Itchies and small seroma blues, POD 22

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I am a mother of three children 10 years old and...

I am a mother of three children 10 years old and younger, and physically fit, but have the usual poochy belly from 3 big babies and deflated low hanging breasts. I've been thinking about a tummy tuck for quite some time and when it came time to really think about interviewing plastic surgeons, and thought about what else I might like to have done, I realized that a flat stomach will accentuate the fact that I have a flat chest. So, I decided on the breast augmentation (not going huge though). After interviewing several surgeons, it became apparent that a breast lift was in order as well.

Then, a complaint I have had my whole life is my hips -- rather square due to genetics of big hips (the bones themselves) and overlying fat. I have never enjoyed clothes shopping because of my hips/stomach area, always finding myself in between sizes and never happy with how pants look on me. So I decided to look into liposuction of the hips/flanks region.

One of the plastic surgeons I interviewed mentioned I could consider lipo also of the saddle bag area (true enough) and because I have a flat behind, could use the suctioned fat to do a fat graft to the buttocks. Oh my! I said I didn't know how I felt about a big bum, but after long discussions with my husband and long looks in the mirror, I decided hey -- it's my fat, why not put it where i could use some curves. I am NOT going for a huge bum, however, just a nice natural curve. (If you look at some before and after photos of fat grafting to the buttocks, you can see lots of people are totally going for the J.Lo look, which I am not.). I have had a flat bum my whole life but haven't thought much about it, but with the taking of fat out of other areas, why not transfer it to where it could also enhance the whole picture. So, I went from "I want a flat stomach" to total makeover. I still have pangs of guilt and anxiety over doing all of this, even with the full support of my husband who has never been pushy, only saying that I could do what makes me feel good/happy. Mostly I wonder what people will think if they guess I've had a breast augmentation. My husband says to just assume everyone knows and just own it and feel good about it. Some days I feel like that. I just hope no one calls me out on the carpet at the pool in the middle of a gaggle of moms from the elementary school this summer! I guess I could just own it then too, right? This is the hard part for me -- being willing to be "out there and loving it!" I do look forward to all of this, I guess I just dont want a big neon sign hovering over me everywhere I go saying "look at THESE breasts!!"

I am a low surgical risk, and so I am not afraid of the anesthesia (6 hours), but I do worry about the recovery. If you've read the topic "can I do a Mommy Makeover with a Brazilian Butt lift" on this site (I hate that name, by the way -- let's just call it what it is, a fat graft), you will see there is controversy over whether to do it all at the same time -- that recovery will be quite difficult. Some surgeons say no way, others say "why not do it then -- you can't do it later if you're taking out the fat at the time of the breast augmentation and tummy tuck: (i.e. fat will be gone). I am going into this with my eyes open, will have lots of help at home, and so -- I am going for it. I'll let you know how that pans out!

I had my pre-op appointment today as I am exactly 2 weeks away from my surgery date. I decided on 325/350 cc (left breast is slightly smaller, thus the 2 sizes). I think it looks very natural, so hopefully it will be close to what it looks like in the office trying on sizers. Mostly, the nurse working with me today said that if I give the surgeon "after pictures" of ones that I like, he will do his best to make me look like those photos. I have some saved, but need to do a bit more looking and saving of photos for my final appointment with him the day before surgery.

Today at the pre-op appointment they also recommended Arnica and Bromelain, 2 herbal supplements that supposedly could potentially help with swelling. I have read a study that was done on plastic surgery patients as to whether it actually helps, and the jury is still out (the study basically said there was no true difference in patient's perception of swelling whether they took these 2 herbs or not), but I figure if it could help with swelling, why not try it. I ended up purchasing the supplement they had at the office.

I have learned so much from the Mommy Makeover gals who have posted to the Nov/Dec Mommy Makeover forum site, and so I plan to post as much as I can after surgery to help whoever is out that and wants to hear the scoop on what to expect. I look forward to chatting it up with all the January gals as well!

I was going to post my before pictures this evening, but my DH has fallen asleep! Maybe tomorrow.

One week away! Just got these photos from my PS's...

