39, 5 Kids, TT+Lipo+BBL & Hoping for Breast Augm. - Dominican Republic, DO

My first post, finally! So forgive me if it's a...

My first post, finally! So forgive me if it's a bit long and rambling...but here goes!

So I had my first child at 19, after getting pregnant my freshman year of college. And ever since, I have felt trapped in my body. 4 more children (and a much better 2nd husband) later, I finally realized this past year it may actually be a real possibility to DO SOMETHING about it after reading about going abroad for cosmetic surgery on this website. Before then, it seemed it would be financially impossible. And before doing the research, the prospect of going overseas for surgical procedures sounded extremely risky. I now realize there are extremely talented and very well respected doctors abroad that do the same work that is done here, and not only for far less money, but in some cases, better! Like anything, you just have to do your research. Same goes for medical procedures in the states.

Aside from surgery, I always knew there were things I could do on my own as far as weight loss, exercise, etc. - and I did manage to lose weight as I've needed to over the years, for the most part, and maintain it - at least until the birth of my last child 8 months ago. Still, no matter how I looked with my clothes on, I felt so sad and depressed about the body I saw naked in the mirror. I have truly felt trapped in this physical space. It made me think of a melted candle. Another reviewer I read recently said the same thing, and I thought then that I thought I was the only one who saw that. But I know there are lots of us out there! And I am happy to find this site and be able to learn so much.

So I've decided on the Dominican Republic, of course! They seem to know how to work with my natural shape. I have always been somewhat hourglass/pear shaped. My boobs are not all that big, but I had a smaller waist and nice big hips with a nice, healthy ass! It looks pretty decent in clothes, but naked, it's a damn mess. All of it is! So I mostly want to return to my natural shape, even if is trying to go back 20 years! It is a horrible cliche, but it's true - we have but this one life to live. I want to be happy. I want to feel my body is the temple that my soul tells me it is. I KNOW it will not be perfect, but I can do better, and I know I can feel better. And as much as people will say it's only physical - yeah, I know that. But the physical is a pretty significant part of who and what we are. I do love myself, I just want to fall in love with my body again.

So I am pretty much set so far on Dra. Almonte. Pictures of her work, her reviews, and my research make me feel pretty comfortable with that decision. The quote is $5100 for TT+Liposculpture of full back, flanks, and waist, + BBL. If I want a breast lift with implants, it is $1300 more and all depends on my hemo/etc. levels, as far as being able to do the breast augmentation at the same time as the other procedures. I know it's a lot - I get that. And I won't, and I know Dra. Almonte won't, do more than my body can withstand. However, I've made it through some pretty excrutiating child births. I have a pretty decent pain threshold, and I trust my mental strength. So long as the end result is positive in terms of my health and my happiness with that naked lady staring back at me from that mirror in my bathroom, I am willing to withstand the temporary pain and discomfort. I just plan to put the rest in the hands of God/The Universe/The Greater Power that I know guides me.

2 of my children are in college, and I have 2 in middle school. The baby, as I mentioned, is 8 months. And I. AM. DONE.! I thought I was done before. My older children are from my first marriage, and I was enjoying traveling and spending time with my 2nd husband, who had no children of his own. Then came this little miss! She is so beautiful, and I am so grateful that she came into our lives, and that I was able to give my husband a little angel of his own. He adores her - it's amazing to see. But hand to God, I am done! And I'm about to turn 40. I'm ready. I am just so, so ready.

I am concerned about taking the time off. I just started a new job in July of this year - 2015. So I won't have 10 days vacation until July 2016. So I am planning to schedule my surgery date at that time. However, even considering I will technically have the vacation time, I work in a small department and I have some concerns about my boss possibly being a bit prodding about me requesting to take my full two weeks all at once, as soon as I reach my 1 year mark. Plus, I work in a medical environment, so it's not like I can just give random excuses about medical procedures. It's no one's business at all! But I am a bit nervous about getting the time off. At this point, it feels so close and so real and so possible - I'll do whatever to make it work.

Basically, I am just totally obsessed with the fact that all this could really become....my reality. The prospect that I don't have to stay trapped in this melting candle body, making sure my robe covers my backside when I lean over the sink in the morning to brush my teeth in case my husband walks in...always trying to hide my tummy from him...being constantly conscious of what I am showing...never getting the satisfaction of walking around in just a tshirt and panties because I know how horrendous my backside looks...never walking around naked period! I just want to be free.

