John M. Houle, MD

Dr. Houle did an amazing job! I’m less than two years from 60 years old and I can wear a two piece swimsuit! I won’t go to anyone else. He also corrected bad plastic surgery and made my breasts beautiful. I’m so happy and so grateful!

I am currently 29 and my 30th birthday is soon approaching! I had a baby when I was 19 and the skin on my breasts stretched so much and I was left with deflated, sad breasts! I have always been so self conscious of them and never really felt like a woman! Well birthday present to myself is coming!! I am sooooo excited. I want something perky, yet no something that screams "boob job" Hoping for a C cup, moderate to moderate plus silicone!

Updated on 22 Jan 2015:


Updated on 22 Jan 2015:


Updated on 24 Jan 2015:
My am 5'6, 110lbs. I have always been skinny and have always had small breasts, but they have gotten even smaller since becoming more active! I am a fitness lover and hope my new breasts will compliment the rest of me and the hard work i put in!!! I am hesitant to post actual breast photos! Maybe after this is all said and done I'll have the confidence;)

Updated on 6 Feb 2015:
Met with Dr. Houle today who took some measurements and we discussed size options. He was so thorough and made me feel so comfortable! I do have a little asymmetry but he said it wasn't enough to do different sizes. Also discussed the gap in between my breasts. I have a 13 BWD (not sure how that falls in the range of being normal?) but we decided to go for an Allergen moderate plus profile textured silicone implant. Size choices are 322, 354 or 378! I feel like the 354 will be best as it fits with my BWD. I don't want something too narrow that would increase my breast gap!! Ah I'm so scared of that but it's my anatomy and I can't change that. And I do not want something too big that will not match my petite frame! Oof so many choices. He will decide which implant looks best and that is the one I will have! I Paid in full today so there's no turning back! Getting so excited and still feeling a little like this is all a dream! Don't wake me :)

Updated on 11 Feb 2015:
So my surgery is tomorrow at 12:30. I am so anxious! I also came down with some kind of weird sickness a few days ago. Trying to fight it and downing the Vitamin C. Seems to be helping a bit. They won't do the surgery if I have a productive cough. So far just a mild head cold and body aches! This sucks! I pray for it to pass so I can be healthy for my surgery... Trying to get everything together and clean so I am ready for what lies ahead. Wish me luck. I am leaning towards the 354cc right now Moderate plus cohesive gel. Hoping it will not be too big?! Excuse me now while I go vomit up my nerves.

Updated on 13 Feb 2015:
Soo beyond words happy with my results! I ended up with 354cc ! I keep telling myself I'm going to wake up from a dream. The pain has tolerable but I'm so glad it's over! The evening was pretty rough, I was up every hour and a half to two. I slept in a recliner which I'm sooo glad I had! 8/10 pain through the evening and a 3/10 today! Just going to take this all in now!! Yay!!! Here are before and after ....

Updated on 16 Feb 2015:
The pain is getting better everyday. Sleep however, not so much. I wake up a lot with a lot of pressure and uncomfortableness! Trying not to take the Percocet and an relying mainly on Ibuprofen.. My chest is bruised from this band and that seems to be causing most of my discomfort! Thing is so tight! I am still pleased with my results. Only feel like I should have gone bigger when I take a full body pic. But when I just look at them in a mirror I am extremely happy! Still can't get all the goop off :) oh and the BLOAT is horrible. I feel yucky like I need to run 100 miles.

Updated on 16 Feb 2015:
I can't stop taking pictures. Like seriously, this is the best thing I've ever done for myself. My results are better way better than the image I pictured in my head. Yay for boobies!! I HAVE CLEAVAGE!

Updated on 18 Feb 2015:
Bloat is finally subsiding!

Updated on 20 Feb 2015:
Swimsuit Shopping! ONE WEEK POST OP! I think this is the best part :)

Updated on 5 Mar 2015:
The 3 week mark is here and I'm still very happy!!!! Finally able to work out a bit and sleeping is getting much easier! The boobies are getting squisher but they're still pretty sensitive.. Almost feels like they are badly sunburned... really weird! Started using silicone scar sheets and am already starting to see a difference.

