All Over Smart Lipo...Hoping for the Best - Coral Gables, FL

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I had the Smart Lipo procedure performed under...

I had the Smart Lipo procedure performed under general anesthesia four days ago on 5/1/13 at 305 Plastic Surgery by Dr. Daniel Careaga on my inner arms, lateral axilas, flanks, upper and lower abdomen and back, along with my inner and posterior thighs...all over. I was told to arrive at 9:30, I had a urine pregnancy test, routine medical questions and then at around 10:45 the doctor marked me up and took pictures. 

The procedure started at approximately 12:00. Considering that the procedure was performed under general anesthesia, I didn't feel a thing. There was a minor issue with finding my vein for the IV and I got pricked three times but that was the only thing I felt. The procedure took about three and a half hours. After I awoke from the anesthetic, there was a nurse with me, and I already had on a full body compression garment. Once I was warmed up with air heaters and blankets. Besides the soreness, I felt extremely thirsty and my mouth was dry due to the anesthesia. The nurse initially gave me ice chips and told me to have some apple juice when I got home. Then I had water. I found that chewing gum helped with the dryness in my mouth.I was sent home with the necessary instructions and prescriptions for antibiotics and another for Vicodin for the pain, which I chose not to have filled and opted for Extra Strength Tylenol instead. 
 I had gauze placed over the incisions and when I got home I slipped in some thin but extra absorbent sanitary napkins. I was sore but the first night went well. I was able to walk around since the anesthetic was still in my system. I was draining mostly from my legs and my right flank. Then next day, I was still pretty comfortable although I was extremely sore. I also went to my post-op visit at 4 P.M. Dr. Careaga said that everything looked well and that he had removed almost the maximum amount of fat allowed by law. When the garment was removed, I noticed that I had a lot of swelling in my lower abdomen and down into my bikini zone. The doctor said that due to gravity, it was normal for fluids to accumulate in those areas and that it would subside. 
Immediately afterwards, I opted to have my first lymphatic drainage massage. Now, this was painful!!!!!!! Nonetheless, based on everything I have read and others who have had this done, the lymphatic drainage massages are key for good, smooth results. The massage stimulated more drainage. Having the procedure done under general anesthesia instead of local tumescent anesthesia there isn't as much drainage. The massage therapist also gave showed me a massage I could perform on my swollen abdomen to improve circulation. The second night was a little worse than the first one since the anesthetic had worn off. On the third day, I was still in pain, but I did purchase a good quality compression garment at Catherine's in Miami Lakes.The garment along with the massages is key to the healing process. The one given to me at the surgeon's office was not the best quality and it was big on my arms. The garment I purchased is Colombian, and it is called, "FAJAS Disenos de Prada" This is a quality post-surgical garment made out of cool microfiber. It has vitamin E which helps in the healing process. It also provides the right amount of compression. It can be placed in the refrigerator for an hour than it has to be left out for 15 minutes and when worn it works as a cold compress. It's wonderful!!!!!!! 
Overall, I have had a very positive experience at 305 Plastic Surgery. They are a new practice that opened in Jan of 2013, so they still have to work on providing the patient with written instructions of how to prepare for the surgery and on providing a specific time to arrive at the center the day of surgery. They accustom to call the patient the day before their surgery is scheduled at 4 P.M. I had called earlier and someone got back to me and told me that I had to be at the center at 9:30. I believe it is imperative that a patient have as much information as they possibly can, so they can adequately prepare. This helps keep the anxiety levels down. Now, to end a positive note...the doctor's staff is kind and polite and responsive to all questions. Dr. Careaga has a wonderful bedside manner and puts one at ease with his confident demeanor. He cares about his patients by putting safety first and he really listens. He met with me twice prior to surgery and he called me the day before surgery to put my mind at ease. I highly recommend him. I will be posting pictures and updating my progress in days to come.

Post Op Days 4, 5, & 6 - On day 4, I decided to...

Post Op Days 4, 5, & 6 - On day 4, I decided to research lymphatic drainage points online and lymphatic drainage massages on After massaging the areas for about three hours, I found that I wasn't in as much pain. I was moving around easier, and I actually tried on clothes for the work week. I had my first bowel movement. General anesthesia can cause constipation. My doctor said it was okay if I took probiotics, and he also recommended Dulcolax-a stool softener. I also purchases a cast binder. It is very thin board made out of cast material, and it is covered in fabric. It is inserted in the front part of the girdle, so the stomach lays flat and doesn't buckle where the closures are at. Not only that, it actually gives you support when you're getting up and sitting down.

DAY 5 - Every day I am feeling a little better. I was going to go back to work, but I thought of sitting all day long in discomfort, so I decided against it. Instead, I went to get my second lymphatic drainage massage. It was painful but nothing like the first time. The massage therapist used an ointment with menthol. Afterwards I was extremely itchy. I purchased a HoMedics Percussion Massager. It helped with the itchiness. The massage therapist said that I was healing well since a lot of the bruising has gone down. She also said that I don't have any lumps. Another thing I have noticed, is that with the compression of the girdle, I don't get very hungry. I've been drinking a lot of water, too. I finished the antibiotic, and since I am just sore, I decided to stop taking the Extra Strength Tylenol. So far, so good.

Day 6 - Today I went back to work. It still hurts when I have to sit and get up, especially getting in and out of the car, but I was fine driving. I went to work. I am a teacher. For the most part, I was pretty comfortable. Although I have noticed that I tire easily, and I sometimes have to stop to catch my breath since everything I do takes a little extra effort. The girdle is extremely snug, and I can't wait until I get to take it off since it is full arm, body and legs (to my knees). My doctor says that I have to wear it non-stop for 60 days, so that the skin lays smooth. Tomorrow is my one week follow-up visit.

