Mid-40's Breat Reduction and Abdominoplasty - Portland, Oregon

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I was an athlete most of my youth and 20's. A...

I was an athlete most of my youth and 20's. A horribly rocky start to marriage resulted in a 50 lb weight gain at 29, and then a broken foot that wouldn't heal for 6 months added another 50 that same year (well, not being able to workout, which is how I kept my weight from increasing). I managed to lose the second 50 three times. Once on my own after discovering a low carb diet, once after the first child at 39 and just recently after my 2nd child in my 40's. But total weight loss has eluded me for over 15 years. I'm currently about 35 pounds from my realistic goal weight and contemplating a BR/TT/Liposuction procedure. My thinking was that I don't seem to be able to get down to that weight on my own, so do the procedures so I'm happier with my body now, and hope that any further weight loss doesn't require revision.

However, after talking with the PS before my consult, I am now questioning if I should wait. And reading the many stories here on RS, I'm starting to wonder if I should be a candidate at all. Most reviewers list their weight and height and I can't get over how much less everyone weighs than I do. It's discouraging. I see women who I think look like they have the same body I have, and then I see their weight is 140 pounds! I can't figure out if I'm built with bones the weight of gold or if I have a serious disconnect between what I see in the mirror and the reality of my body.

When I was talking to the PS, I heard myself saying, "my weight is mostly muscle" and found myself cringing afterwards that he must hear that from fat women all the time. The thing is, I'm in really good shape. I work out all the time and lately have been doing 2-5 hours a day. When I had my second C-Section, the OB-GYN actually said after the baby was delivered and he was sewing me up, "wow, you have a LOT of muscle here." I think I've clung to that - that if only I could lose the leftover paunch of fat, there would be a six pack underneath waiting to be uncovered.

Similarly, I've had a dream since I sprouted large breasts overnight when I was around 17 years old of getting them lopped off. When I gained weight, I became a full D cup, and with the babies and breastfeeding, I maxed out at a 38K cup. I'm back down to a 34DDD, but no amount of weight loss will get me to the small B I so desperately want to be.

I found some great results (according to the before/after photos) from a PS on the other side of the country and I thought, hey, the PS I like closer to home will be able to do the same thing, right? Wrong. He's much more conservative and so I am realizing that if I do the procedure with him, I am probably not going to get tiny B breasts or massive lipo with my TT. I will have to do more than one surgery over time, and I don't know if I can afford that or if I'd want to go through it more than once. And I'm not sure all the pain and money will be worth it if I'm still forced to wear an Enell bra to exercise. I would find it a complete waste to have D breasts, and a C would be disappointing.

So, I'm backtracking and wondering if I should maybe just get some liposuction done to reduce those hard to burn areas of fat on my back, thighs and upper abdomen and then work on losing the final 35 pounds before going for the BR/TT. Maybe if I get down to my final weight, there will be enough shrinkage that I will get that small B that I want. Of course, I just had my first mammogram and found out I'm level 3 density, which seems like it will be harder to remove as much as I want taken out. I had so hoped it was all fat!

Finally, I don't want to post my surgeon until I am set to do the surgery with him, but I will say now that I didn't do a bunch of consults like we're supposed to. I looked online and went through websites and narrowed it down through before/after photos, physician comments, and reviews. I really liked this one guy for some reason and so just set up a consult with him. After talking with him on the phone, I like him a whole lot for his honesty and integrity. He was not in a hurry to get off the phone, he answered all my questions and he pretty much discouraged me from having the surgery if my plan was to lose more than 25 pounds after due to the high chance I would have skin sagging and need a revision. As much as I'd like to go with a doctor who takes big risks and sees some amazing results with a few of his patients, I think I'm more comfortable with a doctor who is realistic and cautious so that I don't have major issues afterwards.

My in-person consult is next month, so I should know by then if I'm going through with the full surgery now, or will wait until I've lost more weight. I will say that just the prospect of getting surgery has motivated me in a way I hope will be lasting. I just don't want to lose momentum by putting it off indefinitely.

I'm 5'3" and currently 175 pounds.

I forgot to put in my "stats" in my first post (thanks TJphnson for pointing that out) and RealSelf doesn't let you edit your posts! I will remember that for the future (need to spell check and really consider what I'm saying...). But for now: I'm 5'3" and currently 175 pounds.

