Casey N. Isom, MD

I have been self-conscious about my breasts since I started growing them in the 4th grade. By the time I was in high school I was 5 ft 1 and wore a D cup. Every time we would go bra shopping I needed a bigger cup size and would cry. When I reached college I was a DDD. I got married and my first child was born and that's when they got really out of control. Nursing had blown my breasts up to an H cup. I remember looking down at them and laughing because they were almost comically huge. After my 3rd baby i started a Journey of weightloss and lost 30 lbs but ny cup size stayed the same. It was at that time I started to seriously consider the reduction. I met with my surgeon for the 1st time in August 2014. My youngest child was 8 months old and I had only recently stopped nursing. The surgeon felt like I needed more time for milk production to completely go away so I scheduled an appointment for March. Over the holidays I wasn't as strict with my diet and exercise regimen and gained back some weight. In march my surgeon and I decided July would be the time for surgery and I was going to lose more weight to achieve the best results. So I hired a personal trainer and worked my butt off. Surgery day came and I felt confident with my health and my weight. The surgery went great and the surgeon was able to leave the nipples attached. When I woke up I was very nauseated and vomited immediately. By the time I got home the nausea had subsided and I was ready to rest. My husband went out and rented me an electric recliner and it was the best 100 bucks we've ever spent. It was helpful and kept me in a great position that was very comfortable. I have been sleeping on it for the last 2 weeks. The first night I did not try and get up at all without the help of my husband. He helped me get to the bathroom and empty my drains. My last bathroom trip before we were ready to go to bed I fainted. Luckily my husband was right there to catch me and guide me to the ground. By day 2 I really wasnt liking the way my left nipple was looking. It was gray and discolored. I rushed in to see the surgeon who loosened the stictches and tape to relieve the restricton. Unfortunately it was too late and my nipple died. It is currently completely black and scabbed over. The surgeon is confident that I still have healthy tissue underneath so we are just waiting for the dead skin to come off. I had surgical drains in for 10 days. The drains weren't too bad for the first week or so but after that the site were they tube was attached wasnvery uncomfortable and sore and stung very badly. I was so happy to finally get them out. The first week I didnt do anything. I stayed in my chair and binge watched television shows on netlfix. I slept a lot because the narcotics made me feel really out of it. The second week I had to try going back to being a mom but it was very difficult. I couldnt pick up my kids and hold them. I had to call in help from my neighbors and parents. If you have children I would highly reccomend having someone available for 2 weeks. This week has been much easier performing my motherly duties. Inspite of the difficulties of the last 2 weeks I would definitely have the surgery again. The surgeon removed 880 grams from my right breast and 920 from my left. I love the look and feel of my new breasts. I cant wait to complete my healing process and get back the gym. For so long exercise has been so uncomfortable and I would struggle with my breasts bouncing and falling out of my bra no matter how many bras I wore. I could never find a swimming suit that fit me because i was close to a 2x around my bust and a l/xl around the rest of my body. I am absolutely thrilled and would love to answer questions anyone has if they are considering this surgery. Also I will keep you updated on the progress of my nipple. By the way, my right nipple looks absolutley perfect. Updated on 13 Aug 2015: Updated on 18 Aug 2015: On friday morning I began bleeding from my incision on the right side. I was going throw 3 layers of guaze like every 2 hours. I called my surgeon and he told me to hold pressure on it and continue to pack it with guaze. And if the bleeding didnt stop to seek help. By about 9 pm i removed the guaze for a shower and the blood just started flowing. So my mom took me to the emergency room. The diagnosis was a draining hematoma and they dressed the wound with a very absorbent dressing and sent me home. I was draining all weekend long. Monday morning I followed up with my surgeon and he advised me to come in. Upon examination he decided to poke some holes to help the hematoma drain better. Once it's drained I will heal much faster. He then removed the scab from my necrotic nipple. I know I have a gaping hole and it's very scary. The wound has to be packed with guaze and replaced daily. Its very painful to remove the guaze from the fresh skin when it has become sticky. Yesterday was a rough day emotionally. I cried most of the day. Not really because of the loss of the nipple because I accepted that a long time ago but because I have this gaping wound that has slowed down my healing process immensely. I am so ready for the pain to go away and to just get back to my life again! I know I wont feel like this forever and I am still happy with my results. Just another obstacle to overcome.

