While of course I knew that pregnancy was going to...
While of course I knew that pregnancy was going to change my previously slim and fairly fit body, it came as a shock to find that by 8 weeks pregnant my pre-existing hypermobility (a fancy terms for stretchy muscles) that had previously meant simply that I got aches and pains and was very flexible, had turned into full-blown pelvic instability. Basically the muscles holding my pelvis together responded to pregnancy hormones by just giving up and going home!
I also had much bigger babies than expected - both over 10 pounds - which took a toll. Despite doing all the "right" things - pilates, post-pregnancy support garments, careful exercise, endless physio - my abdominal separation never came back together after my second baby, and now it's really impacting on my self confidence (via a bulgy pregnant-looking tummy) and my quality of life (via lower back pain, core weakness and not being able to exercise properly).
While I've kept pushing towards new fitness goals - I ran my first 10km a few months back - my body is letting me know more and more that it can't handle what I'm asking of it. I get so upset when I listen to my husband talk about his workouts, knowing that even a little 3km run sends my hips and pelvis into painful spasms.
Anyway, I'm hugely looking forward to getting my significant abdominal divarification repaired so that I can hopefully begin to exercise properly again and banish my back pain. Not having a bulgy tummy will be nice as well!
Should I add lipo?
I'm reading all these reviews where people had liposuction along with their tummy tuck. It doesn't seem to be as standard here in Australia - you certainly can have both but it doesn't seem like most people do like in the US.
Anyway, it's got me wondering whether I should consider flank and/or thigh lipo with my procedure. While I decided to have the surgery primarily for functional improvement reasons, I'm obviously also hoping for a very good cosmetic result (to make up for the scarring!)
The main barrier is my husband - he's medical and may be a bit disapproving or think it's unnecessary from a strictly functional point of view! But the way I see it is that I'm going into hospital anyway, being anaesthetised anyway, wearing a support garment anyway, "out of action" and needing help anyway. The procedure is at a reduced rate for us so the cost isn't too problematic.
So my question is - would or did you have liposuction?
Spoke to surgeon - adding flank and outer thigh liposuction to my procedure.
After seeing my surgeon this morning I feel really glad to have bitten the bullet and spoken to my husband about adding flank and outer thigh liposuction to my procedure. I've got a couple of fairly small but stubborn fat pockets on my love handles and outer thighs that have been resistant to every exercise I've thrown at them and I'll be very glad to see them gone.
My surgeon was very careful to explain how he manages the risks of combining the two procedures and said that he thinks I'm an excellent candidate. He obviously left it entirely to me, but when pressed agreed that it will really enhance the aesthetic result.
To my surprise, my husband was very supportive of my decision to add the lipo as well. Although I've always tried not to moan about my body (in my opinion there is nothing less sexy than continually pointing out your flaws to your partner!) he knows that my body changes since having our kids have left me feeling dumpy and down and not myself.
In other news, seeing the before pictures he took at my first consult up close and personal on my surgeon's big screen has definitely reminded me that I've got good reasons for wanting this surgery! Holy confronting, Batman! ;)
Why all the rush?
There are lots of ways in which now is not really the best time for me to get this surgery.
I'm still breastfeeding my one year old, with no plans to wean him. That poses logistical difficulties, since I won't be able to lift him after the surgery and other people will have to help me lift him up for nursing. Also, I'll be in hospital for five days, so my parents are going to be bringing my two kids to visit me each daily, not least because I'll need to breastfeed my little guy. He's currently having two feeds per day, so I'll have to take my trusty breast pump into hospital to express milk for the feed he won't be there for, or risk getting mastitis.
In general terms, my kids are still quite little. I still lift my three year old up for hugs several times a day. I lift both kids into their carseats. I carry them up the stairs. None of this will be possible while I'm recovering, and as a result I'll have to rely on my parents and expensive paid help (my husband works very long hours and travels a lot, though of course he'll help where he can).
In a perfect world I would have been able to choose to wait another year, at least, to have my abdominoplasty. So, why am I doing it now?
For me, this operation is primarily about addressing the functional problems that a big abdominal separation causes - back pain, core weakness, pelvic spasms, inability to exercise properly or lift heavy objects without pain. Of course I'm hoping for a good aesthetic outcome, too, but I wouldn't be contemplating the surgery if it weren't for the functional benefits it offers.