Updated on 18 Mar 2015:
I have been using silicone scar sheets up & up brand purchased from Target for two weeks! They are wonderful! Already noticing a difference!

Updated on 12 Apr 2015:
Happy as can be. Have had a little boob greed and wished they were bigger of course haha but I really love them regardless :)

Updated on 12 Apr 2015:
Scars at 2 weeks vs 2 months using silicone scar sheets. LOVE

I am a 33 year old woman who has lost 160 pounds. I am 5'10" tall and currently weigh 170 pounds. I have been married a little over a year, and have never and will never have kids.

I have been researching surgeries to correct my loose, saggy skin since my weight loss stabilized in the fall of 2012. I have been seeing Dr. Houle since the spring of 2013. He talked me through my options, explained everything, and has been very understanding and helpful during this time.

I know I'd like not only my breasts and torso dealt with, but my upper arms and inner thighs as well. Money, though, is an issue, and with numerous health problems, Dr. Houle figured that my insurance would cover a panniculectomy and breast reduction, so I decided to try for those first. He was right. Insurance is covering both, but for esthetic reasons, I decided to pay out-of-pocket for the back part of the belt lipectomy, instead of having dog-ears at my sides where the incision for the panniculectomy ends. When bills are paid off, I would still like to do my arms and thighs, but know that insurance will not cover those, so am willing to wait.

Surgery is a little under a month away, and I am filling my time researching what to expect in attempts to prepare myself. Reading the experience of others has been increadibly helpful, so I would like to do my part by sharing my experience as well.

I will add an update with before pictures when I can get to some better lighting.

Updated on 11 Dec 2014:
I haven't asked the doc for the official before photos he took, but I decided to take some of my own, from various angles, with and without clothes.

As a reminder, I'm 33, 5'10" tall and currently weigh 174 lbs. At my biggest, I weighed 329 lbs. I lost the weight over a three year period, and have been at my current weight for about two years. I have not and will never have kids.

Updated on 11 Dec 2014:
A Freudian would tell me that I didn't forget, but that I dreaded posting it, and therefore "forgot." A Freudian may be right. Well, to remedy this possible instance of parapraxis, here I am in all my naked, doughy, droopy glory.

BTW, I plan on getting my arms and inner thighs done at a later date.

Updated on 17 Dec 2014:
I have so many emotions right now, it's a testament to the complexity of the human brain.

I'm nervous, of course, you might even say scared. It's a big surgery, lots of incisions, plenty of time under anesthesia... I'm also anxious about what the results will be. My back problems make me wish my breasts will be as small as humanly possible, but my vanity still wants enough padding up top to look good in women's tops and dresses, and I want to wear clothes without having to accommodate (hide) a lumpy tummy.

But I'm also excited. I know there can only be improvement, even if it doesn't end up perfect. In fact, I'm not expecting perfection. I'm also looking forward to actually being able to buy bras in department and clothing stores in the mall, rather than having to buy them online. I'm looking forward to buying all-new clothes to match my new body.

I'm looking forward to having a new body, one that actually lives up to the years of work it took to lose the weight! It is so frustrating to work so hard, and be (mostly) happy with how you look in clothes, but to look at your naked body in your mirror and still see lumpy, droopy, rippled, jelly-like rolls. I'm tired of looking like I've wrapped ten pounds of uncooked pizza dough around my body, which is slowly drooping its way toward the earth.

I can't promise that I'll be coherent enough or even inclined to update right after surgery, but I promise I will as soon as possible.

Here goes...

Updated on 18 Dec 2014:
I'm out of surgery. Evrything went okay. In quite a bit of pain right now. Feels like I was attacked and shredded by an angry Wolverine (of X Men). There are sharp pains where (I assume) the incisions are. Feels like surface pain, nothing deep down. Will update after appointment tomorrow. Thank you all for the well-wishes!