Had 5 pregnancies one of which twins - lost 70 pounds after the last baby but no matter how small I got and how much I worked out my stomach wouldnt flatten and I could NOT get anything close to a 6 pack. Also I had a hernia that kept bulging out after it was fixed 2mths prior to the TT. Im done with babies and its just time to get my body back. Plus I needed the hernia fixed and some scar tissue removed anyway so it was the perfect time to do it!! So far healing has gone very well and I am so happy! Updated on 27 Jul 2015: Everything is healing great. Scars are looking good. I still have some pain in the top part of the muscle above the belly button thats sore. Also a lot of numbness in my whole abdomen. Still cant lift more then 20lbs but I forget sometimes bc I am doing all the normal stuff I forget I still have limitations. Also still have to sleep propped with pillows under head and feet. But i do stand straight and walk great its just the numbness that gets me at night if i am not elevated. Applying Scar guard 2 times daily. And still wearing my spanx for a little longer bc I have some extra swelling on my lower abdomen so that helps control it. Feeling great overall. Updated on 27 Jul 2015: I didnt get before pics on my phone but I will post the ones my PS took when he gives them to me, for now these will have to do.

In two weeks I will be having a tummy tuck with muscle repair and lipo of the abdomen and love handles. I am so excited and equally filled with dread in anticipation! I have bounced back and forth with my decision to have this surgery, (dread! excitement! huge scar! no more front rolls! excitement! dread!) My peace to move forward came in conjunction with my realization that no matter how hard I try to fix it on my own, my body is permanently damaged by the miracle of my children. My pelvic floor is basically collapsing, I have diastasis recti, and my bladder...well, it tries hard. ;) I am moving forward with this abdominoplasty to heal my core and tighten up my pelvic floor, and to remove the excess skin and belly chub baby that won’t go away no matter how much weight I lose! I am *almost* 5’ 2” ;) and as of today for these before photos I weigh 129 lbs. I have had 3 beautiful children, one of which was 10lbs and stretched my little body as far as it could go. ;) I have always been a little chubby, and I am not expecting miracles from this procedure. It won’t make me skinny, but I hope in time that my flatter tummy will be a stronger motivator to get more fit and toned. Thanks for sharing my journey with me! Updated on 23 Apr 2019: Well, as is typical of me, I am laying awake in bed instead of sleeping. *sighhhh* Ha ha, I will make up the lost hours on the surgeon’s table! I have prepared in every way I know how, and now the only thing left to do is wait till it’s time to drive over there. Honestly, for some reason the thing I’m worried the most about is my period!! It is supposed to start either today or tomorrow (bad timing on my part with scheduling, whoops!) and I am stressing about how annoying/inconvenient a thing it will be to be bleeding and cramping during this fragile healing time. The other thing I’m most worried about is nausea. I’m the barfiest person I know. I never met a narcotic I didn’t throw up ;) I asked the hospital pharmacist if there was a narcotic that was less likely to cause nausea and he suggested tramadol, because it’s synthetic, so I talked to Dr Isom about it and he prescribed that for me instead of hydrocodone. A few nights ago I decided to try one when I got a bad headache, to see how my body responded and sure enough, I got nauseous and threw up. I ate food with it and everything. So I tried one of the zofran he prescribed and that didn’t do anything, so I finally took some Benadryl, which is also an antiemetic in case you didn’t know, and put myself to sleep. :) Friends, I just really really hate barfing. :( Dr Isom prescribed me a strong anti nausea pill to take before the surgery called Emend, so I’ll let ou know if that seems to do anything in case there are any readers who suffer from this like I do and are worried about it. Well, wish me luck this morning! 4 hours out and counting! Updated on 25 Apr 2019: I survived, yay! There is such a surreal feeling going into an operation like this. I felt strangely detached, like I was watching it from someone else’s perspective. The surgery went perfectly. Dr Isom came to see me in the recovery room before he went home and when I asked him how much skin he’d taken off he showed me with his hands and it was a lot more than I was expecting! I’m so glad. I can’t wait for the next few months to see the swelling go down and watch the scar fade. Updated on 26 Apr 2019: My entire abdomen feels like one tight solid mass. My binder hates me and I hate it back. ;) I worry constantly if it’s too tight or not tight enough! I have a lot of very tender areas in my upper/middle abdomen that feel hard to the