Found a Great Website for Body Image reference/self-check

Ok, so I have been depressed since reading the real self reviews because I weigh a lot more than the other women my height getting the same procedure(s) I want, and I started wondering if maybe I'm a little deluded about what I actually look like. I did a google search and found this amazing website: http://www.mybodygallery.com/index.html#.VQSwOZPF_qw. You put in your height, weight, age, and other factors that can narrow it down and the gallery shows you real women who have photographed themselves so you can see other women your size (or any size). What a relief! These women all look like me. Sure, we are different and there are differences between the women too (some are obviously athletic and have more muscle, some carry the weight in different places), but after seeing them, I know I'm not crazy, and also these women are beautiful right where they are =).

The things you don't think about...

I'll keep adding to this I'm sure, but here are some things I already love about RS (and all of the women who post here):
1) All the prep lists and reviews of products used for better post-op healing.
2) The pre-op jitters posts, the post-op mood swing posts and everything in-between. I may not KNOW how it feels yet, but it really helps to be PREPARED for these emotional and physical ups and downs.
3) Stuff you wouldn't think about that will make a huge difference, like making sure you schedule your surgery after your period, so you don't get it during those first 3 weeks of healing (because you tend to swell up and also because it would suck to change pads in addition to everything else going on!). I scheduled mine before thinking about this, but luckily it hits just after mine ends...whew! I think I would have canceled if I screwed that up.
4) The positivity of the messages and support. I have yet to come across a catty, judgemental or even negative comment. Even when it's about complications, women are so supportive of each other in this forum - it's all about what to do next, how to move forward.

So if anyone is reading this who's already been through the surgery, feel free to add any other "things you don't think about" that you wish you'd known ahead of time =).

There is such as thing as OVER exercising!

I go to my in person consult on Friday, but I'm pretty sure I already know what the PS will say - that I should continue to lose weight before having the surgery - so I'm not all that excited.

I've been very discouraged because I don't think it's humanly possible for me to work out any more than I do, and my diet is so strict my M-I-L gave me crap because I asked the waitress to check whether the soup had any flour in it before ordering. I don't eat sugar, I don't drink caffeine, I don't smoke or drink alcohol. I eat a very low-carb diet and I rarely (and I mean once every two or three months) cheat at all. And yet, I lose no weight. I've been plateau'd at around 170-175 forever. Well, it turns out I'm apparently OVER exercising. No joke. If you workout every day of the week, and/or several times a day and you aren't eating enough, your body produces too much cortisol and you gain fat, especially around your mid-section, and you can even be losing muscle! Wonderful! So now I have to back off exercising and maybe even eat a few more carbs and then possibly the fat will start burning off and I can get down to my goal weight. So, ladies in my situation - if you are doing everything right and you see the muscle definition coming but the scale doesn't budge...maybe you are doing too much. Just google "Am I over exercising" and read the many articles on this phenomenon.

I'll post again after my consult.

What was your consult like?

So, I had my consult and have been having serious doubts ever since. Can you tell me what yours was like? Especially if you had a BL or BR and a TT.

Consults, or "how to read between the lines."

So, I've been silent for a while, as I waited for the surgery date to arrive. I'm considering starting a new review because I don't want my final doctor to be confused for the earlier consults I had. I will also keep a journal as things happen and take plenty of pictures. Gotta pay it forward for all those women who came before me and posted their pictures online - you women made it possible for me to make an informed decision and I want to do the same for the women following after.

So much has happened since I last wrote. I had four more consults, and have learned so much about the consult process now and I want to share that with you. So, the main point I want to drive home: if there was something off about your visit, DON'T try to explain it away. In fact, if you find yourself trying to justify something about the visit, cross that doctor off your list. I have learned that many plastic surgeons have an ideal patient type. If you aren't that patient type, they will discourage you from choosing them by 1) not spending any time with you, or 2) telling you they can't do what you want, can't take off as much as you want, to the point of lowballing the numbers so that you will definitely not choose them, and 3) not giving you any details about the surgeries beyond saying something like, "I think you'll be very pleased with the results." These are all code for, "don't pick me, I don't do good work on your body type" without having to refund the $100 consult fee you paid.

