Full TT with MR & Lipo of Flanks, Hips, and Thighs

I have been reviewing posts and stories on this website for over a year. I finally had my own consultation yesterday with Dr. Jeffrey Poulter. I was super nervous, but quickly became comfortable with the staff. They were very friendly, understanding, and professional. Dr. Poulter talked with me first about my goals and the procedure itself. Then I had "before" pictures taken and returned to the exam room for the personal consultation. He was honest, straightforward, and understanding. I have had 3 c-sections (one vertical, 2 horizontal) and hysterectomy. I have lots of scar tissue on my stomach and an ongoing rash on the lower section that I've experienced over the past few years. Dr. Poulter thinks my insurance may cover the panniculectomy. I was thrilled!!! He is submitting a letter and my photos to my insurance. The wait begins. He said it could take 4-6 weeks to hear from them. If approved, I could be scheduled for December. I am praying it will be approved!!!

So I discovered yesterday that my insurance covered my consultation visit with Dr. Poulter! That's very encouraging. My procedure is still under review to see if it will be covered and if so, how much it will cover. I have scheduled a follow up consultation to view my options (full TT, panni with lipo, or panni only). He has video imaging that can show you what your results should look like with each option.

Right now, I'm leaning toward panni with lipo just because I only have 2 weeks for recovery before going back to work full time. ??? Any suggestions out there from those who have had panni removal? It is my main objective, but I don't want to be disappointed. I also want to be realistic. If my new flat tummy (with full TT) looks super duper, I'm afraid the rest of me (inner thigh, outer thigh, upper arms, etc., ) will only look worse. I've lost nearly 50 lbs. over the past few years, but some areas just aren't responding to all of the exercise. Looking toned all over would be terrific, but it isn't my main objective right now - I just want my clothes to fit right and to not be embarrassed about my stomach when I put on a swimsuit at the gym, pool, or beach! :-(

I am sooooo ready to say goodbye to this awful stomach!!!!

Well, I had a follow-up consultation today....which did not go as I thought it would. I thought I would be reviewing before/after pics of Dr. Poulter's tummy tuck patients, getting more details on the appropriate procedure for me, and scheduling a date for surgery. (I should note that I was advised by the office manager, with whom I've had email contact since before my initial consultation, to schedule this follow-up appt. to have my questions about the procedure answered by Dr. P....like panni only, TT with or w/o MR, and if lipo will be needed. However, what I received today was confusing to say the least.

I met with Dr. Poulter again, who seemed puzzled by my visit (approx. 4 weeks after my initial). I explained why I scheduled it and he admitted that he couldn't give me more info. yet because he didn't know what the insurance would cover. He also admitted and apologized for having "very recently" submitted the letter to my insurance. (I discovered later today that BCBS received the letter YESTERDAY even though it was dated 9/27/2013.) :-/ He encouraged me to follow up with them to see if my procedure would be partially covered. He explained that he could give me more pricing specifics once we knew. He also explained that the extended TT would not include lipo of the flanks, but could include lipo of the upper abdominal area " if [he] thought it was necessary." Lipo of the flanks (or any other area) would be additional. He did mention that relocation of the bb would be necessary.

Disappointed, I left the appt. He did not charge me for the visit, which was good. I immediately called my insurance after the appt. I discovered they had just received the request for pre-approval, that it was in review, and that I could expect a response within 30 days or less. The rep noted that some of the codes on the cost analysis would have to be updated/more specific by Dr. Poulter. I emailed his office mgr. to let her know this. The rep also told me that there was nothing else to do at this time.

So now I'm wondering if 1) I should see another PS in my area (due to the delay in sending the request and to compare procedures)? And 2) I should go ahead and book the date with him so as not to miss my window of opportunity in Dec.???

My RS friends who have had or will be having an extended TT - has your procedure included lipo of flanks or upper abdomin w/o an additional charge? Would you visit another PS at this point??? I'm thinking that if he forgot to send in the letter to my insurance until the day before my follow-up appt., what sort of treatment can I expect under his care during/after the procedure??? :-/

I found out today that BCBS will not cover the panniculectomy because I don't have a documented history of rashes (I.e. By a physician). Even though I've had them literally for 12 years now, I was too embarrassed to go to my general physician for treatment! :-( Oh well. I am determined to have the procedure regardless. In fact, I'm thinking about adding inner/outer thigh Vaser lipo and upper arm later on. I've worked really hard to lose this weight and I want to enjoy it, not continue to be embarrassed by the stubborn areas I can't change with exercise.

I emailed Dr. Poulter's office to let them know. I want to move forward with this and with my life. To be continued.....

