Extended Tummy Tuck W Flank Lipo After Major Weight Loss - Washington, DC

Hi All! My name is Beth and I am a 28 year old...

Hi All! My name is Beth and I am a 28 year old female with no children who used Weight Watchers to lose 88 pounds. I hit my goal weight almost two years ago, and despite exercise and eating right, I have a lot of excess skin and fat around my midsection that causes me extreme anxiety. The thought of changing my shirt in front of my girlfriends literally makes me cringe, and I am so self conscious that I do everything in power to make sure no one can see what I've got going on in that area.

I've wanted to get a TT for a while now - pretty much since I hit my goal weight and realized I had an "apron" that wouldn't go away without surgery. What held me back until now is that I was too embarrassed to talk to a doctor about it, and I thought I couldn't do the procedure prior to having kids. But, I'm young and have worked hard to get where I am health wise, and feel like I deserve to be happy in my own skin. The future pregnancy thing was my biggest concern, and something I addressed with every doctor I've had a consultation with. I'm told that it's OK to go ahead with the procedure even if I do want kids in the future, and while they can't predict the results post pregnancy (just as they can't with anyone who gets pregnant), they can say that I will bounce back better than I would if I didn't have this procedure.

I consulted with three different doctors, and had a really hard time deciding between the first and third consultations I went to. After making a long list of pros and cons, comparing surgery date availability and cost, I finally made a decision to go with the first doctor I saw and liked very much. I've been really impressed with the entire staff in the office, and they were able to provide me with the phone number of a patient who had this same procedure done with him in September after going through major weight loss who is about my age.

I'm hoping to book the surgery this week for July 29 - which is just over two months away! I am SO excited for the after, but obviously nervous about the procedure itself. I'm thinking that I won't need too much muscle repair since I've not been pregnant and am pretty strong underneath all this extra skin/fat, so hopefully the recovery won't be too bad.

I've been pouring over these forums for months and finally decided to share my own journey. I also have a blog you can check out at BethsJourney.com where I will be documenting the process, but I plan to update here too to connect with so many people going through the same thing!


Good luck with your journey. You will not regret your decision and your date will be here before you know it
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Thank you! I'm so excited, but also scared!!

Surgery Date Set!

I booked my TT surgery for July 29 and the pre-op for July 11, which is just 7 weeks from today! I am soooo excited, but just wish it was here already. :)


Good luck on your journey. I too will be having a tummy tuck but decided to go to the Dominican Republic to have it done. I live in DC, what doctor did you decide on?
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I decided to go with Dr. Ruff after three different consults. I got such a great feeling from him, loved his approach, and was able to speak with a former patient of his who is around my age and got the same procedure done in September 2012. She was so thrilled with her results that it sealed the deal for me. Did you see any doctors in DC or just decide to go to DR?
I consulted with two docs in the area and was considering them but because I am having more than one procedure done and don't wish to take out a loan I decided to go to a reputable doctor in the DR. I will be going to the cosmetic surgery center at GW hospital for follow ups.

Recliner v. Hospital Bed

I am thinking about renting a hospital bed or recliner for recovery. I live in a studio apartment and have a regular bed and a couch, but I've heard it's much better if you have a recliner. Has anyone recovered without use of a recliner? Were you OK? Do you a recliner or hospital bed is hte way to go?

Thanks in advance!


Hello, there are quite a few of us on here from the DMV. A lot from PGC particularly. Had my surgery April 19th and am very please. My PS is in Columbia and I am very pleased with him. Had my surgery at Northwest hospital in Baltimore. We should all together for a TT meet!
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6 weeks til pre-op!

It's crazy that my pre-op is 6 weeks from today!! I feel like time is going to FLY by. I am so excited.