touch. I’m hoping these will just be normal things that will go away soon. I feel like I look very round like a tree trunk. I hope that I will eventually have a waist! It’s hard to be patient and let things go at their own pace. I’m feeling so grateful that things have gone well so far, and I’m sure I’ll continue healing at exactly the right pace for me. Updated on 7 May 2019: Today is my 2 week surgery anniversary! ;) I am feeling *almost* back to normal as far as energy and range of motion; I am almost able to stand up straight and my walking speed and gate are nearly there. I feel stiff when I get up from sitting, and a pulling in my abdomen if I bend certain ways or stretch too far. There is a tender area in my upper abdomen where one of the sutures is tugging a little bit. I am only taking Tylenol periodically for mild pain and that’s it! It still hurts to cough or sneeze though. Today at my check up they removed the clear surgical tape (ripped it off mercilessly is more like it, ha ha! Holy cats, that smarted!) and placed a breathable cloth-like tape over the incision. This is to help hold the edges together for a hopefully thinner scar. The tape will last a week or so and then I’ll put on a new batch, until it has been 2 months. What else have you guys done for scar care?? Should I be rubbing something on it? Or just leave it alone?!? Updated on 25 May 2019: My swelling has gone down a lot and I’m enjoying seeing a little bit of a waist developing ;) I developed a rash on my incision from the tape, so I stopped using that and ordered some silicone strips online that will be here soon. I hope my scar won’t be the worse off for this itchy mishap!

My skin was great until 6 then slowly got bad. By 19 I was experiencing cystic breakouts and tried a ton of OTC stuff to clear it up. I have a ton of scarring because of it. I never did clear it completely with otc stuff but the Nutrogena Pore Refining line did help a lot. I also used their Visibly Even line to address hyper pigmentation effectively. I even started using a clarasonic regularly with Philosophy Purity and saw further improvements with minor blemishes. Even so I still got deep, painful, inflamed cystic acne that would never come to a head. Nothing I tried could even touch it. I eventually gave up on having clear skin until during my pregnancies (at 30 and 32) and while breastfeeding my skin was glowing and perfectly clear. The nice skin kept up through breastfeeding and slowly got worse as I weaned. I joked I would have had kids years a decade earlier had I known it would give me clear skin. Having my skin revert back to "normal" was soul crushing. I didn't want to return to being unable to make eye contact or leave the house for days because my skin was so bad. I didn't want my kids to ask what was wrong with my face or pile on tons of makeup to cover it. By this time in my life I now had insurance so I went to the dermatologist. He wouldn't prescribe any oral meds until I weaned so I used Aczone cream morning and night for a few years with a trention cream that increased from .025 to a .04 microspheres at night. My skin kept getting more and more cystic acne so after I weaned I got a prescription for 50mg/day. (2-25mg pills, one in the morning and one at night.) The doctor required I be on some form of birth control because the medication affects your androgen levels and will feminize a male fetus. He also warned me it takes months for it to start to have an effect. We scheduled a blood test checking potassium prior to a 3 month follow up. Within a week I could tell my oil production was reduced because I could now skip a day of washing and use dry shampoo, where I never would have been able to do so prior. I had a few moments of lightheadedness when first starting and had to pee a lot as it is a diuretic. I also needed to increase my water intake and take the medication with food. At follow up blood levels were in the middle of the normal range but my skin was worse than before but not a bad as it was pre-pregnancy. We changed topical to a clindamycin astringent in the mornings, trention micro .1% at night and increased the spiro to 100mg/day with two 50mg pills, one in the morning and one at night. Within a month my skin has completely cleared! It took me 4 months and an increase to 100mg/day for it to work for me. Im so glad I gave it a chance and stayed patient with the process to get to this result! I will never ever willingly give up this medication. This is seriously a godsend and I didn't want to take accutane which was my last ditch resort if spiro didn't work. If you have hormonal acne you need to try this! Many (including me) have skin got worse before it gets better but it is worth it! Don't be afraid to ask for an increased dose if it's not working after a few months, and if the dermatologist won't prescribe it find another or go to an endocrinologist. It's worth it to stick it out! It takes a long time for this med to work.