In Australia, if you have an approved medical need for an abdominoplasty as I do, the government covers a small portion of the costs (about $1000) of having the procedure done in a private hospital, and a little more towards the cost of the anaesthetic. More importantly, though, the fact that there is a government-approved item number for my surgeon to claim against means that my hospital stay of five days will be covered by my private health insurance.
Unfortunately, the item number for abdominoplasty is almost certainly being withdrawn from the end of October, so there will be no rebate, and my private health after 1st November will class all abdominoplasties as purely cosmetic procedures so the $10,000 cost of the hospital stay will not be covered any longer. The abdominoplasty part of this surgery will cost me several thousand dollars this month, or over $15,000 if I wait until next month. I couldn't justify that cost difference, so decided to pull the trigger now, even though the timing is far from ideal in some respects. I'm not alone in this situation - of the four surgeons I met with, three were having to schedule extra lists to fit women in before the law changes.
I feel sad to think that so many women who, like me, have been slammed by the process of having children and significantly lost quality of life and health as a result, will now not be able to afford to have this procedure. One friend has just had her third child - after her second she had an 8cm abdominal separation. Her baby is only days old and there is no way she be able to have surgery before the end of October. She and her husband will not be able to spend $15,000 on her operation when she's physically able and available to have it done; she will likely be stuck with the resulting health problems for life. You could say she "chose" to have children, but our country wants women to have kids, and none of us are completely in control of how childbearing will impact our bodies and health.
I feel angry that the government is quietly cost cutting by denying women surgery they need. By cleverly choosing abdominoplasty to target for these cuts, the government knows that if anyone objects they can imply that they are simply preventing public money being wasted on wannabe yummy mummies seeking aesthetic upgrades, completely ignoring the pain and risks women undergo when having kids. I think they are using women as a soft target for undermining our normally excellent and equitable health system.
As I said to my husband, if having children resulted in functional damage to men's penises, there'd be a high profile national task force recommending fathers be eligible to attend free clinics on every corner, with state-mandated paid time off and extra foot rubs while they recuperated. It's just a shame our government doesn't choose to value the price women pay in their health and wellbeing to give birth to the next generation of Australians.
I'm SO EXCITED!
I'm excited to be in the countdown to surgery. Only two and a half weeks now!
I'm excited to (eventually) not have to wear particular styles of clothes to camouflage my tummy. I've found a brand of dresses that both suit my figure and match my style, but it will be nice not to be so restricted. And the fugly mum clothes that I've collected to try to disguise my midsection without every liking them are all GOING TO CHARITY. Yes, I know I was yelling there. Just got a bit excited.
I'm excited to be able to rebuild my core strength. To actually be able to do a crunch. To not get stuck flat on my back like a flailing beetle because I can't sit up without feeling that my stomach contents are going to be ejected through my midline towards the ceiling.
I'm excited to one day not have this lower back pain any more!
Mostly, I'm excited to feel like myself again. It's going to take longer than I want it to, and I'll be impatient and probably have down times. But, fingers crossed, I'll get there in the end.
Somewhere I saw a suggestion to take pre-surgery measurements for the sake of comparison.
As someone who sews I know that measuring yourself with a tape measure is notoriously inaccurate, but still...
Measurements as at 12/10/2015
Widest part of hips - 39 inches
Bust - 37 inches
High waist (narrowest bit, well above belly button) - 27.5 inches
At navel - 33 inches
At level of hip bones - 35.5 inches
At the time this photo was taken, just before I got married in 2011, from memory my measurements were about 34-26-36!
I'm really looking forward to getting my waist back and not feeling so boxy anymore!
Saga of the Zombie Belly Button!
As soon as I started seeing surgeons while researching my tummy tuck, I got confirmation of my feeling that since having my kids there was something extra weird about my stretched-out belly button. Like a lot of women contemplating an abdominoplasty, I've got a small umbilical hernia that makes my belly button bulge slightly.
My surgeon, Dr Belt, has taken a very thorough and careful approach to getting my hernia repaired during the tummy tuck operation. His rooms have organised a general surgeon, Dr Steven Allison, to attend during the operation and repair my hernia using a little bit of mesh, and a couple of days back Dr Allison asked to meet with me, despite the fact that I won't see him again during or after the surgery or in hospital (unless something goes wrong and I end up with a black belly button, aka "Zombie Navel").
