2 Weeks PO - Mommy Makeover- Full TT with Significant Diastisis Repair and Implant Exchange

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I am a 33 year old mother of two wonderful...

I am a 33 year old mother of two wonderful children, a 4 year old boy (c-section) and 2 year old girl (vbac). For the last year I have been staying at home with my kids. Before that I worked for six years as an attorney. I am a little over a week away from getting a full TT with major muscle repair and will also be exchanging my saline implants for silicone. I have been on RealSelf for more than 2 years reading everything I could about these procedures, trying to come to peace with my stomach, or getting it fixed. After many consults, thoughts from people on this website, and many of my own sleepless nights I finally decided to get it done and am scheduled for June 8th.

I have a huge diastisis, the result of having two very large babies and have felt abnormal for years. I am 5'8" and hover between 145 and 150lbs. With my son I gained about 60 lbs. He weighted 9lbs 12 ounces at birth. I was determined to do things differently the second time and gained less than 30lbs, but still had a 9lb 8 ounce baby. I carried both of them straight out in front, as if their feet were on my spine and their heads were at my belly button. Despite working out hard (very intense cardio, weight training and running) five days a week for two years, I feel like I am in great shape but still look very pregnant.

For some reason, I am terrified of this surgery. I had implants when I was in my early 20s, but I think because I didn't have kids at the time I maybe felt like I didn't have as much to loose. I am worried I will not wake up from surgery, worried I will have complications that will make it hard to be an active mother, worried that I'll hate the way I look with such a huge, prominent scar. I could go on and on. Oddly, I'm not really worried about the pain. I know it will be difficult the first few days, but after having a c-sec, impIants, and 45 hours of totally natural child birth, I think I can get through the pain!

I finally decided to go through with this for a couple of reasons. First, the long term consequences of not getting the surgery started to weigh on me. My PS said my diastisis was the worst she had seen; partly because of the size of the gap in my muscles, and also because she said I don't have a lot of fat tissue on my belly to cover it up. I have scoliosis, and although right now I can mostly compensate with other muscles to protect my back while I workout and even go through normal life, I know I won't always be able to. Second, at my last consult I saw the pictures of myself standing there letting everything go and I was shocked at what I saw. I don't feel like the person I saw in those pictures. I am tired of having to look at the clothes in my closet I can't wear. And I'm tired of not wanting to plan beach vacations or go boating because I don't want to wear a bathing suit.

I chose my PS because I really like her as a person, she is very well qualified, and also because she does the progressive tension/drain free TT. She said it will take between 5-6 hours and the surgery plan is as follows: progressive tension TT, muscle repair with possibility of needing to do umbilical hernia repair (PS said if I have one it's small and she can't tell for sure if I do until surgery); PS left open the option of maybe needing to use mesh to help hold everything in, but said it's not likely; will do some lipo of the flanks if she feels it's necessary but again said not likely and if so, only a little. I am also going to switch my saline implants (330cc filled to 391cc) to silicone (haven't decided yet on size, but will go a bit bigger to help with lift). Will be doing a capsulorrhaphy to get implants closer together and a bit higher on my chest. Right now the implants have fallen too far towards my arm pits. PS said if I feel like I need a small lift a year after chaning implants she'll do one then. And now after writing all of this, I am about to talk myself out of it! It seems like a lot to do and a HUGE surgery and HUGE risk. I have until Tuesday to make any payments to the PS and hope I can stay as sure about doing this until then so I don't back out! She usually requires a portion of her fee to hold the date, but because she had an opening and I am able to get it done so soon after deciding she said I could just pay in full at my pre-op on Tuesday. Not sure if that is a good idea for me!

Still on track for surgery on the 8th. I'm...

Still on track for surgery on the 8th. I'm getting so nervous though! I am organizing things and cleaning like I never have before just to stay busy. I am so scared something terrible will happen to me during this surgery! I can handle the pain/recovery period, I know it will be tough, but I know I can get through it. I just don't want to do something that will take me away from my kids and husband. I try to tell myself that the drive to surgery is riskier than the actual surgery itself, but it is so hard not to worry! Will ask PS for something to help relax and/or sleep when I go to my final pre-op on Tuesday because nights are the worst for me! I just can't stop thinking about all the terribe things that could happen. Any advice on how to handle it? I look at my stomach pics, think of all of the people here that have made it through fine, remind myself of the real health reasons for doing it, etc.

