26 with PCOS, Lipo on Arms, Upper/lower Abdomen, Interior Thighs/Knees - New York, NY

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I have always struggled with my weight. I eat...

I have always struggled with my weight. I eat relatively well and am extremely active, working out 5-6 times a week. I have PCOS and am insulin resistant, so I have to maintain a very low carb diet to really see results. I'm 5'6" and have stayed between 175-185 lbs for the last 5 years. I was able to get down to about 160 about 10 years ago, working out with a personal trainer 3x a week, and even then I lost a lot of weight, my arms didn't slim down to the same degree as the rest of my body, and my pear shape was still prevalent. I still want to keep my curves, but I want to flatten my stomach and reduce the fullness of my arm and thighs.

I'm excited and terrified. Surgery is in 20 days!
I met with two surgeons and they both decided that general anesthesia was the best option for me because they could be more aggressive with the multiple areas I wanted to target.

Pre - Op Meeting

Over the last two weeks, I have been in contact with Dr. Karlinsky's staff about finalizing the amount, the actual date of the surgery and scheduling pre- op meeting. Her staff is absolutely amazing; I love Susan and Janette!

I came into the office today for my official pre - op blood work, urine sample, pay my balance (I'm paying up-front), get my prescriptions and meet with Dr. Karlinsky with any other questions I had about the procedure.

During the consultation two weeks ago, Dr. Karlinsky had already looked at me and we discussed realistic results, but we went over the details today thoroughly. I honestly expected to be standing there in the nude much longer, but that wasn't the case! She is very warm and knowledgeable (even provides her personal cell phone number to her patients), but also has a no BS approach. Usually Wednesdays are the day the she performs surgery under general, but she was flexible with my schedule and my needs and we're able to do it on Thursday instead. They even have a staff member who will bring me home from the surgical center and stay with me overnight!

My largest concerns were 1) scars and 2) loose skin on my arms specifically. I'm very fair, so unfortunately I most likely will have a decent amount of bruising and red scars (from the cannula entry points), but I was assured everything should fade in time, of course. Regarding my arms, since I have good skin tone/elasticity, I shouldn't experience saggy/loose skin. I have significant fat ("bat wings") on my arms, so while my expectations were managed and they won't be perfectly thin after the surgery, the size will be significantly reduced.

I have my list of instructions, including what not to take (advil, aleve, vitamin supplements, etc) for the next two weeks. And the day before the surgery, I will get more detailed instructions from the surgical center the day before.

I'm excited, scared, nervous, but I know I'm in great hands! 14 days!

One week to go!

So my blood tests came back normal, so I am cleared for my surgery next week.

I purchased some super absorbent maxi pads and wee wee pads for the leakage after the procedure. Since I'm getting my abdomen and thighs done, I also took another person's advice from RealSelf and purchased a female urinal, just in case I'm too sore to bend.

I have an extremely active/hectic lifestyle and I'm afraid that 1) I'll be out of commission to for too long or 2) I'll make things worse and prolong my recovery because I won't slow down. I fear that I will bruise to an extreme and won't be able to conceal it, especially because I'm getting my legs and arms done and it's the summer time where most people show a lot of skin. I attached a picture of the bruising that occurred from the blood test last week that shows how easily I get black & blue!

I hate that I may feel helpless and fragile post surgery, but I know the long term benefits will outweigh the short term discomfort, so I just need to focus on being positive and patient!

This time next week, they'll be wrapping up my surgery! 7 days to go!

Surgical Center Follow Up

So I had an unexpected call from the surgical center that Dr. Karlinsky will be performing the surgery on Thursday. They had to ask me a battery of questions regarding height, weight, past medical history, any experience with general anesthesia and allergies. They also fielded a few of my questions about where I would be able to store my personal items when I arrived by myself in the morning and so on.

It made me more anxious to just get this over with! The weather is finally getting warm and it's going to be a challenge it stay comfortable during the summer months with all the bruising and swelling!

The nurse confirmed I'd get another call on Wednesday to confirm all the details. Less than a week away!


I'm getting nervous and anxious! I just purchased a whole slew of flowy, maxi dresses so I can be comfortable for the weeks after surgery. I spoke with the doctor and she said we could contour down my thighs and to my knees, so I'll definitely have to wear longer dresses to cover the CG and bruising.