I liked Dr Allison a lot. He was kind and funny, and his only reason for meeting me was to ascertain that I was aware of the risk that my belly button might not survive the surgery. He said he hasn't lost one yet, but also explained roughly what can be done to create a sort of faux belly button if the worst was to happen.
All this is such a contrast to my experience meeting Dr Lily Vrtik for a consult a few days before I first met with Dr Belt.
Dr Vrtik was nice, though she seemed a bit rushed, and she came highly recommended to me by a close family member, who liked her a lot. On examining me, though, she noted my little hernia and told me that repairing it would be likely to kill it, while leaving it would give me a bulging out belly button in contrast to my newly taut tummy, and it would probably be visible through my clothes.
She went on to suggest that the easiest and best option would be for me to just agree before my surgery to let her remove my belly button altogether. She even said that nobody would ever notice that I didn't have a belly button! (STOP PRESS - I WOULD NOTICE!!!)
Initially, although saying that I was fairly sure I wanted to keep my belly button even if it was going to bulge out, I felt I could live with that outcome. I even booked in for the surgery with her.
But there were some niggling questions. Why had neither of the other two surgeons I'd seen said anything about my hernia being problematic to repair? If removing it altogether was really the best way forward, why had nobody else suggested it? When I told my husband about her remarks he seemed a bit non-plussed and said "I don't see why she couldn't get a general surgeon in? And if your belly button didn't cope with the repair, surely she could make you a new pseudo-umbilicus?" He's an anaesthetist so sees a lot of surgery; it was helpful to hear his point of view, because I too had been wondering why a plastic surgeon couldn't give me a mock-up belly button of some kind if that was necessary, but also wasn't sure if I was being unreasonable in my expectations.
On my husband's advice I sent Dr Vrtik an email asking for clarification about the hernia issues, but also decided to go ahead with my previously booked consultation with Dr Belt and ask him about how he would manage the hernia.
I'm so glad I kept that appointment! Dr Belt noticed the hernia immediately, organised for me to get an ultrasound to ensure his clinical assessment of it was correct (it was) and talked in detail about the way he would prefer to address it.
Unlike any of the other surgeons I spoke to, he wanted to use a general surgeon who has more experience than him with hernia repairs to attend during the operation and fix it. He carefully outlined the procedure and how my belly button's blood supply could be put at risk by the combination of the abdominoplasty and hernia repair surgeries. Basically, because the umbilicus is cut out at the surface for the tummy tuck and then cut into internally for the hernia repair, that can leave it deprived of blood circulation and ultimately kill it. So worst case scenario would be either removing it during the operation when they realised it wouldn't survive, or getting the repair done then having it turn black and rot post-surgically, requiring a revision. Eww, Dead Belly Button Walking!
He talked about the risks and benefits of the repair, and told me that if the worst came to the worst and my belly button couldn't be saved following the hernia repair he would make me a neo umbilicus - kind of a dimple in the right spot that wouldn't be exactly like a belly button but would fool a casual observer's eye into thinking I still had a belly button. Apparently the risk is small of this being needed, but more than anything else I was relieved that my surgeon "got" that having a belly button might be important to me!
All this was such a relief. I immediately knew Dr Belt was the right person to be doing this surgery, and cancelled my booking with Dr Vrtik.
To be fair to Dr Vrtik, she rang me to discuss my concerns with the hernia repair in more detail, which is when I told her I'd decided not to proceed with my surgery booked with her. I'm sure she's a brilliant surgeon (my family member was delighted with her results), and it may be that her remarks about my belly button being dispensable might just have been casual comments rather than indicating any lack of interest in getting my repair done properly. She didn't suggest using a general surgeon to do a repair, though, and that was really the clincher for me that made me feel so comfortable with Dr Belt's commitment to getting me the best outcome possible.
So anyway, that's the Saga of the (Hopefully Not) Doomed Belly Button, and now I just have to trust I won't see my poor, stretched out and mangled current belly button swapped for one that will turn up its toes and morph into Skanky Corpse Navel! Fingers crossed!