Before Pics... Waahhhh

Who Does Best Boobies in DR? ...And teeth?

So in the event I go back for a R2 for the tittays, who in DR does them best? For my other work, I'm mostly settled on Almonte but also keeping an open mind for Robles as well as Leon. Thoughts?

While we're at it, teeth whitening? Who's done it there or has info?

And while we're talking about fulfilling our lifelong wishes of physical self improvement, I'm also considering a nose job at some point. Mostly for tip refinement - I've always been deeply self conscious about my nose. But I don't want to take any chances with that and I also don't want some one-fits-all ski slope nose. I don't mind my bump all that much. Anyway, just thinking and wondering if any of you have any experience with any of this as well.

I Just Emailed My Boss for Time Off! Eeeeeeeek!

So as I discussed in my first post, I've been really nervous about submitting the formal request for time off to my boss as I've only been with this employer for a few months, and it's a small office (though within a huge organization), AND it's in the medical industry, so they're all doctors. Don't really want to have to get into specifics about why I want my 2 weeks vacation as soon as I'm eligible for it this coming summer (2016).

When I casually mentioned needing a medical procedure recently while inquiring about how much notice I should give if I needed time off during the summer, she asked why I didn't just use my sick time instead of vacation, which I did not want to go into. Now another RS member mentioned to me that she will be seeing her regular doctor after she returns from DR to ask him for a work excuse for any additional time off, so the medical authorization is coming from here - not an overseas doctor (which screams plastic surgery - and that's more than they need to know!). Brilliant! If I need more time off than whatever I manage to take, that's what I'll be doing.

Lesley at Dra. Almonte's office confirmed to me this week that Dra. Almonte still has availability for the last two weeks in July. So I decided to go for it and send my boss the email formally requesting 2 weeks off for vacation. I waited until she left for the day, but I did it. Eeeeeeeeeeee!!!

Let's hope I don't get one of those "Let's discuss this when I'm back in the office" replies. Noooooo - I hate discussing in person. Let's just text or email like normal, civilized anti-social human beings, please? Eh!

Next step - if this goes well - my deposit!! Oh my gawd - can't wait!!

Need Help! If You Had Tittays Done Same Time as MM!

Ok, that's a long ass title so I'm using abbreviations that probably only are relevant on RS. But basically what I would like to know is if you are post surgery for a mommy makeover (the DR package! Lol) - specifically tt+lipo of back, flanks, etc+bbl AND got breast augmentation at the same time (with or without breast lift), what did you have to do in order to get all your procedures at once? Or to not be able to? Basically, what was your experience? I've been told by Lesley, Dra. Almonte's assistant, that my BMI will need to be below 35 (I'm well below) and hemo at least 13.5. That may be challenging from what I've read, but if I have the option to do an iron transfusion, I likely would. So any of you have experience with this? I'd really like to get all the procedures at once, if I'm healthy and all my stats good.

At CECIP Waiting Patiently

My turn any minute!

Made it!

So I made it and all is well at the moment. My hemo was 13.6 or 13.8, not sure, but I believe I was able to get all my procedures. I did not ask for breast work because I decided a few months ago that I'd rather the first round be concentrated on the initial work being as right and tight as possible. I haven't been able to see the full work yet bc I'm only about 12 hours out and haven't been out of bed. Also havent gotten the full update from Almonte but hope to see her in the morning and get details on what she did in surgery. I did wake up towards the end but only have a foggy memory of it and was not in pain, just felt work being done on my tummy. I also did have to get a blood transfusion but I'm fine so far - husband said Almonte was very concerned about my color (I don't remember). Woke up in a lot of pain but they've given me IV pain meds when I ask so all is well at the moment. Only concern is having to lay on my back, but I've got the boppy pillow wedged under my thighs as much as I could with the help of my hubs and very restricted movement. Not sure if it's doing any good but it did take some of the pressure off at least. I'll worry with more when I'm able to have more power over my sleeping and laying positioning. Right now I'm just so grateful to God, my angels, the doctors, nurses, assistants and the UNIVERSE for getting me through the surgery. Now recovery begins! Update more later.