Last night I went to the grocery store and stocked up on Gatorade, fruit (pineapple, watermelon, berries), yogurt (almond milk, I'm dairy-free), and cereal. I wanted food that was easily consumed and digested.

Tonight I will take more pre-op pictures and measurements!

More Pre - Op

I just wanted to document my measurements pre - op. This will be the last update before the surgery. I hope I have amazing post - op pictures to share! You all have been such great support, thank you so much!

Thighs: ~27 in
Hips: ~47 in
Over belly button (when I'm completely relaxing my abs): ~45 in
Natural waist: ~35 in
Under bust: ~37 in

It's done!!!

Wow! The procedure is over!

Here is a play-by-play. I hope it helps you feel less stressed by knowing what to expect.

5:30am: wake up
6:15am: arrive at surgical center
6:30am: urine test, fill out paperwork
- taken to the back room to review my file with nurse to change into gown/hairnet/socks, put my belongings in locker, and take vitals and check pregnancy test is negative. I don't do well with needles so I had to lay back in the chair and get a boost of something to help my heart rate to go back up (I went white after they put the IV in my hand)
- took pre-op photos with Dr. Karlinsky, she marked me up with the purple pen and went over procedure again. I briefly asked why she didn't make marked all the way down my legs, she firmly said we will just do the upper and knee area. I didn't want to push the issue right before surgery.
-Meet with anesthesiologist to review file again, discuss past surgeries, and was given an anti-nausea patch for behind the year (similar to what you get on a cruise ship for motion sickness)

- walked into the OR with my IV in hand and straps were put around my arms, legs, etc. I breathed into an oxygen tube. Dr. Karlinsky asked me if I was ok very often, it was very comforting and Brittany, the nurse, was AMAZING. I felt in great hands.

Everything went black.

~10:35am: woke up to the many people in the OR trying to put me in my compression garments. I was totally loopy, don't remember anything but the doctor joking that I was boisterous and she told the surgery follow that usually "it's not that difficult." Not sure what she was referring to, but it didn't bother me at all. I was just hoping I didn't punch anyone when I was coming out of anesthesia. I also remember them putting in a catheter and I watched myself urinate into a container while sitting halfway up in my compression garment in the OR. That was super fuzzy and I remember thinking "omg, did I start to pee myself and they had to stop me from making a mess!!?."

~10:45am: next thing I remember was laying in the recovery area in bed. My abs and left arm hurt very, very badly. No nausea. I was so happy I was alive!! I was asked every 30 seconds how I was. Dr. Karlinsky came by and checked in - she said everything went very well. The fat in my stomach was very bloody and not the usual yellow "good" fat.
She took out: 1.5 liters out of my abs, 400cc out of each arm and I think 300 cc out of each thigh.

11am: blood pressure taken, maxi pads changed again because they were already soaked and 2 Percocet. Thank goodness for pain meds, I was like a 7 on a 1-10 pain scale for my abs.

~12pm: blood pressure taken again, the nurse got me out of bed. The white blanket they gave me was SOAKED red/pink (tumescent fluid + blood). She brought me me back to the locker and helped me put my clothes back on (a dark green tanktop, black light cardigan and black sweatpants). I was escorted to waiting room (now packed, it was dead this morning at 630am), and Susan from Dr. Karlinsky's office was waiting with a smile for me!!

I was surprised how easily I could move around. Once the pain meds kicked in around 11:20am, I was sooooo much better. At first I was concerned about what the hell I did.

We took the elevator down and hailed a cab. Again, I was so surprised I could move easily but I had SEVERE cottonmouth, which is normal from the anesthesia . Granted they didn't do the entire inside of my legs like I originally thought, mostly the inner-top inner and inner- knee. I'm nervous it won't be yield the results I want - but only time can tell!!

12:15pm: back at my apartment, we changed the pads again! Since I live alone, Susan and I just set up a wee-wee pad on the floor and stood on it while we zipped on and off the compression garment. It's pretty gross, I was definitely trickling out liquid but it was under control. THE CG is already stained, but in 24 hours when I shower, I can quickly rinse it and hopefully it will look better.

12:30-2:30pm: I finally ate something: some gluten-free chips, pineapple and LOTS of water. I had probably 4 20oz bottles of water. I've been pacing around the apartment and walking around, we've been replacing the maxi-pads as needed.

2:45pm: I took my next pain pill and now I'm relaxing and watching TV! More updates and pictures soon.

Day of surgery: photo update!

Here is the sexy, sexy CG with all the stains and the maxi-pads underneath - I definitely stood up and aided the leakage. I have a cream couch, so I put wee-wee on the floor and I've stayed in the maroon cotton robe that they gave me at the surgery center.

I have a 930am appointment tomorrow with Dr. Karlinsky and then I can't wait to shower!

Post- Op Check Up

I had the best time with Susan last night! She took such good care of me. I was falling asleep around 9pm last night, so we changed every single pad regardless of how wet they were just in case during the night (and change of position while I slept) caused leaking. Honestly, the whole leaking thing isn't that bad if you are diligent about it. There were times Susan and I were just hanging out and talking and all of a sudden I looked down and had wetness. Like I mentioned before, I massaged a few areas when I saw they were really leaking and tried to get the most out of it before we re-padded. I thought that was super helpful.

I put down wee-wee pads on my bed and on the floor next to my bed just in case I had a lot of leakage. Fortunately, only my left knee leaked and of course it wasn't completely on the pad so a little got on my bed. Nothing too crazy.

I got into bed and was feeling fine. I woke up around 1030pm because of pain, so I took another pain med (last time I took one was 6pm, so I stretched it). I set my alarm for every 3.5 hours to take a pill. I woke up intermittently throughout the night because I was stiff. I'm also a stomach sleeper, so it was not as comfortable sleeping on my back. My forearms swelled up a bit, but I expected that. They just look really fat right now! :(

My throat is still a bit sore from the intubation tube, but it's not unbearable. I've been sucking on my lozenges. Yesterday I just ate the crackers, pineapple, protein bar and then miso soup and a salmon avocado sushi roll. Of course, tons of more water.

So I woke up this morning at 830am to get ready for my 930am post-op check up with Dr. Karlinsky. We were going to take a cab, but I wanted to walk (because I woke up so stiff) and take the subway. Her office is only 2 stops away from my apartment, so it was only a 15 minute walk + ride. My lower abs are hurting the most - so unfortunately when I walked through the subway turnstile it hit me right in the lower abs - OUCH!

When we got into the office, I was greeted by everyone! It was great - Dr.K and her fellows looked at me right way, no wait time at all. They asked how I was feeling and if I had any issues. They stripped me down and looked at all the incisions and the bruising. I'm not as purple as I thought and I pretty much stopped leaking. I'll take pictures tonight after I shower- PROMISE!

The only issue was walking back after the appointment. I took the subway back by myself and I started feeling a lot of pain in my left knee, so I had to walk really slowly. I was feeling a bit fatigued, so I came home, ate a banana, took some arnica pills and now I'm in bed.

My best friend is coming over tonight and sleeping over, so I have someone here while I'm in the shower (I don't want to get dizzy and faint by myself!)

I will see the doctor next Friday for my 1 week check-up, but she requested I text her this weekend just to check in - she's too sweet!

Day 1 Post - Op

I am very swollen! I had a friend come over to check up on me, but we wound up going out to lunch and walking around. That was a bit of a mistake, because now I am swollen in my feet, hands and forearms. It's not terribly uncomfortable, but I feel like a sausage. Since I came home I've just been drinking a ton of water and trying to elevate my legs!

I finally took the CG off and showered! Let me tell you - the shower wasn't as pleasant as I thought! It was the weirdest sensation on my stomach and every time the water hit the back of my elbows where the incisions were, it stung like crazy. It was nice to be clean, but definitely was a bit of a struggle.

I rinsed off my garments and my best friend helped dry them with a hair dryer so I could put them back on soon after my shower. She's a lifesaver!

I'm still leaking out of my right knee and left elbow, but minimally. I still take the pain meds every 4 hours and the only real soreness I have is in my lower abdomen (which is DARK purple!). I'm surprised I didn't bruise as much - but it's still early!

Day 2 Post -Op

Slept pretty well last night. My friend slept over in my bed so she could monitor me just in case! I didn't leak at all, so I think I'm totally done! Fingers crossed.

I still put my alarm on for every 4 hours for my pain meds. Since I'm still really sore in my arms and lower abs, I want to continue taking the prescription strength pain meds. Hopefully by tomorrow or Monday I can transition to extra strength Tylenol.

I also started taking my antibiotics yesterday. I forget to mention, twice a day I take Erthromycin because I'm allergic to Penicillin. I haven't needed to take any anti-nausea medication because the anesthesiologist gave me a patch behind my ear before surgery. I just took it off this morning, so hopefully the nausea doesn't get too bad.

I'm going to take it easy during the day - I have a birthday party I want to go to, so I'll save up all my energy for tonight! And pray the swelling goes down a bit!

Day 3 Post-Op

I'm going to stay inside the rest of the day. Last night while I was out with my friends, my feet and arms BALLOONED like crazy. Too much walking, too much heat. It's made me swell like crazy and my left knee actually leaked a bit while I was out - good thing no body realized that pink fluid was dripping down my knee. I also think my compression garment for my arms is making my forearms swell because it's too tight. It's painful in the creases of my elbows and rubs, making red marks (I attached a picture).

I woke up this morning with still semi-swollen feet and very swollen arms. I went the entire night (8 hours) without a pain pill. My body is still sore and numb and when I showered a few minutes ago, I still had very weird sensations all over my body. It wasn't nearly as painful as the first one.

I'm laying in bed with my feet elevated without my CG for ~30 minutes to see if that helps with the swelling. I hope so!

Day 4 Post-Op

I am still VERY swollen. Since I got my arms, abdomen and my inner thighs/inner knees, I need to cover quite a bit. My current CG only goes to my mid-thighs and doesn't compress my knees. They used ace bandages post-surgery, but they're bulky.

So, on Amazon, I purchased on the Rago High Waist Leg Shaper. It's a high waisted compression pant that go below the knee. I can wear that plus the arm CG that my dr gave me and it covers everything I need.

I'm still very store, I had to cut a slit in my arm CG because the sleeves went to my mid forearm and was cutting off the circulation and causing severe swelling. With the slit, I'm much more comfortable and still have enough compression for my arms. I still have chaffing in the inner elbow because of the garment. Sometimes I'll put a pad in there (I think some people use foam) to help reduce the rubbing.

I took a pain pill yesterday around 5pm and then tried to go the rest of the day/night with only Tylenol. I was able to get to about 12pm today, but this is my first day at work and I was so incredibly sore. So I took another prescription pill around lunchtime. I'm feeling much better.

I haven't had a huge appetite for the last few days: I'm eating mostly dairy-free yogurt, pineapple and other fruits. I had french fries the other day and my entire body ballooned, as I mentioned.

I'm nervous about not getting the results that I want. I look at other peoples' pictures on this site and their abdomens are already so much flatter just within a few days. Don't get me wrong - my arms and abdomen are improved, but for the amount of money I spent I just want to ensure that it's going to get noticeably better. My inner thighs and knees are very tender and I can't tell a difference yet. My inner right knee is incredibly bruised, but the other parts on my legs look like they've been barely touched. Again, I know I'm still very swollen, it's only 4 days out. I weighed myself and I actually am 5 lbs heavier than surgery so I just need to be patient.

Day 5 Post-Op

I woke up feeling very nauseous this morning. I ate an actual meal last night, so that could have been the reason. I had some anti-nausea pills for the pain meds, so I just took one of those and was feeling much better.

This is day 2 back at work, I'm feeling pretty good. I think figuring out my outfit is actually the hardest part. Yesterday I actually showed up in sweat pants and a long sleeve athletic shirt, but today I'm wearing a maxi dress and cardigan. Even though I put a slit in the upper body CG, I am still swelling in my forearms, so before I left for work I took off the CG for 30 minutes just to relieve some pressure.

while the CG was off, I took a look at my arms more closely and I'm very nervous. Dr. K said that she took out 400cc in each arm, but I'm not seeing a huge improvement. I'm worried about sagging and that my arms looking worse than before. Obviously, in the CG they look awesome and thin. I hope they continue improving. I also see no improvement in my leg. My abdomen is definitely getting better but not as flat as I thought it would be.

I know, as I say every single day, I just need to be patient.

Day 6 Post-Op

Not much to update! My bruises are healing very quickly! I have been taking arnica pills and using arnica topical treatment daily.

Unfortunately today I ate soup for lunch not thinking about how much sodium was in there. I swelled terribly and I've been uncomfortable the rest of the day. My CG felt like it was cutting off my circulation, it wasn't fun.

I am also starting to itch. I read many people on here equate itching to healing, so hopefully that's true! I'm still hoping I will shrink more day by day, but it's hard to tell.

Day 10 Post-Op

I had my one week post-op appointment with Dr. Karlinsky on Friday. She said everything was healing very nicely and that I didn't need to continue wearing my CG if I didn't want to. I'm a little disappointed on my arms because the "bat wings" aren't completely gone, but she said the skin would hang if she took more out. I'll focus on building up muscle and see if that will help the shape. They are quite smaller than before - I didn't realize it until I put on my suit jacket and the arms were loose! I'm still very numb on the back of arms and she said it could take 5 months to "forget I ever had lipo."

My stomach still has a little bit of swelling and hardness, but Dr. K said I should see a bit more shrinkage. I voiced my concern about my legs not being as slim as I had hoped, so at my 3 month post-op appointment we are going to revisit perhaps doing more.

I only have the bruise on my inner right knee - I've been using arnica pills and topical religiously and I think it helped tremendously. The incision site just stopped bleeding/leaking as of today, I'm so happy. It was super annoying that a week post-op I was still dealing with changing band-aids every few hours on my right knee.

I've been waking up in the middle of the night/early morning feeling swollen and tight in my CG, even though the morning is supposed to be the least amount of swelling. I'm going to keep wearing the CG for a few more weeks just due to comfort. Once the weather gets too hot, I'll shed the arm CG, but most likely keep the torso CG until the pain from my abs are completely gone. Sometimes when I bend a certain way I get some pain in my abs, but it's not often.

Overall - I'm pretty happy. This is just the beginning, I can't wait to start running again next week! Until then I'll go back to my barre classes and lifting weights this week.

Day 12 Post-Op

Well, I worked out for the first time yesterday. I didn't wear any compression and it was a boot camp with lots of running, pushups, burpees, and other plyometric activities. And WOW it hurt. My skin is still numb and the up-and-down movement really hurt. I last about 45 minutes and I was probably only giving about 75% effort. I was a bit swollen afterwards (and I didn't eat the healthiest dinner, since this was the first time I had exercised in over 10 days, so I was ravenously hungry).

Today I did my usual barre class, much lower impact. The abs section was the only thing that was a little bit of a struggle, but overall, I did about 95% of the class without any pain. Again, definitely a little more swollen afterwards, but it felt so good to workout!

I'm still not happy with my legs, but my abs and arms look much better. They're getting better with every day. I'll post some pictures this weekend. I need to continue focus on eating well, since I can't do the high impact cardio that I really want to do! Maybe I'll try wearing more compression next time I run, that should hopefully help!

The bruise on my inner knee is nearly gone and everything else is completely healed. I even wore a tank top this morning at my workout and didn't feel anxious/paranoid that people "knew" I had my arms done.

Lastly, I seemed to have worn out my CG (the one I got the day of my surgery, with the zippers) because the seam on the inner right thigh popped (I thought I was supposed to get smaller...not pop the seams!) I purchased a whole slew of normal compression (spanx, flexee) garments, so I'll review which ones I like! Regardless- it's been a good week!

15 Days Post-Op

I'm not posting pictures today because honestly, I'm feeling completely bloated and swollen. I'm feeling a bit frustrated, but I think it's because I've been working out too much and not wearing my CG enough. I'm now wearing the body CG 24 hours and the arm CG only 12 hours (when I'm home/sleeping). I know some doctors don't allow any workouts, but mine said to listen to my body. I guess I need to listen to it and stop making my body swell. Everything (arms, legs, abs) aren't at the place I thought they'd be - but again - it's only a little over 2 weeks post-op and I need to realize that even though my bruising is gone (COMPLETELY!) the trauma is still there and I may be prolonging the swelling if I don't slow down.

This week I started a low-carb diet, so that should help with the results.

100+ days post

So. It's been awhile, I know I've been terrible at keeping up. When I was pre-op I hated when people stopped updating their blogs because I wanted so desperately to know what happened and how they were healing!

I am now 3 months and 20 days post-op. I want to make one thing VERY CLEAR that while I've lost 30+ lbs, it's probably ~90% attributed to my eating behavior post op. Two weeks after the surgery, I went on Optifast (a 800 calorie diet) and lost about 15 lbs in ~1 month. I now follow a ketogenic diet (similar to Atkins) which is high fat and extremely low carb. I've now lost 30 lbs since my surgery. I'm happy about my results (and many people have noticed and congratulated me), but I'm not sure how much of it was the $8k+ I spent on lipo and how much of it was the diet change.