(If it does, I sincerely PROMISE to post photos!)
Attack of the glamour garment!
Oh my goodness. Here's me trying on my post-surgery garment... which my surgeon has ordered me to wear 24/7 for the two weeks prior to surgery. On first try I knew there was no way in the world I could wear it full time in the lead up to my surgery, so I've compromised and am wearing my own very firm control garments day and night instead. After surgery I guess I'll just have to suck it up!
The superwoman look with the undies over the top is because the garment is majorly crotchless and so without them the photo would be totally NSFW. Though I gather that lots of women wear them like that after surgery anyway, because otherwise you're pretty exposed, plus a friend who wore her knickers *under* her post-lipo garment ended up with permanent creases in her thighs from the seams. :/
This thing is ultra tight, especially behind the knees, and after challenging myself to sleep in it last night instead of my regular MiracleSuit I'm slightly dreading wearing it full time after surgery. Eeek!
Does anyone else get a sore back and tummy cramps from wearing tummy compression garments? I was in agony when I woke up this morning, and I haven't even had the surgery yet!
Packing for hospital!
Even though I don't go into hospital until next Monday, I'm going to be away all week, so I need to start packing tomorrow.
Unlike for many of you ladies, here in Australia most people stay in hospital for a good few days after an abdominoplasty; my surgeon says to expect 5-7 nights. I won't be discharged until my drains are out.
I've seen lots of posts about what people are buying for their recovery at home, but not really any about what to pack for 5-7 days in hospital. Even after having two caesareans it's kind of difficult to imagine what I might need.
Can anyone give me any suggestions for my list? What did *you* find useful, can't-live-without or not very useful in hospital?
Last couple of days and I'm totally snowed under!
Everything is hitting me at once right now - I'm trying to care for my kids with no childcare, get my tax done before going into hospital (paperwork totally gives me cold shivers) plus working on a political campaign PLUS doing some contract legal work on a matter for a client who is insanely impatient....
The only thing that's keeping me sane is running!
Funnily enough, I'm not at all worried about the surgery but I *am* worried about spending 4-6 weeks without being able to exercise. Being sedentary has never done very good things for my mental health.
Has anybody else had this fear? Maybe I'll be able to do some gentle walks???
Six hours to go!
It's midnight, I'll be leaving for hospital in just under six hours and I've finally stopped running around like a chicken. Bags are packed, washing is done, bills are paid...
My husband will be flying back from interstate with our kids when I'm coming around after surgery; I think we were both feeling a bit glum that he can't take me in and be there when I wake up.
I'm not especially nervous (okay, maybe just a little bit) but despite insisting I could just catch an Uber I am actually kind of glad my long suffering sister is collecting me to drop me at the hospital at 6am.
Just in case I have any regrets down the track, here's my "Remember Why You Did This" photo... Admittedly squeezing into compression garments is never an attractive process!
More to the point, though, is what these pictures don't show - like that after my little 3km run yesterday my pelvis spasmed for 36 hours and was so agonising that a few times I nearly fell over when the pain hit suddenly.
Hopefully the operation tomorrow will stabilise my pelvis and these bouts of pain and spasm will reduce. Fingers crossed!
Made it through Operation Day!
26 Oct 2015
Day of treatment
Here are a few piccies.
So far, so good. I've been of surgery a little over twelve hours. No vertical scar, I'm told Dr Belt out my piercing scar but left my bblly button without any vertical scar. Can't wait to see it!
Meanwhile, here's hopi g my surgery date buddies are feeling good.
26 Oct 2015
Day of treatment
This morning Dr Belt and his lovely registrar came around to change my dressings and check my belly button.
Dr Belt told me that Dr Allison had done a very clever repair on my belly button hernia and that they kept and eye on it for a couple of hours and while it hadn't looked like the healthiest belly button on earth for a while there it was clearly coping now. So that's good news.
He also said that my scar was at the level of my old Caesar scar because the tension involved in lowering it further would have resulted in a thicker scar. I'm fine with that, especially since he apparently completely got rid of my old belly button piercing.