Since my last post, I discovered that Dr. Poulter's office is now quoting me $10,586 for TT, $12,586 if I want to add lipo of flanks. In order to book a date in December, I need to put 25% down and pay the rest by the surgery date. I'm rethinking the whole thing at this point.

I keep asking myself 1) why did the price change? 2) why did it take him so long to send the request to my insurance? 3) do I really want to use Care credit to pay for this elective procedure when we've worked so hard to become debt free these past 4 years? And 5) what if something goes wrong and I require more recovery time (which I won't have in Dec)?

Call it cold feet, fear, or wisdom, I just don't think I'm ready to do this. At the very least, I want to visit another PS to compare... :-/

Just made a new consultation appt. today with Dr. Tattini for Nov. 6th. :-)

Although my consultation with Dr. T went very well (staff was very friendly, professional, etc.), I didn't leave feeling certain that he was the one. I saw the photos of before and afters and he answered many of my questions. He does not require an overnight stay, and does not use a pain pump. His procedure includes lipo of flanks, but not of upper stomach because he said that interferes with the blood supply needed to heal the TT scar. The scars in the after pics didn't look as neat as Dr. P's and the upper abdomens looked poochy (as compared to their new lower region), but the belly buttons looked better. Overall, I liked his friendliness, personality, and the time he spent going over everything with me.

Nevertheless, I have one more consultation scheduled with a PS in Indianapolis this week. He has 40 five-star reviews on this site! I thought it might be worth the nearly 3 hour drive to see him. His online before/after pics look really good too. I figure I get one shot at this, I might as well make it count by making an informed decision! :-)

Forgot to add that Dr. T's quoted price was $8300 for full TT (inc. lipo of flanks) and that price was confirmed at my consultation. I'm thinking that it is probably less because he doesn't require an overnight stay. ?

Well, what a ride these past few days have been! I had my third consultation this week with Dr. F in Indiana. LOVED him! Loved him and his staff SO much that I wanted to book the surgery....BUT I find out after the consult they don't accept Care Credit, which I had already been approved for. :-/ So now I am applying for financing (0%) with a bank they recommended....but I find out that they may not qualify me because I don't live in Indiana!!!! Ugh! I want to scream. Really? Keeping my fingers crossed that it still works out. I really want him to do my TT, which includes lipo of the sides and back (to make it smooth) for $8000. If I am approved, I can have it done Dec. 16th. Praying and hoping this one works out. He truly was worth the 3 hour drive! :-)

Financing worked out and I can't wait! Hubby has been amazingly supportive through all of this. He's a keeper. Ordering my compression garments this weekend and getting scripts filled before they expire. I've actual lost a few pounds too since my original post through whole foods diet and increased exercise. Current weight = 164. Exactly 4 weeks pre-op...

Joining the flat side in 8 more days! I have a pre-op appt on Tuesday with Dr. Fata. Then hubby and I are going back Sunday evening to spend the night so I'm there early for Monday morning surgery. Can't wait! Work has been so busy these past few weeks, I've hardly had time to think about it. I also realized last night that I need to complete my christmas shopping by next weekend! Yikes!

My pre-op visit went well and I'm 3.....yes, 3 days away from surgery now. Nerves are building. So much to get done before Sunday night when we leave. At the pre- op visit we decided to add some lipo of inner thighs as well to smooth things out. It didn't add much to the cost and I think the result will look better. He didn't think I needed outer thigh lipo. I'm praying for a speedy recovery. :-)

Now with that done, I'm more focused on the surgery. It's 1:26 am and I can't sleep. Nerves are getting to me. I think it really comes down to my having to depend on my family to take care of me.....I don't like that, but I know I have no choice. I'm the caregiver in our family. I'm the shopper, the cook, and the planner. When I'm incapacitated, it seems everything is out of whack....which causes me stress! I'm praying for a speedy recovery and empathy from my family members. :-)

Ong! I still have lots of bandages, binder, etc., on, but I am already LOVING the flat side!!!! Everyone has been so kind and helpful here. Would totally do this again in a minute! Still have catheter in right now, for a couple more hours. Percocet for pain. Good stuff. Eating first foods - crackers, tomato soup (my fav) and water. Will post some pics soon.

