I'm three years post-op VSG. Went from 316lbs to steady 188-192lbs. I've been in that range for over a year.
I still feel fat. Mostly because of the loose skin on my belly and persistent fat around my nipples. Of course people say things like, "you don't need it," or, "don't lose any more weight!" Which is of course a totally messy thing to say, because they almost surely haven't been treated like a morbidly obese person. Going from 48-52" to 30-32" pants, it's like going from being partially invisible to visible, strangers are 100x nicer and more polite to you, and people don't assume you're stupid, sick or impulsive. But feeling fat is still in your head.
I think that only (formerly) obese people understand that feeling, where the residual self image as fat overrides reality. A few weeks ago, I was clothes shopping with a friend and I made a comment how much smaller he is than I am. He responded that even if I'm a little taller, we wear the same size shirt and belt. I couldn't even process it. To me, he looks 3 times smaller than me... I used to be more than double his weight.
Booked with Brandon Reynolds, M.D. of Reynolds Plastic Surgery in Las Vegas, Nevada. He made me feel comfortable right away. Another doctor I consulted with had suggested flank lipo too, but Dr. Reynolds recommended doing one side of the body at a time.
I am nervous about anesthesia - VSG was the only time that I've been under as an adult (when I checked in for VSG they gave me a dose of morphine early to get rid of the jitters). I'm also concerned about the pain and recovery since I will not be able to take much time off of work. At least I have a desk job, and am mostly seated during the day. I only needed two days of pain meds after VSG, we will see how I hold out after this.
Updated on 15 May 2020:
Well the hard part is past now. Checked in for surgery around 9 yesterday morning. I was Dr. Reynolds' second surgery of the day. We met for a few minutes, also with his anaesthesiologist, Dr. Reynolds - his brother! (I've known their family nearly 14 years). We had the surgery at Smith Plastic Surgery's new center, which opened in January, and is immaculately clean and bright. I only remember a couple of minutes in the theater though before they dosed me with anesthesia. I was talking with them at noon... and next thing I knew I was being woken up around 6pm.
They reassured me everything went smoothly. Pain was crazy intense and I was shivering heavily when I woke up. They gave me a fentanyl patch and that calmed me down in seconds. They loaded me up to go home around 630-645pm. I was still only half coherent from the fentanyl, I remember it (12 hours later) but have gaps of time missing.
The pain was escalating at home until I took the hydrocodone/Norco which got me to sleep. I was up about every 2-3 hours in the night. One saving grace is that we bought a sleep number bed last year that adjusts shape. I joked that made us honorary seniors, but it has now been useful.
My post op appointment is in an hour. I haven't been able to see anything yet because I didn't want to loosen the binder.
Updated on 17 May 2020:
Cleaned up the bandages and checked out the stitching on day 2. Perfect lines! I am completely pleased with the placement and belly button. Impressed with the amount of lipo he was able to do. It looks like the top of my abs and rib cage will have immediate definition once the swelling subsides.
Updated on 24 May 2020:
Day 8: Pain under control with 1 Norco at a time. Was able to sit a full day at the office. So much easier to get ready without drains, easily 15 mins faster.
Day 7: very little in drains (4-6ml) for 3rd day in a row. Dr confirms drains can be removed, stopped by and got them removed. Surprised that it didn't hurt, they just clipped the stitches and popped them out. Half day at work, had two hours of client meetings and several court conferences by phone. Still getting used to sitting in office chair. Got crazy amount of swelling at night, had to lie down from 6pm onward. Woke up 2am sweating profusely and couldn't sleep until 4am.
Day 6: a pretty chill day. Stopped by office for a couple of hours to clear out 500+ emails, a court conference, cut some checks and approve documents. Ate lunch at friend's restaurant and then dinner at nice quiet sushi restaurant. Dosed up and watched about 8 episodes of The Simpsons to end the night.
Day 5: WORST DAY of post-op, mentally. Only slept like 3 hours. Had panic at 3:30am about drain maybe being infected, then I was out of meds and my doc wasn't available that day for refill scrip. Tracked down a doc friend who could see me. Only highlight was meeting some friends for dinner and card night. I played a few hands and joked around. Really bad swelling later, worried that it would get so bad stitches would pop.
Updated on 30 May 2020:
Dr. Reynolds said that this week I should be working on standing up straighter and that I can start some light upper body exercise. So I've been working on my posture with very gentle arm stretches, but it is still extremely tight around the seam. I'm carrying at least 10 lb of fluid swelling. I have a phase two binder garment that's supposed to arrive next week to help smooth the swelling out. it was counterintuitive but wearing my underwear elastic above the stitching, rather than below it, was far better for the pain and it pushed some of the swelling up and away.
Sleeping is still very difficult to get more than two or three hours at a time. I am not a back sleeper at all, so I have to lie there until I am so fatigued that I just pass out. I stopped taking the hydrocodone 6 days ago (day 10) and I've had withdrawal depression and extreme sweating when I sleep.
I was able to start driving myself again by day 11. Stopping the hydrocodone brings a second wave of pain that the Tylenol doesn't really control. By day 12 I was able to work a full day at the office.