Oh, I forgot to mention that the swelling has also...

Oh, I forgot to mention that the swelling has also gone down.

1 Week Post Op - Every day I feel a little better....

1 Week Post Op - Every day I feel a little better. I went to my first week post-op visit and although it was an extremely short visit-less than two minutes with the doctor-he said I was healing well. My bruising has diminished, and I still have a burning sensation in my thighs. He also said that I could wear the compression garment for six weeks instead of the initial two months. After he left, the nurse removed my stitches and forgot one in the back of my thigh. The girdle is still killing me since it extends from my elbows to under my knees. Ugh! It is, however, a very good quality garment. The nurse saw it and showed it to the office manager so they could purchase them in the future. The info on the girdle is included in my initial post. I also got my third lymphatic drainage massage at the doctor's office. For some reason, it hurt more than the second time, but never as much as the first. I don't even want to go in for my fourth massage, which is scheduled for Sat. Considering that I am still bruised, every time the massage therapist touches me, it's soooo painful. I think she is applying too much pressure. Based on some of the research I have done on this forum, some doctor's recommend starting the massages after one has healed about 2-3 weeks post op. My first massage was the very next day after surgery. It was excruciatingly painful!!!!!!! I am thinking of waiting until my two week post-op mark to do my fourth massage. Let's see if I can muster up the courage to go in on day 10.

Day 8 - I am still swollen and bruised, and I can still feel a burning sensation in my thighs and other areas. However, my range of motion has improved. Today I was able to do a few leg lifts. It feels good to start getting back into the groove of things. Yay!!!!!! I have been wearing a cast binder once I get home from work until bed time to ensure a smooth tummy. So I wear it for about eight hours a day. Still hoping for good results.

4 Weeks Post-Op

Yesterday was my 4th week post-op visit. My PS says that I am healing well. I asked about some fat deposits (bra rolls) that are still present. He said that I have to wait about three months and if it doesn't go down then he will do a touch up. I'm glad that he does touch ups; however, I hope it is swelling and it goes down since I do not want to go through this again. He told me to wear the compression garment for another four weeks. Although he had told me to wear it for a minimum of six weeks when I had complained about it at two weeks.

At four weeks I still feel pain on my arms, flanks and especially my inner thighs. They feel like they are on FIRE. I also have some hardening and lumps around my midsection and arms. My inner thighs are hard close to my knees, and there are some lumps on my upper right inner thigh.

I also had my fifth massage yesterday, and it hurt something fierce, especially when she massaged my inner thighs. I feel like I am getting punched in my thighs, and when she tries to work out the lumps the pain is unbearable. She doesn't even give me a chance to rest in between, so I can catch my breath. It is brutal. She has an extremely heavy hand.

If anyone says that this is a quick process with minimal pain, they are lying!!! It is very painful, and he healing process is very slow. Besides that the compression garment is uncomfortable although it does provide support to tender, tingling skin.

Still hoping for the best. I will post a picture soon.

4 weeks Post-Op Pics

Here are the pictures to my 4 weeks post-op post.

Relief for Burning Sensaation

My skin feels like it has been burning for over four weeks.. I just put Maximum Strength Preparation H on all the areas where I had Smart Lipo, and what a RELIEF!!!!! I feel a lot more comfortable. I am going to try it before the lymphatic drainage massage, which is torturous on my thighs. Thank, God and Preparation H.

Six months post op and back touch up

On Nov 25, almost six months after having the initial procedure of smart lipo on my flanks, inner thighs, inner arms, and back, I had the touch up procedure performed on my back. Some of the fat I wanted removed is still present, which I hope will go down once the swelling subsides. Today is day eighth day since I had the touch up under local anesthesia...which I do NOT recommend. Despite the anesthesia, it is extremely uncomfortable and painful. An anti-anxiety medication would have worked wonders. The procedure was quick, but very unpleasant. The surgeon first injects a shot of local anesthetic, in this case on each shoulder blade. Then he opens an incision and inserts a pump which distributes an anesthetic. The doctor told me that I would feel a burning sensation. I felt something dripping towards my breast and around my back. It felt warm; however, I did not feel the burning sensation. Afterwards, he inserted an ultrasonic cannula which is what extracts the fat and "tightens the skin." The jury is still out on that one. Anyhow, even though a local anesthetic has been inserted under the skin, I could still feel the cannula moving under my skin and it was painful, especially when the doctor would reach areas that weren't numbed. Then I would feel a pricking sensation. OUCH!!!! Like I said, I wasn't given a valium or anything which would have helped exponentially; therefore, all I could do was tightly squeeze the edge of the operating bed. Once the procedure was over, the doctor stitched the incisions. The total amount of fat and blood removed was about a pint. It took approximately 30 minutes. Thus far, I have been wearing a compression garment which I only remove to shower. I experienced some bruising on the tissue surrounding my under arms, but not on my back. Unfortunately, I haven't seen any changes yet. There's a "little" less fat, but the bulges are still there and this is an area where I really wanted "a lot" of fat removed to create a smoother silhouette. I will post an update around the one month mark. By then all of the swelling will be gone. Hopefully, the results are better than what I am expecting.

Six Months Post op and Back Touch Up

OOPS! Its been seven months not six. As for the rest of the surgery, I am satisfied with the results, especially my waist and arms. ;-}
Miami Plastic Surgeon

I can't say enough good things about Dr. Careagas. He is attentive, dedicated, and confident. Bottom line he is everything you want in a plastic surgeon. I visited various doctors before choosing him, and I am glad that I made the right choice. In one word....EXCELLENT!!!!!!!!

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
4 out of 5 stars Wait times
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