One week away! Just got these photos from my PS's office -- they were very kind to me to let me use them. Oh that side view -- can't wait to get to the 'flat side'!!!

Here we goooooo ladies! It is 12:10 am and I have...

Here we goooooo ladies! It is 12:10 am and I have just had the last of my "food" for the day, as my surgery is 730 am today (Wed). At my last pre-op appointment today, my PS said it would be good to do a liquid diet for the rest of the day as some have mentioned that they were also recommended to do. Boo! There is a nice Italian restaurant around the corner from his office that I was going to go to for lunch with my DH and MIL!! Ah well. Lipton noodle soup, which is more soup than noodle, was my main course for the rest of the day, along with some protein shakes. Did the whole Fleet enema thing, which worked wonders (it's really not bad). I am getting the bedroom and bathroom all ready at this late hour. I don't think I could sleep if I tried!! I made a spreadsheet of the meds and when they need to be given to me (it is quite the laundry list!) and so I feel good that all of that is taken care of. Pillows, towels, & throw up bin are by the door. Water bottle with electrolyte water ready to go -- though I doubt I'll be super thirsty on the way home -- probably more like a snoring puddle of bandages and pillows! Loose pants and zip up sweater (a huge one) are ready to put on, along with the undies I want the PS to mark me in. I'll update when I am able!

Hi Ladies, It’s Post Op Day 8 and I’m sorry...

Hi Ladies,

It’s Post Op Day 8 and I’m sorry I’ve been so incognito! I started to blog last night, got to the finish line and then hit something and poof! It all went away. So, I’m writing this into a Word document hoping that I have better luck.
So, my surgery day was Jan. 9th with Dr. Squires in Denver, at Porter Hospital. I had a breast lift, augmentation, abdominoplasty (“tummy tuck”), lipo of flanks and hips and fat transfer to the glutes (also known as the butt in the common vernacular). My surgery time was 730 am so I had to be there at 530 am.

Being the procrastinator that I am, I decided to organize my bedroom and bathroom, where I knew I would be spending a lot of time, which included organizing a lot of loose paperwork that has been piling up for who knows how long. Filing – who enjoys that? Not me. I just keep buying more rubbermaids and labeling them “filing” thinking that I’ll get to them one day. I also got all of my ducks in a row in the bathroom – hair products in one area, make up in another, and a tub of all of the meds that I knew that I would need to be taking over the next week or so. I also made a Word document (chastised by my husband as to why I wouldn’t have just used Excel – whatever!) – to make a table of all of the meds and when they need to be taken, and across the tops, the columns were the 24 hours of the day where you could tick mark off when they were given. This ended up being a Godsend, as they followed it to a tee, making sure to set alarms and rouse me enough to get the meds into me – with crackers – (I noted in big bold letters that they needed to make sure to give me either no salt saltines or graham crackers BEFORE they gave me any narcotics, which in my case was Percocet). By the time 430 am rolled around and it was time for us to drive to the hospital (40 min away), I was pretty exhausted but happy with the results and surroundings I had set up for myself. My Mother in Law (heretofore now referred to as my MIL) is in town for 2 weeks to help take care of me, and of course, my husband (aka “DH”). We have 3 kids, so the extra adult is a definite MUST if you have kids.

We got to the surgery center, checked in, and my DH had to wait in the waiting room for about a half hour while they got my history and started my IV. They used an 18 gauge IV in my left forearm, which is kind of tough skin, and that is kind of a big needle, so that smarted. I wasn’t too pleased and at that point was really just ready for them to knock me out and do the surgery so I didn’t have this nagging ache in my forearm. I actually had some topical lidocaine at home – kind of wish I could have put that on ahead of time to numb the area ahead of time. My DH came to sit with me and then eventually they wheeled me down to the Women’s Surgery floor, which is interestingly, is on a different floor from the regular surgery floor. The anesthesiologist, who looked no older than me (I am 40) but trained at Duke, so I felt supremely confident in her abilities, asked if I wanted something to relax me before they wheeled me down the hall to the OR. The OR is generally an absolute beehive of activity – they are opening trays, transferring you to the rather tiny OR table, taping on EKG lead and on and on, and so I said Yes! Give it to me! (Versed is the drug they usually give). And from there ladies, I don’t recall another thing. I remember the anesthesiologist saying that I probably would begin to feel the effects of the Versed and the next thing I know, John, the very kind recovery nurse, is offering me hot tea and graham crackers, God Bless his soul. There was something about that first 24 hours after surgery where EVERYTHING tasted SO good. Maybe it was the 12 hour fast before surgery, but I kept remarking to everyone how “this tea is the best tea EVER!” (It was Lipton brand tea, one packet of Splenda). Too funny.