In general I'm feeling okay, though with a couple of bad bouts of nausea. Apparently lots of patients here have had nausea today so just in case it's a virus going through the hospital all the nurses are suited right up and I was advised not to bring my kids in to see me. :(
Got up once for a little stagger with the help of a walker but there was no way I was to the point of being able to have a shower. I had kind of thought the initial recovery might be about the same as a Caesarean, but it's a fair bit more severe than either of my Caesars, even after long labours.
Anyway, onwards and upwards. Time to put some TV on....
Yeah, so the recovery is a fair bit more full-on than from a caesarean.
The very nice and patient nurses tried to get me into the shower today but I nearly passed out when they took the garment off, so it was mission abort while I sat clutching the toilet having the cold sweats and trying not to barf everywhere. It was a big relief to get back into bed!
Even having cut back on the stronger pain killers I'm pretty dozy most of the day and my idea of getting work done in hospital was seriously optimistic. I can hardly focus on watching TV.
Onwards and upwards, though. Everything is healing well with minimal bruising or oozing and one drain might be coming out tomorrow, fingers crossed.
Day 3 - Ouch
My kids just left from a visit and after half an hour of having a three year old clambering over my bed and breastfeeding a wriggling 18 month old I'm feeling very sore and quietly relieved to not be worrying about having my drains yanked and instead to be able to space out with some TV.
The drains are definitely the most painful part - my belly button is fairly numb and the incision itself burns from time to time but doesn't sting constantly like the drains.
Today was a pretty good day - I got up twice, once for a heavenly shower and once for a walk then a sit in the chair next to my window. Both little activities left me a bit shattered but at least confident I can get myself up if I have to.
This is a tough recovery but I'm feeling better each day. Still very glad to be in hospital rather than at home, though!
One drain out today
Such a relief to be a bit less tethered!
I am obviously still very hunched over but it feels good to be a little bit more mobile.
Swelling is very evident above and below the incision but I'm already feeling stronger in my abs and less sloppy in my tummy.
Day 4 PO
Quite swollen but feeling better and better. My belly button might be slightly off centre but I really don't care. :)
Day 5 update & photos
Came home from hospital today. It's so nice to have the drains and drip gone, and to be watching tv on my own couch!
Dr Belt said he was happy with my results so far. Apparently I have less bruising than most patients, but then I only got 200ml or so taken from each liposuction area, so that might be part of the reason.
Dr Belt has been extremely meticulous about checking on me every morning, plus having a registrar check me in the evening and sometimes also phoning in to check on my drains via the nurses. He really is very fastidious and careful in his approach, which is exactly why I chose him to do this surgery. He measured me multiple times to ensure I got the most neat and symmetrical result possible, and his attention to detail regarding my hernia repair was outstanding among the four surgeons I met with.
My cosmetic priorities were a smooth, straight, low scar and retaining a natural looking belly button and so far my expectations have been met in full.
The care at Greenslopes Hospital from the nursing staff and physiotherapist were also excellent; I'd recommend anyone have their surgery there.
So far I'm feeling good about the decision to have this surgery and looking forward to enjoying the functional results as I recover. I can't wait to start running again and rebuilding my new improved core muscles!
This is what minimal bruising looks like!
I'm turning all the colours!
Overdid it yesterday and could barely walk by evening. Being home probably means I need more naps and rests, not less.
I'm looking forward to being able to stand straight again one day. :)
Garment indentations! Day 10 PO
I took these photos yesterday and can see that already today I'm able to stand slightly straighter.
Note the indentations caused by naughty me wearing undies under a light compression garment I've got. Oops - apparently garment indentations that form after lipo can sometimes be permanent. I hope note this time!
Had my 10 day post-op consult today. Dr Belt is happy with my progress, though he didn't miraculously announce that I don't need to wear the Nightmare Garment any more.
Boo, he said I need to plod on with it for another 4.5 weeks, so no miracles here. It's cutting into my thighs and knees, taking skin off my groin and giving me lines from the zips and is just generally a massive pain. :(
I'm still very stiff and bruised, but hopefully it evens out and gets easier soon.
2 weeks PO - and bikini shopping!
Now 2.5 weeks in and I'm feeling much better. Still slightly hunched and it's certainly getting harder not to overdo things as my mobility improves. Yesterday I had a couple of work meetings in the city and my taxi dropped me off a long way from the meeting venue so I ended up walking a kilometre or two all up, and today I'm shattered as a result! Must try not to get caught out like that again...