I'm doing just fine in my own bed with a ton of pillows to prop me up and two under my knees, so basically sleeping in a reclined "beach chair" position. The only thing I purchased for my place was a toilet seat riser and that has been super helpful. When I'm not in bed (with my computer, water, pills near by) I walk around my apartment for exercise so haven't needed special seating. All of the questions to ask your ps at pre op are good ones, and I've learned the dr.'s all seem to have different ways of doing things. Maybe ask how long you'll have to be in your compression garment, and ask if your anesthesiologist is a Dr. I hope all goes perfectly for you!
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I forgot, the hospital bed/recliner question-- are those for ease in getting in and out of bed/chair? I did not have either and did fine. What I had to learn very quickly is how to use my arms in place of my abs to prevent the searing pain that would occur if I tried to engage the abdominal muscles. To lower into bed I'd hold onto my husband's arms, become somewhat of a dead weight on him and let him lower me onto the bed or into the chair. I hope you have someone coming to stay with you the first 1-4 days, and practicing ahead of time those movements with them couldn't hurt. I have read some reviews that said a hospital bed and/or recliner was a lifesaver. I didn't get up and down very much so for me it seems like it would have been overkill. Getting in and out of the car was a bit rough the first 2 weeks but I was driving the Sunday after my Thursday surgery so it was doable. Everything was just slow-going and a matter of making adjustment for the abdominal weakness. Also, I want to mention the mental side of this, which threw me for a loop. I had several weeks of "why did I do this to my healthy body?" type of thinking and regret. The emotional rollercoaster too shall pass. Good luck!
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Best wishes to you and thank you for sharing! I look forward to following your journey. Congratulations on the weight loss--wonderful job!
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Pre-Op Today!

I'm so nervous I can't sleep, and this isn't even for then surgery itself!


You will do fine today. Did you write all your questions done? I always forget half my questions when the doc comes in.
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Yup I have them all in my iPhone! :)
Good to know you didn't need a recliner. My bed isn't too high so I think I'm gonna stick with the bed and lots of pillows. Thanks for the additional question ideas!

Pre Op DONE!

You can read all about it here if you want to: http://bethsjourney.com/pre-op-appointment/

But my pre-op was last Thursday and it is so surreal that the surgery is so close - two weeks from today! I am now paid in full and am just trying to get all my ducks in a row to be ready before the surgery. I ordered Arnica tablets yesterday on Amazon because my surgeon advised me to take those one week before surgery to help with recovery, and I also found out I am getting those little anti nausea patches to put behind my ear that they will apply during surgery. Supposedly those help a lot when you come out of anesthesia, but we'll see!

Two more weeks!


Sounds like you're ready to me! I also had a behind the ear patch and I never once experienced nausea. I wish you the best!
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Thanks Mandy! I'd never even heard of them before, but was excited when they mentioned it!

Before Pictures

At first horrifying, but honestly kind of liberating in a way now that I know I have less than 2 weeks in this body. I've worked so hard to get to where I am now, and yet I hate what I see in the mirror without clothes on.


Sounds like you're ready! Good luck.
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I think that you are going to be thrilled with your results, congratulations on the weight loss :) You've earned this surgery!!!
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Feeling ready!

11 more sleeps until surgery day. I got all my scripts filled today and my apartment is starting to look like a sick person lives here!

Here's what I got:
- Antibiotics
- Zofran (nausea)
- anti-nausea patch for behind the ear
- vicodin

Over the counter:
- Colace
- Tylenol
- Arnica tablets

- Shower bench
- Breakfast tray (for meals and computer)
- body wipes (for sponge baths)
- face wash wipes
- gauze/tape

What am I missing??


I have an adjustable hospital like bed. I am so glad I had it. I think recliners are to restrictive. You can get a similar effect with body pillows. I have the large u shaped pregnancy pillow and still use it today. It's comforting.... Good luck to you!
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Cough drops :) after my surgery my Throat would get really dry and scratchy anytime I would try to have a conversation for more then a minute . I'm sure from the tube down my throat during anesthesia. Can't wait to see your after pics, you will do great !
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Ahh good one - thank you!

One Week to Go!!

I cannot believe that at this time next week my surgery will be finished and ill be home, assuming all goes well. Today I took my first shower with antibacterial soap, as my PS asks that you use that in the shower for one week prior. I also started taking arnica tablets yesterday, stopped drinking any booze (will miss wine!!) and taking birth control or Advil/aspirin, and that's pretty much it! I am feeling so ready for July 29 to be here. I'm at the point where I feel like I can't do anything else to prepare, and I have so much trouble not doing something to get ready for such a huge life altering day.

