Smartlipo Abdomen (Abs) - Female Mid 40s - Atlanta, GA

Background
I committed to improving my health in 2015. At that time I was 197 lbs and feeling tired and miserable all the time. I had been struggling with my increasing weight for nearly 15 years and for my 5'2 frame, it was time to make changes. I was in my early forties, dealing with PCOS, borderline Type 2 diabetes, and didn't want to hit 45 feeling this same way. I gave up my biggest vice of Diet Coke and lost 10 pounds in 6 weeks. That encouraged me to join OrangeTheory and I immediately fell in love. Committed to four workouts a week and within 7-9 months I had lost 50 lbs. Everything was getting smaller except my tummy and it was driving me crazy because it is my biggest insecurity. I plateaued and then in early 2017 I tried the HCG diet twice and while I did see a weight loss, it wasn't for the long-term.I have stayed with OrangeTheory and recently started 9Round and hope to see some additional changes in my body as I head into 2018. My goal with this procedure was to reduce my upper and lower abdomen to give me more confidence and to offer some additional motivation to stay on track with a healthy lifestyle. I am certainly not looking to earn my Victoria Secret Angel Wings with this procedure, rather to address a lingering physical insecurity and feel better and more confident.
Consultation
Easy conversation with Dr. Kulkin to discuss the procedure, risks, my expectations, and any concerns. He clearly articulated the procedure and the after care, along with setting realistic expectations of what the upcoming 6 months what entail. He was reassuring in that my expectations for the procedure were achievable,but also dependent on me 'doing my part' and continuing to eat well and exercise. This procedure is not weight loss and he does a good job of reminding you of that. After my consultation I met with coordinator to review the pricing and scheduling. Once payment was made, a date was set and the paperwork was sent electronically for me to review and sign. I did find out that if you use a no-interest offer through Care Credit, the provider covers the financing costs upfront, which may be added into the total cost of the procedure. By offering to pay in full for my procedure, I was able to save about $500, so that was a good win for the provider and for me.
Pre-Op (Nov 2017)
Arrived at office about 1.5 hours prior to my scheduled 12:00 start time. During this time they reviewed the procedure with me, took my vitals, completed my pre-op photos, did my markups, and fitted me for my compression garment. One thing I wish I had done was pre-op measurements, as your weight will not really change with this procedure. Photos and clothes will start to tell the story but measurements would be good as well. I took antibiotics the day before, day of, and then each evening and morning for the next week. I was given a prescription for Xanax, which I filled but did not take. I was also given a prescription for hydrocodone to manage the pain afterwards. Wear dark, loose fitting, comfortable clothes and slip-on shoes or flip flops. You will thank yourself later as bending over will be a little challenging or uncomfortable.
Procedure (Dec 5)
OR was cold so I recommend socks for your feet. Once I was on the table and sterilized, Dr. Kulkin came in and began the 'bee stings' which were the injections to numb the areas. This is an accurate term for these injections. Doesn't hurt, but does sting as the medication is injected. I had 4-5 of these on my abdomen. Once that is complete,a small incision is made at each site and fluids are injected under the skin. This is a very odd sensation, as you can feel the cold from the liquid and the weight of the liquid on your abdomen. There is a little tugging as the tool is moved slightly within the site, but no pain. This process took about 45 mins I believe to complete each site.
After the fluids are in, he took his laser and inserted it at each site. Once inserted, he would move it left and right, back and forth, to melt the fat. The tugging here is a little more intense, not painful, but certainly an odd sensation. Every so often I would feel a 'hot spot" similar to small electric shock when you touch something. As soon as I felt this, I would tell him and he would increase the numbing meds at that site, and then go back to melting. I probably felt this 5-6 times (mostly around my belly button and above my pubic bone) and he would immediately stop and do what was needed to make me comfortable. This process took approximately 45 - 60 minutes. Once complete, he used a vacuum tube and began sucking out the fat. Again, tugging and pulling but no pain. I could see containers filling up as he did this. I appreciated his commitment to the best results, as he would go back over areas a couple times as needed with both the laser and the vacuum. During the entire procedure, I was alert and engaged in conversation with the doctor and his nurse. Music in the background and overall a relaxed environment. He and his nurse were constantly checking to make sure I was ok, not in any pain, and doing well. This was very reassuring! Once he was satisfied, he inserted a drainage tube, sutured my incision site, and reviewed the aftercare steps with me. I was then helped into my clothes, my vitals taken again, and I drove myself home. Had I taken the Xanax I would not have been able to drive home. However, based upon my conversation with the doctor and other reviews, I didn't see the need to take the Xanax. Left the office around 3:00.