That's another thing, you may think that doctors who charge $100 are somehow BETTER than those who don't, but that is the farthest from the truth. Of the consults I went to, all but one charged no consult fee (or waived it if you mentioned RealSelf) - well, that's not true. One office told me on the phone it would be free since I was inquiring about having my insurance cover the BR surgery, but then informed me in the office after the visit that they would be sending me a bill for the TT portion. I was blindsided by that, and a bit miffed since I would have just had the BR consult and not done the TT consult until after we knew if she was the right doctor for the BR. The consult was in May, however, and I have yet to receive a bill, so maybe they decided not to proceed with charging me after the fact.

Anyhow, all my consults were board certified PS's with good reputations. The truth is, that $100 makes you second guess saying no because you already put down a chunk of money and it's hard to just toss that money away. And of the doctors I saw the only two who wanted payment for the consult were also the two who pretty much blew me off. I'll post a separate update about each consult so this doesn't get too long.

Consult #1: Dr. S

I had a phone consult with Dr. S since I was scheduling my surgery to happen only a few weeks after I was able to get an in person consult appointment with him. It was all rushed - on my part. He was very nice on the phone and answered my preliminary questions. I expected at the in person consult that he would go over the surgery in detail with specifics about my body and what I could expect. Instead, he was very short with me in the talking portion and pretty much snapped my head off when I showed him the pictures of the size of breast I wanted to end up with. I was really shocked by this, and it threw me off. I had all these questions prepared and when he rudely informed me, "you're never going to look like that," I really lost my focus. I tried to tell him that I didn't expect to have breasts exactly like those pictured, but that I wanted to give representations of the SIZE I hoped to come out with. Now having some time to ponder it after the fact, I realized I should have asked him, "well, I'm trying to get an idea of what to expect on the other side, if these pictures aren't realistic, then draw me a picture that is." Then, for the physical exam, it was...not humiliating, but very close. He spent less than five minutes with me, said, "I think you'll be very pleased with the results" and that was it. I was in shock. I had waited excitedly for a month to have this final consult, where I would find out the details of what to expect in my surgery, and he just totally blew me off. I called my husband, who had the kids at a nearby park, and he couldn't believe I was done already. He told me the whole thing took about 15 minutes, and I did wait in the waiting room for some of that. I really felt like crying afterwards. I spent the entire time we were on vacation after that trying to talk myself into going ahead with the surgery, but finally, with some prodding from my husband who knew right away, I determined that the only reason a doctor would be that short with you is because he doesn't want to do your surgery.

I was a bit put off by the whole plastic surgery thing after this, so I took a break to rethink.

Consult #2: Dr. G

My next consult was with a PS who is employed by my insurance company, and I wanted to see if I was a candidate for a BR for medical reasons. After waiting in the waiting room for a while, I was somewhat impressed with Dr. G at first. She did an exam of my abdomen and breasts and had this cool way of representing what to expect afterwards - she said she'd basically take 1/2 my breast volume off, and so pulled one of my breasts to the side and cupped away 1/2. That was the first time I really got an idea of what to expect for ME personally. However, she said I wouldn't qualify for medical BR because they required 600g be taken out and that I would at most be 350g, which she later changed to 300g. I have read the reviews on here, and I *know* that anything less than 500g and I'm gonna be a D to DD cup, which is NOT what I wanted. For the abdominoplasty, she said I had too much inter-abdominal fat and so she wouldn't do any muscle tightening. That pretty much cinched it for me as a NO, since her expected results weren't worth the pain of surgery or the recovery time. I asked her about Exparel and she said she'd never heard of it. Oh, neither had Dr. S - I forgot to mention that in Consult #1.

Dr. G was very likable and confident. I didn't feel uncomfortable or rushed with her, but her nurse was more concerned with getting us signed up for some stupid online web medical tracking program than with us. She stared at her screen the whole time and we were clearly not as important as the computer. My husband is a physician, so I get that EPIC is all consuming for medical records, but it shouldn't be at the expense of polite human interactions. And the other thing that really bothered me was that the nurse informed us AFTER the visit that the TT evaluation was billable, even though I'd been told the consult was free since it was for an insurance related BR when I made the appointment. I specifically asked because I wanted to know what the consult fee would be if there was one. I was irritated at this bait and switch, but it's now almost the end of July and I have't received a bill, so maybe the front desk informed the nurse that whoever spoke to me said it would be free or covered by insurance.