12 Days Post & Recovering

Surgery went well and I'm back in the US and recovering at home. Apparently I bled a lot during the back lipo and required a few bags of blood afterwards. Initial recovery was very painful and uncomfortable for me, but the drain has been the worst part for me. It's extremely painful when they had to unclog it in Almonte's office and the periodic burning in my back and side was debilitating, even if only momentary.
As a note, while in the recovery house, the nurses would tell me if I wanted to get the drain out soon I needed to drink 3 bottles of water an hour and walk, walk, walk. Id been told by Almonte I needed to walk even more bent over than I was, which was killing my back, to ensure there was no strain on my incision. I was so concerned about post op complications that I walked extremely bent over for about 7 days post op - which was great for my incision but painful and made me not want to walk as much as the nurses were trying to get me to do. I came home 9 days post op with the drain as I was still draining a lot. The more I read up on the drains once home, I consistently found that INACTIVITY is key in stopping the drainage and having drain removed. Apparently, those who are more active tend to have their drains in longer. Restricting movement allows the layers of tissue to heal back together, which is what ends the drainage. So I've been relaxing and keeping my feet up as much as possible. I'm still draining around 150 ccs per 24 hours, but I'm hoping it will continue to decrease daily.

Another note - after I got home, a bit of my drainage tube tugged out somehow (I didn't even feel it) exposing about 4 inches of the drainage holes that are supposed to stay inside you. Since the holes were exposed, it stopped getting suction and wouldn't drain. I was told by Almonte's office that I would need to sterilize it with chlorhexidine and reinsert it. I was crying, I was so anxious! Thankfully, my sister who is a nurse was there and didn't feel comfortable doing that in a non sterile environment. I called 3 hospitals/urgent cares before I found one who would even look at me. I was so worried about getting judged, but they were all so kind. The Dr. didn't want to reinsert the tube, even sterilized, as it was too much of a risk for infection. So he sterilized it and occluded the holes that were exposed to allow suction to return, then secured the tubing to keep it in place. So there is about 4 inches of the tube that is supposed to be on the inside still outside of me, but it's draining so I'm fine with that! I was SO grateful to them! He also put me on doxycycline to try to prevent infection in case any bacteria entered while the tubing holes were exposed. So believe me, I am taking it easy!!

Regarding the faja and massages- I was extremely bruised after my procedure and did not move to my stage 2 Faja before coming home. I'm still in my stage 1 on the 3rd row of hooks and will go to a local faja store once I get my drain out to get measured and into my stage 2. I also wasn't cleared for massages until 2 days before I went home due to bruising, but once I was cleared I decided to wait until I was home as Tania (Dr. Placencia) told me not to get them by hand, but with the ultrasound method. I'm assuming that is more gentle, and the masseuses at the recovery house were fairly heavy handed. I still haven't gotten any massages as I'm just trying to recover from the drain right now. I've read gently using a rolling pin or paint roller at home to massage yourself can be just as effective as the expensive lymphatic massages.

Regarding results, I am of course super swollen but am very pleased so far. My waist looks really small and so far it looks like Almonte did exactly what I asked as far as putting volume back into my lower buttocks. Can't wait til the drain is out and swelling goes down!

Recovery is definitely much more pleasant at home!

Question for Those Who've Had Drains Removed (or Not!)

How long did it take you to go from 100 ccs drainage to less than 50 in 24 hrs? I am 17 days post op from my tt, full Lipo and bbl and am at 100 ccs very light yellow, clear drainage for the last 48 hours. I was at 150 ccs or more a week ago. I am really restricting activity as I've read that is the best method for healing and particularly for drain removal. As I mentioned in my previous post, I've already had issues with the drain and I am soooo ready to have it out. I go back to work in one week (very low activity job) and also finished a full cycle of doxycycline yesterday, which I was put on after a bit of my drain tube tugged out. No infection symptoms, but concerned about having the drain in too long AS WELL AS trying to keep it in until I'm below 30 ccs a day as that seems to be the US standard and I want to lessen chances of seroma as much as possible.

So! How long did it take you to go from 100 ccs drainage to less than 50?

To make it all even better, I've developed some intense upper back pain (left side and kind of wraps around my rib) that only seems to be helped by codeine, of which I only had a few and am out of now. I've had some times crying on the couch, so tired of that pain!

I have an appointment with a regular doctor tomorrow about the back pain and also to check on rapid resting heartrate issues I've noticed since the surgery (I realize this has been an issue since long before the surgery) so hoping he can give me something for pain.

