18months Post: BRM, Panni/TT with Lipo (insurance covered it all, but Lipo).

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*Treatment results may vary

I'm 5'2" and currently 160 and dropping. If you...

I'm 5'2" and currently 160 and dropping. If you subtract the weight my PS wants to take off my boobs and my apron, we're actually looking at about 148 :)

So far my experience has been a roller coaster and I've not even had the surgery yet! If it's all covered I know for certain that it will be worth it.

I've had quite large breasts since the age of 16 and the tension headaches/neck/back pain as well, I distinctly remember trying to get a strapless bra for prom at Victoria's Secret (back when they used to have real sizes) and being told that I was a 36DD, but I could easily wear a DDD. Thank god for Marching Band and being a concert instrumentalist, without that I'd probably have such poor posture that permanently curves my spine.

I've always had a little bit of a weight struggle - my weight fluctuated from it's low of 135 (in high school) to upwards of 190 (as a senior in college). My average has always been about 150 and I have huge tatas and large, muscular thighs and I've always had a little "pooch" in the lower abdomen.

After graduating college in 2004, I maintained a weight of 150 for a few years and that is what I weighed when I met my future husband the following year. I began taking birth control in 2005 since this was my only serious relationship and by the time I was shopping for a bra for the wedding in 2008 my bra size was up to a 36G. My weight had gone up and then back down as it does with a new relationship and I was at 149 on my wedding day. That was the last time I was under 150. All the while my tatas never changed size, I'd be a happy girl if I lost weight in my boobs!

Not too long after our wedding I'd gained 20 pounds, I'd say within 3 months. I worked really hard at the gym, I would go to jazzercise 6 times a week for 45-90mins each workout. Nothing helped the weight come off so just before our 1st anniversary, I had my Thyroid tested, while it was in the range of normal it was still skewing to one side and I was prescribed synthroid and the mother of all diet pills, Phentermine!

I lost 10 pounds in the first week. Since it was really expensive to see the Dr. who was prescribing the pill and my husband and I decided to have our first child, I stopped taking the phentermine. But that 10lb weight loss triggered my body and I was immediately pregnant.

When I found out I was pregnant I was about 170. During the first trimester I lost 5 pounds since I changed my eating habits...lots of small meals, lots of extra veg and fruit, to be extra healthy for baby. I woke up the morning of my second trimester and I gained 25lbs overnight. I'm not kidding it was that fast, I literally went from having lost weight to my joints and muscles aching because of the extra weight. No matter how I proceeded at this point I couldn't stop gaining weight and at the end of it I was up a total of 65lbs! I was at 230 right before delivery. (This happened to my mother when she was pregnant with me, but when you start at 90lbs, it's not a big deal!) I knew I was going to have a skin apron by the time I hit the third tri, I hadn't even reached terminal weight and I had a huge apron.

Once my boy was born via emergency c-section in Dec 2010, I lost the first 40lbs of baby super fast, like in a month. It was an amazing feeling, however the last 25 hung around and I'd had a few extra pounds on me to begin with. I went back to the doctor in Dec 2011 to test my Thyroid and get phentermine. Again I lost 10lbs in the first week! It was such a great feeling I was at 173 for my son's first birthday, only a few pounds shy of pre-baby weight. I was trying really hard to get my headaches under control, exercise and get 20 more pounds off when...

I found out I was preggers again on New Year's Day!! I know, I'm really fertile, I was on birth control and I was taking a class 3 narcotic. I immediately stopped the Phentermine, the pill and my headache meds and started freaking out that I'd already done damage to baby 2! Turns out I wasn't very far along at all and baby girl is perfect! With her I only gained about 30lbs and I lost almost all of it by March of this year. Then LENT. Seriously I gave up fast food, sodas and chocolate - AND I gained 14lbs back.

I was pretty depressed and said F it for another month. My daughter was getting less and less interested in nursing and more interested in food, but I was hoping to get her to a year. Around 2 months to her birthday, I really started working out a lot and restricting calories. I joined GymPact and logged everything I ate with LoseIt! Since she was giving up on nursing anyway, I wasn't too concerned with cutting back on calories and by 11m she was done and I'd lost 7lbs. I went the next day to my PCP and luckily he agreed to give me the RX for phentermine and suggested that I do it for the full 3 months (you have to go back every 30 days because it's a controlled substance.)

I decided I was only going to do 2 months and get the 3rd month and use it at half dose to ween myself off and save a couple of pills for Christmas and Thanksgiving. Well I didn't see as fast of a result this time with the Phentermine, it was actually a little discouraging because I'd seen such dramatic changes the first 2 times I'd tried it.

But that's because I hadn't changed my habits prior to the Phen the first 2 times. This time I was already doing what the pill would make me do. For me this time around the pill just made it easier to STICK with the low calorie diet I was on. See, I could literally eat all day. I think about food constantly and that's what Phen does for me. It takes the thought of food out of the equation.

I'd always known I wanted a Reduction. I never knew I'd need a panniculectomy/TT. I've got it on good authority, thanks to 2 c-sections, that I actually have a pretty tight abdominal wall, but the skin flap is unbearable. I can't wear any pants unless they're 50% spandex or 4 sizes too big.

Here's where the roller coaster begins. I called the PS I wanted to use, Dr. John K Long of Houston. (I had a girlfriend who had 2 c-sections as well and went to Dr. Long over Christmas 2009 to get a panniculectomy - she was back at work, light duty, in 2 weeks. I couldn't believe it! I knew I had to use him, if it came to it.) I set up a free consultation and I was an excellent candidate for the panniculectomy and breast reduction. He said he'd remove 500g from each breast...that's a total of over 2lbs of my chest! They told me from there what I needed to do to get going on getting the insurance's approval.