After this consult, I had one with Dr. AG (see Consult #4), and he inquired why I wasn't trying to go through insurance, and I told him that Dr. G said I would never be approved and that 350g was the max she'd remove. He very politely pointed out that PS are all humans and they all have their ideas of what will look best on a patient. Some are very firm in getting the symmetry right (big hips/big boobs) and others are more willing to listen to a patient and do what they want instead of what is considered the "norm." He also said that surgeons have their method that they learned in residency and some methods are more restrictive in terms of how many grams can be removed. This was really helpful to me. Based on what Dr. G told me, I had given up on getting approved through insurance, but Dr. AG made me rethink that, and he was right.

So, lesson learned from this consult: don't take one doctor's word as law. If every consult says the same thing, then it's probably true, but in my case, all of the other consults for TT said I could have muscle tightening and three of the consults said they would remove between 500-600 grams. This doctor was either too conservative for me, or again, didn't want to operate on me and so gave me results that were unacceptable to ward me off without having to say no.

This is also why you should get a minimum of 3 consults, and I would actually recommend getting at least 5.

Consult #3: Dr. L

We were the first appointment of the day, and the office manager wasn't in yet, so Dr. L actually came out and gave us the paperwork to fill out. I think I fell in love with him right there because it showed such humility. He also didn't act like it was beneath him or that his staff had done wrong. You get the impression that they all work as a team there, which is nice. By the way, I say we because my husband determined to go with me to all my other consults if possible since the first one was so bad. So, Dr. L was very professional, kind, and really listened to what I wanted to achieve, especially in terms of the breast size. He then examined me and told me what he thought he could accomplish for my body. I say this last, because if a doctor just explains what a BR and TT are, that doesn't help me if they don't tell me what my BR and my TT will look like.

Dr. L also went into detail, and I mean DETAIL about every possible complication, how common they are, and how bad it could get. You are not going to get fluffy rainbows and puppy dogs with this doctor. He wants you to go into the surgery with your eyes wide open for all possible complications. I really appreciated that. The only thing I was worried about with Dr. L was that he didn't use Exparel and I'm deathly afraid of narcotics because I've had such a bad reaction to them in the past.

After the consult, both my husband and I felt like we'd found the first doctor who we'd want to have doing my surgery. I didn't even bother to ask Dr. L about getting approved for insurance for my BR because of what Dr. G said about it needing to be 600g, which would come back to bite me later...but I'll get to that in another post.

Consult #4: Dr. AG

Dr. AG was my final consult of this round. I honestly didn't expect much going in, but he really blew me away. First of all, before I even scheduled a consult, he answered several of my questions via email. He's huge on email and customer service. If you go with him, you will never be complaining about your doctor not being accessible to you!

Dr. AG was clearly very busy - his office was buzzing and he had plenty of patients to see. However, he did not rush us at all. He took a good amount of time just talking with me and my husband. He's a nice person, or if you want to be cynical, he comes across as a really nice person. He did a full exam, but didn't have me strip down, which was nice. He went into detail about what he could do for my TT and gave me a lot of information I did't have from my other consults. I mentioned to him that I couldn't seem to make a dent in my upper abdominal bulge, no matter how much I worked out, and he pointed out that some of that bulge was from my muscle separation, and once that was repaired it wouldn't be nearly as pronounced. I'd never realized that. As I mentioned above, he told me he felt like I would qualify for insurance coverage for my BR, and encouraged me to get a consult from a preferred provider for my insurance company.

Dr. AG was also the most current on all things PS. He knew about and uses Exparel. He does twilight sedation instead of general, he knew all about the use of arnica, bromelain and lymphatic drainage. In other words, this guy keeps on top of what's new and working and tries to provide the best possible outcome/fastest healing/least amount of pain for his patients. I really appreciate that.

Sadly, Dr. AG doesn't do large BR - it's just not his thing and he was nice enough to just tell me that instead of making me feel like I was too fat or delusional about my expectations. He even referred me to another PS who he trained under who does them, so this wasn't a blow off. And even though he probably knew I would end up going with a PS who could do both procedures at the same time, he still followed up with emails, answered my questions about Exparel and wanted to know how my final consult went with a Dr. on my insurance plan.

