Nicholas H. Papas, MD

I recently had a tummy tuck on Jan. 14, 2014, combined with an ovary removal. I have to say the procedure went far more smoothly than I thought it would. I am 47, have 4 kids and weighed 133lbs before surgery. My surgeon did not use drains which has been nice. It definitely is major surgery, so expect significant recovery time! Here's my three favorite things that have made all the difference in my well-being since the surgery:
1. Rent a recliner! I can't stress enough just how helpful a power recliner is for overall comfort, getting up and down, and sleeping. I got mine from Rent-A-Center for just over $30 a week. Worth every penny! It's been my 'command station' as it includes a power plug for a computer as well as a USB port for my phone charger. It also has a little table for putting my meds on, water bottle, etc.
2. Pain ball! My surgeon attached a pain ball to dispense medicine--has made things so much easier and was worth the extra couple of hundred dollars.
3. A walker! I borrowed a friend's walker and it is so handy for making those long trips to the bathroom. I also take it for a spin around the house to get the circulation going in my legs and it's great. Very handy for supporting your weight so your poor back can get a break.
I'm only on day two post-op but so far so good! Might add before and after photos when I get the nerve in a day or so.

Updated on 17 Jan 2014:
Doing noticeably better today. Had my husband put the plastic chair in the bathroom for a shower later but still debating whether or not I should wait one more day. I was able to walk back to my recliner from the toilet without my walker, which was a huge accomplishment. Pain ball is just about empty, so strictly on Percoset and the occasional Tylenol now. Feel pressure on my lungs which makes it a little difficult to take deep breaths but not too bad. Will post photos if I shower.

Updated on 18 Jan 2014:
Oh my gosh, I thought I'd have my daughter help me shower. We got the giggles and then all heck broke loose: the more I tried not to laugh the more painful it got! Oh it was terrible. Laughing will be the death of you, so avoid humor at all cost! I got some pictures so I'll post them when I my insides glue themselves back together. OUCH!!

Updated on 20 Jan 2014:
Can't believe it's only day 5 since my TT and I don't need any pain meds. This whole process has been a lot better than I thought it would be.

Updated on 20 Jan 2014:
Went to the doctor today to take out my pain ball tubes. I'm glad I never needed drains. My doctor said some patients don't need them. He stitched me together instead with quilting stitches on the inside and apparently, that reduces the need for a drain. He said I was healing nicely. I go back in two weeks for another check up. Only thing that bothers me is my poor back, even though I can stand pretty much straight up now.

Updated on 25 Jan 2014:
Feeling so much better. Standing almost completely upright. Still have to take it easy. I would definitely say you need a full two weeks to recover from this procedure to the point where you can go back to doing simple things. I tried sleeping in a bed last night but laying on my side started to get uncomfortable after awhile so back to the recliner! Tried a flexees garment but couldn't sleep in it--back to my binder the surgeon gave me. Wish the swelling was gone!

Updated on 25 Jan 2014:
I guess the drains approach worked okay! I still have swelling, though. Wish I could sleep in my bed but laying on my side starts to get uncomfortable internally after awhile. Tried sleeping in my Flexees garment but it was just too uncomfortable. Overall, this process has been a lot better than I thought it would be. Pain level is not terrible--pain meds take care of that! If you're thinking of doing it, do not be deterred by fear of pain. I thought childbirth was a lot worse!

Hello.. I am having a tt and thigh lift this wednesday...1-18-12!!

I am nervous.. 11 years ago i had the gastric bypass and have lost and maintained 210 lbs... gone! Five years ago i had arm lift and breast implants...had my first baby 11 months ago at age 40 and now i am ready to do this...i think!



Updated on 1 Feb 2012:
i am two weeks post op now... the worst part is the swelling.. by the end of the day i feel like my skin is going to burst.

I’ve had large breasts since middle school, and I’ve hated them ever since. After developing neck and back pain, grooves in my shoulders from my bra straps, rashes under my breasts, and general physical discomfort, I knew I needed to do something.
I went to see Dr. Papas in April of 2019 and received an ok from my insurance company for coverage in July. (Otherwise I could never afford a reduction!)
I’m scheduled for my surgery on August 7th! I will do as many updates as I can.

Updated on 4 Aug 2019:
This will be my before... Measurements today were 35” under bust and 43” over.

Updated on 7 Aug 2019:
About 1000 cc was taken out total, I believe.

Updated on 8 Aug 2019:
Pain wise I feel ok without more than ibuprofen/Tylenol, but I will play that by ear. I’d compare the soreness to having pulled all of my chest muscles. First post op appointment is on Monday.

Updated on 8 Aug 2019:
Post op day 1

Updated on 9 Aug 2019:
More bruises and some more swelling. H tape I itchy. I took full shower today an used my hair dryer on cool to dry out the girls.