I'm getting a breast reduction and lift tomorrow. I've been wanting one of these for years but haven't been able to afford it. Fortunately, I'm still on my parents' insurance and it's actually covering it! I was a DD by my high school graduation. They've just kept going since. Granted, I've put on some weight since then, but I've also lost quite a bit recently. They're "pendulous," heavy, awkward, and cause all sorts of problems. You ladies all know what I'm saying. I'm super nervous. Not as much for the actual surgery, more for the recovery. And the Frankenboob. I'm very much not looking forward to that. Any last minute tips are appreciated. This site has seriously been the best help I've found. Updated on 7 Dec 2016: So I'm 24 hours post waking up. I'm a fair bit groggy, so I apologize for any spelling and grammar mistakes. I'm feeling pretty rad so far, considering. They lipo-ed under my arms and I was warned that's where it would be the most sore. And it sure is. Feels like I pulled every muscle even remotely connected. I also have a headache, but it's bearable. I'm seriously so much smaller. It's incredible. I haven't really seen them yet, as the big bandage don't come off til Friday, but I'm a little worried they're going to be too small. My mom, who went with me and is taking care of me, says they look great and that my nipples are "cute." That was one of my concerns - hated them before. I've been existing on saltines and ginger ale. I'm trying some soup now that I switched from Percocet to Hydrocodone. The P made me super nauseous. The surgery itself took 4 hours. From check-in to check-out I was in the hospital from 6 AM to 2:30 PM. I don't remember much of it, which is just fine. Everyone was so nice and professional. They answered all my questions and helped me stay calm and put up with my nerve based weird sense of humor. I was intubated and given a catheter, since it was such a long procedure. Fortunately, they put both in after I was out and took both out before I woke up. Had a bit of a cough, but no soreness from either of those otherwise. I'm including a pic of the lines drawn pre surgery. It's basically the only one I have of them before. Updated on 13 Dec 2016: It's been a week and I'm feeling awesome! Had my post-op yesterday and got my drains out, thank god. I was beyond sick of them. It was nice to sleep and not worry about yanking them out. I was almost comfortable! It wasn't as horrible getting the drains out as I thought. I'm still pretty numb under my alarms, so I sure that helped, it just felt sort of weird. For some reason I expected huge gaping holes where they were, but that's not the case. The tubing was much smaller than I always think it is. Dr told me everything looked great and is healing nicely. I still have to wear a bra 24/7 for a while, but I'm a-ok with that. It's more comfortable and makes me feel more secure. I can pretty much do everything normally now, just have to watch my energy level and not do any heavy lifting, not that I do that anyway, haha. I'm still fairly numb under the arms and on the sides. It's very itchy, especially at night, but since its numb, I can't scratch. Most aggravating thing in the world. Since getting the drains out, I've swelled up a bit. Totally normal amount and there's no exceptional hardness or discoloration. I can't wait to go bra shopping! I'm making myself wait since I'm not positive where I'll end up, but I'm pretty sure I'll be a 34C which is exactly my goal. Seriously, Dr Isom and his staff are the best. So nice and friendly and so very good at explaining things 8000 times when I ask the same dumb questions over and over. I have absolutely zero complaints and fully plan on going back there, when I'm fabulously wealthy, to get everything tightened and polished. Next appointment is the day after Christmas! Updated on 13 Dec 2016: The one with the shirt on my shoulders is from Friday 12/09 and the other is from yesterday 12/12! Highlight I've forgot to mention? The first word on my run tattoo is visible again! It's been gone for years!