Updated on 25 Dec 2014:
I thought I'd share some pictures and experiences so far.

Starting a few days after surgery, I started getting massive throbbing headaches at the base of my skull whenever I moved my head. Called the on-call number and asked them about it. They said it was most likely sore neck/back from being on the table for so long, and then unable to really move since. They said it should be fine, to take ibuprofen along with my Percocet (as Percocet is good for surgical pain, but unlikely to help with that type of headache), but to go in if it got worse.

It got worse! The headaches got so bad, and when I would move my neck from looking down to looking straight, it would get bad enough that my hearing would go muffled for a second or two as the back of my head throbbed so bad, it would make me forget I had just had surgery.

I went in to my local Urgentcare. They agreed that it was probably a sore neck or a pinched nerve from surgery, but just to be safe, sent me for a CT scan, because pressure headaches like that after a surgery can be caused by a blood clot or bleed.

Went for CT scan, and there was nothing wrong, so doc gave me a script for a muscle relaxant.

While on the table, though (more specifically, while getting off the table), I felt what I was sure was a rip happen along part of my incision in the back. I had my mother, who had driven me to the hospital since I was still on narcotics, check. It looked okay, but it did happen in a spot that she had noticed the tape (which goes over all of my incisions) was peeling earlier.

Well, now the incisions themselves are mostly dry and itchy, which means they're healing. That one small spot on my back, though it hasn't separated, is still "open" and weeping. It hurts occasionally, especially when engaging my back muscles.

I also had a few days of bad heartburn. It may be a combination of the half-reclined position I'm in most of the time, along with the binder around my middle, squeezing me like a sausage. I still can't eat much before I feel uncomfortably-bordering-on-painfully full, which is partly because of the binder, and partly because I think the few days of no food/tiny amounts of food I went through after surgery shrunk my stomach back down to my post RNY size. I've been told by my primary care doc and my bariatric surgery team that I shouldn't try to lose any more weight, so I hope I can try to increase the amount I can eat in one sitting sooner rather than later. I'm not good at grazing, I've always preferred to be a three square meals type of girl.

What's really annoying me are the drains. They are held into place by a sutures, each of which wraps around a tube and goes into and out of my skin once. They keep pulling, to the point that I feel like someone is jabbing me with a sharp needle. The ones coming out of my mons pubis were hurting especially, because it would tug each time I sat down, stood up, and took steps. I taped the tubes down with medical tape so they would stop pulling, which has made a world of difference! The one at my hip hasn't caused pain yet, but as you can see, is pretty angry looking.

My only discomfort is the fullness and burning in my lower torso, which I think is the swelling, and which gets worse if I eat too much. Too much, in this case, is the two Swedish meatballs and four little chunks of pineapple I had for Christmas dinner, so that's not very much.

I don't have much of an appetite yet, in fact, even the smell of breakfast cooking makes me nauseous. Liquids seem to be my friend right now, with water, Atkins shakes, and milk being all I can really tolerate without feeling this weird full pressure. When I do have solids, it is always very little I can handle before I feel sore, so I always start with the meat at every meal. I have had to scoop most of my side dishes onto my wife's plate, even when I've only served myself small portions of everything to start with.

Once I get the swelling down and the binder off, I have no doubt my appetite will come back, I just hope that happens sooner rather than later.

My wife and I are hosting Christmas at our house, with my parents, brothers, grandmother, aunt, uncle, and cousin in attendance. Hosting the holidays a week after surgery could have been trying, but everyone is being super helpful, and I'm not having to lift a finger. I did help make Christmas cookies, the parts that I could do sitting down at the table, but I fatigued pretty quickly. Everyone has been very understanding.

Updated on 30 Dec 2014:
Yes! I finally got my drains taken out on Saturday! It is so much easier to sleep and move around without those things pulling on me! The two holes for the drains in my mons pubis are already scabbed-over and dry. The one in my hip is the only one still in the gooey stage. I am changing the dressings on it when needed.

The part of my back incision that was weeping is still doing so. When my drains were taken out, they looked at that part too, and said that it isn't infected. They gave me after-care instructions for that, as well as for the drain holes, and instructions to continue monitoring my temp as long as those parts are open, to ensure I don't get an infection. So far, so good.

It's not quite two weeks after surgery, so I'm surprised at how well I'm already feeling. As part of my after-care bag they gave me as I was leaving the clinic the day of surgery, they gave me a potty lift to raise the toilet seat and make it easier on me. I never actually ended up putting it on the toilet. Even though using my core and chest muscles hurt at first, my thighs are fine, and I've been using them as much as possible when standing and sitting. For non-runners who don't quite have the leg strength I do, though, I can see how that set could come in useful.

What I have found indespesible is sleeping in an recliner. They let me know ahead of time that this would be preferable, and even let me know which hotels in their area offer them, as I am from far enough away that I had to stay at a hotel the first night after surgery to be in town for my first follow-up the day after. Ihave mostly been sleeping in one since I've been home too.

But, let me not be unrealistically happy and shiny about my recovery so far. Less than 14 days ago, I did have major surgery, including large hunks of my skin removed from my body, and I am feeling it. The part of my incision that is still open feels like someone is stabbing me in the back whenever even slight pressure is put on it (and since I can only sleep on my back, it is impossible for me to eliminate all pressure from the area). My whole torso does have a slightly sore, burning feel to it. I feel like ten pounds of meat stuffed into a five pound sausage casing. I have almost no energy, and the few times I have tried to do simple things like clean up a bit, or go grocery shopping, I have lost what little steam I do have, fast! Right now I am really good at one thing, and that is watching TV. I'd say I'm good at sleeping too, but I do tend to be only able to get into light sleeps, in which anything from a surge of pain to a car driving by on the street can wake me. Television and cat naps, that really seems to be all I'm good for right now.

Emotionally, I was really expecting more ups and downs at this point. I've read enough of other people's experiences that I prepared myself to be going through some level of buyer's remorse or physical insecurity at this point. I also tend to respond to narcotics with depression, so was expecting that based on my own experiences on meds in the past. Well, I stopped the percocet already (though I have been taking Tramadol, not sure if that's a narcotic). The emotional stuff is either still coming, or has skipped me altogether. I feel pretty emotionally stable right now, considering. I don't find myself regretting getting this done, and even in times when the pain is a bit worse, instead of wishing I had never done this, I find myself wishing I could just fast-forward through the painful bits. I'll keep my fingers crossed that the emotional stuff will pass me by.

Well, I'll see you at a later update!

Updated on 7 Jan 2015:
I thought I'd write a post highlighting the things I've been using in my recovery.

First of all, and most importantly, I'd wager, was the recliner to sleep in. It was the push-button kind, rather than the lever kind, and that made all the difference in the world. The only thing that would have made it better would be if it were to lift kind, because getting up out of it was kinda tricky that first week. If there is only one thing you should make sure to have before getting this done, make it the chair.

I also used a shower chair, not only becuase of the lack of energy that first week, but for me specifically, I am quite a bit taller than my wife. Lifting your arms to wash your hair will be a no-go for a while, and assuming you're lucky enough to have someone who will attend to you in the shower, you just need to make sure your head is actually accessible to them. I am 11 inches taller than my wife, she wasn't going to be reaching my hair if I weren't sitting.

They gave me a toilet chair elevator as I was leaving the doc's the day of surgery, but honestly, I didn't even take it out of the box. I can see how it would have been nice, and if I had had it before surgery, I would have installed it, but after surgery I wasn't in the intallation mood, amd never really bothered asking anyone else to do it. If I didn't have as strong thigh muscles, I definitely would have needed it.

As for suppliments, I started a pre-surgery regime a month before surgery, and I'm continuing it for a month after, at least. First off, I made sure to take fiber and a probiotic. I also started a high-quiality multivitamin, vitamin C, and CoQ10. I have Vitamin E oil that I will start applying topically to my scars as soon as my doc okays it.

Speaking of scars, along with the Vitamin E, I have Mederma scar cream, and also plan on using silicone gel sheets. I see my doc for a three-week followup on Thursday (that's the day after tomorrow), and plan to tell him about my thoughts then. Assuming he thinks this is a good idea, I'm assuming he'll tell me when I can start.

I also plan on asking him when I can start doing other things too, like soak in a bath (I've missed my baths!), working out, etc. i also want to ask him how long he estimates patients swell, on average. I'm eager to get new bras and tops and whatnot, but don't want to splurge until I know my shape is as it will remain.

For people who have done this, did your size have a drastic change, or was it subtle? I know my breasts are way smaller, which will certainly affect the fit and possibly size of my tops, but did your pant size change with a LBL as well, or was it just the fit that changed?

I plan on taking another round of photos once all the tape is off my incisions and they're all closed up, and a final round of photos when my swelling is all gone, but who knows how long that'll be!

Updated on 7 Jan 2015:
Scars are looking really nice. There are a few small places at which you can barely even see a seam!

The tape they put over the incisions has mostly fallen off, though it's still there in some places. But I still have this one area that's open.

By the reviews I've read this is totally common, I'm putting antibiotic cream on it and keeping it covered, and docs have looked at it. I'm not worried, but I'm really ready for it to be closed.

Here are some pics of it taken a week ago, and then yesterday, to show how it's progressing.

Updated on 8 Jan 2015:
Just had my three week post-surgical follow-up appointment. In a week, I can start my scar treatments everywhere except that one part in the back that's open. He said I shouldn't get fitted for bras or buy new clothes until I'm AT LEAST six weeks post-surgery. So I'm only half-way there.

I asked about how much skin was removed. They copied the pathology report of my breast tissue, which has exact measurements on what was taken off. 436 grams were taken off my left breast, and 438 grams were taken from the right. That's almost a pound off each side!

They didn't take precise measurements of the back and belly tissue, but they estimated about 1.700 kilos from the back and 2.200 kilos from the front.

The totals for that day: 4774 grams (which is 10.524 pounds!!!!!) of flesh was removed from my body.

Here are some pics taken today.

Updated on 5 Jul 2015:
After surgery (as you can see from previous pictures) I still had a mons that hung down too low, and a small bulge above my navel too. Surgeon said to give it six months, because sometimes swelling can last that long and may correct itself in that time. Well, after six months, those problems were still there, so doc agreed to a revision surgery.

Revision surgery was on July 2, 2015, and I am now 3 days post. I have less incision this time, since last time was breasts and all the way around my middle, and this time is just the front. Last time I had four drains, this time I have one.

I am swelling more (and getting more in my drain) than I did last time, though. Pain isn't that bad anymore, mostly just the discomfort from swelling. When I get a burst of energy, I'll take new pictures.

Updated on 13 Jul 2015:
These photos were taken on Wednesday, July 8th (six days post-surgery). There was quite extensive swelling at the time. I usually wear size 8 jeans, and when this was taken, I couldn't even button size 10s. The day before surgery, I weighed 170lbs, when this was taken I had swollen up to 178lbs.

Unlike after the original surgery, I have hard sections of swelling around my navel this time, and now, even 12 days after surgery, can still feel them (though they are smaller. This morning the scale was back down to 172, and I can button my size 8s again. When I spend any time out of my binder, though, the swelling increases, so I'm keeping it on for now.

One interesting tidbit: the blood that's not draining into the drain is causing some interesting bruise patterns under my skin as it moves south with gravity. These bruises showed up after these pictures were taken, and now range from purple/black to olive green/yellow.

This far after surgery last time, I had already gotten my drains taken out. This time, my drain is still in. Output is low (about 25ml a day) but the color is still pretty red.

