Tall and Thin With Cankles - Hanover, MD

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I've always been skinny, and am now (at 31) pretty...

I've always been skinny, and am now (at 31) pretty thin. Although I could use to tighten up and lose maybe 10 lbs, I've always had a "problem area" on my ankles. Being physically active and bean-pole skinny most of my life meant nothing; I still had cankles. I eventually found out that targeted fat loss was a myth, and no amount of calf exercises would have any impact on my fluffy ankles.

I don't know exactly when I started thinking about lipo, but I got my first consultation in 2010. I didn't really have money to do it then, but this was when I found out about Smart Lipo... which meant that they could melt the fat and tighten the skin instead of the skin remaining loose and lumpy after.

Towards the end of the 30th year, I decided it was time. I'd wasted enough my on student loans, which I had nothing to show-for, so I figured I might as well spend my money on something I really, really wanted and would make me immensely happy... for a long time! I consulted with a doctor (Nov 2013) in Chevy Chase, MD who was nice enough, but I just wasn't sold on him. Then, at the end of January (2014), I found Dr. Ashruf... who sold me immediately. I set up an appointment then an there.

Five Days Post Op

Things are really moving right along and I'm very happy so far.

I was scheduled Feb 26 at 10am. After changing and getting marked up, the procedure probably got started around 10:30 or 10:45am. The room was nice and warm and the operating bed was heated, which was fantastic. They made sure I was totally comfortable before they got started. The first step was injecting the tumescence which helped numb everything. It wasn't a lot of fun, but just like a series of shots... not bad. Once I was numbed, the doctor got started with the laser, which melted the fat and tightened the skin. Then, the actual liposuction began. That probably took the longest (I could be wrong).

They estimated it would take about two hours, but it ended up taking almost four hours... and I wasn't at all surprised. I had a lot more fat in there than most people realized. They removed 1500 CCs and had to replace the "fat canister" once!

Once they were done, and squished out some remaining tumescence (yuck lol), they sat me up, put some gauze on, and helped me into the compression garment. This was probably the least fun part. I got really dizzy and hot, but that was to be expected. They let me drink an orange juice and sit back until I felt okay again.

When I arrived home, it wasn't long after that I had to replace the gauze again. I am not great with body fluids, but I pushed through my light-headedness since I didn't trust anyone else to NOT inflict pain on me. The first gauze change was the worst, but I managed it. The following days have gotten easier and easier. I cut myself out of my underwear and showered in the garment on the first or second day (which rinsed out a lot of the gross-looking drainage stains) and actually put on my bikini bottoms because they had string ties. That was super convenient (since the doctor recommended not taking off the compression garment for three days) as I was able to soak and wash them in Oxiclean when I showered the following days.

Yesterday, I was finally able to take the garment off completely and have it washed. Today, I only have one gauze patch on because there's one spot that keeps leaking... but the doctor isn't worried, and I'm not (now) since it leaks less and less by the day.

I actually felt good enough to take some "after" pics!! I'm hoping the doctor will provide me with the real "before" pics since I didn't take the time to snap very good ones. Everything is looking really good... and I'm still swollen!!! I'm really happy with the results so far, and I'm relieved to be past the worst of the process.

Stitches Out

Today I finally got my stitches out. That was pretty painless and quick.

I'm still swollen and thought maybe I'd overdone it (walking around too much) because, last night, the swelling seemed to be going down, but today seems like my feet are swollen more than ever. Apparently, that's both normal and okay. It actually helps the healing process to walk around a bit. But, as I expected, the doctor just said it's now a waiting game... waiting for things to heal, and waiting for the swelling to go down.

I could take a pic, but I don't feel like it... there's not much to see but fat feet and yellow legs!! I scheduled my Venus Freeze (VF) session two weeks from now. I have a feeling that's when I'll really start seeing the difference. I was actually pleased to find out Dr. Ashruf had even removed a bit of fat from my feet around my ankle bones. SCORE!! In two more weeks, I bet the swelling will have gone down significantly, and the VF will sculpt what's left. I'm still pleased, still excited, and am now totally past the worst of everything. YAY for ANKLES and NOT CANKLES!!! :D


I think today my body MIGHT be going back to normal, but the night before last was THE WORST night for sleeping since my procedure. I kept waking up because I felt my whole body was swelling. My skin felt puffy all over and just... wrong. It was totally disconcerting and lasted the whole day. I downed several glasses of water because I knew I hadn't been taking in enough fluids and that was probably the reason I was feeling this way.

Last night, I thought it was going to be the same, and it was for the first couple hours of attempted sleep. I would get this feeling of swelling in my face and maybe even my throat, so I would jolt awake and, consequently, send a rush of adrenaline to my legs which exaggerated the feeling of being swollen. Eventually, I got into a position sort of sitting up that I could finally get to sleep in. Today, I woke up feeling normal again... even though I haven't looked at my feet.

I am really OVER being swollen. I want to work out, too. Laying around, especially since it's been so cold, has really given me an intense "cabin fever." I'll start Venus Freeze March 21st. I'm not really sure if that's supposed to help with swelling exactly... it will at least make thing LOOK normal/better. I'll also be glad when I can stop wearing this compression garment.

Can ya tell I'm feeling a bit irritable? Nahhhh... ;)


So, I know I already posted today, but I measured my ankles and calves for the third time... once, two nights before the operation (Feb 24th), once on March 7th, and just now.

February 24th, 2014 right calf (16"), left calf (15.5"); right ankle (10.5"), left ankle (10.5")

March 7th, 2014: right calf (14.5"), left calf (14"); right ankle (10"), left ankle (10")

March 11th, 2014: right calf (14"), left calf (13 7/8"); right ankle (9.5"), left ankle (9 5/8")

I mean, how fantastic is that?! I've lost two inches... off my freaking calves! I didn't even think I had fat calves (I've been surprised how small they are... time to work out)!! My ankles (predictably) have taken longer to stop swelling, but I'm already an inch down on those, too! It looks like that peek in swelling was worth it somehow... like, the last dying gasps of thick lower legs. HA!

And I'm still swollen?! Lol how strange it'll be if I end up with chicken legs. I always insisted I'd rather have chicken legs than cankles. Well, it's true. My only concern now is lumpy unevenness, but that's supposed to be solved by time and Venus Freeze. *crosses fingers* >_

Latest pics...

Everything is still lumpy and weird right now... happy with the diminishing size, waiting for the shape to emerge... with the help of Venus Freeze in a little under 2 weeks!

Progress, Slow and Steady

I just had my third of four Venus Freeze treatments today. It's hard to say what is just normal healing - now that I'm five weeks past my Smart Lipo procedure - and what's the result of Venus Freeze.

My left leg is clearly going in the direction I have been hoping for. It was, and remains, about a half inch smaller than my right leg (not optimal, but just is what it is). I do believe the Venus Freeze is definitely helping heal the puncture wounds, which aren't raised or puckered... just smooth, red spots that I'm sure will diminish in time. My skin is smoothing out and softening where it had been kind of tough just under the surface and lumpy (presumably from swelling and scar tissue). It seems the swelling does fluctuate about a half inch: smaller in the morning, larger in the evening.

I felt encouraged this morning when I measured my right ankle, which has remained stubbornly plump even though the doctor said he had removed probably all of the fat and didn't think there could possibly be much left. In the thickest part, it was 9.5 inches today... and, just the other day, it had been 10 inches (originally 10.5). I could also tell there's probably about another half inch or so of swelling still in that area. All I'm hoping is that my ankles will no longer bulge. As I said, the left ankle is noticeably smaller and only slightly bulgy.

The feeling is really starting to come back, too... and I think that part is a bit ahead of schedule. It sort of just feels like pins and needles all the time, which isn't extremely pleasant, but it's a good sign. Oh, and I can shave without having to avoid scabs (gross, I know). I don't have anymore open holes or scabs to watch out for.

I'm totally thrilled now that both legs fit comfortably inside all my boots and socks... no constriction anymore! I folded up my pant leg to look like capris and, for the first time EVER my ankle (the left one, mind you) just looked normal. The relief is indescribable. Who thought a person could feel so much satisfaction from normalcy? I can wear flats, capris, boots, heels, skinny jeans... and not feel awful. I cannot wait until it's just no longer a thought or hesitation.

Not Thrilled

I haven't updated in a while because I'm trying to be patient with the healing process. It's been 3.5 months, so there's still plenty of time before I hit the six month mark, or even the nine month mark. I got Venus Freeze which is supposedly still doing its thing six weeks later.

The puncture holes are, indeed, healing nicely... but my calves are lumpy and there's still fat around my ankles (which is the area I had this procedure done for in the first place). More than likely, I'll have to get more work done in October or November... which is fine as long as my legs at least look normal afterwards. There are weird dents and fat pockets. I guess my skin will loosen up in some places? It just looks weird right now. I'm trying not to be too discouraged. I know I won't even have Barbie legs, but I feel deformed at the moment.

I've still got my fingers crossed in the hopes that more time and healing will solve some of the problems I have right now, and that one more "polishing" procedure will smooth and even things out.


Feeling Better

So, it's been just under a month since my last follow-up (June 6th), but I think there's been some improvement since then... which is relieving. I'll post some more pics soon - some from my follow-up, and some more recent ones. The lumpiness seems to be smoothing, so my legs look a little more normal. There's still some redness/discoloration, but the doctor said that meant I was still healing. I can actually see some definition in my calves for once.

Regardless of how much I improve between now and my next follow-up (July 18th), I'm still positive I'll need some touch-up work (prob in Oct/Nov). At this point, I'm feeling it won't be as much as I originally thought; I just need one or two spots on my left leg and a larger area below my right calve zeroed-in on. I think I'd feel better about myself right now if I could tan (sooo pale), but alas... First, it's simply not good for my skin; second, it's particularly bad for my sensitive, post-op skin.

Anyway... I actually hope I just feel silly by the end of it all; like, I was just being paranoid or something. It's really hard to know what's normal when I've never done anything like this before. I don't know how I'm supposed to heal, or how I'm supposed to look while healing, or how long healing really and truly takes. I already heal slowly below the knee, so I'm sure that factors in. I guess I just had no idea what to expect. I thought I'd be swollen but that, when the swelling went down, it would all just be smooth even if red. Wrong!

The lesson here is: expect lumpiness and discoloration; expect healing to take longer than was originally estimated; be patient... like, REALLY patient. If you have a good doctor, they're going to be willing to work with you and make sure you're happy with your results.

Okay... signing off... :)


So, I had yet another follow-up today. I've been feeling like there's been a little improvement in appearance, and my doctor thought so as well. When we reviewed the pictures from last time versus those taken today, I felt I could see a difference. Upon closer inspection (from the comfort of home), I realize there may not actually be much difference after all... I feel I'm standing on my tip-toes a little more in my pictures from today, so whatever difference there is is due to that.

You'll notice there's a little nodule on the front of my left leg (right side, for you). He says he can easily remove that, and I'll probably have that done in November. Now, he's saying we should wait an entire year (from the date I first had my procedure) to do any real revisions. I get it; I'm okay with that. Maybe a year's worth of healing really will take care of a lot of my concerns. But, overall, I'm pretty discouraged. On one hand, I can now fit into my knee-high socks without super constriction; I'll also be able to wear boots this winter without the same problem. As far as showing off my legs in shorts and dresses? I doubt it. I guess I'll never feel good about my legs... which is disappointing considering that was the entire point.

Maybe I'll be pleasantly surprised as things continue to heal. Maybe if I lose a few pounds and gain more muscle, that'll be the real difference I need now. Who knows? I really just wanted to not be ashamed of my legs.

Revisions on Tuesday (3/2/15)

An entire year later and I'm about to go back to get some revisions done. I'm still (obviously) not pleased with the appearance of my legs, but I think/hope this session will do the trick. The Dr removed a lot of volume the first time. It took almost 4 hours. As far as I'm aware, there wasn't a lot of contouring done. This session will be more about contouring. He has set aside another 3 hours for this round. Of course, there's still some volume to be removed (mainly in my right leg and both inner ankles), but I'm really, really hoping for some smoothing and symmetry.

I'll post some pics in a bit... have a good "before the second after" photo. The silver lining remains that I can now/still get into socks/boots that I was previously unable.

Finally Feeling Better

First of all, the recovery (from the revision) has been much, much easier this time. The procedure only took, at most, an hour and a half. There was very little drainage afterwards and I've been able to wear compression socks most of the time rather than the garment/crotchless pants. I think the socks have helped keep my feet from swelling, which is awesome. They're much tighter than the garment. Actually, the garment is now too big on my left leg. That's either because it's been stretched out or because my left leg is just that much skinnier... even swollen. Also, I was able to shower the day after, which is nice... having to wait to shower is just gross. I've felt a little more pain this time, but it only seems to be brought on if I stand for too long.

Anyway, as always, my left leg is looking much better than my right. For one thing, less was removed from my left leg and so it just won't be as swollen. I took off my sock last night and could actually see my inner ankle bone. Holy shit. It's looking really good. Almost normal. My excitement is only tempered by my right leg. It just never looks as good.

My right leg is looking BETTER. More was removed, so there's more swelling. I just can't determine if it looks the way I want it to yet. I know that there was a lot of fat removed from my ankle because it's super bruised, swollen, and painful to the touch. I have months of waiting to see ahead of me again. I'm starting to massage both legs, which is necessary but not fun. Well, it feels good afterwards.

Anyway, I'm feeling hopeful. This may be the last time my Dr is able to do a revision without charging full price, but I would probably get more done if I ultimately feel it's necessary. I hope it's not. I don't want to be a serial plastic-surgery-getter. I also don't want to have spent all this money and not have a satisfactory result.

We shall see.

Finally Happy

Well, I looked at my legs in the mirror this morning... all bruised and swollen... and felt pleased with them for the first time in my life. Are they perfect? Are they Barbie legs? No. But there's no longer a fat pudge on the inside of my ankles. It just tapers down and is smooth, maybe even a bit concave. At this point, there's still swelling... and that's even more encouraging. It can only look better as I go. And, well... all I need to do now is build up my calve muscles, lose another 10 lbs, and I'll feel phenomenal. Maybe, in 6 months, I'll finally let myself have a good cry... let myself feel happy about my results. I have been prepared to only feel regret about this decision, but I think I can finally feel like I did the right thing for me.
Baltimore Plastic Surgeon

I've never had to wait on Dr. Ashruf. When I came in for my consultation, he came right in and started talking with me immediately... and he was very engaging and passionate about his work. He made a point to tell me everywhere he'd studied, and the various plastic surgeons he'd studied under. He obviously has a vested interest in keeping up with the latest cosmetic procedure technology, as well as getting mentored by some of the best plastic surgeons in the world, namely Brazil. I just really liked Dr. Ashruf from the beginning, and had a great feeling about him. I felt he cared about me as more than just a potential client or one patient among many.

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
3 out of 5 stars Time spent with me
4 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
5 out of 5 stars Wait times
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