Elective surgery with fibromyalgia? Worth it

Part 1: my experience with Dr. Weintraub of Duet Plastic Surgery.

I had 3 different consults and picked Dr. Weintraub even though she was the furthest from my home, because I loved the aesthetic results I saw on Duet's website, and felt that she had taken my health history more seriously than the other doctors. I also appreciated that she and Dr. Lim were a team in the OR.

At my pre-op, I felt she was clear about her expectations while also listening to me well. We had a serious, in-depth conversation about how muscle repair related to fibro and another aspect of my health history. She had some concerns that it could negatively impact my health and that fibro would make it a very difficult recovery, and I reminded her that feeling stronger in my body is what had brought me to this surgery in the first place (more on that in the next "chapter"). After more discussion, we reached an agreement on how she would handle this in the OR and what my responsibilities were after surgery to protect my health (non-fibro health aspect). She also reiterated that my breast lift would involve a reduction to one side as I had about a cup size difference between my breasts.

Day of surgery, I'd expected to be nervous but was actually feeling calm. If I had been nervous, her demeanor would've been helpful. We just chatted about our kids while she marked me up, so that would've distracted me from any nerves, I think. The nurse and anesthesiologist at the surgery center also had reassuring demeanors and their professionalism also instilled confidence.

Post-op, she's also been reassuring and encouraging, and quick to respond with advice when I had questions about my recovery. Commuting far from my home for appointments has been a pain but worth it for the faith I had in the practice's safety and the results. I will say I'm glad she's within driving distance though. I wouldn't want to have a surgeon too far to go to for follow-up if there were complications.

She extended the scar around my hips further than expected in order to achieve a good shape, which she told me when I was in recovery. It's exactly what I would have wanted her to do, but I know some people would probably have a problem with waking up with more scarring than they expected. I would guess most plastic surgeons would make the same decision under the same circumstances so I would recommend anyone who would absolutely not want this done (not just patients of Dr. Weintraub but anyone) should have a big conversation with their doctor about exactly how much of a scar you are okay with.

I'll let the results speak for themselves. I still have swelling, but wow. I'm still in disbelief about how good I look and excited to see the final results.

Some of this is fibromyalgia specific but TBH a lot of it applies to anyone. Maybe some of it is over-sharing but I'm trying to give info that I searched for and had trouble finding. The short version is that recovery has been a lot easier than I expected (but to be fair, I was expecting it to be really bad).

I spent years thinking about a breast lift and/or tummy tuck but worried about the risks and also thought, "I don't need any more pain in my life so why would I have elective surgery?" Then, I was researching muscle repair surgery because I figured maybe I could reduce some non-fibro back pain by helping my abs, and upon learning that it's usually done as part of a tummy tuck and it's usually the most painful part of the tummy tuck, I was in for the whole thing. After Dr. Weintraub assured me that the breast lift would be the least painful part, I tacked that on too. She recommended that I see my neurologist to make a plan to use my existing gabapentin prescription as part of my post-op pain management. This was a huge help and I definitely recommend it if you have any pain condition that you're using gabapentin for.

It turned out that for me, the muscle repair was not the most painful part. I guess this shouldn't surprise me, but I've had the most pain where I have the most fibro pain - across my hips - so the flank lipo has actually been the most painful. The muscle repair pretty much only hurt mildly unless I sneezed, coughed, or laughed, which fortunately I didn't do much of (I acted like it was 2020 leading up to my surgery to avoid getting sick and avoided watching comedies in recovery). And of course I also didn't use my stomach muscles for anything. Now at 4 weeks it's the same. I hardly feel the muscle repair, still very tender over my hips, but just to the touch. It no longer hurts if nothing's bumping it. Feels bruised but visible bruises resolved long ago.

I had exparel and I'm sure that helped. I did have some mild dull pain for a few days in the muscle repair right after that wore off, and also strange wiggly/tension feelings through my abdomen. I started having more pain around incision sites on day 5. I had a little bit of electrical/vibrational sensation in the skin all over my belly starting also starting day 5, and a slight burning sensation sometimes anywhere that was having swelling. I think that lasted about a week, maybe 2. I had swelling a lot below my armpits from the braline lipo, that seemed to get trapped by my first post-op bra which had a tight band, so that got better after I swapped out for some seamless post-op bras without a separate elastic band.