Taking just 1 Percocet every 4-6 hours now. Got up, walked around, and went to bathroom already! Doing just fine. Should be heading home some time this morning after I see the dr. Not looking forward to the 3 hour drive home though. My fingers & toes are pretty swollen, look like sausages! Ha! Will post "after" pics once garment comes off. For now, here's what I have. Thanks for all the well wishes and prayers! :-)

First night home went ok. I didn't set an alarm though for pain med, so I woke up at 3:00 am to go to the bathroom and discovered it hurt a LOT more than it should have! :-/ I also had some leaking around the drain incisions. I called the PS and he said not to worry. I just needed to keep the lines flushed. Had to get garment washed today - disgusting by day 3. Also, when going to bathroom this afternoon, one of my drains just fell out. Panicked, I called the PS. He said not to worry, I have two and my drainage has been very low. The second one will come out on Monday at my visit. I have to say, I am super pleased the results so far!!! I'm swollen and purple in places, but I love what I'm seeing! Never thought MY stomach could be so flat! And he did a great job shaping my hips & thighs. I'm still puffy, but that's ok. :-)

Of course, half of my body was covered in plastic wrap, but I didn't care. It was wonderful to have my hair washed. With the added steps and my slow pace, it took FOREVER to do, but it was worth it. I've been on my feet too much today and my swelling is telling me so. Time for a Percocet and a nap!

Still feeling pretty good. Some soreness in my back & tummy area and puffy (especially around knees), but overall good. Still taking Percocet, but stretching it out longer now. I know that everyone says not to weigh right after a TT, but I couldn't resist. I actually weigh the same today that I did pre-op. Given how puffy I am right now, I'll take that as a good sign! Today was first BM. The stool softeners are definitely worth it! Not sure how that would have gone otherwise as I'm still pretty numb in the lower area. ?

Still wearing my CG round the clock. I'm also wearing compression stockings at night. During the day my legs and knees swell a lot. If they were more comfortable, I'd wear them during the day too. But they tend to bunch up at the knees when I'm walking around, almost cutting my legs in two. Not good. Planning to check on some other options online.

Looking forward to my post-op visit on Monday and getting this last drain out. It's not painful, but is always in the way... :-/

Ok, so the past 24 hours have been interesting. My first BM was no problem and I thought I was out of the woods in that area. However, late yesterday afternoon I discovered I definitely wasn't! :-( Had a not-so-easy BM yesterday, then an excruciating one today, despit taking stool softener 2x day for the past 7 days. Ladies, TAKE your stool softener, MOM, whatever you must to avoid what I experienced today. Seriously. That was more painful than anything related to the surgery! I suspect 2 things led to it - probably not drinking enough water and a side effect of the Percocet. The good news is I have weaned off the Percocet completely now and am just taking Tylenol. Feeling pretty good otherwise. Hang in there everyone! :-)

Another interesting and painful day in the bathroom dept. Even though bms have not been an issue itself, the after effects of the really bad one yesterday has trumped EVERYTHING related to the TT by far. Lots of tears today. Hubby reminded me that last Sunday (day before my surgery) we had Panera (which I rarely eat) - too much bread! That was a big contributor to my painful BM yesterday. I have issues with that when I don't eat enough fiber, which had reduced because of the TT. Pretty much eating jello, yogurt, and crackers at this point. Drinking water. Still taking Tylenol round the clock and have added Prep H to the regimen. :-(

Showers have been complicated with the plastic wrap, exercise band (to hold the drain & tube), and waterproof surgical tape to hold everything in place & keep the incision & drain dry, but are TOTALLY worth it! Feel so much better after a shower. A little weak for being on my feet that long, but worth it. :-)

Heading back too see Dr. Fata tomorrow to get drain removed - Hallelujah! Overall, I'm very pleased with the results, but have noticed some weird indentions on my hips. Not sure if it's related to the swelling (still have that all over) or if it's indicative of needing more lipo in that area? I will ask him tomorrow. My legs are still really puffy too so I can't really tell the effects of the inner thigh lipo either. I know they will continue to go down though. Got to be patient. It's only been 6 days.

I received my stage 2 garments in the mail yesterday. Even though I followed the sizing guides, they both look extremely small! Praying they will be comfortable enough to wear when my stage 1 garment is finished. Hate the feeling of those zippers against my bruised outer thighs, especially while sleeping.

Still glad I did this. Happy healing everyone! :-)

Drain is out! Woo hoo! Dr. Fata took out my second drain today and removed the stitches in my belly button. I'm still in my stage 1 garment for another week. Blah. Ready to say goodbye to those zippers pressing against my sore hips. I have to go back next week for another visit. I think he is doing more to my belly button and to my incision. Things were much better in the bathroom dept. today too! Thank The Lord! But I definitely think I overdid it with the 3 hr car ride over, some shopping after my appt, dinner, and return drive home. I'm exhausted! And my stomach muscles are twitching. Time for bed! :-)

I had my 2 week post op appt this week. Things are going well, with the exception of my "angry" belly button (lol! That's what his nurse called it - she cracks me up!) :-) Dr. Fata told me that it is taking longer than the rest of me to heal for some reason and that I should give it another 1-2 weeks before I start the marble technique for shaping it. His nurse sent a marble home with me and recommended that I use the paper tape to hold it in place so as not to aggravate the area further.