I didn't go with Dr AG, mainly because I just couldn't bear to have two recovery periods - that's too much down time and exercise is what keeps me sane - but I would recommend him to anyone in a heartbeat. And if I get other work done down the road, I would consult with him for sure.

Consult #5: Dr V.

So, Dr. V is closer to my home than all the other consults (1 hour versus 5 hours and 4 1/2 hours away) and she is a preferred provider on my insurance. She was my final consult and I only went in for the BR this time, waiting on the TT until I found out if the BR was approved.

I had a terrible experience with the office staff. I was kept waiting for a long time without anyone even acknowledging me, and then when they finally did, I was given all this paperwork to fill out that basically signed away all of my rights. I explained that I didn't want to sign anything about pictures being posted anywhere or whatever until I decided to have the surgery and even then until the surgery was done. She told me I had to fill it out, but that if I had questions I could hold onto it and talk to Dr. V about it. The woman and her coworker then began to complain loudly about how if no one gave permission to use their pictures then what would prospective patients have to look at. I couldn't believe how rude they were. I didn't want to sign the paperwork at the consult, so I just tucked it into my purse and no one asked me for it. The woman at the desk was too busy complaining to her two co-workers about how she wasn't paid enough and how other people made more than her and how she deserved more money. I had to bite my lip from pointing out that maybe she didn't get more pay because she spent all her time being rude to potential patients and bitching instead of actually doing her job. Yes, that is how miserable I felt by the time I finally went in to see Dr. V.

Once past the gorgons in reception, everything changed. Dr. V was great. She was nice, professional, and really listened. She did the most thorough measurements by a mile than any of the other PS's I saw. Maybe she had to because of the insurance pre-approval, but still, I wish every surgeon did that because it really gives you a sense of what's going to happen and how they figure out how high to raise your aereola, etc. Anyhow, I really liked her and she also felt I would get approved, so it was just a matter of them submitting and getting approval.

When I scheduled the consult (which took a month to get in), I was told I would be able to schedule my surgery within 2 weeks of approval, which would have been within my designated time frame for having the surgery (mid-late July). However, at the consult, I was told she was booked out until August. I was disappointed by this, but figured since she's closer to home I could still get it done in the fall or early winter. I asked how long approvals take and they said 2 weeks.

Two weeks later, I hadn't heard back and so I called the office. I was told by someone who was very short with me, that it was submitted but they hadn't heard back. I called my insurance company to see if they would tell me what the hold up was, but they told me I had to talk to the Dr.'s office. After a month, I assumed it was rejected. So, I gave up on insurance and scheduled my surgery with Dr. L as a private pay.

Fast forward to the Friday before my surgery and Dr. V's office calls me to tell me I've been approved. I'm shocked. WTF???? So, I call my insurance company and ask why it took almost 2 months to get approved. I'm informed that the claim was submitted a day or two after my consult, but rejected due to poor picture quality. It wasn't resubmitted until July 21st! She said their turnaround is typically 48 hours! So when I called 2 weeks after my consult and asked about the status, whoever I spoke to already knew it had been rejected and didn't bother to resubmit for another MONTH even though I was obviously anxious to find out.

Consult tip from this visit: Even if you love the Dr. if the staff is so abrasive that you want to walk out, chances are you are going to hate going to that office and they may stall your paperwork! I hope Dr. V and the admin of her organization figures out that the front office staff are LOSING HER POTENTIAL PATIENTS.

Also, don't be an idiot like I was and think that you can't request a second office apply for pre-approval just because the first may have been rejected. I called my current PS's office as soon as I found out I had actually been approved and basically begged the office manager to submit a pre-approval ASAP so I could get the BR portion covered by my insurance. I don't know if she's going to do it, since it's no skin off their backs if I can't get approved in time. But for me, it's THOUSANDS of dollars. And I'm not gaming the system or anything. I had letters from chiropractors and massage therapists who I've been seeing for years with neck, shoulder and back pain. It was just a question of would I hit the magic 500g (not 600g as Dr. G. told me) mark or not, and frankly, if I didn't I was okay with paying out of pocket, but if I did, then the insurance should cover it. BUT, they won't if it's not pre-approved. So, right now I'm crossing my fingers that Dr. L's office manager went the extra mile for me and got the pre-approval submitted in time. I'll find out by Wednesday next week whether we made it under the wire or not. I hate that it's up to the Dr.'s office and we as the consumer have no control over when or whether they submit the paperwork. And again, it was my fault for thinking the claim was rejected instead of that Dr. V's staff just didn't bother to resubmit it for over a month. I should have had Dr. L's office ask for pre-approval as soon as I decided to go with him. Well, it's always 20/20 after the fact, isn't it?