My Plastic Surgeon (“PS” as they are referred to on this site) uses a lot of local anesthetic – which means that he injects a lot of anesthetic into the skin itself before he makes his incisions. Thank goodness for that. I had no pain when I woke up, and actually, they had to keep telling me to keep a bit hunched over, as that was a fresh new incision there where I had my tummy tuck and you don’t exactly want to be stretching it out so much so quickly.

My MIL and DH gave me my meds around the clock, drained and re-set my drains (you have to re-set the suction on the drains after you empty them), did my belly button gauze + bacitracin, and God Bless their souls, they have washed my hair every day and given me a sponge bath, lotioning me, powdering me – I am fluffed and buffed like a queen and am very thankful.

Today I did get one drain out. Interestingly, my drains are on the outer edges of my hips – way out lateral –not up front like I see in most people’s post op pics – and I highly recommend this technique – in front they would just be way in the way of everything. I have been wearing fleece XL sweat pants from Old Navy and XL v-neck tops also from Old Navy (let’s show off a bit of that cleavage, eh??), which has worked out nicely. I also bought XL Hanes grannie panties. The compression garment has a hole for going to the bathroom which is adequate, but I wanted a little something there between my hoo ha and the fleece sweats and the granny panties just give me that extra security. The funny part, or not so funny part, is the first time I was up to the bathroom – I sat down and peed right through the grannie panties. Oh well. Those went to soak in the sink, got a new pair on, and lesson learned – take a look down to make sure that you have the garments off that need to be off to be free and clear for a clean shot to the potty.

Going #2 (BM) is a topic of avid covo on this site. For me, the stool softeners have been ok, and then I did take some Milk of Magnesia pretty much every day. Just don’t overdo it, ladies. The adult does is 2-4 tablespoons. Start with 2T and go from there. While 2T plus the stool softeners basically had the stuff pouring out of me (don’t worry, I did make it to the bathroom with time to spare, and grannie panties did come off), you do use your abdominal muscles even to get that out. So, do what is necessary to not have to give birth during this process. Lamaze breathing should not be required. But go for it if you need it (Lamaze breathing works, when needed).

Speaking of Lamaze breathing, I had one of the 2 drains out today and as the very kind and sweet tech tugged on my left drain, I could feel a pinch all the way over on the right. And it began to hurt more and more and more and… wait! This isn’t supposed to hurt! She said sometimes they kind of get into a stitch and that’s probably what happened with me. She gave me a moment to rest and asked if I was ok. I asked to hold my husband’s hand which sounded so lame, but I needed to hold onto something, and I squeezed and she got it out and all is well. Next drain comes out next Thursday. Until then – feel free to email with any questions!

Happy healing to those in the same position (my current position is sitting on a Boppy nursing pillow, wearing my surgery bra, shirt, and a sports bra, with small ice packs tucked in between the sports bra and the shirt – isn’t that a pretty look??)

Hi Ladies, I've mentioned to a few of you on...