In my seven day follow-up, I was pale, weak, and winded. Apparently, there was a small bleed after surgery, and I had grown anemic. Doc prescribed iron supplements. My hemoglobin is up to 11.5, and my strength is a little better, so based on how much is in my drain tomorrow morning, I may get my drains out tomorrow.

I'm looking forward to the swelling being done, so I can get this binder off and see my final shape). I'm also looking forward to the time when I don't feel like I'm ripping myself a new one every time I sneeze.

But, as you can see, even with the off-the-charts swelling in these pictures, and the fact that I couldn't even stand with a straight back yet (even now, I'm still doing the old lady shuffle) it looks incredible! When the tape come off the incisions and swelling is gone, I'll take more pics.

Updated on 26 Jul 2015:
I was getting better, but then I got worse. The night of July 15, I got a fever that spiked up to 101.9 and didn't break until the morning of the 16th. It only broke for about an hour before it started creeping up again throughout the day, back to the tripple digits by night. I called the on-call medical professionals at Midsota, and they told me to come in the next day. They appointment schedule was full, but they would have someone see me during their lunch break.

The swelling had increased (as had the pain), the area was VERY warm to the touch, and was pretty red. The doc who saw me took in my story, gave me a look, took my vitals, and left the room to cunsult with my surgeon by phone, who was in surgery at the St. Cloud hospital all day. She came back with the reccomendation that I have an irregation and debridement of my surgical site. This meant going back under the knife, and cleaning out the infected surgical site.

Since I have rhumatoid arthritis, I am on quite a few immunosuppressant drugs. The worst one, humira, I stopped taking 3 weeks before surgery, but I continued the other two I take, because without them I am not functional. Given that I had signs of infection (including rapid heartbeat) and was taking some heavy duty drugs that are designed to weaken your immune system, she wanted to be safe, rather than sorry.

She told me to head over to the hosptial rather quickly, to force some IV fluids and have blood drawn. My surgery was scheduled for 6:45pm. My bloodwork showed both my white blood cell count and my CRP were both wicked high, sure signs of infection.

Well, my doc went in and cleaned me out. He got out some [RS bleep] infection stuff, but not too much. He also cleaned out that hard lump of hematoma that I had been feeling. They took out the old drain and placed a new one elsewhere.

I spent a day in hospital on IV antibiotics, then they sent me home with a 10 day course of antibiotic pills, which I haven't finished yet. Already, I feel lots better. Temp hasn't raised above 99.5 since surgery, and I got my drain out on Thursday. I'm still pretty weak, and tire easily, but the same was true of my surgery in December, so that's just normal.

I still have some swelling, which I fully expect to go down over the next few weeks/months, but at least I can get my old jeans on again! It was an ordeal, but nothing I couldn't survive. Even with these complications, I have never regreted for a moment having this done.

I will take some pics once my swelling is completely gone.

Ready to get rid of my "stretched out poochy stomach" yuck! No getting around it, this is the one thing that ages me, it screams "menopause" has got to go! I work out at least 5 days a week, usually more and am running the Ragnar two weeks before my surgery. I can't wait to have a flat stomach to match the rest of me!

Updated on 12 Aug 2014:
I had a list of questions and he took all the time in the world to answer. He is even going to get the pain med that I requested (the long acting three day analgesic). He is the best! I feel so good about going into this now. I'll post my before pictures soon.

Updated on 27 Aug 2014:


Updated on 5 Sep 2014:
What a journey! My one drain will come out on Sunday. I go back to work on Monday. I've gone out twice so far driving to the store. I have no idea how my clothes will fit since I've been wearing yoga pants and tank tops! I think I should get clearance to workout like usual around the second week of October. I will try to wall each day to build up my endurance. Feeling good though!

Updated on 17 Sep 2014:
Feeling good. Staying positive!

Updated on 9 Oct 2014:
So happy I did this! Feeling great!