I had to go to my PCP and get them to back date the referral to the date of the consultation, plus I needed at least 1 letter of medical necessity. The PS gave me a couple of sample letters to help my doctor(s) write the LOMN. Well, I saw my PCP and he said he'd send the referral but not my letters. I was a little taken aback since he'd been seeing me pretty regular with the Phen and I'd told him of my plans to apply for approval for these procedures.

After the "fail" with my PCP, I went to my OBGYN and she said she'd write whatever I needed for the stomach and boobs, and send it over. Phew, well at least I had one letter. I decided I should get a second letter since I couldn't count on my current PCP. I went to my old Dr. who'd seen me as a child, through puberty and up until I got married and moved across town. He only wrote a letter for my breasts, specifically noting my asymmetry (left is 1.5 times larger and 2lbs heavier than right).

I followed up a few times the week of 10/14/13 with the PS to make sure they got all my info and that it was sent off for approval. On 10/24 I got a call from my Aetna nurse coordinator...

My panniculectomy was APPROVED!!!!! But my breasts weren't?????? Let's see, tell me how that makes sense? I have a 15 year history of chronic neck/back/shoulder pain and I've seen eye doctors, dentists, chiropractors, massage therapists, well, you name it to try and treat my weekly Tension headaches, but that's not enough evidence, even with 3 letters of medical necessity (including the PS's)????? BUT my 3 year old skin flap, which I only had 1 additional letter for, plus a short hand note from my current crappy PCP, was approved?!?!?

Obviously I was shocked. I thought I'd be fighting a different battle. I really thought I'd be fighting for my stomach and not my breasts, that was a no brainer. I'm a 34H and I'm 5'2. Regardless of how much I weigh that cup size is too big for my frame. The Aetna nurse told me it was only denied because according to Aetna, based on my height and weight, I needed to remove at least 650g from each breast...She said, just go back to the PS and see if he'd be willing to talk with the review person and explain his case and maybe up his estimate or up the amount he'd be willing to take out.

She also told me that 3 operational codes were submitted - breast reduction mammoplasty (denied), panniculectomy (approved), and abdominoplasty (denied). I didn't know they were submitting the TT - I could have told the PS that it'd be denied my Aetna flat out, every time because the code for that is listed as strictly cosmetic. I was a little frustrated because I was trying to figure out why the submitted a TT when that's not what I asked for - I knew the difference going in.

So I immediately called the PS. My immediate concern was the Boobs. I relayed what the Aetna nurse said about taking out more and talking with the reviewer. And then I said, I need to know how much it will cost IF it's not approved. Then my next concern was the TT added on to the panniculectomy. I tried to get a straight answer on the phone, am I REQUIRED to have the abdominoplasty, if I'm having the panniculectomy????? She just kept telling me not to worry about it. Well that really didn't help me very much, since I was already majorly stressing about the boobs.

So I'm out running errands the next day and I get a call from the PS. She said that Dr. Long didn't think the review would do any good since he didn't think he'd be able to take out more, enough to make them overturn the pending denial. Well that alone made me feel a little hopeless, I understand that Dr. Long is very busy and that he shouldn't waste his time. I'm sure he's had this sort of experience before and knew what the outcome would be if he couldn't go to the table with some compromises. I trust him, but I was still disheartened.

So to that I asked "since I'm getting the panniculectomy, there's cost that over lap, right? OR, anesthesiologists, etc? HOW MUCH will it be out of pocket, taking into consideration it's a piggy backed procedure?" To which she said "$6700". I tried to clarify at that time that it was in fact the additional costs after taking into consideration my other procedure, but I wasn't thinking very clearly and was beginning to break down.

So then I tried to clarify again, did I need the abdominoplasty if I had the panniculectomy? Is it required? She started talking about codes and the insurance company, and I said I know what codes and which is approved and denied...I HAVE TO KNOW is the TT required as part of the panniculectomy? And how much will it cost me?? She said she'd call me back soon, but I should get my appeal letter ready and send it to her asap since we weren't doing the review.

Here I am in the middle of Home Depot having a mental break down with both toddlers in tow, because even though I got the tummy procedure approved it looked like I was still going to have to pay for it, to some extent. I really thought the overlap was going to be much bigger where the breasts were concerned, so that nearly $7k figure fried my brain. And all I could think was that the TT was going to be something astronomical, even given the panniculectomy was covered.

I could barely hold it together as I left the store. I tried calling my husband and emailed my mother. I just couldn't believe, all this way to get the apron approved and dangled in front of me, but to have it snatched out of my hands because it seemed to be lumped with the TT. I'd already underestimated price greatly and I wasn't going to make the same mistake again. I was just going to spiral downward into depression.

I wanted to start my letter but I didn't know where to begin. So I called the Aetna nurse back, since she said that if I had any questions I could just call her. My main question was, do I make an emotional appeal with the letter, at the risk of sounding superficial, or go strictly factual? But I barely got the question out before I started sobbing hysterically on the phone, asking how they could deny a 15 year history of tension headaches and that I meet all qualifications, except the amount to be removed by 18%.

The Aetna nurse is really awesome, she actually works for a division directly devoted to my husband's company and was pretty shocked that I was denied in the first place. She said that obviously this affects me deeply and that speaks to my quality of life. She told me to lay it all on the line, since I didn't have anything to lose at this point.

I wrote my letter, I began with a very emotional plea, emphasizing the hopelessness I was feeling. Getting this letter down was very cathartic and it gave me something to focus on the rest of the day, instead of moping. My letter is 3.5 pages, as I said it start with emotion but gets straight up in their face with the facts, I went point by point on their Clinical Policy Bulletin and outlined all my symptoms and how long I've self treated, how many doctors I've seen, how many OTCs and RXs I've taken...I'm hoping that based on the poor quality of life since the age of 16 coupled with the overwhelming factual evidence, they will have no other recourse but to reconsider.