More on Dr. L and a Final Word on Consults

So, I had my pre-op visit with the nurse, as Dr. L was on vacation (knew this going in as I was going to schedule my surgery that week but since he was on vacation, I scheduled it the next week) and all went okay. I was a little nervous because I found out she's not the nurse at my surgery, so I was worried about whether my concerns/requests would get to Dr. L in time. I needn't have worried - he sent me a really nice email to address my concerns about pain management (he doesn't use Exparel, but he actually uses a long-acting marcaine which is very close to what Exparel does) and also recommended supplements that would help me with my healing and circulation (I have poor circulation on my extremities - hands/feet). I already had complete confidence in Dr. L's surgical skill, but his email also bolstered my faith in his keeping up on the post-op stuff that makes recovery easier for his patients.

Now, my only worries are if I'll get insurance coverage in time, and also how much time the Dr. spends pre-surgery on telling you where the scar will be for the TT. I really want it to be a pretty smiley face like I see on most of his pictures, but there are a few where it's not like that, and I'm sure there is a medical reason why. I want to know if I'll get the smiley or not just so I'm prepared and not disappointed.

Final word on consults: Take your time and listen. I thought the consult was the introduction. That everything would be gone over in more detail at the pre-op, but the pre-op is just about filling out forms, going over post-op care and checking vitals if needed. And I get the impression the pre-surgery routine is going to be all about marking you up and getting you on the table. So, think of the consult as the detail session. It's the most time you will spend with the PS before your surgery, and you should ask all of your questions then, and voice all of your concerns then as well. You won't get another chance like that face-to-face. That's not to say that any of these PS's wouldn't answer questions via email or phone - almost all of them offer that and I got quick responses to several follow-up questions. But, I do think patients have a different idea of how the process works than the PS office. Your consult is the big meeting, so make the most of it.

Started my Bromelain - down to a few days until the operation

Well, it's three days before my surgery so I've started on my Bromelain supplement. I'm using the Vita Medica Surgery Recovery pack, which includes multi-vitamins that you take morning and evening two weeks before and then two weeks after your surgery, and Bromelain, which you take 3x/day starting 3 days before your surgery and then 7 days after. I'm also taking Arnica Montana starting tomorrow (2 days before surgery), but you have to buy that separately. You can buy directly from Vita Medica, but I got it for 30% off at DermStore.com, so be sure to shop around if you decide to use it. The vitamins were designed specifically to aid in healing and also eliminate any supplements (like Vitamin E, omega III, etc.) that you are warned against taking.

All that's left is I need to shop for after surgery care, like gauze and tape and also whatever I plan to eat, like protein shakes or whatever. I have put that off because I'm a low carb eater and I am going to have to bend that if I plan on juicing and "drinking" my meals a bit. Also, I don't pay any attention to my salt intake. I'm naturally blessed with very low blood pressure and never have had to worry about it. But I read on RS that it will swell you up mightily, so for the first time I really need to keep track.

My PS's office sent my pre-approval paperwork priority mail, so it should arrive tomorrow. I wanted to have it messengered over by a courier (at my expense) since the surgeon and insurance office are in the same city, but she had already sent it out. They gave her a P.O. Box and express delivery and couriers won't deliver to a P.O. Box. I would have called my insurance company and gotten the street address, but it's too late now. I just have to cross my fingers that it arrives in time tomorrow for then to review and approve it before Thursday.

It's even more depressing if I don't get approved in time, since I found out that the surgery center and anesthesia are both in-network as well as the doctor, so everything BR related would be covered at 80%. Still kicking myself for not realizing that not hearing back from one office doesn't mean my claim was rejected.