Post-Op
Got home and felt tired from the adrenaline and activities of the day. My abdomen was very swollen, felt like a waterbed or jello (weird!!) and was very cold. The drainage tube was easy to manage and honestly, I cannot imagine not having one for this procedure. If you don't have one, you are going to have a hell of a mess to deal with for the next 24-48 hours and that's just not something I think anyone would like to worry about. I would empty the drain about every hour or two. Energy level was surprisingly good and I sat in my home office and caught up on work. Dr. Kulkin called around 7pm to check in and make sure I was doing well. Reminded me that I can call him directly on his cell if I needed anything (WOW!!). Around 9pm the pain started to kick in so I got settled in bed, took a pain pill, and slept for about 3 hours. Woke up, emptied the drain, and went back to bed. Had trouble going back to sleep but managed to rest comfortably for a few hours. Finally got up around 7am and was able to get myself out of the compression garment, take a shower, get dressed, and drive to my follow-up appointment. At the appointment, they removed my tube and stitches. I was also helped into my compression garment. This sucker is tight but man does it feel good once you get it on. It helps keeps everything in place, which minimizes some of the discomfort. Follow-up appointment for a month later was made and I was sent on my way. I elected to take the day off, however, I could have gone to work if needed. I just wanted the extra day at home in the event I was sore or not feeling great.
Week One
Fairly uneventful but definitely felt soreness throughout the week. Used pain meds for the first two nights and then didn't need them any longer. I have a love-hate relationship with the compression garment (love it when it's on, hate putting it on). I am wearing it literally 23 hours a day (only taking it off when I shower) and throw it in the laundry every couple days. Going to the restroom is easy thanks to the openings . Definitely soreness with anything sitting or resting on my abs, especially around my belly button. Significant bruising on my lower abs and pubic bone area. Not surprised at this given that I bruise easily, but it was a little startling to see all the deep bruise colors. For work, I've been wearing a lot of loose fitting skirts and dresses so that I was comfortable and nothing was pressing on my stomach. At home, it is loose fitting leggings or yoga pants pulled up high so the waist band was not on my tender areas. Able to move and sleep pretty well, with the occasional reminder of tenderness when making certain movements. Not a lot of changes in my appearance as I am still very swollen and carrying fluids.
Week Two
Still feeling 'bloated' at times and swollen, although I believe I see some changes in my body. Hard spots under the skin around my belly button and lower abs, but have been told those will go away. Loose fitting clothes are still the way to go, although I did wear jeans one day and immediately noticed the new extra space in the waistline. Compression garment is still really helpful and am surprised at how well it really holds everything in tightly. Bruising has faded substantially and the tenderness primarily remains around my belly button and lower abs. Sleeping has become more restful and comfortable.
Overall feeling good and happy with how my body is recovering from the procedure. I am excited to see how my body continues to heal and change as I head into the next couple weeks and months. I will continue to update and post pictures.

Starting to see some noticeable changes. Definitely still swollen in areas, tenderness remains all around, and some lumpiness is present. I am confident all of that will continue to diminish as the weeks continue on. This week was the final week of my compression garment, although I have continued with Spanx and the like under my clothes. They certainly help with tenderness, as they hold everything in place. Excited to see even more changes happen over the next couple weeks.

Still having some tenderness in the mid-section and near my belly button. Feel like I am still swollen in areas and lumpy. Continuing to wear my Spanx compressing garments and definitely appreciate the support they provide. One month visit I Friday and hoping to be given the OK to get back to my HIIT workouts. Feeling good about the changes I am seeing and hoping the next several weeks continue to bring reduction in my abs and the swelling/lumpiness.