Hi Ladies,

I've mentioned to a few of you on the forum how I overdid it yesterday and am now swollen. Usually if I sit in the recliner, on my Boppy pillow (remember those from nursing? It's so I don't crush the fat grafting I had done to my bum), and ice down my top with bags of frozen peas and abdomen with same, have coffee, I then feel so much better. Ugh. Today not so much. I am blue. And you know what makes me feel so much better? Reading all the updates from you Realself ladies who are going through all kinds of similar ups and downs, chiming in and cheering on those that are about to have their big day - this site is SO helpful. I am currently in my iced down recliner set up, so I am sure that is helping, but - you gals are the best. Just wanted to say that first off. I really mean it. {Virtual hug}

A few notes, thinking about yesterday - what could I have done that caused this extra swelling? I washed and dried my surgical bra and compression garment and so was in bike pants and an 'Ah Bra' from QVC which is a spandexy, soft bra that feels smewhat supportive (wrong). Usually I am just in that get up for the hour or two it takes to wash the garment and bra but it was the last day my MIL was here yesterday (she came to help me and was an absolute angel - she could seriously be a personal assistant, or first assisant to the Queen, honestly, with how helpful

and kind she was), and so we were playing with the Ipad we gave her as a thankyou gift we gave her and I didn't get back into my get up until porobably 2 pm. Also during that time we did my usual routine of sitting at the sink, washing what I can, then she washes my hair, I dry it, put on make up (why? Just because it makes me feel better - sounds so silly as I type it), get dressed, but by the end of all of that I felt like I was wiped and that my abs were strained - even though this has been my usual routine every day. Lesson learned - get something more supportive to wear when the usual post-surg sexy 'shapewear' is being washed. When you feel, during your boring usual routine that you are getting strained for really no apparent reason (other than forgetting that compression garments really act as your abs, which are connected to, well, everything it seems), maybe ditch the make up session, take a muscle relaxant and have a nap. Hoping for a better rest of the day...

Here are some post op pics ladies. Not so pretty...

Here are some post op pics ladies. Not so pretty with the ORIGINAL steri strips on (coming off at appointment on Friday), including dried brown blood (ick) all around the areola of both breasts and all along the tummy tuck incision. Yay! Also, there is still a ton of bruising on my bum and even the purple marker "x" marks that my surgeon made on my cheeks, so I couldn't bear to actually post pictures of my bum yet. Not sure what I think about my bum, maybe it's a bit fuller, hopefully now doesn't look too much like a fat bum. But, whatever, I am so happy with everything else, the bum isn't an issue for me, and I think still oddly swollen in places. My breasts, today are particularly swollen compared to even a few days ago. Anyone remember that old video game "Tomb Raider" with the gal who had gigantic breasts? I feel like her. (Never played that video game by the way, just have seen my then boyfriend, now husband, play the game and she was well, very top heavy). As I just uploaded the photos, I have sort of a feeling of geez, IS there that big of a difference? But I am happy with the result. This is the early icky post op photo with swelling etc. I'll be sure to post when things look better as well.

Yay! My second drain is out. This time, no pain,...

Yay! My second drain is out. This time, no pain, just a pinch at the end as it exited the skin surface. Apparently they do lightly stitch the drain in (which makes sense because it is like a noodle, so it would slide all around in there if you didn't) and so - mine was in there pretty well (both of them). I can shower in 24 hours. Yay me! Hope everyone is doing well. I feel like a free woman, and now will have to be especially careful not to over do it. Oh happy day.

I tried on my pre-op jeans out of interest as to...

I tried on my pre-op jeans out of interest as to whether they would fit or not, based on some of the comments on the forums about not fitting into your prior jeans/pants for a long time after surgery (or at least longer than hoped, since the whole idea was to get a smaller waist and abdomen!). Now, recall I had the abs made smaller, and the bum made a bit bigger (fat grafting to bum), so I wasn't sure what to expect. Sure enough, jeans fit, and I do fill out the trunk of those jeans better with the new junk (haha), but ouch, the front of the jeans presses on my tummy tuck incision at the level of the outer hip bones. I am going to stick with the Old Navy soft XL fleece PJ pants I bought for recovery and which I have been living in since POD1. I LOVE them. It may be hard to go back to regular pants!!

On another note, on the way home from getting my 2nd drain out, I made a victory trip to the Macy's and Victoria's Secret to get my bra size measured (yes, I should have just gone home and had a nap, but I did do that later). Both gals at measured me at the 2 stores said I was a 34D, and when I pressed them about it (closer to D? closer to C?), and said how I have quite a bit of swelling, they both told me I was definitely closer to a C, so that is probably where I will land when all the swelling goes down. Yay. Sounds good to me!