A few non-pain recovery notes -

I was SO hungry, not in stomach but in body sensation. Sometimes suddenly and with nausea/shakiness. For the first week, I was eating and drinking every time I was awake b/c my stomach also felt full easily. This all has gradually lessened. I still think I'm a little hungrier than normal even now at 4 weeks post. Having protein shakes to grab helped a lot during those sudden horrible episodes.

I got my period on day 3. I had drains in the pubic area and had been going without underwear. Using very loose underwear that I could keep down around my hips so it wouldn't touch the drain sites (because it hurt when they moved), with pads that I had to change very infrequently was helpful. I am normally a menstrual cup kind of girl and there is no way I would have been able to reach in for that on day 3.

Speaking of which, reaching to wipe was the worst part of pooping. I managed to avoid constipation and actually going didn't hurt at all, but reaching was hard! Felt that in the muscle repair and I think tenderness in the skin whether due to swelling or just the repositioning. If I had to do it over I might have bought one of those reach assistance "toilet aid" devices. Whew. I took citrucel starting a week before surgery and started docusate sodium the day after and I'm sure that helped with avoiding constipation.

It has been taking more time for my scabs to go away than I expected, but Dr. Weintraub has reassured me via photos that everything is healing well. I'll attach a few photos here b/c it seems like most of the photos I found were of problematic healing but I think it's nice to see normal healing too since it is a little scary not knowing what's normal.

Here's a little more about recovery especially in terms of what I needed for pain relief -
Day of surgery and day 2, I took percocet every 6 hrs and double my usual Rx of gabapentin. Returned to the office for removal of breast lift drains on day 1.
Days 3 and 4, I only needed tylenol every 4 hrs plus double my usual Rx of gabapentin during the day, and took percocet once at bedtime and once upon waking overnight.
From the 5th day after surgery onward, I didn't need any percocet, but was still using Tylenol every 4 hrs and double my normal amount of gabapentin.
Day 9 was my post-op, tummy drains and all tape removed. Dr. gave me the go-ahead to alternate tylenol and advil instead of just using tylenol.
Day 14 starting to turn another corner, started slowly weaning back down to my normal amount of gabapentin.
Day 16 really starting to feel like I can do everything normally as long as they are not up too high, down too low, or lifting things I’m not supposed to.
Around 3 weeks, needed a couple days of a lot of rest after doing too much around the house. Still having a lot of tenderness at lipo areas. Only taking tylenol in the morning and at bedtime, and advil once in the middle.
At 4 weeks, other than lifting I'm pretty much self-sufficient. Taking tylenol or advil 0-2x per 24 hrs and I'm at my normal gabapentin dose.

As far as my initial decision? I do think it's helping my lower back, even though I'm not active enough yet to really know if it's helping me feel more stable. Sitting around as much as I've had to during recovery would normally have my lower back extremely unhappy and it's doing better than I'd expect. But we'll see how it responds once I start picking up heavy things again. That and balance are my two big questions. So, fingers crossed on the function piece, but aesthetically alone it's already worth the recovery, even with fibro.

I'm feeling mostly like myself! Almost normal amounts of energy (for me anyway) and haven't been taking any tylenol at all for almost the past 2 weeks. Still have some pain over the hips and compression is still very much my friend. I've been getting the zappy zings around the incisions but they're more surprising than anything. I only have one place left with a major scab refusing to shed, and a couple other teeny tiny spots. My back still feels better than pre-op so I'm happy to be getting that benefit I wanted.

As far as the aesthetics at this point - The scars are all nice and thin, some places more than others - I can't believe how thin my vertical breast lift scars are!! I hope they stay that way, and still of course I'm looking forward to the scars fading. My breasts are getting a nicer shape, though there's a little puckering near the scar on the left breast that I hope will somehow smooth out. I wouldn't mind it at all but it's in the cleavage that would show with a plunge swimsuit, which I like to wear. I think it's probably related to stretch marks from puberty and nursing, but I'm going to ask my surgeon if there's anything that I can do to help it smooth out or if it just will with time, and if not, if there's anything (cheap) she could do. You can also see that my waistline is a little bit asymmetrical, but that's mostly down to my ribcage being formed differently on each side for my whole life, combined with some asymmetrical swelling.