hernia repair, not ready to discuss the lipo yet. I stocked the fridge, cleaned the house, set out outfits for the kids, wrote down the school/activity schedules and prepped the bed/couch for post op. Here's what I had on hand to take care of myself in case I survived:
1. Two plastic shower curtains (one for the car ride home and one for the bed) to protect the car and the bed from bloody fluids
2. Large pack of Gatorade
3. 3 boxes of nonstick gauze pads
4. Two rolls of surgical tape
5. All of my medications from my doctor (two painkillers and an anti-nausea med)
6. Stool softeners and milk of magnesia
7. Hydrogen peroxide for cleaning the compression garment (NOT for cleaning wounds!!)
8. Bendy straws so I didn't have to sit up to drink
10. Extra clothes set out by bed. Make sure they are dark, loose and can be thrown away.
11. 10 or more old towels that are clean and can be thrown away or stained.
12. Absorbent pads. I found these by the incontinence supplies (Depends, etc.). You can also use puppy house training pads. Get the largest size you can find.
13. High protein snacks like nuts, dried mango, and peanut butter.
14. Saltine crackers to eat before meds.
15. Plastic containers by toilet to urinate in. Sitting on that hard toilet HURTS post op.
16. Post op instructions and my doctor's phone number put in an obvious place for my caregivers to find.
17. 4 days worth of 24 hour care for me and my kids.
18. Extra advil and tylenol to take AFTER I was done with the prescription meds my doctor gave me.
19. My kindle.
20. Iphone charger easily accessible from bed.
That's my top 20 list.
The day of surgery arrived. I took a sleeping med. The doctor gave me the OK for ambien, the night before surgery. I had a cup of black coffee and a glass of water 2 hours before my surgery was scheduled. Then, nothing. My mom arrived to take the kids to school. My hubby went in to round on his patients and would meet me at my doctor's office before I went in for surgery. My mother in law, a former nurse... thank GOD, was there to take me in for surgery. I wore old very loose yoga pants and a zip up sweatshirt with my black ugg boots. Glasses, no contacts. I packed my ID, a few old towels, the shower curtain, an absorbent pad, and a gatorade in my backpack. I threw on a hat and we were ready to roll.
The nurse came to get us at the reception area.
She gave my mom, who successfully dropped of the kids, and my mother in law some coffee. My hubby arrived. Doctor came in. I lost it. Crying like a baby.
He hugged me. Told me to change into surgical socks and a gown. Gave me a cozy blanket. After I changed, it was the moment of truth! He took me down the hall to a white room with a black wall and took the before pictures. My embarrassment of my front butt reconfirmed the reason for my surgery and I settled down a bit, excited to toss that monkey off my back. I got back into the gown with a renewed sense of purpose.
I came back to the room and kissed my mom and mother in law goodbye with a few tears. Then, the marking began. I felt like I had pledged a bad sorority as the doctor marked my fat. I offered a joke about making a t-shirt that read, "Body by Dr. ####". I told him if he did a good job, I'd wear it around town and bring in a ton of business for him. He laughed and said that was good motivation. It lightened the mood a bit. He finished and told me the anesthesiologist would be by soon.
I cried more as we waited for her.
She came in and asked me questions about my medications and when I last ate. She weighed me again. I started to freak out about the medications she was going to give me. Thank God my husband was there to tell me that the meds were no big deal. I didn't have general, but I did have some medications to help me "sleep". The meds are similar to what you get when you have a colonoscopy or endoscopy. I was reassured by him. She left and told me to wait for the nurse.
The nurse came and weighed me again, took my blood pressure and told me that all was going to be OK. I said goodbye to my husband (literally.... have a great life and take care of our kids) and she walked me down to the OR.
I couldn't look. Operating rooms freak me out. I looked down at my socks and cried instead. I told them I was a bad patient and hated this type of thing. They held my hand and reassured me. Again. I felt like a diva, but those were my feelings and I felt better just letting it go. It took them a while to get my IV started, but they were gentle. I cried and cried. They kept trying to get me to relax. Good luck. The sweet anesthesiologist tried to distract me by asking about my kids. That made me cry harder, as I was sure I was leaving them motherless for vanity! She changed the subject again when she saw my race markings on the back of my legs (they put your age and number on your legs with a sharpie marker for identification during triathalons). I explained that I did a triathalon last weekend and that I...........out.
I woke up and promptly told the doctor to hurry up because I had to pick up my kids at school. I was pretty loopy. Ha ha! He went out to tell my mother in law that I had done great, but wanted to be sure I wasn't going anywhere today but home. They got a good laugh out of that. He gave her post op instructions and she went to get the car prepped with the towels, pads, and shower curtain in my backpack.
The first thing I remember was sitting in a wheelchair rubbing my eyes. The nurse kept saying, "Hands away from your eyes, hands away from your eyes." She put on my glasses and hat. I was fully clothed in my yoga pants, sweatshirt, and boots. I had a compression garment on that felt wonderful and very wet. Gross. She gave me a blanket too. She wheeled me to the car and away we went. I was totally out of it and felt drunk.