Victoria Secret has like 3 places in their store where they have "NO underwire" bras. That's it. Really? Yes, really. Who has suggestions on their favorite non underwire bra brand/style? (For readers not understanding why this matters -- apparently post-breast augmentation, the surgeon won't let you wear an underwire for awhile -- probably too much pressure on that incision under the breast).

Hi ladies, It's been awhile since I've updated....

Hi ladies,

It's been awhile since I've updated. Mostly my energy has been coming back day by day and so I've been able to make one or 2 outings per day -- to the bank to get something notarized, to preschool pick up (not physically picking up the 4 year old, of course). Last week I noticed I was having a lot of itching along the outer edges of my hips, along the outer most parts of my abdominal incision. I was to take of the steristrips at post op week 4, but leave them on until then (they are indeed a good barrier to infection). I think my CG probably rubs the most along the hip bones when I move, thus the irritation, along with 3 weeks of adhesive on the skin. Also I was having some chafing in the groin regions from the CG -- not red, raw, just mildly noticeable to me, but a dark red/brown that I wondered if it could/would scar if I didn't get on it right away. So I called, and spoke to my PS's office and the decision was made I should take the steristrips off where irritated to let the area air out and calm down, and to continue with putting a little cortisone cream on the irritated skin around (not on the incision) the incision where there was redness. So I've been doing that. Also, I could try spanx instead of the CG and maybe try not wearing the CG at night. I love my CG -- it really supports me, and so I did go get spanx and that day, was out of the garment for awhile, just wearing yoga pants with a strong band of enforcement in the front ("tummy control yoga pants"). When I got home, I wore the spanx and I think I slept that night without a garment on. I did buy also a "waist trimmer" band from a sporting goods store, which I tried and which gives extra support, but makes you a bit sweaty (yuk).

Anyway, in the shower yesterday I decided to soap up my abdomen, which I haven't done a ton of actual "washing" of -- as I want to avoid that incision and the belly button, and as I ran my hands across my upper abdomen, noticed a fluid wave under the skin over my right upper ab. Yep, that's a seroma. So I called and was told that compression is good for that, so going back to my CG is preferable, and that my PS would like to see me a bit earlier, Tues next week instead of Thursday. So I peruse this site about seromas at 3 weeks and it seems serial aspirations, early, is the way to go. Mine doesn't make any sort of bulge, and so it probably is very low volume, so I am wondering if he'll even aspirate at this point. But my preference would be to try it, along with strong compression, to get it to go away faster.

So today I wake up in a bit more pain -- lipo sites, achey big chest (worse in the morning after lying down all night), stiff abs, a bit hunched, and overall a bit down. I did get myself showered/hair/makeup (just because it makes me feel better; yesterday I skipped make up and looked so yuk/tired, blek!), all my ducks in a row (lots of 4 x 4's over areas of the incision I don't want right up against the garment; a 4 x 4 folded long ways along each groin region with pure cornstarch baby powder on it to keep the CG off my groin and the area dry as it can be), so I am looking good, but eyes are already heavy. Today is just a blah day. Also, it feels like everything is a bit itchy today, so when the 4 year old comes home, I think one Benadryl is in order and a good nap. I sure hope the 4 year old cooperates with that plan!! He usually does.

So that's the scoop here! I'll post more pics when my redness dies down around my incision and I'm feeling better overall. Hope you all are doing well. Each day can be so different, I've found.
Denver Plastic Surgeon

I have a friend who had a breast augmentation with Dr. Squires. I always thought "gee, she is just one of those lucky gals whose mom was well endowed, and so she got the good genes." Then one day I was talking about a tummy tuck and she told me she had a breast augmentation with Dr. Squires. Really??!!! I had no idea they could look so natural! He is extremely personable, patient, kind, answers all of your questions, and has a staff of very warm, kind, sweet ladies that are a huge part of your pre-operative and post-operative process. Don't underestimate the value of the staff and whether you click with them as well! By the way, I think his work is AWESOME. I just love my new look more and more.

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