So far I am down 45lbs from 187 scheduled for TT on 4-22 excited, nervous, scared are few of the words that come to mind. I have lots of excess skin from pregnancies that no matter my weight loss wouldn't go away. Now It will forever be gone in just a few short days. I am excited that I will never have to look down and see sagging belly nor will i have to tuck into pants anymore!! But the thing I think I am most excited about is being able to wear underwear again without them rolling down or giving me a rash wear it would rub under the belly and on my pants. I am nervous just because I don't know what to expect after the surgery and scared well because all surgeries we take risks when being put under. In the end I will be so happy with my results that all my hard work and the temporary pain, and the Dr's final touches I will have the body I want!! Updated on 20 Apr 2014: I am getting closer and I figured I would ad some pre belly horrific terrifying pics. Not for the faint. These are battle scars from 3 beautiful babies that are about to he rid forever. Well there will be some stretch marks left but not nearly as many that I have now. Hopefully I am able to get some after pics with in the first few days after my TT w/MR and lipo. Still really not sure what to expect, before I had any children I weighed 97lbs. I don't ever want to be that small again because people thought I has eating disorder. But to be 125-135 I would be alright with that. I am not sure if I will lose any weight from the surgery itself even though my Dr. Told me they would be taking lbs right away as my loose skin is quite heavy. So I will wait and see. Updated on 21 Apr 2014: It's really happening....OMG!! My time is for 10:45 am to be at the hospital. I can't wait to be done with this so the overwhelming anxiousness will be gone and I can start the healing process. I do have to stay the night which is fine. I will let everyone get used to me not doing everything for them for a while....lol My husband bless his heart is a god send. He took 2 wks off to help me. I will try and post pics when i get home from the hospital for some updates. Talk to you all on the flat side. ;) Updated on 23 Apr 2014: Well everything went well he removed 5lbs of excess skin and about 2 lbs fat from the lipo. I'm in pain my pain pump had to be taken out this morning because at some point last night the catheters got pulled out so dbl the pain. Haven been able to get up and walk yet. Waiting for the nurses to remove catheter. Hoping to go home at some point today. But in order for me to do that I have to take deep breaths and not get sick from my meds. I was able to get a quick pic when the nurse was checking my bandages. It looks good so far from what I can talk there's to much indents from the garment and the padding he has on under it to really tell. Im gonna get off here and try to sleep cause I didn't get any rest last night in here with nurses in and out all night. Updated on 24 Apr 2014: Holy tamole bring on the bruising. 2 days post op and I have major bruising going on. I itch but too numb to scratch it..LOL still waiting to see what I look like under this girdle. Hopefully today when I go to Dr for my dressing change I'll get a peak. In weighed myself last night and somehow gained 20lbs while at the hospital when I know he removed 7lbs of skin and fat. How do you manage to gain? I'm gonna go with the swelling. Haven't had an appetite. Try to eat Lil so I don't get sick from all this medicine. Updated on 24 Apr 2014: So have the binder off. And I still can't see the difference other than the pouch of skin that was once there. Hopefully when some of the swelling goes away. Updated on 25 Apr 2014: Well thought today would be the day to try and shower. WRONG!! The Moment my girdle came off began the hot flashes and faint feeling, and Dizziness. Didn't start out that great this morning either. Missed a dose of pain meds in middle of night and woke up to nauseating pain. Ended up having my husband give me sponge bath laying in bed. Girdle can not come off or I get instantly sick. Updated on 26 Apr 2014: Stopped taking