What else? I found a great deal on Craigslist selling a portable raised potty, shower seat, walking can and walker for just $50! And they were in very good condition. The woman selling them had two knee replacements (not at the same time) and after that, didn't need them anymore. Well, it was $50 plus the amount I paid the babysitter ;-). My husband says I'm "mitigating" everything about the surgery by planning for stuff that may not come to pass, but I just think I'm being well prepared. From reading all the other RS reviews, I don't think I'll regret having a walker or a shower seat. And the potty thing is great - it's like a walker but with two bars across instead of one and the toilet seat sits on the two bars. It has a lid, a seat and then underneath there is a place where you either put a bucket or an open "funnel." This would be great for camping where there are no toilets =).

Ok, enough about potties! I really want to post some pictures, but I packed the camera bag and left the camera at home...d'oh! Luckily, my hubby is back home right now working so he'll bring it with him when he comes tomorrow. And I'll take some before photos and upload them. I know from reading reviews, it's crucial to have good before photos in order to see the difference!

And finally, I just want to say thank you to all the women who posted on here before me, who answered my private messages about their surgery or doctor, and who have commented on my review. I don't think I would have gone through with my surgery if it wasn't for the information and experiences you have provided me.

What to tell your kids/friends

So, I am not ashamed that I'm having these surgeries, but I have found myself only telling people about the BR, since that is considered "medically necessary" and not "vanity." When I was explaining to my girls (ages 7 and 3) why I had all the medical equipment I just bought, I told them it would be really tough for me to walk because I was having the muscles in my abdomen repaired and the stitches they put in make that area very sore for several weeks. I told them I'd have a big incision like a happy face =), and so I needed to be very careful not to do very much while it healed. This seemed to be enough information for them and then I realized I'd hit on my "what to tell" spiel.

If I need to tell someone about my surgery, I'll say I had a BR and abdominal muscle repair. I like the sound of that better than a "tummy tuck" or "mommy makeover." It's entirely the truth, I just don't have to say that I'm also having a bunch of loose skin and fat removed too ;-).

The Great Manual Lymphatic Drainage Experiment

So, I am scheduled for my pre-op LMD session tomorrow morning. And then, once I'm cleared by my PS, I will start a series of post-op LMD sessions, about 2-3 a week for at least a month. It wasn't cheap, but I have read studies that say LMD can reduce swelling and increase healing time greatly. I believe the average time for a procedure to heal completely was 4-9 months, but with MLD it was 3 weeks to 3 months. That's a huge difference, so I'm giving it a try. I'm using a therapist who is certified in the Vodder Method of MLD, whose practice is based around MLD, both for post surgery and also lymphedema, so she's skilled. I'll keep you posted on how it goes.

I'm loving my insurance company and my PS's office!

If you've been reading my posts to date, you know that I got majorly blindsided the Friday before my surgery week that I was eligible for insurance coverage of my BR. I had erroneously thought it was rejected, but the PS I was going to go through just didn't resubmit the application with legible photos until months after my consult. Well, thanks to the PS's office manager going the extra mile for me and the insurance company's pre-approval department fast tracking my application...I was pre-approved the afternoon before my surgery!!! Woot woot! I'm so grateful right now, I just can't say. I had accepted that I would have to pay out of pocket, but when I found out I could have gone through insurance, well, it was a little devastating. I felt like a victim, but I was also blaming myself for not realizing what was going on. So, it really lifted a weight when it was all set to right. I may not even qualify if I don't hit that magic 500g mark, but just knowing that they approved me validates the years of neck, shoulder and back pain I suffered from over-large breasts.

MLD - Pre-Surgery sesssion

Today I had my first manual lymph drainage session with a lovely therapist named Alice Fernandez. She is Vodder technique certified, which is the gold standard of MLD. It's a very gentle form of massage that basically opens up the pathways between your lymphatic system and the "central drains" in your body. I found it fascinating when she described the basics to me. Your body produces fluid that can be trapped in the body after trauma, or just general activity. The MLD technique "unclogs" the pathways and pushes the water towards these lymph drainage sites, where it takes the water in and purifies it and then puts it back into your blood stream. I think that's about right, if crude. It reminds me of a water treatment plant, sort of. Anyhow, it was pleasant and in a few places I could definitely sense a release in the area. I suspect it will be more pronounced after the surgery when the fluid build up is more pronounced.

