Treatment Provider

Michele A. Shermak, MD
Board Certified Plastic Surgeon
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November 9, 2010 I am now 19 days post TT! I...

November 9, 2010

I am now 19 days post TT! I can see I actually have a waist again. I had my last drain out last week. That was a freeing moment. I am still walking hunched over. The PS said she took off "a lot" of skin. I think I am 2 inches shorter. LOL When I look down my tummy is smooth and flat ( though the skin is still swollen). I read some peoples comments about their pubic area swelling like a softball. I wanted to mention that the morning after my twins were born they were bringing in groups of nursing students to show them how the how swollen my private parts were! So now in comparision my pubic area looks great. Also update on pain medicine...I tried only taking motrin after 1 week but it didn't fly. At the end of the day I have been taking one Percocet. Hopefully I won"t need it much longer. My scar is healing nicely. She put Dermabond skin glue on my incision and it is starting to peel off. Underneath the scar looks good. However, I am still pretty swollen. I have succumbed to the superwoman syndrome and have been running around for the last 6 days. ( Stopping in at work, doing housework, doing errands for our bathroom renovation, buying paint and hardware, talking to contractors, driving kids to tutoring etc...) I am moving around much more slowly than usual and only getting about 30% or less of what I usually do. I can't imagine going back to work after 2 weeks. Kudos to those of you who have! I will try to be patient and realistic. My hubby has been very helpful with the kids even though he works a lot. My children are even trying to be more cooperative. I am hoping for an energy breakthrough soon....

I find I am getting tired easily. My son was reading to me this afternoon and I fell asleep in the middle of the story.

October 28, 2010 I am Post op day 7 of...

October 28, 2010
I am Post op day 7 of abdominoplasty, lipo, upper and lower blepharoplasty and fat transfer injections to the nasolabial folds (the line that goes from the nose around the mouth. So far I am very glad I did it.

My advise in a large nutshell: 1. Get a good and qualified plastic surgeon with proper training and credentialing. Ask doctors and nurses you know for "the inside scoop." It's always good to get an opinion from people who have seen various outcomes or worked with the PS in some capacity. (I would also suggest contacting the chairman of plastic surgery at a top notch teaching hospital and see who they recommend in the community.) Then you can interview the various PS's. 2. Get or rent a big comfy recliner chair. Or rent a hospital bed for 2 weeks. 3. Make sure you can take off from work for at least 2 weeks. I am thinking 4 would be best. It sounds like some people go back in 2 weeks, but why not give your body more time to heal when you've already made the investment in yourself. 4. Make sure you have help at home and especially if you have young children. 5. Only let supportive people visit you. 6.Take extra Vitamin C. I realize there is only anecdotal evidence that this helps post op healing. I suggest doing it unless you have history of kidney stones. I've been taking 500 mg 4-6 times a day.

I am an active professional 48 year old mother of 3 children. I have a girl age 11 and twin boys age 8. I was very large with both of my pregnancies. I am normally 130 lbs, 5 foot 4 1/2 inches and went to 160 with my daughter and 175 with the twins. Well you may say that seems normal. However, I was one of those people was was "All Baby". My belly was huge and enornmous respectively. My twins were born at 38 weeks by vaginal delivery at 6 lbs 12 oz and 6 lbs 9oz. Since they were born I noticed how lax my belly was and how many rolls were above and below my waist. (It was like I was wearing a buffet of pot roast and several large muffins). I had rolls at the top and botom of my underwear, above my waistband etc. Clothing shopping was a challenge because if the waist fit the hips and thighs were 2 sizes too big. Essentially I have wanted a tummy tuck since they were born. 8 years later I finally have had the financial resources, the time and the nerve to move forward. (And the boys are a little more manageable). I decided to get the eye surgery at the suggestion of the PS. Also the elementary school lunchroom lady asking me repeatedly if I was the boy's grandmother helped my resolution to have the proceedure.

The weeks before the surgery I was running around trying to get lots of things done for the household as I knew I would be out of commision for some time. I was very anxious leading up to it. The morning of the surgery we got there and the staff brought me and my hubby into a small room where I changed into a hospital gown and put on compression stockings. One of the women took the "before" photos. The doctor came in and answered all my questions and proceeded to do the skin markings. She was very confident, reassuring and professional. (She was referred to me by my dermatologist/friend who told me..."I've seen 'em all and she does the best TT around here".) The nurse anesthetist was also terrific. I have asthma and had no complications or wheezing after the surgery. Nor did I have a sore throat which some people get from the intubation. Once the anesthetist gave me some versed I felt woozy and then Bam! Operation complete and waking up in the recovery area. Pain in my abdominal wall and flanks was severe. My eyes didn't hurt at all. I looked like Frankenstein. My eyes had lots of black sutures along w steri strips to hold the end of the top lid sutures in place. My lower face was swollen. And there was bruising around my eyes and cheeks. I had my twins go to grandmas for a long weekend. I think my daughter was a little freaked out by my appearance and she told her brothers that "Mommy looks kind of scary". My hubby has been a good nurse and helper although he had to go away on business on day 5. I am lucky to have such good in laws and friends who have pitched in. I had 2 abdominal drains and a Marcan pain pump. I think the pain pump helped pain from the skin. I can't tell if it improved the pain in my abdominal muscle. The PAIN in my torso was significant. It hurt to move even the tiniest bit. Walking to the bathroom was an event. I had awful pain in my lower back and neck which I think was from sleeping in the recliner and not being able to move normally. Also the "love handle lipo" area was really sore. The worst part was the first 3-4 days. I took all the medicine she directed me to take. I took the Dilaudid on a schedule. I did feel MUCH better once I started ibuprofen. For some reason I thought had to wait a few days to take it because I thought it would increase risk of bleeding. I called the PS and she said no that I should take the ibuprofen and the narcotic pain relievers and that the ibuprofen also has some anti-inflammatory properties that are helpful. I started weaning my self off the dilaudid on day 4 and stopped taking it day 5. I had some percocet 5/325 leftover from the bladder suspension I had last year and used that on day 5, 6. Now I am just taking ibuprofen. I took colace and ate lots of fruits and veggies and bean soup. It did help with constipation but not the gas. The PS also prescibed Arnica jel for the facial bruising and swelling.

Yesterday was my first post op visit. She thought I was healing beautifully. She removed one jp drain (looks like a grenade with a tube attached). There was an ouch moment but mostly it just feels weird. She took out the blepharoplasty stitches. She looked at the TT area. She glued the skin there and the stiches are underneath and absorbable. The umbilical sutures are looking good. I think she 'll take those out along with the last drain next week. I took out the pain pump myself yesterday morning before my appointment. It did not hurt.

I will make another entry after my next appointment.

Provider Review

Board Certified Plastic Surgeon
1304 Bellona Ave., Lutherville, Maryland
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Overall rating

She has lots of experience and excellent training and credentials. She responds to concerns either by phone or email very promptly. For a long time she did the body work on post bariatric surgery patients. She is current on medical and surgical standards. She has published numerous papers. AND she has common sense.