I just keep telling myself it will get better!

Seroma - Local PS Opting Not to Drain Yet

So as much as I wished it away and tried to wait as long as possible before taking my drain out, I developed what seems to me to be a pretty large seroma. I am just under 4 weeks post op. Drain came out 20 days post op after draining less then 30 ccs per day for 2 consecutive days and I noticed the seroma in my lower abdomen within 48 hours.

I found a local PS who would see me ($200 consult fee I had to get out of the way, of course) that same week and was very kind, patient, and took the time to answer all my questions and really attempted to calm my anxiety. The seroma started about 1-2 inches below my belly button, and the area where I could see the fluid moving across horizontally was maybe about 5 inches. Laying down, the PS couldn't palpitate/move around much fluid and didn't feel she'd be able to aspirate much. I stood up so I could show her how much more visible it was at that angle, but she still did not appear alarmed and felt it was best to allow it time to resolve itself. I believe her preference is to avoid risk of infection by trying to aspirate with a needle unless absolutely necessary. I've read some things online that say the seroma will only continue to refill, which is why multiple aspirations must take place, and that it can become more of a risk than is necessary when it will just resolve itself if given time. This seems to be her standpoint. She does tummy tucks, boobs, all that - so I would expect she is very experienced with such a common side effect as this.

As I said, that appointment was last Friday, today is Tuesday and it seems to me to have gotten a bit bigger. I definitely have a very swollen pooch when I look down, although it's not as visible from the front or the side. When I press on the center of my lower abdomen or just to the right or left of center, I can feel the fluid move almost (not quite fully but almost) hip to hip, which is a uncomfortable feeling. It seems to me to be at least a cup of fluid, if not more.

I switched to my Stage 2 compression garment last Friday after that appointment (I had been wearing my Stage 1 garment 24/7 for the first 3 weeks while my drain was in -- I was concerned putting on the Stage 2 garment would irritate the drain site or might even chance tugging a bit of the drain out and losing suction as I had accidentally done before and had to go to an E.R. to fix it), and I've been wearing the Stage 2 now (Maria E brand) for 24/7 since then. Although the PS I saw preferred I not use added foam to ensure the compression was uniform all over, I did add back in the folded over foam over my abdomen again yesterday. I just keep thinking I need to press that area as flat as possible. I feel like I am obsessing over this thing and over other people's opinions and experiences in online blogs (surgeons, patients, etc) about seroma treatment and constantly anxious about whether the local PS I saw made the right call. It seems that almost everyone opts for at least attempting to aspirate these things. I could honestly deal with waiting several weeks or even a few months for it to resolve itself IF I knew for sure it would and that it was not likely to cause a cosmetic problem, such as leaving a permanent pooch. I did not go through all this to have that kind of result from an issue that could have been prevented.

Has anyone gone through this and had their seroma, even a large one, resolve itself without leaving visible proof that it was once there?

I know I have to keep reminding myself that I'm not even quite a month out yet, and honestly I'm okay with that as long as I don't have to worry so much about the what-ifs. I can deal with the swelling, I can deal with the tightness, I can even deal with the (hopefully temporary!) lumpy places from the lipo under my armpits that feel so sore and tender and totally alien. But it's hard for me to deal with walking around with what feels like a cup and a half of liquid pushing and sloshing around my lower belly. I mean, I can't actually feel it sloshing around when I walk - but in my mind, you know... And when I take the garment off to shower, I worry that I need to protect and support my belly out of concern for the pressure it must be putting on my incision -which looks great otherwise.

I called and made a follow up appointment with the local PS on Monday ($100, not as bad as the initial consult fee), so that's in a week. Of course if I were to have any signs of infection, which I don't expect, she will see me right away. So when I go back, I'll see if she agrees that it's gotten bigger and what she feels is best to do, if anything. If she still prefers to give it time, I'll ask her specifically about the chances of it forming a bursa/capsule and leaving me with a permanent bulge, and how long we can give it to resolve on it's own before that became a bigger risk.

I guess we'll see.

Thoughts? Your experiences? Can someone, ANYONE, tell me they had one - a large one (large to me) - that did go away on it's own?

- Sleepless and Second Guessing in Texas

3.5 Wk Post Op Photos

Dominican Republic Plastic Surgeon

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