Also, anyone go through this without having pre-op...

Also, anyone go through this without having pre-op medical clearance? I asked the PS about what I would need and she said given my age, fitness and medical history I wouldn't need to do any pre-op tests, not even a blood test. Does that sound normal? I feel like most people do have at least some pre-op tests, right? My PS is very well qualified, having been on faculty at a well respected medical school and a former head of plastic surgery at a major hospital so I can't imagine she is being unusually risky or cutting corners.

Surgery is tomorrow! I had my final pre-op a few...

Surgery is tomorrow! I had my final pre-op a few days ago and am just about done getting everything for recovery. I am so nervous! My PS spent a long time with me at my pre-op going over all of my lingering concerns. She said the risk of a serious, life-threatening complication from doing both TT and breast implant revision together compared to doing only TT is still so small (like 2 in a million compared to 1 in a million), but said if it would make me feel better, she would do the TT first (normally goes second, but it's the most important part of this for me, which is obvious when you see my pics!!) and if there was some reason (TT takes longer than she thought, I'm looking like surgery is being harder on me, etc) she'll stop and do the implant part later. That made me feel a lot better. Also got an RX for Ambien because I hadn't been sleeping more than 2-3 hours a night since I scheduled surgery. If anyone is feeling as nervous as I am in the last few days leading up to surgery, totally ask your PS about it! It was so nice being able to sleep the last two nights!

Plan to take my kids to the park for a picnic today and then drop them off at grandparents' for the weekend. That will be hard, saying goodbye, but I'm going to have to stay cool so I don't scare them. My 4 year old seems a bit worried when I talk to him about it. I have told them that I have a hole inside my tummy that I need to get fixed so that I can be strong. They know that I will be slow for a while and that Dad and other family members will have to do everything I do for a while. I plan on having them come up onto my bed sometime that first week to sit by me. Anyone else try that?

Off to make one more meal for my family and then work on packing for my kids. It's 5:30 AM but being busy really helps!

Up super early this morning. Have to be at the...

Up super early this morning. Have to be at the surgical center at 6:15. It's only 15 minutes from my house, but I was wide awake at 4:30! Sort of laughed to myself because if there is ever a day where I don't care if I'm tired it's today. 5 hours in surgery and then sleeping for most of the rest of the day!

First day PO and feeling pretty good. Everything...

First day PO and feeling pretty good. Everything with the surgery went great. PS said worst diastisis she'd seen. She did progressive tension, but ended up having to do a fat graft because it would have been literally skin and muscle without it so I did come home with one drain. So far only putting out 10 ccs every twelve hours so she said she likley will take it out tomorrow, Worst part of recovery at the surgery center was my eyes; they were so itchy and irritated. Better this morning though. Taking Percocet and Valium. Saw a pic the PS surgeon took and it look amazing. Boobs are good. Ended up with 400cc silicone which is exactly what I wanted. Sleeping in my bed with LOTS of pillows. I have three people here taking care of me and helping get out of bed. But, I am up walking around and eating a but; yogurt, applesauce; jello, just easy stuff. More about my PS soon. Hands down, she is the most amazing, caring, talented PS I could have ever asked for.

PO Day 3. Wondering why in the world I was ever...

PO Day 3. Wondering why in the world I was ever so nervous about this! Honestly, for me the pain has been slightly more than my c-section, but still not bad at all. I was home from surgery Friday at about 5:30pm. It's Monday at about 3:30 and this is what I've done so far: one and only drain came out yesterday. It was a breeze. PS called on Sunday morning to check to see how I was doing. Had one drain (and she apologized so much for using it but had to do a fat graft and felt it would be better) put out 10cc first 12 hours, 10cc second 12 hours and then 8cc the next 12 hours. So, Sun am she said we could take it out. My step mom is here with me and is a retired cardiac critical care nurse so the PS told her she could take it out. Snipped a stitch on the side and pulled it right out. Burned, but not bad. Showered today. Lovely! Washed my hair and blew it out. Got in compression garmets (waited to do that for my first BM which was this morning). I had on an ace bandage type wrap before. BM was frusterating, but not bad at all. Took M of M and lots of prunes but nothing so PS said could try Dulcolax. First one didn't work so I waited a few hours and tried another and worked like a charm. I was a bit worried about it hurting so I just wrapped my arms around my sides and sort of applied counter-pressure and it was super easy. Glad that is done. Eating okay, but not much of an appetite yet. Just trying to remind myself I need to and having simple things like greek yogurt, applesauce, etc. I honestly think there is so much less space for my stomach that I may eat less going forward. PS said that is not uncommon when the diastasis was so big.