Updated on 12 Aug 2019:
I’m ready for the tape to be gone. But I feel good. I’m not very happy with the asymmetry and I do kind of wish they were smaller

Updated on 22 Aug 2019:
The tape has come off. No pain but skin around scars very irritated. Not happy with nipple difference at all.

My doctor didn’t have me wear any bra post op, I had dissolvable stitches and no drains. He cleared me for basically anything.

Updated on 22 Aug 2019:
New pic

Updated on 23 Aug 2019:
I meant to add this pic yesterday. The scars look scary to me and I’m not sure if I like my nipples at all

Updated on 28 Aug 2019:
I’m so upset about this. They look worse every time I see them. Dr. said after a year he could revise them in office, but they’re not just lopsided. They’re two very different sizes!

Updated on 8 Sep 2019:
I feel much better about the size. Fingers crossed about the wonky nips. :-D

Updated on 7 Oct 2019:
Still very sad about the nipples. They don’t look anything alike. Not sure if anything can even be done.

Updated on 10 Dec 2019:
Left side is considerably bigger than the right. Nipples are totally different in position, size and shape. On my left breast it looks like part of the scar area is actually part of my old nipple. It has the same consistency and color as that type of skin. :-(

My next follow up is in February. Hopefully he’ll offer solutions. I feel like he should be willing to fix this. I’m a very reasonable person, but I haven’t seen anyone else have this kind of result.

Updated on 13 Feb 2020:
Dr. Pappas said he will fix the asymmetrical nipple on the right for free, but seems unconcerned about the unsightly areola skin on my scars. Should my old areolas not have been totally removed except for the “new” nipples/areolas? I haven’t seen any other patients pics look like this and now I just hate my breasts. I’m so discouraged.

Had a tummy tuck and breast augment four months ago. Love the tummy tuck but the breasts, not so much. My surgeon went with a larger implant (450cc) and removed some skin from under to tighten the breasts. Definitely an improvement in volume but not shape/lift. Also the left one points outward a bit and falls way to far to the side when I lie down (left was always a little bigger/droopier) I'm scheduled for a traditional anchor/wise pattern breast lift and he is going to tighten the breast pockets. The only thing I am afraid I'll regret is not exchanging my implants for smaller ones- I even thought about explanting just because I don't want them saggy but at my consult my surgeon said he thinks he can get close to my wish pics by doing the lift and pocket tightening.

Updated on 4 Mar 2017:
Hello! Surgery went well, I'm feeling pretty good today. Hardly any pain in my right boob but left one is pretty sore and is oozing a little blood. It's the one that needed more work. My throat is KILLING me! It feels like someone punched me right in the throat and swallowing makes me cringe! Must be from the breathing tube? I didn't have throat pain last time ???? I drank some slippery elm tea which helped a bit. My doctor doesn't use compression garments after surgery, that worries me a little because I want to be sure they are stabilized and not stretching the implant pocket out or moving too much. I did put my Dr. Rey sleep bra on this morning just for a little support. Hope that's ok.
Have a wonderful weekend!


Updated on 5 Mar 2017:
I sent pics to my nurse and Dr. wanted me to come in to the office. He removed the tapes from the left nipple for better blood flow. I will see him again at noon today. I didn't sleep well all night worried about my nipple dying and falling off. So worried about it. But I got up and made it to church today! Feeling better mentally but prayers needed!

Updated on 6 Mar 2017:
My surgeon has been keeping a close eye on me since my surgery Friday. He wanted to see me Saturday based on the pics I sent him. I guess there was a blood flow issue and he thought he may have to remove some stitches but removing the tape was sufficient. He called me on Sunday and asked for more pics to see if I needed to come in, he said they looked as he expected and I could just come in on Monday. So today was my appointment, they did say that the area at the top of my nipple will slough off but that it should heal fine after that. PS did not seem overly concerned about the way it looks but I have to wonder if he's just trying not to worry me, yet I am very worried. I've seen enough here on Realself to know that this could get really bad- and this is only the third day! I'm trying to think positive and use healing affirmations and lots of prayer. I'm eating well and staying hydrated. I've been using some light therapy (red, blue and infrared) and I'm keeping the area clean and dry. Any suggestions?
I'm so thankful for RealSelf and all the info shared here. Thank you all for being here, it helps to not feel so alone. ????

Updated on 9 Mar 2017:
Thank you so much for the prayers and encouraging words! So thankful for RS and all the info and camaraderie! I appreciate the judgment-free-zone! Feeling a little better about everything, doc said there will be some sloughing in the top area of my areola but that it looks superficial and should heal nicely. I sure hope so, it really does look terrible! Left one is also getting lower than right, hopefully just swelling but at this point I'm okay with some asymmetry I just want to heal without more complications. I definitely do not want any more surgeries!
Thanks again for your support!