The main points that I addressed in my letter were regarding the psychological scaring from massive tatas at a young age, how my tatas and borderline body dysmorphic disorder affect my relationship with my husband, my mother's breast cancer history, my sleep issues, asymmetry, and tension headaches. You see, according to my Aetna nurse, even though I know a few of these items were mentioned in various letters, the ICD-9 codes (reasons for medical necessity) weren't referenced on my pre-cert request. And the headaches are the MAIN reason I want my tatas reduced. I've got headaches weekly and I take 2-6 pills daily to combat or eliminate them.

After I've drafted the letter, I read it to my husband. It was midnight or so and he was pretty tired, and then he says, "how long was that?!?!" He was worried it was to redundant or emotional, so I went over what the nurse said. The doctor's have sent the medically factual letters, it's up to me to make the emotional appeal and that's what I did. I stressed and stressed the issues I have and have had over 15 years, hoping that Aetna will realize how much they're actually spending on treating the symptoms of a relatively easy fix.

I sent the letter to the PS office and called the following morning to check that it was received. I didn't want them to think I was hounding, but you know how emails are, one wrong character... So the staff member who answered the phone said can she call you back?

An hour later, while I'm walking around the mall with my kids, I get a call. It's the PS office and FINALLY I have some good news, the TT in conjunction with my Panniculectomy only costs me $500 out of pocket. I'm getting MAJOR cosmetic benefits for $500, that's less than a third of what it costs for stupid Ionithermie (which doesn't work) at the medspas!!

I finally got the answer to my question, NO the abdominoplasty is not required, but if you want the best results it's highly recommended. Even though cost was no longer an option, I needed that answer...it was just driving me insane.

So, this is where I'm at now. WAITING for the insurance to finalize the denial so that we can begin the appeal process. My appeal letter is sent off and ready for the second we get the next green light. My mom has given me a little hope, she was denied with both of her surgeries on the first applications, but eventually it all worked out. I'm trying very hard to be optimistic about this, but I don't want to get my hopes up too much.

Officially sent off for appeals

I just got my approval letter for the panniculectomy and my denial letter for the breast reduction and abdomniplasty.

I've sent my appeal letter and the denial over to the PS office so they can file the appeal. Fingers crossed. I'm hoping that since I've lost a few more pounds since the initial pre-cert request that it may be turned over. Literally the only reason they won't approve my request is that they don't think the PS is taking enough tissue out of my boobs. They require nearly 650g each, based on my BSA, and he applied to do 500g each. This is a 30% difference, but my height was listed wrong and I've lost 7 lbs. That drops me down to 1.74 BSA and Aetna only requires you remove 590g each - now we're talking about a less than 20% difference. I meet every other qualification, over and beyond.

I asked them to consider that they did approve my panniculectomy and that's a significant portion of skin/fat to be removed and would lower my weight a little more.

Additional Lipo Consultation on Monday

So...I had a few more thoughts about my surgery and although I thought I was prepared going in the first time, I have a bunch more questions. Frankly I didn't want to go gung-ho with my first appointment because I didn't want to get my hopes up in case nothing was covered.

So there's 3 scenarios:

1. Breast Reduction denied. So I only have the TT/Panni done on 12/13. This will only cost $535 after insurance covers most of it.
A.) my PS doesn't automatically do lipo with the TT/Panni, so I'm going to see if he thinks I need my flanks lipo-ed. If so, how much extra that costs ON TOP of the $535 I'm spending. I'm worried that my "love handles" will stick out a lot more after the TT/Panni without the flanks being done. I figured if this was necessary based on my current shape that he would have recommended it, but I don't want to assume.
B.) I'm going to also ask about a small amount of lipo on my inner thighs. I just CAN'T get rid of that little jiggle on the inner thighs and I've been in my MBTs and walking since March...I've lost and inch but it's not firming up. I'm not trying to go crazy here, but while I'm under the knife I may as well get everything done, with in reason if I can afford it :)
C.) My bingo wings - HA! They're not that bad, but I'm 31 and constantly lifting babies and they haven't improved either. I'm going to try the homemade body wraps (for my inner thighs as well) to see if it help, otherwise this is an option. If the cost on the lipo on increases a little per each body part (based on time and equipment use) it seems like it would make more sense monetarily to get it all done at once, but I DEF don't want to stress my body too much...this is all just conjecture at this point.

2.) Breast reduction (includes lift) is approved after 1st or 2nd appeal, before 12/13 and I go ahead with the TT/Panni and the BR - BEST CASE SCENARIO!!
A.) Still want to see about the flanks, it's top priority as I don't want my back/middle to look funky after having all the hard work done!
B.&C.) Not nearly as important - so unless the cost is minimal I'm that worried about it. I could always try this at a med spa later on when cash is easier to come by :)

3.) Breast Reduction not approved until AFTER 12/13 - or not approved and I have to save up for it. Obviously I will have already had my TT/Panni (possibly with extra lipo). I will do the BR before the pre-cert expires (or in a few years after saving), so another year from now, when I'm as healed as I can be before going under again. Depending on cost of the lipo:
A.) I'm pretty sure that I'll be having the flanks done - if the PS recommends it and it's not cost prohibitive.
B.&C.) if the cost is more than about $1500 extra, I'll save up for it and have it all done when I go in for my BR...

Lipo Consult

Had my consult this morning.

Yes, if I want the desired smoothing/flattening for my hips/love handles then I need Lipo on my flanks. I'm a little sad, but I kinda figured it. I asked the PS about the transition from my new belly to my old sides and back, and he said that yes, the fullness that is there will still be there after. Even with the TT and the skin being stretched, there wouldn't be any improvement in the hips. Since I have a pretty good amount of jiggle there, he said that it would be noticeable and that he would recommend the additional work. He also agreed with me about the Lipo on my inner thighs.

PS did tell me that I didn't need it on my arms, he said that there was very little fat and that I wouldn't see much of an improvement...so I'm not really sure how to get definition in my upper arms since I've been doing tricep dips along with all other manner of arm work outs...

So, I'm going to look at the $$, but I'm about 90% sure that I'm going to do the additional lipo on the flanks and my thighs. It's a little more than I wanted to spend, the total to be added on to my current out of pocket figure is $3300. BUT the thing is, the Lipo on the flanks would cost about $2700, so it makes very little sense to get the flanks done and not the thighs. And since the only other Lipo I wanted is the arms and he doesn't recommend that, I can't bundle Lipo later to save any additional out of pocket costs.

I have to let the PS know at least 7 days before 12/13 so they can order my compression garments, since I'll need different ones than just the TT garments.

As far as my boobs go, I haven't heard anything back from Insurance. I called Aetna today and the CSR on the phone said that he would "expedite" the appeal. That's not the right term, but he understood that I wanted to get an answer before my surgery date, because if I got the approval it'd save Aetna money by doing all the covered procedures at one time.

So that's where I'm at now. I don't want to half a** it, I don't want to come out with a flat tummy and a lumpy hip and thigh. That really seems like it would be a waste of my time, plus with the lipo this'll take of a little more weight to add to my BR case if the appeal is denied.


So I sent my letter/appeal off 22 days ago. Yesterday, after my Lipo consult, I called Aetna member services, but I also called my nurse coordinator and left her a message. I thought she might be able to tell me more.

She called this AM and told me that my procedure only JUST reached the appeals desk yesterday!! I'm certain it's because I called yesterday, and thank god I did...

I'm just so angry that it's been sitting there for 3 weeks doing nothing but causing me stress! You should see the amount of hair going down the drain when I shower. I'm trying hard not to think about it, but it's hard to be detached and objective. This is not healthy making, all this waiting.

How can they disagree that removing over 2 pounds of breast tissue won't help my neck/back symptoms? I get that 2lbs off an entire body isn't that much, but off a targeted area that projects outward and puts a pull on your spine??? You know what? How's about they hold up a 10lb weight in their hands, directly in front of them...for 15 years. Then I'll swap it for a 7lb weight. Then can they tell me they feel no relief??

Nothing on the Breasts...yet.

Argh! I don't know why the insurance told me to call and check back in a week, the rep on the line couldn't tell me anything. There's no way to check the status and I'll know as soon as it gets approved or denied.

It only took 12 days from submitting the first time, I was hoping it'd be much quicker this time but it's been just shy of a month :( I've only got 2.5 weeks left until my Panni/TT (and yes, I'm doing the lipo) and I just want to know one way or the other before hand.

Argh! Aetna!

So my appeal for the pre-cert on my breast reduction was submitted on or about 10/30. I called after 2 weeks to check on the status - I really didn't expect anything to come of it, since I knew the status would basically be approved or not.

It's a good thing I did call because it hadn't even been to the appeals desk and the nurse coordinator called me to tell me so and that I should follow up every week. Last week the person on the phone said there was no change, or no new information she could tell me.

This week, I called yesterday and the lady on the phone told me that it was still not at the appeals desk and has been bounced around for the past month. This is so frustrating. How is it that my document isn't even in the right place? I've called twice in regards to it, so should it at least be at the appeals desk!?!?!

I'm fine if they don't have a decision, but I'm not happy that they still haven't even put the paper on the correct desk! I'm hoping my nurse coordinator will call me back today with some suggestions on what to do here.

A Little Hope

So my nurse coor from Aetna called me back yesterday. She told me that she spoke with her supervisor and he advised that if I faxed my appeal document to him directly that he would walk the information over to the appeals reviewer.

The nurse coor also stated that the Dr. that normally reviews their pre-cert requests was out and the sub just flat out denied everything based on the guidelines without making any allowances since it wasn't his normal group. Well, the normal Dr. typically makes allowances in the grams, if it's within reason, so she said there's a good chance that if the appeal gets to her in time, that it might be approved since the difference in the required amount and the estimated amount to be removed is so small.

I am a little less sure of success today, though. I followed up with the supervisor today and he didn't really seem "all there". Or as gung ho as my nurse...

Fingers Crossed!


My breast reduction has been APPROVED!!!! I'm super happy and excited, but also very anxious. This is a pretty big procedure all around and I've never been under general anesthesia before.

Less than a week!!

Next week this time I will be recovering and will have a NEW BOD,

Pre-Op Appointment


Hit send before I was done...

So I got all my markings done today and got all my questions answered.

But I'm freaking out a little about the Breast Reduction. You see, Aetna already made a huge concession to agree to the 500g (vs 640g/breast) and my brain has been working overtime playing negative nelly asking me, "what if the PS only gets 475g?"

I'm just so worried that my PS won't be able to get enough out now...

Beyond all this unnecessary stress I'm putting on myself, I got home from my appointments and was putting my little girl down for her nap and I had an accident! I was looking for her binky and either I bumped into the shelf or baby girl did, but that caused a chain reaction whereby a frame fell into a snow-globe and knocked it off the 5 tier bookshelf. The globe landed directly on to my right index finger nail bed. I'm spewing blood (and venom) all while writhing on the floor hoping my husband would get up the stairs as fast as possible (THANK GOD) he was home.

Anywho, I'd been trying to grow my nails out and now I'm actually going to lose a nail!

Can it get any worse?


I was trying to post from the hospital yesterday but I was having a little trouble getting my pics to upload.

When I woke in recovery (where I waited for an hour) I felt a burning in my inner thighs and hips from the Lipo, a great amount of discomfort and pain in my entire torso and a tightness in my chest.

I was warned on Thursday that I'd be in full compression and I might feel like I couldn't breath. But I was to take long, slow, deep breaths to help clear the anesthesia. I don't remember remembering this but apparently my brain is smarter than me and I did a I was told previously. I don't remember anything else of my recovery hour other than being wheeled into my room where my husband was...around 2pm.

According to my husband Dr. Long was very pleased with the whole operation and expects that I'll be very pleased with the results. I dozed on and off for 5h, got up to pee at least 4 times (not easy to move in the abdominal binder, at all) and got discharged around 730/8p.

I could have stayed longer but I wasn't getting any pain meds via IV only fluids, so basically I was doing exactly the same thing as I would be at home... I really do feel if I had an overnight with IV pain meds I'd be in a lot better shape today.

Before I left I was still feeling very nauseated so they gave me a shot of Phenogrin and that helped. I would get nauseous every time I stood to go pee...that last time I stood up to pee I didn't get nauseous, only light headed. Improvement.

So we got into the car and headed home. I threw up in the car about 10min from the house, I caught it in a container, but it was a horrible experience all around. It was quite painful, hurling. But I threw up right before my next dose of Tylenol3, so it was lucky I didn't lose that.

We got home and my kids were still up, on the couch with my mom. It was good to see them but my girl (16m) was not satisfied with her half-assed hug d immediately began screaming for me. My husband took her up stairs, then my son (3y) and got them "out of the way" so my mom could help me get situated.

My girl continued to cry for a long time and it was hard for me, but I tried to tune it out since there wasn't anything I could do. Originally my plan was to hunker down in bed, but it proved to be too high to get in and out of, so I'm camped out on our sectional. It's pretty good since the powder room is only 10 feet away.

The kids finally quoted down by around 1030p so I turned in for the night. I have my phone alarm set for every 4h so I don't get behind on my pain meds, but they aren't working at all. I'm currently taking 1 T3 every 4 hours but after my c-sections I could take 2 every 6, that's seemed to work, but I'm following orders and only taking the one.

My husband retired to our room, but left the door open in case I needed him while my mom slept upstairs to take care of the kids. I got up to pee every hour and a half, it was difficult but not horrible.

I feel asleep after my pain meds at 430a and slept til about 730a, that was a little harder to get up from but it's gotten easier now, through out the day. My main source of pain is my binder. It is bunching and cutting into my ribs pretty bad. I try to adjust it as much as possible without taking it off but it doesn't work that well. I can feel a burning in my incision across my pelvis but I'm not hurting anywhere else. I barely notice my chest in comparison with my abs (there's a little soreness when I get up, but I think that's more from using my arms/shoulders to move). I only feel my hips when I pull my binder down and it's sore like I have a good bruise, which it expected. I feel my inner thighs when I go to the toilet, but again, it's the same as the hips...sore but easily manageable.

Other than that I've had a pretty serious headache. I was combatting a migraine T/W/R and I still was symptomatic before surgery. My anesthesiologist assistant was great, he gave me a little something to calm me down and to help with the headache. It dissipated but came back right after I woke up. My PS okayed my migraine treatments so my husband went out this am for my refill. My head finally stopped hurting a little while ago, so not there's really only pain in the one area- my abs/binder.

I'm also chafing a little under my arms where my bandages and binder are rubbing, but that's tolerable.

I'm able to keep all my food and drink down. Been eating oatmeal, popcicles, chicken&dumplings, saltines and I've had V8 fusion and water.

I'm laying on our chaise portion of our sectional with a bed rest pillow, my maternity body pillow, some pillows under my butt for extra support, I bought a soaker pad (potty training for later with my son) and I have that and towels and sheets covering where I'm laying in case my tubes leak or I have an accident.

I have. Table nearby with my phone/charger, iPad/charge, water, books, Chapstick, pills, I also have been using frozen peas/ice packs for my head and neck which are really sore from strain of not using my abs to get up and down.

I'm just anxious to feel somewhat better....since my head is starting to hurt again. I can't wait until my postop appt on Monday. My breasts will be free and I can see them and take pics. Plus I hope my binder will come off so I can breathe and get them adjusted better.

Another pic

Day 3

I thought I submitted an update yesterday, but it's not here.

Yesterday was INFINITELY better!!! And so is today.

Sat Night I was able to sleep really well. I actually slept through my alarm at 1230a to take my pain pill, I was scheduling it every 4h. My husband woke me, I took my pill and went right back to sleep. I heard the alarm at 430, got up took my pill and went back to sleep, then I slept til 7 when my son got up to play. So that night I slept about 8.5 hours mostly uninterrupted. The rest of the ya was great, there was a couple of times I needed to cough which sucked and I needed to blow my nose, too - that was awful! But yesterday is what I was expecting, soreness and tiredness that was similar to what I felt after my c-section. I didn't have any "pain" except for a mini migraine that popped up twice during the day. That was the worst because normally I just take my meds and get comfy and it's gone in an hour max, but it's very hard to get comfortable with the binder and I'm putting so much stress on my neck avoiding using my abs.

Today, I'm great. I'm still sore but there no pain and my head is much better. As far as my various areas:

Breasts- I itch around my bandages, especially in the back and underarms. There's no pain and barely any soreness. I did have a zinger, but not in my nipple, it was in my underboob. Can't wait to see them today, they are pretty high and tight from what I can see. Around my bindings I measure 38inches, before with a bra on I measured 42.

Lipo- flanks, my back and hops are sore, but I can't see if I have any bruising so right now I'm lead to believe that the soreness is from my tight bindings. Can't wait to get them off for a few seconds today! My hips measure 42.5in around my binders and before I was at 40.5in. Obviously there's still swelling, I'm not getting into a tizzy, I'm just noting facts for my records :)

Thighs- again no pain. There's soreness, but it's def not from the bindings. The binding isn't tight around my thighs, I tried to see if there's bruising but I can't see any. I was 22.5 around my birthmark before now I'm 22 with the bindings. The swelling has definitely increased because yesterday when I stood they didn't touch, but they are touching today.

I see the PS today at 2 and I can't wait to get this stuff off and breath and find out all the crap he took out/off.

Forgot my stomach!

The most important part!

I'm very sore in my muscles and there's a mild burning around my incision, but again no pain unless I'm caught off guard by a cough or sneeze or I have to jerk for one reason or another.

Day 3 Post Op Appt

I was so excited to go to the surgeons office today :). He was like "so you haven't taken any of this off?"

I didn't know I could!! Now that I've showered and adjusted my bindings and I'm in clean clothes, I feel amazing. I'm not good enough to go out anything, but a zillion time better than yesterday!

New Pics!

Morning vs night

So I it felt a world better after the shower but after sleeping I could tell the swelling was WAY down. So I weighed and measured, I'm down to 160 from 161.5 (yesterday am and 164.5 sat) and I still haven't drained my tubes this morning (or gone to the bathroom in days).

I'm inches different today!
Bust 39 (sports bra only, that makes me at 34DD)
Waist 33 (with compression)
Hips 42 (with compression)
Thigh 21.5 (with compression)

I'm gonna email the PS today about putting lotion on my Lipo spots. My thighs look like deflated balloons so I wanna get on top of that now, since the compression garment isn't really tight on my thighs.

Other than that feeling pretty good, my abdomen is still really puffy swollen, but I'm getting a good idea of what I'm gonna look like.

So much going on!

I've forgotten a few things...

Thursday after pre-op I was terrified that if I went through with the breast that it could still be denied after, leaving me a MONSTER bill. I called my nurse color from Aetna and left her a pretty frantic message. She called me back before end of day.

She had good news. Basically, if I understand her correctly, my boobs were approved for reduction regardless of weight removed, based on my other symptoms/history. So as long as the breasts are filled as a reduction claim, they will be paid!

Also I forgot to tell you what happened at the PS yesterday. It was a short visit of al short visits! He unwrapped me- breasts first and helped my put my sports bra on. I was moving my arms and all but put it on myself...he said well, you've got excellent use of your arms unlike a patient he just saw 4 weeks post op who could barely move them!

He said my boobs looked great and I had barely any swelling. Then he had me lay back on the table and took off my stomach binding! Amazing! I was so happy to breathe! He said that everything else looks good too, obviously there's swelling but he was VERY happy. He took 6lbs of skin off!!

So I can't wait for the swelling to go down, I'm already 5lbs down from surgery with swelling and I know he took off nearly 10lbs of skin, fat, breast altogether... So I can't wait!!

Day 5

First day out. This morning I went to Dunkin with the Fam for a coffee and breakfast sandwich, then to Target to pick up a gift for a birthday party this weekend. All in all, we took it slow and were out for about 1.5 hours. I was DEF ready to get back home after that.

I'm officially under 160!!! I was at 158 this am and that's the first time I've been south of 160 since 2009. If you only caculate the weight taken off by my PS (breast tissue, skin flap) that's accurate. But there's still a ton of swelling!!! I can't wait to see what another week looks like.

I finally went to the "bathroom" last night. It was bad but only cuz of the gas pains. I'd done as a few others suggested and took some dulcolax. I've been taking 1/night since 2 days prior to surgery. You can take up to 3 every 12 hrs but I've never really had an issue so I just wanted to make it a little easier.

My inches are pretty much the same today, but the weight was the biggest difference. Also, I'm doing really great with my drains. I've got one down to less than 20cc/day and the other is around 60/day. I'll def lose one on Monday at my next appt, even if the other levels drop, I'd still keep it for at least another week to be safe.

New pics!

New pics

Just over a week! More pics :)

I can't believe it's only been a week, it feels like forever and I'm starting to forget what I was like before!

I've been out of the house nearly every day - the first day out was Wed and that was a little harder than I thought. Then we went to the mall on Thursday and saw Santa (short line) and I tried to return some of the too big bras I bought to Victoria's Secret (yes, I said too big at VS! I never thought that'd be possible!) but the line was wrapped around the store multiple times.

Friday I went back to the mall first thing and was in and out in a few minutes. I took it easy the rest of the day because we had a kids party on Saturday to rest up for. The party went really good but we took it easy the rest of the day, 2 hours of running around after the kids was enough activity!

Today we went out to the store for a couple hours and I got some new nighties/bras! It's so exciting to actually be able to buy something in the store!


I can't believe it's been 2 weeks. It feels like a lot longer, but it's been totally worth it. Monday the PS took off the tape and took out 1 drain. I also don't have to wear the full garment anymore just the tummy binder...but I've come up with my own configuration that feels more secure.

I wrap the 2 ace bandages from my boobs around the lower portion of my tummy (over the big scar) and just covering my belly button. Then I have this Lytess slimming corrective belt (L/XL) that I pull up to my bra line over the ace bandages. It is supposed to have nutrients and stuff in it and is supposed to slim your tummy and thighs if you wear it 24/7. Mine is a few years old and has been washed, so I doubt it has anything in it.

Then I put the big white binder over that - the one my PS gave me, which is basically a postpartum belt.

This is what wear pretty much 24/7, except for showers and I take the white off every now and then to breathe a little better.

On Wed (Christmas) I was down to 155!! That's 10lbs down from surgery :) with 6 of that being belly skin and nearly 2 being boobs.

I've got a ton of pics, my belly scar is looking a little angry but otherwise everything looks great. My tummy is still like completely numb, my tatas are tender and I only have sensation in my R nipple, my left is still asleep.

The swelling up top has gone down a lot, but my belly, hips, and thighs are still big. I bought a new pair of in between jeans, a size 12 at gap which is easily a 10 at Old Navy (gap def runs small). I actually squeezed into both pairs of my size 8 Old Navy jeans that I ordered over Black Friday! I'm wearing medium tops and even a bralette.

I'm thinking my second drain might come out Monday :)) it's down to 25cc, if it gets down to 20 or less he said he'd take it out. But I wanna see it at 10 or less for 2 days - I really don't wanna get drained via needle. So I'd prolly keep it in for another week unless he advises against.

More pics

All Drains Out - Worries about Lipo results.

I thought I posted on Monday after my PS appointment but I guess it didn't save/load.

Any who, over the weekend (12/28-29) I some how irritated my last drain stitch. I only ever had 2 drains and my first drain was out last week (12/23). I was really worried that my drain exit was getting infected because it was very tender to the touch and red. This was a big change from my "normal" state. I called the after hours number on Sunday morning a little before 8am.

Dr. Long called me back within a few minutes. I explained to him what I was feeling (and apologized for calling so early). He said that I probably tugged on the stitch and that's what was irritated - he asked me to cut the stitch holding the drain and said that he'd just remove the drain the next day at my appointment. Cutting the stitch was a little difficult given the location on my side, but I did it and within an hour the pain and tenderness were gone.

Thank goodness. I'm glad I called - I know it wasn't an "emergency" but my worrying about it was making it worse.

Anyway, I went to my appointment and Dr. Long removed that last drain. It was the longer one - it went all the way from my left to right side and it's really good he took it out when he did because (unlike the first one) I felt this at the exit. It was quite tender so I bet my body was starting to try and heal around it.

I had a few questions for Dr. Long about the different textures of my abs, back, thighs, hips, and I'm a little worried that I'm not going to get the results I was expecting. Not that I'm not happy, I am, but I have a feeling that there's going to be a lot of ''pudge" leftover.

He said I was still swollen - obviously. But when I asked him about my upper abs (the little "roll of skin" below my boobs above my belly button) he said that was all me and that it'd come off when I was able to go back to working out. Well, I had a minor amount of pudge up there before the surgery but I thought with the whole skin stretching that it would smooth out a lot more than it appears to be.

Also, I'm worried about flanks. Right now there is NO definition between my butt and back and hips. It all looks like one big butt. It's a little depressing since I had lipo on my flanks. I was hoping, that even with the swelling I'd see somewhat of a difference in over all shape, but I don't feel that is the case. I know I have another 6 weeks until I'm supposed to see real results and even longer for the final result, but I thought I'd see a little bit of a change.

The same goes for my inner thighs - they didn't touch the first day, when I was laying in the hospital bed. But every day since they have still been rubbing/touching. I asked about those too and he said that it'll be like magic - one day clothes will be tight since I'm swollen and then the next clothes will be loose.

I know the Lipo was done - I felt the burning and soreness. The bruises on my thighs are just not finally going away, but I never really had bruising on my flanks. I know you can't go too crazy with the Lipo because of your skin and all, but maybe I didn't ask for enough?

Dr. Long is very dry, sarcastic, and is a straight shooter - he's not one to elaborate or to give an over abundance of information. He doesn't withhold anything, but I wish he were just a little more loquacious. Maybe I'm not asking the right questions. I have no complaints about him or his work, don't get me wrong. I know I'm a fast healer but my amazing recovery has got to be just as much a direct result of him being an amazing surgeon.

Alright, well, I'd appreciate some feedback on the Lipo. Did anyone see something similar?

Oh yeah

As long as I have no fluid build up, I will be cleared for active duty on Monday! I can get back to the gym - I can't wait to get my 30 min to an hour by myself to read and walk!

I'm already released to pick up the kids as long as it doesn't hurt. I never really pick up my son anymore because he's 3 but my girl is definitely glad I can pick her up now. She has completely revolted against my husband at nap and bedtimes - she knows I can pick her up and takes advantage.

Freedom :)

Saw my PS on Monday, I am free to work out and basically do whatever I want to do :)

Last week my drains came out and I was allowed to pick the kids up as long as it didn't hurt. And I was told I'd get to go back to the gym as long as I had no fluid.

Well, I have no fluid! I was very diligent and measured morning and night to try and catch and swelling/fluid build up ASAP! I marked on my body where I measured so I would do the same two spots twice a day. I fluctuated a half to an inch from morning to night, but over the week my am measurements only hovered around 33in in my upper torso and 41in for my hips. I would have liked to see it go down, but I was happy it didn't go up so I'd be released to normalcy :)

I asked about some redness on my tatas and he said it was normal. I also asked about my "bump" under my belly button. He said that it would be there for about 8 months because it's swollen but not from "swelling" as a result of the trauma. What is left there bump-wise is lymph and will gradually dissipate as the body heals completely.

As for the lumpy back, he said that it is still swollen and should got down a bit more, is I'm just excited to start seeing improvement there. I don't have to wear any more compression, but my tummy still feels jiggly and numb, so I bought a new garment. The spanx just aren't cutting it.

I bought a fajas Colombians from CaribbeanShape (MariaE) on Amazon Marketplace. I got it in L and it was so small, I was able to zip it but I couldn't bend over. I contacted them about the size and returning it. They were really helpful and courteous and directed me to a better style, on with all hooks that I could get an extender for. I should get it today or tomorrow. I can't wait to try it on and take pics. I got the first one on and put my new jeans on and they were HUGE!

Other than that, feeling good. I'm still tender on all my incisions and the tissue is still tender if I bump into something of if the kids need to be picked up, but I think another week or two and I'll be in top form.

With clothes on :))

I look a lot better with clothes on:). These are my size 31r jeans from gap, they're about a size 12, but they're loose. When I walk they fall off my but, so I could probably squeeze into a 10 at gap.