Trying to think of other milestones. Went outside for a bit this morning with my coffee and looked at my garden. Saw both of my kids. They climbed up on the bed and gave lots of gentle kisses. Liking to have a few visitors now. Tried going downstairs last night with husband for some different scenery. Couches were not as comfortable and coming back up stairs wore me out so I'll wait to try that again for a few days.

Loved seeing my new shape. Still swollen and I can't stand up straight yet so there is a bit of loose skin when I bend over. It disappears when I stand up straight but just not quite comfortable with that yet. Feel like PS got the scar nice and low and straight. Boobs look a bit weird still, but I know from when I had BA done the first time that they take a while to settle in. All in all pretty easy and actually pretty nice to be pampered!

Morning of PO Day 4. Slept great last night. ...

Morning of PO Day 4. Slept great last night. First night that we didn't set an alarm for pain meds. I woke up naturally at 6 hours and took two Lortab. Seems to be what works best for me now; 2 Lortab every six hours. Got out of bed to take them and then back into bed by myself! Had to ask hubby to help get me positioned after I was back in and he was surprised I'd done all of it myself.

The only thing bugging me now is the stupid hole in the compression garmets for going to the bathroom. Could use some advice on this one. I think someone else here posted about the CGs and referred to them as the baboon pants or something like that. I am HATING how the hole seems to just squeeze right around my va-jay-jay! :) Everytime my hubby sees me without pants on over the damn CGs he starts laughing which of course makes me laugh too! Any one else have that issue or ideas of how to help? Seriously the hole is just in the right spot and is the perfect size to wrap around my girlie bits and always squeeze them slightly out!

PO Day 5 Morning. Easier and better everyday. I...

PO Day 5 Morning. Easier and better everyday. I think my real issue now is that I am going to have to force myself to take it easy still. I was outside walking in my garden last night and decided I HAD to pull out some radishes that were going to seed. Yea, not such a great idea to crouch down and twist. Had some burning pain right on the crease of my leg and hip, a few inches from the scar. No more gardening this week! Did make it downstairs to our TV room last night and hubby gave me a wonderful foot rub while he watched the first NBA Finals game. Felt heavenly.

Met with PS yesterday afternoon for first time PO. She said, "you're healing like a teenager." Yea! She said everyone in the OR was laughing during the TT because when they brought the muscles back together there was a six pack, which is why they did the fat graft, to make it look more natural and feminine. I swear, working out and being in good shape is the best insurance policy ever! Makes healing SO much better!

PS also said BB looks good (we were worried I might lose it), gave me the all clear to start massaging new softer boobies and said I could wear any bra I wanted so goodbye to CG number 1, I won't miss you at all! Also said I could start wearing Spanx for the tummy so I may start rotating it with CGs. I was a bit worried about the size of my tummy below the BB. It looks bigger than I expected. She said it's all swelling. She tried to drain some of it with a needle (holy crap, closed my eyes when I saw that coming, but it actually didn't hurt at all). Couldn't get much fluid out. She said it's not the seroma-like swelling you can drain, it's just fluid in the tissues that needs new lymph and vasculature to drain. She to relax and give it time and it will come down. She said in the OR before any swelling it was totally flat. She also said that in a few months when swelling is done if I still don't like it she'll just do a procedure in her office to snip off any extra skin. Same for my boobs. My right is a bit uneven because baby number 2 only nursed from the right so it got an extra year of breastfeeding and is therefore droopier. She said when everything settles down she can snip a bit of skin in her office under local and do a mini lift on it. So, glad to hear that there are easy options if I want a minor fix on a few things. She also snipped off a mole I had on my right side during surgery. I hadn't noticed it was gone, but a nice added benefit. That thing drove me crazy while I was prego so glad to see it go too!

1 week and a day PO. Still doing well. I had a...