Over the last 3 months, I learned quite a bit. Here are few valuable things I want to mention:
1) As my previous posts mention, I did cardio VERY soon after the surgery and I would suggest to NOT do that. It made me swollen and bloated.
2) Avoid salt like the plague, that will also make you extremely bloated.
3) Drs all have different views on CP. I wore my body CP for 6 weeks post, and my arm CP for only 3-4 weeks post, and mostly only 1/2 days. Wear it as long as you feel comfortable.
4) My inner thigh skin felt really "weird" for 1-2 months post op. I can't describe exactly what it was, maybe it was the lack of fat pushing out the skin, but it felt more delicate and a slightly different sensation than the rest of my skin when I touched it.
5) My arms lacked sensation / were extremely sensitive for about 2.5 months post-op. Be patient and be careful when people touch you! I had a few people playfully punch me in the arms (And they didn't know about the surgery) and that was PAINFUL.
6) RELIGIOUSLY use scar away. My scars are pretty much gone and I used it 3x, every single day.
7) Focus on your eating and workout schedule post op. It really, really matters. I need to work on building more muscle in my arms - they're less full (which is great), but still not where I want them to be!
8) Give your body time to heal. I was SO IMPATIENT and it made me emotionally and physically uncomfortable. It's so easy to say, but so hard to put into practice!

Anyway, so: my 3 month check up with Dr. Karlinsky. She is a very to-the-point type of doctor, as I've mentioned before, I expected her to tell me that I looked fantastic when I walked in the door- but she said no such thing. Very clinical. Her staff (Janette and Susan) were SO EXCITED and showered me in compliments, so that felt amazing.

I told Dr. K I was about 98% happy with my results and felt that my inner thighs were not even. She mentioned that they weren't even to start with and that I needed to wait until the 9 month mark for 100% of the healing and scar tissue to subside. I feel that because we did the inner thighs and inner knees (not the space in between) there is more "lumps" / "waves." Dr. K said if we go in and fix in 6 months, she'll be ultra conservative. Again, I'm happy with my results, if anything, they motivated me to get my eating under control.

Yes, I'd 99% do it again. Yes, I'd go back to Dr. K, but if you're looking for someone who is going to hold your hand and be all warm and fuzzy, she's not the dr for you.

Thigh Revision: April 2015

I know it's nearly my 2 year anniversary, so I wanted to give you the rest of the updates!

I wound up going back to Dr. K for a revision April 2015 because I felt that my thighs were a little lumpy, she warned me that thighs can be tough and cellulite would not go away, however she only charged me $500 for the equipment fee, and did the procedure in her office.

I arrived to her office, she brought me the in-patient procedure room. I changed into disposable underwear because she didn't want the fluid to stain my clothes. Dr. K and her fellow doctor just had to minimally smooth out the back of my thighs. They did procedure in less than an hour. She started with injecting me with a numbing agent, then cutting small slits in the back of my thighs and using the cannula, she started sucking out little pockets of fat. Again, it was only to smooth / even out a few parts.

After we were done, I put a short compression garment on under my pants, including the maxi pads to soak of the fluid and then went to the pharmacy to get my pain medication. The pain was quite minimal and only needed to take pills for 1-2 days post procedure. It still took a few months to even out completely, but was very happy with the results.

Body Transformation (not complete, yet)

So, 2 years after surgery, I am extremely happy about my results, but as I mentioned before: the surgery helped me jump start to work out hard, stay committed and eat clean. I workout 6+ times a week, often doing two-a-days. I have a triathlon team whom I swim, bike and run with, am part of a crossfit gym to get my weight-lifting in, and have a regular gym to use for cardio and for classes, like yoga. I have totally integrated eating ketogenically into my life and working out is part of who I am, instead of a chore I have to accomplish.

I can add measurements later, but ultimately, I have transformed my body. I was over 30% body fat when I started, and I've lost nearly 10 percentage points, I have muscle definition on my abs and arms and I am down to a size 6-8.

I feel fantastic and realize now that I probably didn't need the surgery, but am glad I did it to keep myself accountable.
Manhattan General Surgeon

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