I've been online shopping for bikinis - YAY - and am so pleased with my new shape. It wasn't my main reason for having the surgery but it's a lovely side effect to feel that I look like my old self again, though with a lot less muscle tone from two ultra-slothful weeks!
(Incidentally my core muscles already feel stronger than pre-surgery. I'm not pushing it by testing them out, obviously, but if I sit up from flat I can feel them helping me, whereas before they gave me almost no support).
I've got lots of front to back swelling so am feeling quite thick through the waist, but from reading everyone else's accounts I know that Tincture of Time is the cure and I just have to be patient.
My belly button is healing really well and looks good. It's starting to spit some stitches as the sutures dissolve. My husband even mentioned that he thinks it's cute and he's not normally a noticer of such things. :)
My bruising is fading and while typing this I've pulled the tape off my lipo incisions, so overall I'm beginning to look and feel less like I've fallen down the stairs.
My parents have been absolute champions helping with my two little kids and it's good to feel that I'm able to take over more of their care again. I can't lift them in and out of their baths or beds or put my little guy in his high chair, but can now do most other things if I take it slowly.
On the whole this process hasn't been nearly as tough as I feared, though to be fair I have been fortunate to have wonderful levels of help from my husband and parents. Having informed and reasonable expectations has made all the difference mentally.
3.5 weeks post-op and swelling like stupid
Everything's been getting to me today!
My scar is itching and prickling lots.
My husband is away and my parents have been great but I feel quite guilty.
My kids have been grumpy, I've got a sore toe and am trying to fight off mastitis as well. Grizzle grizzle!
Back still hunched and giving me a sore neck, plus I've caught a nasty cold. Sneezing is still no fun!
Right now I'm hoping to hear from people about when their swelling dropped off and when they were walking upright again?
Also has anyone heard of people using diuretics to control swelling?
Scar woes at 4 weeks post-op
My dressing started to really lift yesterday. It was meant to last around six weeks and I'm only 4 weeks today, but perhaps because I shower twice a day it hasn't held on as well.
I peeled it back where it was lifting, trimmed the excess and covered the incision with the breathable sticky tape dressing we use for pretty much everything in this house from covering insect bites to mending books.
Anyway, that was all fine, and the bits of scar I saw mostly looked nice and thin and clean, but the right hand end is very raised and ropey, and it's pulling quite painfully, as though it's over tensioned somehow. Has anyone experienced this? I actually feels like a piece of cord under my skin in that spot.
I rang Dr Belt's rooms and they said to text him a photo, plus I've made an appointment to see the nurse tomorrow. Hopefully there's something we can do to soften and flatten it - it's definitely not pretty, as well as quite uncomfortable!
In other news, swell hell continues unabated, and watching all my muscle tone melt away is a bit disheartening. Bye bye, butt! It's certainly going to be great to get back to the gym in the next few weeks.
Nonetheless, this is just a little blip in the generally very good recovery I've enjoyed. I'm still grateful and pleased to have been able to have this surgery, happy with my results so far and confident they will continue to improve.
3+ months post-op update
I'll probably make this my final update. Thanks to everyone who offered me support through this process.
I'm so grateful to have been able to have my surgery; there's a whole set of frustrations and discomforts that are now lifted out of my life.
Dr Belt and his staff have been amazing.
My scar is thin and flat and is already pretty well smoothed out. Dr Belt was absolutely meticulous in placement and it shows; I've never seen a lower scar and it's very straight.
I've had a couple of little stitch abscesses, one of which had to be dug out yesterday but that's a tiny blip in a mostly smooth process.
My belly button is a good shape and healing well and once the redness dissipates will look fairly natural, I think.
I'm finally back fully exercising now and that's a huge relief - having my diastasis repaired has been life changing and my back pain is already better and improving steadily.
If you have kids you'll need plenty of support after this surgery, but it was worth the struggle through the first weeks. Good luck!
Scar update at 3+ months post-op
Just realised I forgot to post scar shots...
The tape is from a little stitch abscess I had dug out yesterday - ouch! Getting it removed was worthwhile, though, as I could feel the stitch poking into me from the inside.
Otherwise I don't need to use tape anymore, just scar gel.