1 week and a day PO. Still doing well. I had a few days earlier this week (PO days 6 and 7) where I started to feel a little weak. I had been doing more and more and by PO day 7 was feeling light-headed, weak, dizzy, and like my heart was beating really hard and really fast. It scared me so much that I started feeling like I couldn't breathe. Very scary. We called the PS and she said to try laying down, suggested taking off CG (I was already in Spanx) and hydrating. Also called my step-mother who was a nurse and helped care for me the first few days. She came over with blood pressure cuff and listened to my heart, lungs, took BP, etc and said everything was great. She asked a bunch a bunch of questions, including if I had stopped taking pain killers. At the point we called her, I had been off Lortab for about 18 hours, having only taken 600mg IBP twice in that time. She suggested I take a Lortab and see how I felt. Of course, I took one and felt a lot better, not in terms of pain, I had been feeling fine with that, but in terms of all the heart and breathing problmes. She said sometimes, even if you don't feel pain, your body recognizes it or the trauma it's had on some level and can send your body into almost a shock mode. She suggested I try taking one Lortab in the afternoon and then once again right before bed for a few days, and then wean down to one at bedtime for several days after that. I guess I'll try it as it really seemed to do the trick!

On a much different and totally terrible note, I had a continuation of my complaints about the CG garmet being uncomfortable in a terrible squeezing-in-the-private-regions way. Just a warning, this may be TMI for some so please don't read if you don't want to hear about a TERRIBLE OB/GYN experience. On PO day 6 I woke up feel really really sore and itchy down there. As I mentioned in an earlier post, the CG squeezes in a terrible way and is almost always moist and clingy and super uncomfortable. I think the combination of all of those things gave me a yeast infection, because I had been super itchy and irritated on PO days 4 and 5. Anyway, morning of PO day 6 wake up and it's clear I'm going to need to do to the Dr. Call, get appt, break the news to hubby that he's going to have to take me and probably come in to help me get on the table if needed. At this point, I had showered two days ago, hadn't shaved my legs since the day before surgery, feeling super disgusting. Off we go to the OB/GYN. Get there, explain what's happened and that I still have the CG on, hoping she would just write me an RX and we'd be off. No. She wants to do a culture, and then asks if she should just go ahead and do my annual pap. Um, NO, are you freaking kidding me?!!! Insists she's going to do the culture and will do the Pap too if I'm still doing okay. Now, the truly bad part. How does she do the exam....through the FREAKING CROTCH HOLE in the CG!!!!!!!!! First thing she says is, "you have the most irritated vagina I have ever seen." Word for word, first thing she says. I looked at my husband and said I told you that thing sucks! Proof that the CGs are terrible! My husband was there in the room for the entire thing and luckily all three of us had been laughing about how crazy this entire situation was from the beginning. I think not many PO experiences can be that funny or humiliating, and certainly was something I never thought I would experience in my entire life.

So this Friday will be 2 weeks since my surgery. ...

So this Friday will be 2 weeks since my surgery. I am feeling generally pretty good. I usually take about a 2-3 hour nap in the afternoon, especially if I have a busy morning. I have been doing one hour outings in the morning: grocery store with help then buying thank you cards for all the visitors, or to the garden store and then to buy a new bath mat and shower curtain, etc. After morning errands, nap, I can be pretty active again like making dinner and weeding garden. So all in all not too bad. I love my new boobs. Basically the same size as before (I went from 391cc to 400cc) but the first were saline, and these are silicone and SO much better. Massaging like crazy because I am so worried they're feeling hard. With my first BA I got CC on one side and had to go back to have it fixed. Trying to avoid that again!

Only worry is my tummy! I tried to get into shorts yesterday from before surgery. Size 4 that were loose around my waist pre-op (my diastasis was super high, like sternum to belly button but then small around my hips). COULD NOT EVEN ZIP THEM AROUND MY WAIST! WTF?!? My PS cleared me to wear Spanx but I am keeping the CG on to help with the swelling; I am avoiding salt like the plauge; eating very clean; drinking tons of water. I don't know what to do. I keep telling myself it's swelling, it will go down, but I'm starting to get worried. Did she not tighten it enough? Will all this swelling stretch the skin out and I'll be left with new saggy skin below my BB? Will I have to get a revision? Terrible thoughts creeping in. So hard not to compare to others on this site that are tiny tiny tiny by this point and get frusterated that I am not there yet too! Will post pics soon so you can see what I'm talking about.

Day 13. Here are some new pics. See what I mean...

Day 13. Here are some new pics. See what I mean about the swelling? Sucks, but I guess when you look where I started from it's pretty good. I never thought in a million years I would think about wearing a bikini again after what I was left with after my babies. Hopefully the swelling in my belly will keeping going down as the days go by.

Two weeks and a day PO. I feel like mostly back...

Two weeks and a day PO. I feel like mostly back to normal. Still supper swollen bellow my bb which sucks, but still early. I have been doing most of my normal activities absent working out. For the first time yesterday I went for a real "I-want-some-exercise" walk outside. I took my two year old in her Bob jogging stroller and went with a friend. We went on mainly flat surfaces and I asked her to go pretty slow. It felt great but I sure noticed a difference that cannot be related to deconditioning. Was only able to do 20 minutes in which time I guess we went about a mile and then we took our two kids to the park for about 40 minutes. Then went grocery shopping. After that I felt SO tired. My body didn't have any energy left and I really needed to nap. Took a two hour nap and then got dressed and went to a family party for my b-day, which is today! So all in all yesterday was a success! Other things I am doing: making all meals for family, doing normal house stuff like laundry, empting dishwasher, etc. Have even VERY carefully helped my two year old out of car, on to my lap etc (which felt totally fine), driving like normal, standing basically straight most of the time, can sleep nearly flat on my back, enjoying an occasional glass of win. Things I can't do yet: sleep on my side, wear my pre-op button up shorts/pants (still too swollen below my bb), shaving legs is hard with the bending and twisting but I can do it. Down to 600mg IBP once a day. I will see PS next Tues and ask about swelling. Happy healing to everyone!

Thanks for all the birthday wishes everyone! It's...

Thanks for all the birthday wishes everyone! It's been a great weekend with one more event to come today. Just wanted to share an experience with true swell hell with you all. I'm sure you all know this, but just in case someone out there like me decides to ignore the warnings we've heard about salt+lots of activity=swelling I'll share the events of my weekend thus far. Up until PO day 14 I ate really clean. Greek yogurt with agave, protein shakes, grilled fish, salads with tiny amounts of dressing, small amount of complex carbs like plain brown rice, a bit of fruit, etc. I was really avoiding salt because I seem to have a bad case of swelling already (in my opinion anyway!) and lots of carbs just didn't sound good. So my b-day roles and around and I jump right back in to a normal "it's my b-day party weekend" diet head first. Pasta salad, mediterranean potato salad, brined BBQ chicken, chocolate b-day cake, glass of wine, the next morning banana pancakes, etc. Then I go get a mani-pedi and do some clothes shopping for a couple hours. After a day and half of eating like that and that much activity I was pretty flat from my sternum to my bb, but from bb to my incision there was about a 3 inch "shelf" of the most awful swelling that just jutted straight out from right below my bb. I could feel it with my legs, like a great big water balloon tied around my waist each time I would step. Yuck, right!!!! Came home and put on the ace bandage-like surgical wrap I wore home from the hospital in and slept in it overnight. No other complications from it at this point, but it was amazing to see how quickly and how dramatically a change in my diet impacted my healing body. Back to my clean eating today that's for sure! If anyone has any other suggestions for how to reduce the swelling I'd love to hear them. Going to my PS on Tuesday and will have to come clean and see what she says!
Salt Lake City Plastic Surgeon

Dr. Keen is amazing! I met with several other PS, all of whom were very well qualified and had the type of credentials I was looking for. I chose Dr. Keen for many reason, but here a few of the main reasons. First, I really liked her as a person . She is very down to earth and I think she truly cares that her patients get a great result. I was very nervous leading up to surgery and she took all the time I needed to address concerns and help me relax. Second, I did a lot of research and I believe that Dr. Keen is at the leading edge of her field, doing things like the progressive tension tummy tuck. Other PSs told me they wouldn't do it, but after researching it myself I felt like it was the better option; harder for the surgeon, but better results and easier recovery. If you read about my recovery I think you can see how easy it is and how wonderful Dr. Keen made my stomach look. I always felt like I was in an expert's hands and the surgical results show it! I also found her to be very relaxed and yet at the same time extremely confident which really helped me. Dr. Keen called my husband Saturday and Sunday mornings (my surgery was on Fri) to check on us and spent all the time he needed with her. I could go on and on with examples of why I think she is so wonderful. Jodi and the other ladies in Dr. Keen's office are amazing, very helpful and really care about you as well. Very easy to get a hold of and they are very responsive to e-mail too, including Dr. Keen! I feel so lucky to have found Dr. Keen through someone else's posting on RealSelf and hope that others do to. I will always give Dr. Keen my highest recommendation!

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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