Michele Koo, MD, FACS

Yesterday I had abdominoplasty, breast lift, and implants done. The closer this date has approached, the more nervous I had become. But, after being underweight most of my life then having gained over 75 lbs with my second child, I decided to do what would make me happy in my skin again. My breasts took a hard hit from my pregnancies as did my stomach. I can't wait to be in a bikini again! Stoked! For those concerned, it is quite uncomfortable particularly getting in and out of bed and walking, with a hunched over back. I honestly don't feel pain in my breasts. I was very nervous and I think that my laparoscopic hysterectomy hurt much worse. I'll post more photos whenever I am able to get out of my garment Monday to get a shower. Attached are before photos and currently with the garment and drains. I am taking the pain medication still on day one post op. My doctors nurse said I shouldn't need it after one day but wow. I'm continuing to take it. On the day of surgery, Dr Koo came in and did all of the markings on me. I could tell she was very knowledgeable and a perfectionist as she marked me. Dr Koo and her assistant Joann have been wonderful to me. From what I am allowed to see under the garment, I can tell my breasts are exactly as I asked for and my TT scar is low and very straight. It's like a small pencil line: beautiful. I can't wait until Monday to shower and take the rest of the cotton from my garment, and to see the results! My only issue right now is muscle pain while trying to stand up straight, getting up and down from the bed (I can get to the bathroom by myself), and having comfort while I sleep. I kept jerking around in my sleep last night and ouch! I will keep you updated with "after photos." I cannot emphasize enough how excited I am to wear a bikini again and not have my boobs be deflated floppy messes! Updated on 28 Oct 2021: This hasn't been a horrible scenario aside from nights whenever I wake up, feeling itchy from the cotton under my garment and the tightness of my garment hurting my waist. I usually take my pain medication and am able to go back to sleep. I hope that after tomorrow, when I am allowed to shower for the first time and take the cotton out of the garments I will get more comfortable. This has not been incredibly painful. The garments have felt suffocating at times and the drains are annoying but I'd do this all over again. I still don't know what I look like under the garments and can't wait to see tomorrow! Updated on 31 Oct 2021: I’m moving around much better and my appetite has come back! Nausea was awful the first week but the last few days I have been on an uphill climb. I can now shower by myself (with my husbands help drying off since I can’t reach my lower legs well). I have been cleaning my incisions twice a day and keeping them covered as the incisions around my nipples have been bleeding on and off and get irritated by my compression bra. My tummy is healing up great, aside from some bruising. Honestly, my breasts are more troublesome at this point while they heal. My drains should be removed on Friday at my two week post op appointment and I cannot wait! I’ll say, they are so annoying to navigate around and always be concerned they’ll get hung on something or be pulled. At this point, I’m barely draining anything. My breasts are less swollen… at first I thought we went too big. But they’re changing as the days go by. The first week is very hard and it is hard to sleep and be comfortable in general. But I’m impressed at how quickly I am healing and how better I am feeling as each day passes. I get ready by myself very slowly… but without help nonetheless and I also barely spend time in my bed. I am out in the living room with everyone and try to do what I can for myself that my belly and chest will allow me to do. What I’ve learned so far is not to panic over bruising, bleeding, or strange colored substances coming out of incisions. My doctors office has been wonderful about answering my questions and being kind when I call. Joanne is the best and I can’t speak volumes enough on her patience and knowledge. I am now beginning to see the results of Dr Koo’s work as swelling and bruising is subsiding, and my review could easily change to a five star before this is over. I’m just waiting for the end result. Updated on 5 Nov 2021: So, I’m over two weeks post op now and I noticed my left breast beginning to look like the incision was splitting near the nipple. I called my doctor and was told to use neosporin. I was told it was normal. Now, my breast is opened up near the nipple and looks like fresh meat and is raw to the touch. Under my breast where the t incision is has also opened up wide and is bleeding. I’m using pads in my bra and have moved to a softer bra. I saw my doctor yesterday and she said it was normal and all superficial. I was told to eat more protein and make sure I keep the area clean. I have done everything right so far, and this is still happening. It’s very painful and horrible looking. My stomach is healing wonderfully and looks great. My breasts have obviously taken a turn for the worse. Idk how long this pain will go on but im going to do what I can to get my breasts to heal. I am feeling some regret now on even touching my breasts. We will see if things get better soon. This is a very scary and painful experience with my breasts looking like this. Updated on 27 Nov 2021: Since my last post, my right breast has also opened up, which is the smaller wound photo. My stomach also opened in two places but Is not as bad or painful. The left breast opened a lot more which was obviously scary and traumatic. My days are currently filled with unavoidable pain, bandage changes, and more bleeding than I like. I see my doctor once a week, aside from this week since she is gone for the holidays. However, she texts me every time I have a question. I’m unsure why this happened but I can say it has been a very frustrating, emotional experience. I’m waiting to see how bad I scar and how this plays out. I can say my doctor has been very nice and available when