It's struck me recently as I've been reading other people's reviews that I have never in my life had a body like what I should have after surgery. A lot of people want their pre pregnancy bodies back, and I haven't even had kids yet and can't stand to be in my own skin. I have been obsessing about belly buttons lately, and really like my PS's work, but I'm not going to bring in a photo because I don't want to be disappointed if it doesn't look exactly like it. I can't wait to have an actually bb and not just a gross overhang of skin like I do now!

What did you all do to pass the time in the week leading up to your surgery (besides of course pour over these forums...)?


Best wishes for an easy morning tomorrow and a happy you in recovery!
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Thank you!!
The big day is tomorrow for both of us!!! Good luck to you!!!
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PO Day 3 - Ouch

So my tummy tuck was Monday and its been a blur pretty much since. I arrived at the surgical center at 6:30am for the 7:30am procedure, and after getting marked up and having my vitals taken, I was back in surgery before I knew it. They first wiped me down front and back with that antibacterial stuff that smelled SO bad, and then they laid me on the table. I don't even remember starting to fade, I just remember waking up in the recovery room once it was over.

I came out of anethesia fine and didn't feel nauseous at all, which was a huge relief. He procedure ended up taking almost 5 hours, and I woke up dressed in my compression garment as well as the clothes I wore to surgery. I felt surprisingly great after surgery and was home by about 2pm. My mom is staying with me for the week, and my boyfriend came over that night to check in with me as well and I was so alert and with it, that even I was surprised.

Then around 8:30pm I hit the wall, and hard. I was in so much pain that getting up or moving was excruciating, and taking 2 Vicodin every 4 hours was doing nothing. I was up in pain most of the night, and my mom called the doctor around 2am to see if he had any suggestion for relief because I was literally in tears. He had her loosen the compression garment because I was basically busting out at the seams, and also said to take 3 Vicodin every 6 hours to see if that helped. He also said to come back to the office as soon as I wanted to after 6:45 am, but after taking the Vicodin and a Xanax, I was able to pass out for several hours.

Tuesday I woke up in excruciating pain, so I went back to the doctor and they removed my compression garment. I turned completely white and started profusely sweating, so I didn't even get to see the results from the surgery at all since I had to lay down so I didn't pass out which was a bummer. Getting that compression garment put back on and then stuffed with foam was one of the most painful things I've ever experienced, but it had to be done.

They also changed my pain meds from Vicodin to OxyContin and Percocet, and since then the pain has been much more manageable. I have been sleeping a lot during the day and getting up on my own to use the bathroom several times a day. It's now day 3 post op and I still have not had a bowel movement, which I think is what's causing me the most pain right now! I feel so bloated and swollen and gurgley in my tummy, I just can't wait to get it out. The doc made me try this cocktail yesterday - 4 oz. enema, 4 oz. apple juice, and 1 shot of vodka and I had to drink it and it was NASTY. To make matters worse, it also didn't help with the BM. I was also told to take some laxatives last night, which also did not help, so I'm sort of at a loss for what to do right now. My mother is out buying glycerin suppositories now, so hopefully those will help solve the problem, but we shall see.

So far, this has been way more excruciating than I ever imagined it would be. I am walking completely hunched over and am having a really hard time getting comfortable. I have no appetite, which is really tough since I need to eat to take all the meds, so I've been drinking tons of protein drinks. Hopefully I'll have a BM soon and things will start looking up for me!


Congratulations on making it through. I hope it gets easier for you quickly- I'm sorry to hear it's so rough right now. Please try to keep the pain meds going until you're out of the woods and know that without a doubt this is temporary. Your body has a lot of recovering and adjusting to do, but in the end I bet you are going to look phenomenal! It probably doesn't matter diddly to you right now about looking good but you are also going to eventually feel better than you ever have and you deserve that! I did not have BM issues but heard many others say Milk of Mylanta was the answer. Lots of us pulling for you and sending good vibes your way. Best wishes.
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Turned the Corner

At long last, I was able to have a BM! I ended up using glycerin suppositories which finally did the trick (after using them three times) and I cannot even tell you what a difference that made in how I feel. Like night and day! I was also able to take my first shower today and got a glimpse at my new body and I am amazed that this is me! Still a long road ahead for recovery, but I am so thrilled with the results so far and feel such an improvement from the last few days.