the pain meds as I feel they were making me feel worse. Suffered with fevers all day and night yesterday was a rough day for me. Today only taking 800 motrin from here on out. I'm really dying to get in the shower but after yesterday's ordeal I'll refrain for a few more days. Drain tube still letting out a fair amount of blood and fluid which is to be expected. If I could stay awake for more than a cpl hours at a time that would be great as well. But I can't make it to the commercials on TV shows without my eyes rolling in the back of my head...LOL Updated on 27 Apr 2014: Decided to go for a ride today went to the stores used a cart the whole time, except the store that didn't have one my amazing husband pushed me around in a wheelchair. Feeling a little wore out but not to bad. Also washed my girdle and took a pic of my tummy I have to say at this point I am not happy with my results. Yes I'm swollen but I don't see no shape I look like a box. Awful!! Ugh.. Shouldn't of looked yet. Updated on 28 Apr 2014: Feeling much better today after talking to my Dr and asking him questions. Able to move around pretty good. Swept my floor this morning made breakfast and lunch. Except walking long distances in which I ride the cart at the store or the hubby pushes me in wheel chair. I do get a pain in my back after a while. I'm not hunched over almost up straight all the way. A few Lil twinges here and there in the belly. My only issue is the constant laughing my husband is trying to torture me with. ..LOL he said he's healing me with laughter. Which is fine but it hurts a little bit. Updated on 30 Apr 2014: I feel great. other than a few tweaks here and there. I still feel very swollen obviously that's gonna be for awhile. although today I have this weird tingling near my waist. I dont know if thats normal or not. (my man package)..lmao my mons pubis area swelling is going down some. still noticeable though to me anyway. I hope I continue to heal like this everyday. I feel great :) Updated on 30 Apr 2014: Some pics before shower. Still very swollen Updated on 30 Apr 2014: Why am I not noticing a difference other than the missing belly butt? I noticed some of you ladies already have a figure. Updated on 9 May 2014: Had my drain removed yesterday. Panicked thinking it was gonna hurt and I didnt feel a thing, However what did freak me out was when i went to change the gauze that when I removed it there was stuff pouring out like a siv...lol I freaked and called the office only to find out that's fine just keep changing it and it will close up in few days well this morning it was closed..lol Phew.. I don't know if I could handle that much longer. Now for this swelling to subside just a little would be grand. I hate this compression garment but at the same time I hate not having it on when I take a shower. The Dr. did say I could get some really snug spanx to wear. Is anyone else experiencing that? Feeling great with compression garment on but when you take it off its still hard to be fully upright? and can't have it off for very long at all? I will post pics as soon as I get my phone back. I broke it and had to send it in for repair :( Updated on 19 May 2014: tomorrow is 4 weeks post and I'm feeling great! Dr said I only have to wear compression garment at night for the next 2 wks, no more day wear. I can go back to Zumba in 2 wks and we are pcs'ing the same time. Healing really good, still lots of swelling though. My man package is starting to go down a lil but still very noticeable to me anyway...lol that's the update here. Updated on 18 Aug 2014: I'm a cpl days shy of 4 months post surgery. still have a swollen mons pubis hate it!! Moved across country, Haven't been to the gym, feel like I dont look any better or smaller. Never had the I can't breathing to deep issue at all or stand straight problem as bad as most are talking about. Still numb from the belly button down. Get really swollen by days end and thats when I feel like I still look the same as before. I will post pics from my phone when I get the chance. Hoping something will start to look up soon. Updated on 18 Aug 2014: