Not At All What I Was Expecting; Several Complications; Seeking Revision - Lutherville, MD

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Prior to having this surgery, I had tried diet,...

Prior to having this surgery, I had tried diet, exercise and shapewear to get rid of my post-baby "jelly belly," which was considerably worse after having my second child. Finally, resigned to my fate, I did extensive research on the procedure and saw six surgeons before selecting Dr. Shermak. In choosing a surgeon, I had many considerations: 1) I wanted an experienced surgeon who does many of these surgeries; 2) a short surgery time (for safety reasons); 3) a pain pump; 4) to be able to go home the same day and not stay at the facility (for safety reasons); 5) the smallest amount of liposuction possible (not a fan and did not like what I had read about it); 6) a TT performed using drains (performed by most PSs and generally considered the safer way to do the procedure over the drainless TT); 7) cosmetically appealing scars (not a fan of the “W” shape, scar low enough to wear my target panties) and belly button (looking for a “natural” looking one; 8) a standard, hip to hip TT (versus an extended TT, where the scar extends past the hips to the back side); and 9) a surgeon who is OK with doing minor revision, such as fixing the “dog ears” common to this surgery. I asked lots of questions and was assured that everything would be the way I wanted it (with the exception of the belly button, where Dr. S. did not promise that the belly button scar would lay inside the belly button). I did more homework, checking the doctor’s credentials, the ambulatory surgical center’s credentials, and reviews on Real Self. I went into the surgery very excited and hopeful about the results, feeling sure I would obtain my desired results.

Note to other Real-Self readers: a con of this surgery is that it is very major surgery. This was the longest recovery from any procedure I've ever had including childbirth and other plastic surgery. It took me four months to fully recover from the liposuction and recovery from the muscle tightening is one year. I am still working on the large and painful scar above my pubic region which will either be removed by being cut out or get broken up by a cortisone shot. (You have to wait six months to do either of these interventions.) Have already tried massage and ultrasound to break up the major scar tissue. I also got a secondary infection that would not go away from taking the antibiotics because I did not take a probiotic (forgot).

Not What I Was Expecting; Several Complications; Seeking Revisions (update

Saw my derm and a PS about getting some of this taken care of. Specifically I wanted the area in the first pictures I've posted, which is just above my pubic region, taken care of because it causes great discomfort. The deem, who had previously stated that he could look at it at six months and do some cortisone to break it up, clarified that he was actually talking about the accompanying TT incision scar. I said no, that's not healed yet and I think it will probably heal well. (This was based on my BR scar. I'm treating the TT scar the same way, so I'm expecting similar results. The BR scar took 18 months to fade.)

Saw the PS that I had used for the BR today. The good news first: he should be able to do something with my uncomfortable area just above my pubic region and the weird flap of skin on my left hip, which I was told by the other surgeon is my fat that "needs more liposuction" is a dog ear and he should be able to take care of it. The bad news: my new (old PS) wants to wait another six months for more healing to occur before he is willing to talk about doing the dog ear or the fat necrosis above my pubic region. A second bit of (very) bad news also: as I had suspected, there really is nothing much he can do about lowering the really high TT scar. He is unwilling to try. He has stated that the scars should heal well and not be as visible, but I know you will always be able to see them if they're not hidden by clothes, which they aren't unless I'm wearing full coverage granny panties (EW!). Further, I'm in my mid-forties so I was looking forward to this operation so that I could wear (and look good in) some sexy panties before I hit menopause and my waist widens again. Looks like I will have to content myself with buying hi-cut lacy briefs

11 Month Update (New Pictures

I was asked by others on Realself to put up some pictures.

Scar is still way too high. Have appt. next month to have something done about dog ears on each side. Have not changed since last posted, unfortunately.

Drain scar looks better but still need to treat everyday. This is one of the "extra scars" I got from this surgery along with an odd one that looks like my drain mark on my left where it looks like the doc made a cut, then changed her mind. (Isn't that what the surgical markings are for?)

The scar tissue from the fat necrosis is down a lot now from constant massage. Sex is fine now, but there is still a very nasty bruise right above my pubic hair that I'm not at all pleased to have.

Maintenance everyday on the surgery is scar treatment two times a day and daily massage of scar tissue. Scars have not faded near what I'd want them to considering how high they are, so no chance of wearing bikini bottoms to the beach anytime soon ;(.

More Pictures

Went Today for My TT Revision Consult - Tummy Tuck (Lutherville)

To try and summarize a 45 minute consult with this PS, he gave two options, both involving lipo to fix my new "love handles": a) smart-lipo in-office, local anesthesia, lipo flanks and b) lipo of flanks, excision of some skin with full anesthesia, hospital. Since I'm not at all a lipo fan and was told earlier in initial consult that making my scar longer would be an option (at least on the one side, I was quite confused. Doc got a better look today and does not want to extend the scar at all since he says correctly that it's too long (since I'm not a morbidly obese patient) and too high (his are much lower, though this is of no-comfort since I don't have a working time machine and Dr. S.'s pictures online at the time showed very low incisions). Scar on both sides extends beyond my hip (farther than promised at consult with Dr. S. ) and goes to the beginning of my back on each side. I have not heard good things about Smart Lipo in terms of the realself reviews and was warned today by this doc. several times not to take the cheaper option, but he also says he's a minimalist and likes to do the option with the least work which is the in-office option. I'm very freaked out, of course since lipo is by no means a perfect science and IMHO doesn't actually remove fat. The fat goes right back on in another place and now you look out of proportion (since it appears I'm really supposed to have "child-bearing" hips. I did mention wanting to keep my curves. Doc wouldn't show me any pics. (which made me quite nervous, as I'm sure he has to have lipo. flanks pictures) and assured me that I wouldn't look square or boxy at the end. At this point I'm up for suggestions from this community. Options as I see it are: 1) get other opinions for a revision from PSs who I haven't seen or used (this guy I used for my BR, but I was still uncomfortable at the consult); 2) book personal training sessions to try and get rid of fat the natural way, knowing this is a particularly difficult area (bottom of flanks/hips) to get fat to leave); and 3) leave it alone and accept my new love handles as the price paid for a flatter (still not flat but better) tummy. Any ideas, folks?

I was very disappointed in this experience. Specifically I was extremely upset with how the surgery itself was run, the technical work that was done, the after-care, the difficulty getting questions answered and the doctor's bedside manner. The surgery itself seemed fairly rushed to me. My husband and I arrived on time, despite a 45 minute commute and snow; however I had to wait two hours prior to the start of surgery. During most of this time I was disrobed (as requested by the staff) without a blanket until the very end. Apparently the staff had forgotten to request an anesthesiologist and they were booking one as we waited. After a very long wait, Dr. S. came in and made her surgical markings in about five minutes. We were rushed into surgery and rushed out by the staff. I was asked to get up before all of the anesthesia had worn off and I couldn't wake up; my body was too heavy. I was then rushed into my clothes by a nurse who absolutely refused to allow me to wear my underwear (kind of important when you're bleeding from your abdomen afterwards!). She also rushed us to the car and refused to help me into the back seat where we felt I could ride more comfortably for the long drive home, which we had explained to Dr. S. we had concerns about. The nurse also forced me to take a medication that I didn't want to take because it interacted badly with another prescription. I had told Dr. S. and she gave us another prescription when we arrived that day. The nurse, who apparently had not spoken to Dr. S., bullied me into taking it. Another area of concern I had was the technical specifics. Dr. S. rates herself as extremely competent and takes the technical book she wrote to all of her consults and shows pictures from it. Unfortunately, I did not have the sense that technically this was a great job. As previously mentioned Dr. S. made her surgical markings very quickly in about five minutes. Because I was so stressed about the long wait before she came in, I forgot to talk to her and show her how low I wanted the scars with my panties prior to her making her surgical markings on my skin. She did the drawing and then I showed her my panties. She looked at my panties and said she could redo the drawing if need be but actually it looked perfect and many of her TT patients wear thongs afterwards. I was horrified when I first saw my tummy. The scar is uneven and very high. On my left side it's only an inch below my BB; on the right it meets the bottom of my BB. This had very unfortunate consequences in my healing. The staff, used to the markings being correct, places each drain an inch or two under the incision so my drains were also an inch off (one an inch higher than the other). This caused horrible discomfort for me as when I wore the binder the drain on my right side rubbed heavy on the binder and epifoam causing a lot of pain. I also noticed several track marks from the lipo which I mentioned to Dr. Shermak who said she would revise if need be but it wouldn't need it. I have what looks like a dog ear on my left side which she won't revise. (She claims this is fat that needs liposuction at my cost.) My belly button, which is a little on the large side to be natural, has a very obvious scar on the outside and there appears to have been some major bruising. No way I'm baring my navel anytime soon aside from the huge scars I would have to show to wear a bikini. There is weird dimpling in my ribs making them look unnatural. Also the skin on my right hip is actually set back farther than that on my left. (The scar on that side goes several inches past the hip where it stops pretty close to the hip on the left side.) I also have an extra incision mark (scar) above where the incision is on my left side. It appears she started making a cut and then realized she was actually over where her markings were. In addition, I feel that Dr. Shermak performed tummy liposuction without my consent that was unnecessary if she had removed enough skin with the tummy tuck procedure. She claims the very hard skin above my pubic area is from lipo in the hip area but all of my symptoms (dark purple pubic region labia after surgery, the hard skin in that area (a fat necrosis) and the discolored skin I have in my crotch area and heavy trauma to the skin itself, point to tummy liposuction. This has caused a lot of pain and discomfort which I'm still having today at six months from the surgery. I was quite upset about this because in the consult I refused Dr. S.'s offer of removing my back bra fat with lipo, and I stated that I don't believe in liposuction but if it is necessary for a good result, do as little as possible. In conclusion, this is not the work I would have expected from an experienced plastic surgeon who performs a lot of these surgeries and has written a book on plastic surgery. The after-care is awful. The care instructions were incomplete (did not include any instructions on bandaging). I had to ask multiple questions about routine things that should have been in the care instructions. During consults, Dr. S. did the re-bandaging of my TT scar very quickly without sticky medical tape, so it fell off immediately and had to be redone. (Bandaging was a very time-consuming process and diffcult process in the first couple of weeks.) One particularly egregious example of the after care was obtaining the Step 2 garment. This was a huge chore. Dr. S. gave vague specifications for a garment on little notice. (She sent an email on Sunday when I needed the garment for Wednesday of the same week. I called her staff, Ann, who is supposed to be available for questions like this, to ask for more specifics. Ann referred me back to Dr. S. I spent a lot of wasted time shopping locally that week for a needle in a haystack. When I came in with something that I thought met the criteria she introduced another criteria, no elastic at the waist, which eliminates most girdles you would use and no crotch hook closures. She did not either of the two garments I brought in, though I didn't have all the information. She visibly lost patience with me and gave me a brochure for a very specific product that I could only order on the Internet. It is a specialty item and is not sold locally. I spent more time that week shopping and bought a shaper by a brand she had recommended (Wacoal) since the other had not come in yet and I wish to stop wearing the binder which was causing much irritation to my tummy lipo area. The Wacoal did not work and had to be taken back. In total, I bought four garments that all had to be taken back and wasted a huge amount of time. A second particular egregious episode of after care came when I was worried about a seroma. I had some symptoms of what they had mentioned on the web which was considered serious. Both the internet and the written care instructions said to contact immediately if any symptoms of seroma were present. This was between my appointments, so I called. Dr. S. was not on-call, so I got her partner, Dr. Basner, who was very short with me, didn't answer any of my questions, reprimanded me twice for calling saying, "This is not an emergency." He said he'd tell Dr. S. I called and hung up. I felt I was treated very unprofessionally the one time I called for what I viewed an emergency. The whole rest of the time I took pictures and emailed Dr. Shermak if I had concerns between visits. I also found in the after care that, though Dr. Shermak responds quickly to her emails, she often does not really answer your question. Many replies were short and evasive. I also got the evasive response, "We can talk about that when you come in." When responding to my question of whether my scars could be moved down because they were so high (in my research on RS, occasionally they can if there is loose skin), she told me not to worry about them and said they would fade to white in 10 months. I guess this was a positive spin she was trying to put forward on a "no, I cannot move them down," but she did not directly answer my question. I had many other experiences like this. Sometimes I got incorrect information as when I was told around three months that the liposuction should have healed and I didn’t have to worry about elastic bands on pants or underwear. I had problems after she said I was OK and had to put on the epifoam and binder again to correct the deformation the elastic caused to the contour. As far as her bedside manner, Dr. S. was often short with me and really lit into me on several occasions causing me some anxiety over my visits. I did not find her sympathetic when I told her about suffering or discomfort; instead she tended to criticize me.

2 out of 5 stars Overall rating
1 out of 5 stars Doctor's bedside manner
2 out of 5 stars Answered my questions
1 out of 5 stars After care follow-up
2 out of 5 stars Time spent with me
4 out of 5 stars Phone or email responsiveness
3 out of 5 stars Staff professionalism & courtesy
3 out of 5 stars Payment process
4 out of 5 stars Wait times
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