Updated on 15 Mar 2017:
I had a visit with my PS Monday, nothing really new happening, he's just keeping a close eye on it. I've been trying to research how long it's going to take for the black part to slough off and what to expect through this process, it's so dry and leathery but PS said not to use anything but soap and water. He removed the rest of my tapes which made me feel a little apprehensive because I know those tapes help with the healing. I wanted to retape when I got home but I will listen to the doctor. I'm so worried about it opening up and turning yellow and making a hole. I've seen many pics like this on RS. I'm just praying it stays closed and doesn't get infected. I wonder if it should be debrided? PS did say as it starts to come off he will be trimming or peeling or something I can't remember what he said. I don't know why I can never remember the things he tells me. I'm thinking about going to a hyperbaric oxygen chamber, does anyone have experience with this? It's supposed to help with wound healing and necrosis. I am going to keep updating just because reading other people's outcomes and stories has really helped me and I hope if anyone else has these necrosis issues they will be able to see the process. I think it may get much worse looking before it gets better?

Updated on 28 Mar 2017:
Just a quick update, not much has changed since last post. All the tapes are off now and some of the black has peeled away. The large black area doesn't look like it is going to come off anytime soon though. I'm going to Los Angeles and Las Vegas in three weeks and I'm hoping it will be peeled by then so I can take a dip in the pool in Vegas :-) Probably not though. My right nipple looks like it's going way out to the left so I guess that's just how it's going to settle. My doctor showed me a pic from the operating room and it looked like my perfect wish boob. I see him weekly so I will try to remember to ask him about it at my next appt. Either way I don't think I'll "fix" it as I plan to leave well enough alone once I get healed. Have a great day!

Updated on 26 Jul 2017:
Wow, I haven't seen those right after pics for awhile! Scary looking!!!! Left nipple may need some tattooing down the road but thankfully it wasn't worse. I wear a bra day (good support) and night (sleep bra) just to try to help support them as much as I can. I actually cant stand the feeling of no bra now.
I sometimes wear silicone scar tape but not always. Hopefully they will fade more as time goes on. I have absolutely zero sensation in either one of my nipples but that has been since my first surgery in October when I got the implants and sorta lift.

OMG My surgery is less than a week away! Thank you sooooo much to everyone here who has shared their stories, it's because of all you that o have the courage to take this step. ????
I made my first consultation with Dr. Steven Carp. I wasn't sure at that point if I even wanted to do it, I just wanted to see how much it would even cost and get some info. After that consultation I decided I was going to do it but that I wanted another consultation with a different doctor just to compare the two. My next consult was with Dr. Pederson. I really liked him and decided to go with him even though he was more expensive. I needed surgical clearance due to a sledding accident which caused my heart to stop unexpectedly. Luckily I was already in the hospital! Everything checked out okay with my heart, they still don't really know why it did that other than possible "high vagal tone/vasovagal response. So anyway.... I made an appointment with my PCP (whom I LOVE dearly and trust with all my heart) to start the surgical clearance process. He said the surgeon I chose was great , but he prefers Dr. Nicholas Papas. I immediately knew I would probably change to Dr.Papas because my PCP is very specific about who he sends his patients to and has never steered me wrong. Now I had to wait for another consultation but it was totally worth it! I really liked him and felt super comfortable and was hoping the price would be doable. He was actually less expensive than all of them and he was my favorite!!!! Yessssssssss
So that was well over a month ago that I scheduled, we had a trip to Los Angeles last week and a wedding to attend this Saturday so that week was perfect for me to do it.
So, I will be doing a breast lift with implants (not sure which size yet but somewhere between 375-425 I think) My doctor orders three sizes based on your measurements and then chooses at the time of surgery what is best. (Unless you specifically know what you want- for me, I'm going to let him decide.) He will do some lipo to my flanks and armpit area. I will have a full tummy tuck with muscle repair.
I actually try not to think about it too much for fear of changing my mind! I'm just going to think positive and keep reading your stories and pray for the best!
Thank you all again!

Updated on 10 Oct 2016:
Saturday night I had a major wave of anxiety just thinking about the surgery and all the "what ifs" that come with it. Then yesterday while listening to my pastor talk about gratitude and blessings i realized that although I am always counting my blessings, for some reason I wasn't counting this surgery as one. This surgery is a gift! Such a blessing, and instead of approaching it with fear and anxiety I am embracing it with excitement and thanksgiving!
I am preparing a list of questions now for my PS that I should've asked before, like about a compression garment (they haven't mentioned this?) and what about a marble for my belly button, is it recommended? I've heard others being on a liquid diet the week before surgery or doing calcium citrate preps, or start taking colace and arnica? My PS hasn't given me any of these instructions but I'm wondering if I should?
Any "two day's before surgery" tips/suggestions?
Thanks!

Updated on 13 Oct 2016:
Surgery went well, it was five hours long! My doctor is so wonderful, he spent quite a bit of time talking to me and my husband before the surgery. I wasn't nauseated when I woke up thanks to my amazing anesthesiologist! It did take a little while for me to get up in recovery because my blood pressure kept dropping when I stood up. They wanted me to pee before leaving but I couldn't pee until 9:30 last night and even then it was just a trickle, but things are better this morning. I did have a dose of phenegran through my IV before I left the hospital and that made any traces of nausea go away. I had a remarkably comfortable night last night, my husband reminded me to take my pain meds (I didn't feel I needed them last night but glad I stayed on top of it- thanks to all of you for the good advice!) today is much more painful, I really have no pain in my boobs at all- but they look like torpedoes! Hope they will go into place eventually. I have no binder of compression garment on anywhere which I thought was strange. Does anyone have any input on that? I will try to post pics later....
Thanks!

Updated on 20 Oct 2016:
Hi! I just wanted to update in case anyone was reading this, it's been a week (and a day) since my surgery. The first few days were the hardest but surprisingly it wasn't nearly as bad as I had anticipated! I took two Percocet every four hours for the first two days then switched to Advil since. My biggest complaint isn't my back! Hurts sooooo bad. Worse than my tummy. I hardly even notice my boobs, they just feel a little tight and pressured. The absolute wors for me is the tickle in my throats that gives me a coughing spell. Dear sweet Jesus! My dogs get so worried about me when I'm about to cough due to all my vocal grunts and moans in trying to availed a cough ????
The one thing that has really helped me which I know isn't just something you can go out and buy but really has been a lifesaver is my Serta i-Comfort bed. I sleep with my legs raised and my head raised and it has been so comfortable. it also helps me get up by raising my head all the way up. Another helpful thing was my toilet seat raiser. The first few days it helped a lot, but more than anything was when it came time to poo I took it off the seat and put it on the floor under my feet, it put me in a kind of "squat" and really made things easy (along with the stool softeners) I've heard of squatty potty stools like on Dr. Oz but now I'm sold! If you have one, try it!
I left the hospital without any compression garments or even a surgical bra. My PS says they are not necessary and can even cause wound healing issues. I was worried about that at first but am trusting my PS. I am really swollen on my sides above my incision and my lady part is really swollen. ???? Hoping my boobs are swollen too cuz they're pretty big. I think I'm getting more used to them. My PS ended up using a larger implant (450cc) and not having to cut my nipple just pulled skin from under to lift (?) I was super worked up about that when I saw my nipples intact but I can see day by day they are looking better. They looked like torpedoes the first few days, my nipples are still downward more than I like to see but at my follow-up they told me once the tape is off from under they will lift up, the tape is pulling them down. I hope so because I really wanted lifted boobs not huge boobs! I am afraid they will be big AND saggy and now I will have two problems! Also the implant is over the muscle so I'm wondering what's going to hold it up! Time will tell I guess but I do trust my PS and I believe that he did what he felt was best for me and possibly less invasive for a good result.
I can't wait to get the drains out, though they don't bother me too much, I just don't like the annoyance of them. Hopefully Monday at my follow-up they will come out. I don't have a scar around my belly button so I guess I had a floating belly button procedure. It looks nice, I'm happy with it. I still have the deep stretch mark that was above my belly button now below it and it's pretty visible but maybe once things settle it won't be so noticeable.

Updated on 15 Feb 2017:
I didn't post pics after my surgery because I wasn't sure how I felt about it. I now realize that I did not clearly communicate my desired results with my doctor. I was scheduled for a "bilateral augmentation, mastopexy and abdominoplasty." I was very open to my doctor's suggestions and had (and still have) full confidence in his judgement, so my
Implant size was not decided upon until I was in surgery. My surgeon decided to use a bit of a larger implant (450 silicone) and I believe he tightened/removed skin in order to give me a lift rather than make more scarring by cutting around my nipples. It is definitely an improvement over what I started with but definitely not my "wish boobs." I feel they are still saggy but now they're BIG and saggy!
I am scheduling a second surgery which will be a full mastopexy using the "anchor wise pattern" I would rather have scars than sag and I should've made that clear to my doctor from the beginning. He is easy to communicate with and I am confident that he did what was best for me. I decided that before I secure the date I will meet with him one last time to be sure that we are on the same page. I need to know that my expectations are reasonable because if it's not possible to have the boobs I want I will not do another surgery. The staff at Renaissance is wonderful and very accommodating. I just called this morning and they fit me in this evening. I was just there Friday for a follow up and consult. By the way I am very happy with my tummy tuck! Dr. Papas made me a perfect little belly button! Now I'm hoping I'll have nice boobs to match my belly!