I’ve had questions or concerns. This has been a scary experience. She has also kept me in pain medicine as this has been a painful experience I could compare to having road rash. I can’t stand my bra or the gauze touching me, particularly in the area of my nipple where it is separated. I also hate dressing changes, as I bleed a lot and it tends to burn for a very long time during and after. Warm showers have helped me directly after a dressing change to ease the pain. I have hydrogel that I apply to the wounds and gauze. I’m still not performing my normal tasks, as when I stand, gravity hits and it hurts to. I’m frustrated, sad, and have some really bad days with depression. However, I see progress with my wounds healing and just have to tell myself to keep going. This can happen to anyone and I’m pretty damn sad that it happened to me. I did this to feel better about my body and currently, I feel like I was in a horror movie. I’m really hoping my doctor is right and that it’s all going to heal great. Updated on 14 Dec 2021: So it’s been the road from hell for me. My stomach has healed well, aside from a few small spots that opened but they closed quickly. My breasts, on the other hand, it seems as soon as I get scar tissue they begin to separate and open back up again. Words cannot describe my frustration. My doctor keeps telling me to be patient and I am taking great care of the wounds. But I can’t help but wonder if something else can be done to speed up this process… and how it couldn’t be normal for a wound to scar and then bust back open this late in the recovery game. I miss doing yoga, exercising, and not being afraid of being bumped when my kids lean in to hug me. I wish I could enjoy my new body and feel sexy. Has anyone else experienced this and if so, could you tell me about the time frame and treatments you used? Updated on 3 Jan 2022: My wounds are getting smaller. This seems to be taking forever and I am still using caution on not lifting too much or moving my arms too much. This is because the tissue coming in is very easy to rub off when it initially grows. I also am not looking for larger wounds. I am so over this. My breasts also appear to be somewhat lopsided. My right breast seems to go outward while the left breast remains rounded. My doctor told me they’re sisters and not twins. At this point, I am not seeking perfection. I just want to heal and be able to do yoga again. I am also ready to throw away the gauze forever! My tummy tuck is healing well and I am standing up straight and have for awhile. I find sleeping on my back most of the night while slightly sitting up is still more comfortable. I am usually a side sleeper. But this could also be partly due to the fact my breasts are sore when I lay on my side still. I am hoping to be healed in the next month. I can’t believe it has taken this long to get healed up. I am thankful that I never got an infection and that I have had family members who have supported me. If I knew I would have had to face this, I would have never done it. But, that’s not to say I won’t enjoy the results. I just wish I hadn’t had to have such pain and depression to get there. I’m still unsure why this happened and I have to say I am very hesitant to have any elective procedures in the future. Updated on 3 Jan 2022: I forgot a photo that includes the larger wound I had and it’s progress. Updated on 15 Jan 2022: I thought I was making progress with my wounds. But, I went to see my doctor a few days ago and apparently a lot of the skin I thought was coming in was dead. I was told I needed to be scrubbing more around the wounds. After seeing her, my wounds are bright red again, tender to the touch and I feel as though I took five steps back. Once again, I can’t stand the way I look or being in my skin. My bra hurts me to the touch. The cold weather hurts. If my kids or dogs bump into me just right, blood seeps through my bra (more so than usual.) I understand that I will heal eventually but this has been three months of hell, and after losing the progress I thought I had made, idk how many more months I’ll have of this. This has greatly impacted my mental health, my body image, my intimate life, and anything I seeked to improve by doing this surgery in the first place. While my doctor has been great by texting me whenever I have needed her, and has been nice, I can honestly say that if I could go back, I would have kept my deflated boobs. Deflated boobs beat bleeding for months any day of the week. However, I would do the tummy tuck again in a heartbeat. That has been a breeze and aside from a few stitches splitting a few weeks in, I had no issues with it and recovery has been as expected. I do not smoke. I eat well. Prior to this I did yoga and exercised at least three days a week. I have followed every post op instruction I received and continue to do so. I am so frustrated and tired of this. Updated on 11 Aug 2022: I officially stopped bleeding from my breasts in early May. They finally closed up enough where I would be able to swim if I wanted to. My scars still hurt, particularly on my stomach. They’re sensitive. I still notice a bit of diastasis around my stomach, but given the experience I’ve had, I’m good with it. I am seeing if my belly button can be corrected because it is shallow and huge. My scars on my breasts are pretty extensive. I look great in a push up bra or a tank top but I’m pretty insecure with nothing on. I’m covered in scars. When asked if I would do this again, I’m not sure. My experience with my breasts was the most painful experience I ever had. I want to say, I don’t blame this on dr koo. Her and her staff were great to me. I avoided infection and dr koo was available every time I texted her: even if it was just to cry and express my sadness. I wish my results would have turned out differently. But, I am happy that I have a flat stomach and that my boobs no longer hit the floor. However, in saying this, I don’t think I would have ever chosen this road if I knew how bad it would be for me. But this was my journey. It doesn’t mean yours will be the same.

Dr. Koo and her team made me feel comfortable and confident about my procedure. The post-op went by quickly, and six months in I no longer experience the extreme back pain I had before. After meeting Dr. Koo, I never second-guessed my decision to go forward with the surgery, and have never regretted it since. Thank you!

My BA is 2 days away!! I decided to go with 400-450 cc High Profile silicone implants under the muscle with an inframmary incision. I am very excited yet nervous and just hoping I chose the right size to get the fullness without being overboard. I very much trust my PS though. Bring on the nerves!!! Updated on 9 May 2016: So surgery is tomorrow and I have to arrive at 9:15am which isn't a bad time. I've already picked up a few things that I've heard will be helpful for the post-op process; prune juice, bendy straws, ice packs, heating pad, protein drinks & a zip-up sports bra. My mom is going to stay with me for a few days, both to help me and for moral support. I am super lucky to have her. The only Instructions I've been given thus far are no eating or drinking after midnight tonight & to wash with an antibacterial soap. I am not to wear makeup, nail polish or jewelry to surgery. I am just going to wear a zip up jacket and maybe some leggings. I can't believe the big day is almost here. Oh and also, my nerves are likely going to be a wreck tomorrow So I will be taking a hefty dose of the zanex my PS prescribed. Do any of you ladies that have had BA have any last minute advice for me? :) Will keep you updated... Updated on 10 May 2016: Just arrived home from the hospital. I got there at 11:30 & got signed in and it was pretty much a waiting game from there. All went well and although my chest pain feels as though I just got done running, it really is not as bad as I was expecting. Just glad to be done. I have this white wrap on until my follow up appt on Friday (which will be my first revealing of my new girls!) it will be then when I will know what size my PS ended up going with. The size seems perfect so far. I did notice before surgery she had written 460 on my left and 480 on my right which was bigger than I anticipated but I am so ready to see them. I had quite a bit of nausea coming out of surgery and threw up a little bit but right now it's manageable. I start antibiotics tomorrow and right now am taking zanex for muscle spasms and hydrocodone for pain. So glad to be in boobie land finally!!! Updated on 11 May 2016: So last night I was a little bit of an emotional rollercoaster, but I think that is normal. I took a peek from above the surgical bra and started freaking out that they looked smaller than I wanted but then my mom reminded me that there is a whole other half of boob there (bottom boob) that I'm not seeing, so now I am good. They do look gorgeous, I am just sooo excited to see them Friday. Woke up this morning and had quite a bit of pain in my chest but as I have been walking around the house, it's gotten much better. My PS said I should start taking stool softeners since I haven't had a BM yet. Also I have permission to start lifting my arms now. I think everything is healing great and I am more than thrilled to finally have boobs!!!!! Will post pics as soon as I can. I was told that even after my Friday follow-up appt, I will still have to wear this bra for a couple weeks :(. Happy surgery & recovery to all of my Real Selfers!! Updated on 13 May 2016: They turned out great! She ended up doing 420ccs on left and 445ccs on right. They are still a lil swollen and my PS told me the fullness on top will soften within the next couple months. I am loving them so far and feel as though will be proportionate with body! PS just got my first shower and I was so nervous that I was doing too much lifting of my arms! Feels so much better to have gotten that out of the way though. I was beginning to feel helpless! I was told compression is best for the next couple weeks so I got a zip up sports bra. If it begins to feel uncomfortable I will just switch back to my surgical bra. Staying positive & patient and looking forward to seeing the subtle transformations day by day! Updated on 13 May 2016: Even though all has been good with the healing, the feeling of homesickness is real! I've heard girls on here talk about that & it actually is something that occurs. I have just felt so crappy all the time (like from the pit of my stomach) and with my chest being so tight on top of that, it's been hard (which is why I didn't post an update yesterday). My boobs are so high and hard right now that i don't even really want to be out in public, however, sitting at home will more than likely make me feel worse. They are still half numb right now and...I am just wanting these next couple weeks to fly... Updated on 14 May 2016: Stats: 24 years old, 5'3, 115 lbs, Inspira SRX silicone 420 L 445 R, sub muscular, inframammary incision The feeling of tightness is slowly subsiding although there is still a bit of pain and discomfort. Question: who else experienced numbness on their under boob under the nipple? Mine it still quite numb but I've heard sensation returns after about 3-6 weeks. Anyone else have a similar problem? Updated on 15 May 2016: This will be my final update for a couple weeks, where I will probably post a 1 month update. Loving them so far and they are looking better every day! Updated on 6 Jul 2016: **NOTE** my nipples were a bit crooked before and remain crooked after surgery as I only got an augmentation and not a reconstruction. I am a 32 D. Updated on 10 Aug 2016: Figured I would post a side pic for you all :) Updated on 2 Nov 2016: Loving them more and more! I think I chose the right size. 6 months down the road and I am just now beginning to get feeling back in my breasts :) Side note-Love this unlined bra from Target!! Updated on 7 Dec 2016: Smooth round Ultra high projection

Surgery is less than a week away. I've lost around 50 pounds and counting and although my arms got 'smaller' they just deflated... still around 16 inches and they look FUNKY. I've come to terms with the fact that I need this surgery for loose skin and people are going to see my scars. I've weight trained; lifted heavy weights (still do) and know from being a size extra small with extra large arms before(when I had lost 90 pounds as a teen) that not much is gonna change this time around either. I think I'm gonna go insane without being able to lift my young kids or lift weights or even WALK BRISKLY for 3 weeks. This is one of my last steps, but man am I scared. Updated on 8 Jan 2016: Here's a picture of my arm pre-op. Updated on 14 Jan 2016: We drive an hour to get to the hospital at 6am, they told me they'd be able to get me in earlier than my scheduled time. I had accidentally eaten a few crackers while feeding my son this morning so they said they'd have to wait a few more hours before surgery. Then, after giving up my ecig I was told she was worried about smoking. I had quit cigarettes prior, but didn't really think about the ecig at the time. After all of that, and having given away my ecig so I wouldnt have access, in my surgical gown in bed, she says she won't do it that day. Not only that, but since school is starting soon, I may not have any time before summer because she's determined to have 2 weeks for me to do nothing but recover. I am NOT going to get that surgery in the summer WHERE EVERYONE WILL SEE THE WORST OF MY ARMS. I am livid. I'm tempted to either switch surgeons or not get it at all. Updated on 14 Jan 2016: If I'm lucky, we will have a new date set for March. If it's not approved I'll probably have to be on the look out for a new surgeon. Not happy.. I don't think I would have been so upset if I wasn't already in preop near surgery time when she cancelled. Not to mention having a babysitter set, a ride in order, getting the family up at 4am and all the schedules I had in life rearranged around this! All my mental preparation and things i had done at the house ahead of time! I seriously feel so hopeless that I want to say heck with doing something good for myself and heck with dealing with this. Sorry I've wasted everyone's time so far and especially sorry for wasting my own!!

Met with PS on June 3, Loved her! She is very honest and open. Wants to take me down to a C cup, which I am fine with, I haven't been that size since my senior year in high school, I'm currently a 38G, however my Left breast spills over the cup so it is closer to a H. I have awful shoulder grooves from my bra straps. I get rashes under my breasts and the pain in my upper back and shoulders is terrible. Hoping my insurance will cover, office assistant said my insurance is known to deny without supporting documentation, so I would have a lot of leg work to do. My PCP was reluctant to just write a letter and wanted me to go for back x rays and physical therapy first, so I'm on my second week of PT and my upper back x-rays showed mild degenerative disk disease (arthritis). I also got my disc of my mammogram results from 2 years ago, back then my OB/GYN sent me because my breasts are so "dense and fibrous" in his words, he wanted to make sure I did not have any tumors. I also go to see him this Friday so I am hoping he will also write me a letter since he had these concerns 2 years ago. Hoping for the best with insurance Updated on 18 Aug 2015: Insurance denied, but I want this back pain to go away! Going to finance, makes me wonder what the hell I pay insurance for! Updated on 26 Aug 2015: My surgery for yesterday went great! I can't wait until Friday when the bandages get removed. I can honestly say there has been no pain, just sore and a bit of a burning sensation if I move to fast. I can tell today they feel swollen under all of these bandages, all and all great expierance! Would recommend Dr. Koo to friends and family.

I have been a patient of Dr. Koo's for years. I was first treated by her several years ago after being referred to her for a breast reduction by my primary care doctor. I was and am still very happy with that surgery. I have sent several coworkers for that procedure and am currently exploring my options for a face lift and eyelid surgery. I would not consider using anyone else.

I was always interested in a breast augmentation due to my small size and frame. I could not be happier with my decision! I have been able to get back to my normal life very quickly with very little pain or discomfort. There truly are no cons to this procedure in my opinion! I am thrilled with the results and would urge anyone who is interested to follow thru with it. It is one of the best decisions I have every made.

Not at all interested in a facelift, Dr. KOO said she would not recommend that anyway. I thought I would come in here and she would immediately want to operate on my eyes and face. I knew my eyes needed to be done but my chin I did not want to do. Dr. KOO said we could improve my skin and do some filler and Botox injections with my eyes and that would make a big difference. I was shocked! My son looked at me and could put his finger on it but said I looked great. I honestly did not think he would even notice. It is not obvious but helped out a lot. I did not want the time away from my office and did not want any of my coworkers to know. Dr. KOO said we would start slowly with skin care then botox then filler and then my eyes. We changed the order because I really did not want the Botox but after we got started and over a few months I totally believed she would make it look right and not weird or fake.

I did the lift and the tummy tuck. Feeling old and saggy and frumpy. My insides felt great but I felt defeated, deflated and a little depressed. I really only felt depressed when I would try on clothes to go out and everything felt loose and I had to tuck my abdomen skin in my pants. Once that skin was gone I knew I had done the best thing ever.

Dr Koo was very interested in finding out what I wanted from my breast lift and augmentation. She was willing to invest the needed time to make sure the end result was exactly what I wanted. This experience definitely met all my expectations and I could not imaging trusting anyone else to perform my procedure. My motivation was because of the appearance of my breasts after breast feeding two children. My breasts were saggy. Dr Koo was able to fix that and now I am very pleased with the overall appearance.