I remember driving down our street and seeing my crazy neighbor. I asked my mother in law to take me around back because I knew I'd be leaking fluid. I'd been having dreams of becoming a human sprinkler with holes all over my body, spouting water everywhere! I didn't want it to become a reality in front of that neighbor especially! She drove into our garage and closed the door so we'd have some privacy.
It took us a while to get up all of the stairs, but I did it. I remember seeing my front butt GONE! Even with the garment on, I could tell. I also could tell that my trusty saddlebags were left behind too. :) That was the best I'd feel for a long time.
I'm not going to sugar coat this. There was blood EVERYWHERE. If you've had a baby, take postpartum and multiply it by 3. You will need a lot of towels. If you need to get up, wrap one around your legs, back, tummy, and between your legs. Cover your carpet with non slip towels to catch the blood that will drip everywhere. I stained four flights of stairs with blood from walking up them just once post op. The drainage is not clear. It is bright red. I filled an entire package of absorbent pads in just 12 hours. I also dirtied 5+ towels, ruined a pillow, and stained my bed, despite the shower curtain. Think of the goriest CSI or Dexter episode. I'm not exaggerating.
Your caregiver can't be queasy. I was so out of it after those medications, I couldn't take care of myself. My mind was not working. My mom and mother in law were so busy taking care of the kids, switching out my towels/pads, cleaning up blood stains on the toilet, stairs, bed, etc. It was crazy.
I felt fine through all of this. Those drugs work wonders and the swelling/bruising weren't there yet. I had some peanut butter toast, chicken noodle soup (be careful of the sodium though) and a piece of pizza. I drank water and gatorade like I'd been on a 3 day hike. My thirst was insatiable. I watched TV, "read" magazines, and dozed away. I cried because I was waiting to die from a DVT. I was scared, thrilled that my front butt walked away, thirsty, afraid that my kids were afraid, thankful for my mom/mother in law, terrified that I'd stop breathing, happy that my legs already looked smaller..... What a ride. Glad it's over.
The next morning, I felt like I'd been hit by a truck. I had been in and out all night. The bathroom looked like a crime scene. Keep your kids AWAY. I was able to organize my thoughts a little better and decided that I would no longer sit on the hard toilet. The compression garment has a sexy cut out used for bathroom purposes. LOL. I found some old tupperware to do my business in rather than torturing myself with sitting.
I decided it was time to begin taking the vicodin/anti-nausea meds. My legs hurt so badly that I couldn't move them without help. I needed help to get in and out of bed/couch, sit up to drink water, shower (big production with lots of help), etc. Light housework was out of the question. I took one pain pill every 6 hours on Saturday, Sunday, and Monday. I should have taken more, but I was too scared.
As the days went on the swelling got worse, as did the bruising. Right now, day 5, my legs are literally purple. I'm too shy to post pictures, but if you google search liposuction bruising, you'll find a few examples. Mine are so bad. The bruising on my right leg extends all the way to my ankle. My whole body is swollen. My rings barely fit. No joke. Anyone who can do light housework or return to work 2-3 days after this surgery is my hero, or simply super human. I'm a tough cookie, but this is no joke.
The anesthesiologist and my doctor called on Saturday to check in. We began measuring my right leg, as it was bigger than my left. Because it was not getting bigger and it wasn't hard, we decided to just watch it. Please be very careful to watch your swelling and call your doctor if you find any hard areas. DVTs are not something to mess with.
I try to get up and walk around every few hours. I drove my kids to school today, limping around like an idiot when I took them to their classrooms. I think it reduces your risk of complications if you try to move around and not sit in one area for too long. I get up and make lunches for them too. Today, day 5, is my first day without help. I only take the pain meds when my husband is home and we are here for the night, around 7 pm. The rest of the time, I take advil because my doctor gave me the OK. Wait until he/she gives you the ok too. I can't make dinner yet or stay on my feet for more that about 40 minutes. My right leg is still bleeding. My tummy and flank areas are healing the quickest. I literally look like I've been hit by a semi on my legs. I've never seen anything like it. I won't need a costume for Halloween. It makes me dizzy just thinking about it.
Showering is an ordeal. Make sure someone is home with you who can see you in your bride of frankenstein glory. I take my garment off and hand wash it. Then I throw it into the dryer. I waddle to the shower. After washing hair, I gently remove the one bandage I have on over the wound that is still bleeding. It's easier to peel off after it's been wet. The other steri strips stay on until tomorrow, when I have my post op appointment. I try not too look too much. It makes me dizzy.
I dry off and wait until my wounds dry a bit before covering the ones that haven't scabbed over yet. I have about 15 different holes and my belly button stitches. They all seem to be healing quite well. They stopped bleeding on Sunday, except for the right leg one.
After hair, teeth and makeup are done, I grab the compression garment out of the dryer and head for a long nap. It's the hardest part of my day.
So, I hope this explanation has been helpful. I'm not sure of my results yet. I think it will take a few months. Overall, I'm glad I took charge of this. I feel empowered by the fact that I've done what I can to achieve my goals. I can say I'll never go through plastic surgery again, but I'm glad I did this even if it's not "perfect." I feel free of my body image issue. That's a good place to be! I'm ready to get back to living in a body that's the best I can make it. One day at a time... I'll be patient for results.