Wow...you look great! Congrats on your flat tummy, cant wait to be on the "flat" side with you:)
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Day 5 PO

Man they aren't kidding when they say recovery is tough. Physically, I am doing much much better everyday, but mentally was a real struggle for me today. I took my second post op shower with the help of my mom, and I started crying in the shower. Not because it hurt, but because I'm having such a hard time being unable to do anything for myself. I had to let it out, and then I shaved my legs, washed my hair, and got out. After the shower I felt much better, but getting that compression garment back on is a bitch! I have to wear three foam pads under the garment over my skin so the lipo stays smooth, and the fit is so tight even without those pads.

At this point, I've switched to Tylenol only for pain since the narcotics were causing me to be so constipated, and that was causing more discomfort than the surgery itself. I definitely still feel sore, but the pain itself has subsided a lot since the first few days post op.

Yesterday I also had clots in my drains, so I had to have the clots removed since the drains weren't draining fluid since they were clogged. During the unclogging process, one of the drains must have gotten punctured because it stopped working and started filling up with air. I spoke to my doctor and he said the drains are placed in the abdomen so they can both drain any fluid from anywhere, so at this point in my recovery one is fine since its basically serving as backup at this point anyway. I went this morning and they removed the one that wasn't working and i didn't even feel it coming out! I was dreading it but it wasn't bad at all!

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New Photos

Days 6-8 post op


You look wonderful!! Those are just fantastic results. You will likely have swelling and rough days ahead, but I imagine you are thrilled with what you see so far. Congratulations! And remember to take it easy. It IS hard not being able to be more independent, but it will only benefit your recovery to sit back and let your body heal. It's doing plenty of work while you rest.
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You look amazing. I'm also following you on FB and your blog. Thanks for the updates. Best wishes in your recovery. :)
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Aww thank you! I am sooo happy. Glad you're on FB and my blog! It's been fun sharing, but i am terrified about posting the pictures there for all to see... this feels so much more private (even though it's not haha). :)

Before and 1 week PO

fun with Paint! :)


Hi, Beth. I'm Beth too. I have lost a lot of weight and have surgery set for September. You look AWESOME!!!
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Hi Beth - great name!! :) September will be here before you know it. The time goes SO fast. Thank you for the compliment!!
You always know the right words to say. :) I am taking it easy, I promise, but love the idea of reminding myself that when I'm relaxing, my body is just working harder to heal!

Feeling so good!

I can't believe how great I feel! The first few days were ROUGH, but things really started turning around at 4 days PO. I was still very slow and walking hunched over then, and then around day 7 I was given the go ahead to start walking upright. Yesterday I went out to Target and to the grocery store, and was walking completely upright. My friend I was with couldn't believe I just had had surgery - our bodies are amazing! Granted, after 4 hours of being out, my back was aching pretty bad and I needed to get back home fast and sit down, but i'd just had massive surgery 8 days ago so... :)

I write a lot about my journey on my regular blog and posted a ton of pictures on there today, mostly comparison shots of the ones above. you can see the other blog posts here IF you're interested: bethsjourney.com/plastic-surgery


Just went to your Blog and read the update. You look AMAZING! Good for you!
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Thank you!!

First Ever Bikini

Seriously, I was always way too chubby, then outright heavy, to ever wear one. Because of my stretchmarks I never thought it'd be a possibility, but you know what? No ones perfect, and it's not that bad!