They also told me to massage/roller the lumpiness that I see in the areas that were lipo'd. So this week I started using a massage roller (from B&B) when I apply the Arnica gel to my inner/outer thighs. My thighs are still sore and so this is a bit uncomfortable, but if it helps smooth things out, I'm all for it! :-)

As for the indentions near my hips, I still need to give it more time, per Dr. He described my TT procedure as bringing 2 "uneven" pieces (upper & lower abdominal skin) together and stitching them. My scar is hip to hip, plus about an inch beyond on each side. The compression garment will continue to shape everything as it heals, but it may never be perfectly smooth.

I still get very swollen in the lower tummy/groin and knee areas if I'm on feet for very long (ie. after shopping, etc.). I'm still wearing my stage 1 garment to help control this...which it does help. I'm anxious to get my stage 2 garment this week because I ordered the one with longer legs to help minimize the swelling around my knees (lipo area).

Things in the BM category are 90% normal again - thank The Lord! :-) At times, I didn't think it would get better. Almost went to the ER on Christmas Eve b/c I was in so much pain again. Miserable!!! I will NEVER take Percocet again. Simply not worth it to me. I'll stick with Vicodin or Rx strength Tylenol? I did switch stool softeners (to Colace) last week and stopped taking pain killers completely. I continue to drink lots of water and resumed my fiber cereal each morning. It all seems to be working!

Although I can't officially work out again until 6 weeks post op, I walked on my elliptical today and started doing some arm exercises. Since I haven't worked out in about 3 weeks now, I'm feeling flabby. :-/ Still taking it easy, but trying to do something that will keep the flab at bay. I felt great afterward, less sore than I thought.

After reading countless reviews & posts online, I also ordered silicone strips this week to use on my scar as soon as I get the green light. I bought Bio Oil too to use on the remaining stretch mark "tops" that were left right above my incision. The nurse had mentioned Mederma and Kelo-Cote for my scar, but I read too many negative reviews online (different sources) to buy either of them. I really want my scar to flatten out too, which is also why I chose the silicone strips. They are made for longer TT scars and are reusable for 3 months. We'll see how they work...

I've posted some updated pics. I'm swollen in these b/c I had the garment off for the afternoon to wash it. It's really hard to take pics of yourself from different angles! Lol! I did the best I could. :-)

And WOW! It is truly amazing how this procedure has changed my figure, my thinking, and how I shop! What a blessing this has become. I no longer have to be restricted only to undies that are "full cut brief," or worse yet "control top panties," or to shirts that are loose fitting. I am no longer confined to certain stores or to certain sections of stores.

I went into Victoria's Secret today with some confidence. I've never been able to shop in that store before simply because of my shape. Choosing undergarments there would have been a joke before. Today was different. Although I didn't actually buy anything yet, I loved the freedom I felt while browsing. I got that same feeling when browsing some of the early swimsuit arrivals (yes, swimsuit arrivals - even though it is Jan 2nd!). Although I really had no idea what size to buy in either of these, let me just say - I am SO glad I did this!!! If you are on the fence about having this procedure, please know that the "flat side" isn't perfect....you will have a large scar, you may have some complications, and your results may not be ideal, BUT it sure can open the door to opportunities you may not have otherwise. Happy healing everyone! :-)

I returned to work last week (3 weeks post) and it went ok. I've been really tired by the end of the day. Taking my multivitamin definitely helps. My belly button is finally starting to calm down and redness is fading. Haven't been able to use the marble yet, but maybe this week. Still so glad I had this done!!!

I'm wearing stage 2 garment now. I ordered a size smaller than my stage 1 because I've lost 10 lbs. since the surgery. Current weight is 156. It fits fine. I got the one with longer legs (mid calf) to reduce swelling around my knees. So far, so good. Bruising is almost completely gone. Still get very swollen when not wearing the CG....especially right above the incision line.

I had to buy new pants for work this weekend because I have dropped a full pants size! After trying all of my previous ones on, I realized all of the waist bands were just too big! A good problem to have I guess. :-)

My only concern at this time is my left inner thigh. It looks a little "stretched out" and wavy compared to my right. My outer thighs are a little wavy too where lipo was done, but not as much, despite massaging these areas daily as instructed. I also have what I think are dog ears on both hips. When I'm not as swollen, I still see them. I'll discuss both of these with my doc next visit since I'll be 2 mos post op by then. If I need a follow up procedure, I could still have it done before summer.

Hoping to start working out a little this week....lightly of course. Walking has been great, but I'm feeling jiggly in areas that I'd worked so hard to firm up. Don't want to lose it!

Updated pics show my BB, incision at this time (using silicone strip to flatten), and thighs. Still pleased with overall results, but I'm pretty sure I'm going to need some touch ups to smooth things out.