I think I'm through the worst of the pain. Dr. Reynolds was up front when he first met with me (and at all times) that what's going to hurt out of all of this is the stitching of the muscles for the abdominal repair... and he was 100% correct! I don't know that anything can really prepare you for future pain. it's something your brain can't really comprehend until you experience it. But the skin stitching and even the liposuction never really hurt, just itching or mild bruising pain. The lipo in the chest left some numbness around the nipples. The abdominal repair pain is a hot, searing, stabbing pain that rocked me from the first seconds that I came out of anesthesia, and nagged me for nearly two weeks. Mercifully, when you're immobile (whether standing or lying down) it usually doesn't hurt badly. But movement and sitting/standing is an ordeal for 12 days. Now at day 16 it's down to more of an ache, and while I'm cautious, it doesn't take me 10-15 seconds to stand up, sit down or lie down.
Updated on 6 Jun 2020:
Finally able to sleep on my side for part of the night, which has helped me get to more than 6 hours per night of sleep now about 3 times. Set a new post-op best of 8 hours today.
Went to the gym today for the first time in a month, and admittedly I hadn't been going regularly pre-op. Embarrassingly weak. Did a little chest, back and arms on machines and some dumbbells. Focused on getting through three sets each exercise and letting it get close to muscle failure on decline.
Was my pre-op weight this morning, so swelling is still at 7-9lbs? Notable swelling across the abdomen and hips still. Switched to a jumper-type compression garment which actually really helps with pelvic pain and disburse the swelling a little - but it is ridiculous for going to the bathroom since you have to remove your shirt. And despite confirming twice on the package that it is for a male, the groin is so tight it doesn't seem like it. That aspect is quite uncomfortable. I considered cutting the garment.
Down to two doses of Tylenol a day. Using PM version to get to sleep.
Belly button scabs all gone as of a few days ago. Still a little bit on my main seam. Still have some bruising and drain tube burn marks, especially on my right. The abdominal drain site still has a prominent scab, the ribcage drains are sealed and just an irritated red now.
Updated on 27 Jul 2020:
I can do most activities of daily living without discomfort now. I can do a few dozen sit-ups, slowly and gently. Occasional stabbing pain at two points of my abs, when I tense up or move. The surface of the skin on the seam is smooth to the touch, although the color is dark purple still.
Went to the beach and took my shirt off for 20-30 mins - doused in 70SPF sunscreen so my scars didn't burn.
Updated on 13 Dec 2020:
The tenderness of the abdominal wall has finally subsided after 5+ months and I can jog again. I’ve gained 3-4lbs which has left a soft layer that bugs me, but still better than the large flap of skin I had, along with a distended potbelly.
I’ll note at this point the dysmorphia I had about my belly skin now leaves me tugging at my flanks. It’s not nearly as bad though, and I can wear a swimsuit at the beach without being overwhelmed by insecurity.
Updated on 6 Apr 2021:
Scar has faded down well. Some laxity to the lower abdomen that has started to bulge a bit after I eat - most noticeable at night. Just had another follow up and the ab repair has held up, so it is either intestinal fullness from foods or extra sub-muscular fat. Nipples sometimes look deflated but my chest has remained pretty flat vertically which is far better than puffy, pointy nipples. Up about 7 lbs due to pandemic activity interruption.
Overall still really happy with the result. Went on a beach vacation and felt great. Actually considering a second round of flank lipo and a little more skin removal.
Updated on 10 May 2021:
Booked again with Dr. Reynolds for some more lipo of the rear flank to get rid of the 'spare tire' fat on the low back, and some skin removal on the flank. Idea now is to continue along the scar that's already there.
Dr. Reynolds said the abdominal repair is holding well so the distention is likely fat behind the abdominal wall along with some bloat from food and drink.
Updated on 3 Jun 2021:
This collage compares day of surgery, 30 days and then a year post op. The scar surface is smooth to the touch and blended into the skin around it, I have to look to find it. I have some laxity/distention to the lower abs but it is tight and the doctor reassures that is just the shape of the lower abs now with some fat I've gained in the past year - I'm up 7 lbs from my operative weight.
Updated on 3 Jun 2021:
Back with Dr. Reynolds for another surgery, this time to take care of loose skin in the low back and some lipo of the roll that was bothering me above my belt in the back (especially since my front side is nice and flat going into the pants.
As assured by Dr. Reynolds, the pain coming out of anesthesia was nothing like the pain after tummy tuck. I was given more pain meds prior to waking up that took the edge off. It's a surface bruising type of pain, and none of the "stabbed with burning rebar" pain of tummy tuck. I was able to walk in the surgery center and get myself into the car without problems. Moved delicately for a few hours but about 4 hrs post up was walking laps of the house and doing gentle squats to get wiggles out (and prevent clots).
We did the first operation at Dr. Lane Smith's new center on Sahara and that was brand new, bright and very quiet facility. This was at Specialty Surgery Center on Tenaya, and it's an older, larger facility that was busier but the nurses were friendly and talkative.
Sleeping the first night was not that bad, flanks only stung during movement. Slept on my belly mostly, and a little on my side. Only 3 ibuprofen so far today. The post-op instructions said I could drive within 24 hours and I did come in to work [office job, self employed] after lunch to catch up on email and customer tasks without appointments. Just gentle on sitting/standing and slightly limpy/hunched when walking.
Updated on 7 Jun 2021:
Bruising set in and makes it look a lot worse than it feels. Slightly weepy at some of the seam. Really only hurts sitting down/getting up (especially into a car), and lying down/getting up. Once walking, standing or sitting still it's not painful.
Updated on 25 Jun 2021:
I continued posting updates for the back lift on this separate review:
https://www.realself.com/review/back-lift-lipo-year-after-tummy-tuck#entry-1272113
Still can't swim because of the unresolved part on the left, and too tender to run or jog for exercise.