You look great! You must be thrilled with your results!
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Yeah!!! So exciting!! And to think you'll be even flatter when the swelling is over!
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It's not that bad?? You're a knockout, Beth!! Good for you, gf. So happy for you.
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Feeling so good

I honestly cannot believe how quickly I've been healing. My bruising is almost nonexistent at this point, which is crazy for just two weeks after surgery. Today is day six in a row of taking no pain killers - so not even Tylenol, which means my last day taking anything was PO day 11. I returned to work this week and had no problem with 8+ hour days. Swelling has been minimal until now, hoping I don't jinx myself! I had a Medsculpt massage yesterday which is to reduce swelling/bruising, and it felt really good! I also had a follow up with Dr. Ruff and he is very pleased with my progress. I don't see him again until the 6 week mark (unless I need to before then) when I'll have my post-op pics and post-op weight taken as well. So, so happy I did this - no regrets!


I am hoping for that kind of recovery too!! You're awesome. :)
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Haha well thank you! :) Honestly, I wans't sure what to expect as far as recovery goes because everyone has suuuuuch a different experience with it. I've been so suprised with how little fatigue/swelling I've had - I really think it's because I picked a great surgeon, and have been following everything to a T that he's told me to do (ie, wearing the compression garmet 24/7, taking it easy, taking arnica for one week pre-op and then continually through recover to combat the bruising). I am so pleased and hope you do have a recovery like mine! I will say, those first 3-4 days SUCKED, but it's been pretty smooth sailing since then!
Thanks for sharing those tips. I'm going to do everything my surgeons says too. He's good, he takes pride in his work and has confidently said (without knowing I am petrified) that everything will be fine. I think I am being realistic in my thinking. I'm expecting seven days of brutal so if it's better, that will be good. If it's longer, I'll deal. :)

PO Day 17 (updated pics)

Took these photos post shower today. My bb is a little gross so they gave me this Vaseline soaked gauze to start putting in there at the docs yesterday. I am so so happy with how I'm healing. The incision looks a little crooked but it's just because of the way I'm holding the camera - it's perfectly straight!

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Side by Side

So pleased - love seeing the before and after.

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One Month PO

Today officially marks one month post op and I cannot tell you how amazing I feel. I am beyond thrilled with the results and am almost feeling 100% recuperated. I'm still wearing the compression garment almost 24/7 and will be for another week and a half, but I did lay out at the pool in a bikini for the first time in my life last weekend! It was surreal. Monday, at 4 weeks PO, I exercised for the first time and went on the treadmill, walking for 15 minutes and then jogging slowly for 20. Wednesday I took it outside and walked for 5 minutes to warmup and cool down, and jogged for 25 minutes. I was told to slowly build up so I'm trying not to overdo it, even though I feel so good! I almost ran in my sports bra because it was hot out, but I chickened out at the last minute! My belly button is still oozy/healing, and I do have that whole 2' incision across my midsection, but I honestly could not be happier with my decision to have this procedure done, and the surgeon I went with. He is amazing.

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Full Photo

I feel like it's hard to see in the comparison shot - here's one month PO


You look amazing! Fantastic results. :-)
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I get your FB updates and I'm so excited for you!!!!! I can't imagine how good you must feel. You look ahhhhmazing. I jump up and down for you when I see your fb posts! :-).
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Spent almost all of Labor Day weekend lounging in a bikini - I'm so happy I could squeal!


You look great! I have surgery with Dr. Ruff in one day! I am nervous but I am becoming alot more excited as the days grow closer. It was nice seeing his work. Thank you for sharing your journey. Do you have any advice for me?
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AMAZING!!! You look beautiful! Congratulations on your successful surgery!
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Washington Plastic Surgeon

I absolutely LOVE Dr. Ruff. He was so patient, attentive, and caring during my consultation and pre-op appointment. He answered every question I had and was very thorough in his explanations so I left feeling so good and excited. He nails that fine line between confidence and cockiness, and is a very talented surgeon with an amazing staff. I've been impressed with everything from the reception area to the surgical center, and from the receptionist to the doctor himself. He is also an amazingly skilled surgeon. I am so impressed with my progress so soon after the procedure and how quickly I've healed! He called me from his personal cell phone the night of surgery to check in and answered a call in the middle of the night when I was in a lot of pain. Highly, highly, highly recommend.

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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