When I pulled these up under the Fajas, they were HUGE. I could easily fit into an 8!

Working out, etc. in the New Year

So I finally started working out again. I'm taking it easy, but I was given the greenlight and I was tired of seeing the scale creep back up thanks to the exercise restriction and the holidays!

My biggest obstacle is physically getting to the gym, with two toddlers and a husband who is away from the house from 7a to 7p, actually going to the gym and not breaking the bank is a big deal. So I bought a ton of small fitness equipment on sale, thanks to the new year. I have a few apps and cash back programs that I'm going to use to pay myself back at the end of the year - PACT is awesome because you wager each week how many times you're going to work out. I you make it every day you said, you don't owe any money. If you miss a day, you pay per day you miss. The winners are paid from the loser pool.

I got a mini elliptical and it's awesome. I used to have a big one but it was loud (hard to hear the TV or use when husband was sleeping) and it was, well, BIG! This little guy is awesome:

It weighs 25lb and tucks into the corner of my Master but I can put it in the closet if company comes. It doesn't have the arm bars - so you don't get that added calorie burn but I think you can buy them to add on or there is a slightly more expensive model that has them - or you could just use weights. Anywho - the biggest complaint for this guy that I read in online reviews was that it was hard to keep your balance. I don't find that to be the case, but beyond that, keeping your balance would be the whole point of having an elliptical without arms so that you're getting a constant core workout. Most reviewers said they just put it near a wall or the sofa to use for balance as needed, but I find that I only need to hold on while getting on to it, but afterwards (I have pretty good balance and center of gravity) the workout is smooth enough for a $90 machine. It's not as smooth as the elliptical at the gym but it's really amazing for $90. The other complaint was that it broke, well I solved that by spending an extra $7 at Target for the 2 year warranty/service.

I also got a weighted hula hoop - still can't use that! A medicine ball and a pilates ring. I'm using the medicine ball to work my core doing this exercise - the Seated Russian Twist: http://www.fitsugar.com/How-Exercise-Medicine-Ball-Home-25821690

You can do it with your feet on the floor or off, but it's a good way to work the core with out the "sit up" or "crunch" which is still really difficult for me right now! I still have to roll out of bed, just plain sitting up is still hard.

My husband and I tried to do chest throws (very carefully) with the MB and everything was great until I missed and got hit with the ball in the stomach - I deflected a lot of the weight but that exercise is tabled until much later.

I'm using the pilates ring as a thigh master - it's only got medium resistance so it's pretty good after about 20 reps I'm feeling it!

Overall I don't have any additional soreness from exercising. My skin is still very tender around the incisions and on my back, hips, and inner thighs from the lipo. If I hold my 20lb baby on my hip it's tender, not painful but it still feels bruised. That's just about everywhere that I had surgery with the exception of my center abdomen which is still numb.

I'm wearing the Fajas Columbianas from Maria E. I ordered another one before this one and it didn't cover my thighs and I couldn't bend over in it. I got this one: http://www.amazon.com/gp/product/B009AH6I9G/ref=oh_details_o00_s00_i00?ie=UTF8&psc=1

in Large, but I ordered the extender. The Large has 4 eye hooks and so does the extender, so a total of 8 rows of hooks. I'm on 6 wide right now and I want to try and tighten it by one row each week. It's really great and shapes me really well. What I love most about it is that is has room to allow my butt to fill OUT. My butt was feeling really flat and was blending into my back with all the swelling from the lipo (or what I hope is still swelling) either way this gives me a butt and shapes me beautifully. I still have the problem with my waist really nipping in right under my ribs -so the garment bunches a little but not nearly as bad as my other garments. I guess this is just a problem with being on the short side.

It finally fits... AGAIN

Within 3 months of my wedding I already gained so much weight that I couldn't fit into my dress. I'd gone from 150 to 180 in no time and despite working out and not eating any differently than before, I couldn't get the weight off. Add 2 pregnancies and well...

I was really hesitant to try my dress on because I'm still a few pounds heavier than I was and I needed a girdle/boustier in 2008!

Imagine my delight when it went on without a hitch!

6 Weeks - Photo Update

7 Weeks

Checked all my measurements today, I weigh 157. I creeped back up over new year to 161, before I was able to resume going to the gym. I've been trying to keep my calories around 1400 during the week (including my exercise credit) and I let myself have around 2000 on Saturdays, my splurge day. This keeps my average to about 1485/day for the week and puts me at losing around 1lb a week.

Around Bust - 39in
Under Bust - 33in (This makes me a 34DD)
Natural Waist - 30in
Hips (tips of my incision) - 40.5in
Upper Thigh - 23in
Mid Thigh (at birth mark) - 21.5

I'm still waiting on my thighs not to touch, but I have actually measured improvement on my thighs. I thought my mid thigh measured at 21.5 before, but it was 23.5 according to my notes. So there has been a change in my thigh size, but the tops are still touching. I'm not sure if they're ever NOT going to touch, I'm going to ask that specifically at my next appointment in 2 weeks.

I remember asking about my various areas for Lipo and Dr. Long warned me off the triceps, but he saw that my thighs were touching and he said he could take care of that...so I'm hoping that it does mean they will eventually not meet.

My husband and I are getting our first date night since November, so that's pretty exciting. Got a lot of cleaning and stuff to do, too since my parents are watching the kids overnight and most of tomorrow. Hoping to get some real cleaning accomplished since I won't have to manic toddlers running around.

18 Month Photo Update

Houston Plastic Surgeon

Dr. Long has been great, as well as his staff. I am so beyond happy with how well my surgery and recovery have gone - I am a fast healer but I have no doubts that everything is going so smoothly because of Dr. Long's expertise. I would recommend him in a heartbeat.

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
5 out of 5 stars Wait times
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