44 and After 4 Kids Needed Nips and Tucks (Tummy Tuck, BA/BL + Medial Thigh Lift) - Traveled Internationally from Asia to LA

I hardly ever log onto Realself, so I thought I'd provide a quick update. It's been almost exactly a year since the surgery. I'm still quite happy with it. One note - the scars have faded a bit but are definitely still there - I'm patient and didn't really expect them to be gone. I ran a half marathon last December and it was fun to train and run - 13+ miles and no stopping! One of the best things about the surgery has been making it much easier to run. The other highlight (of my life) was a woman last weekend asked me what I do to stay toned, and then commented that I have a "perfect waist and boobs..." Best of luck, all.

Six weeks out, and things are progressing.

- Ditched the compression outfit (is there a place where we can donate these things???)
- Ditched wearing a bra at night
- Traded off Bio Oil for scar treatment with silicone gel strips
- Got a tiny granuloma (where the last drain had been) lopped off and stitched up by a local doc
- Snipping off suture knots I see as well as any I can feel right below the surface (even though they're dissolvable, until they dissolve, they're annoying...) - helpful Olga had given me pointy tweezers and scissors with a hook on them and my OCD loves them...
- Got the hubby mandate to toss and replace my "granny" underwear with a "no limit budget" but now find that my pre-kids La Perlas fit fine (did not seem to object to/notice that they were not new) - as the mother of three boys, I say without disparagement: men are so simple
- Booked a few beach adventures (Langkawi, Malacca, Bali, Krabi) - kids are dying to go to the beach and surf - but pledge to be covered up (lest scars become permanently dark - don't want that!)
- Started to exercise - man, I'm a tub of lard! - goal is the Angkor Wat Half Marathon in December

On the horizon:
- Underwire bras - can't wear until 6 months post op
- Scars fading - like waiting for a pot to boil
- Being more healthy in earnest - my husband has begged me to eat more healthily and exercise more; I should take as a compliment that he'd like me to kick around longer...

Conflicted: I think I have knots under some of my scars that are too imbedded for me to dig out. They are mildly annoying. Don't know whether I should (a) leave them alone - "they'll dissolve eventually in as long as 6-9 months," (b) massage the scars in line with the theory that massaging bumpy scars helps them heal and flatten out more quickly, (c) try to dig them /cut them out of the skin and cut off the knots - there was some doc commentary about desirability of removing pesky knots under the skin... (d) other? I'll ask Dr. Hughes...

Photos of where my daughter and I will spend next week and how things are shaping up at 6 weeks post op; you'll see silicone gel tape and bandage where granuloma was removed.

I'm 4 weeks and 2 days post op, and I'm feeling great. I give it another week or two before I feel complete flexibility around where my thigh lift incisions are. Things are still a little tight at the incisions because - by definition - you're tightening the skin there. I don't want to over-do it there - I want to let the incisions heal, and that takes patience and time. When you think of it, it's actually amazing how quickly the body recovers!

I've read Q&As about doing a tummy tuck, breast lift and augmentation + medial thigh lift in the same surgical procedure. Most doctors responded from the doctor's perspective, saying it's best to do it in 2 separate procedures since the multiple procedures can result in a longer surgery time so that's more time under the knife, under anesthesia and puts you at higher risk. All makes sense. I would guess the most important thing is going with a surgeon with lots of experience doing the procedures at one time.

From a recovery perspective, from my experience, I had the tummy tuck, breast augmentation and lift and medial thigh lift done at once. I think that my total recovery time is taking about as long as it takes to recover from the single procedure that takes the longest to recover from: the thigh lift. The incisions for the thigh lift are in a place that gets a lot of action (not like the breasts which were fine immediately or the tummy tuck which just sits there). It's at a joint that gets movement incessantly (like trying to heal an injury on your knee). Also, it's right where you go to the bathroom, so there's no avoiding that. The recovery is tough, no doubt about it. I'm relieved that I got the surgeries done at once.

I've been extremely fortunate to have had no complications - and my heart goes out to anyone who has encountered any - because God knows, just recovering is hard enough!

I was concerned about blood clots. I've read that the chances of developing blood clots is higher with thigh lifts and also with multiple procedures. I guess that's one reason why I went with an experienced surgeon. I know that there are a lot of great success stories from traveling outside of the US, but it was very important for me to get the surgery done in the United States. These are serious and complex surgeries. The medical standards, regulations and certifications are much more stringent than anywhere else in the world. And having had family members who have tried to get into med school or pass the boards in the US (and then have gone to the Caribbean when they failed in the US) - I just couldn't take that kind of risk. (Believe me, I'd never want my cousin performing surgery on me!)

Moving around after the surgery and walking around during my long 24 hour flight back home - 11 days post op were also things I did. Finally, keeping the drains in (even though they were a MAJOR pain), taking the antibiotics as long as the drains were in and being religiously clean with rubbing alcohol - probably helped ward off infection. Again, I don't know if any of this had any bearing on not having any complications - but I'm glad I followed my doctor's advice.

Finally, it's been reassuring having chosen a surgeon who is extremely responsive whenever I have a question post op. I happen to live half way around the world from my surgeon. But even if I lived in the same town, when you go through this, you have all kinds of inconsequential questions you want to ask and not feel like you're bugging someone. Dr. Hughes responds quickly and decisively with specific instructions on what you should do - regardless of whether it's the weekend, before 9AM or after 5PM. Clearly, his work and his patients are very important to him. So I was impressed when he was available to talk with me live when I was interviewing doctors - but that shouldn't be surprising - he's trying to win my business. (And anyone who is unresponsive during the marketing/sell phase should be a red flag! Imagine how responsive they'll be when you're having an emergency problem after the surgery! And even worse - what if you're having an emergency problem and they're not in the US and therefore aren't subject to US liability???) Dr. Hughes has been great with answering questions before, during and after the surgery date.

One correction - finally found my breast implant tags, and they are Natrelle Allergan 234 ccs.

Good luck to all out there.