A Quick Comment on Reading and Interpreting Review Ratings

I just want to encourage all future reviewers of PS's on this site to NOT enter in your ratings until you are at least 3 months out from surgery. Why? Well, you can't change your ratings. So, when you rate your doctor all 5 stars across the board after your consult, but then have a change of heart because he was callous about your pain, or you had multiple complications, or whatever the case may be, you can't change that 5 star rating and every woman after who sees he has a 5 star average will think he's amazing, when in your case, he really wasn't.

It would be like giving a gymnast a perfect 10 (yes, I know they don't have those anymore) after she finishes her mount, or awarding the gold medal in swimming just after they dive in. You need to wait and go through the full experience before you rank.

That's not to say you shouldn't post - just hold off on the review part until at least 3 months out. When I first started looking I saw these PS with 5 star averages and I would read the review and they sounded great. But then, when I actually read through the full review, things would go sour about 3/4 of the way through and by the end, if you judged by the updates, that doctor was not a 5 star anymore. It took me awhile to figure this out though, and it made it really hard to narrow anyone down by ranking alone. In fact, I would say the 5 star ranking means VERY LITTLE. You need to read all the way through reviews starting with the most recent and go back. That's really the only way you'll know the "whole story."

Another phenomenon I've noticed is that women have a really hard time admitting their disappointment. Or, I should say, the disappointment is clearly there, but they do a good amount of work trying not to throw that disappointment on their surgeon. You will see comments like, "Well, I still don't like that my belly button is way too high, and the dog ears on my hips really bother me, and the open wound below my breast is still oozing, but I know Dr. X is just the best doctor ever and he's been so great." Part of it, I'm sure, is that the person is going to go back to Dr. X for revision maybe, and doesn't want to piss him off, but also I think some of it is that as women we don't want to seem or act like victims and so we go out of our way to blame ourselves, or at least lay all the responsibility on ourselves instead of saying, "my surgeon put my belly button way too high, he didn't do enough contouring and now I have dog ears that need revision and he dismissed my early concerns about the small opening below my breast and now it's an oozing open wound." And again, these doctors get 5 stars. So, you really have to take those ratings with more than a little skepticism.

I think the best way to pick a PS is to read reviews and find several who sound good from past patients, then look at their before and after pictures. And I mean really look. Are all their patients thin and you are not thin? That should tell you something. Do you want a large BR, but they only have 3 pictures of BRs and the women still look huge after. Again, that tells you something. Do any of their pictures show the TT scar or are the women all wearing underwear to hide it? If so, be sure to find RealSelf reviews where women show their scars. The shape and smoothness of the scar will tell you much about the PS. For breasts, really look at the areolas - both size, shape and symmetry. Some PS's are much better than others at getting them looking almost identical and having a beautiful round shape. If this matters to you, look closely and pick a PS who has that artistry. Not all of them do. If like me you have one breast bigger than the other, find a PS who has before/after photos of women who also had this problem and see if they did a good job in the after of getting the breasts to the same size.

Finally, choose from all the PSs who passed these screenings and set up consults. Meeting them in person will tell if you they are the right one for you and whether you feel comfortable and confident with them. And then anytime you feel jittery or question your decision, go back to those before/after photos on their website and reassure yourself. My PS makes beautiful areolas, and his TT scars are almost always beautiful smooth "happy faces." That calms me down every time =).

The day has arrived

We're about to leave to drop off the kids at camp and then head to the surgery center. I'm trying to be zen and not be anxious. Just keep moving forward....I got some pre-op pictures this morning and will try to upload them soon.

Surgery Day

My surgery was yesterday (7/30/15) and was pretty much a blur. Showed up at the surgery center, whet through the pre-surgery routine, met my anesthesiologist and talked with my PS. While he marked me up, we talked about breast size (as small as possible) and the TT scar - might not be as low as I would like because my hairline gets in the way. He said he'd try to cut out both c-section scars, but couldn't be sure because of their placement. I guess I'll find out when I see the results. Then we walked to the OR I got on the gurney and remember a mask being put over my mouth...and the I woke up in a recovery area and it was 6 hours later. I was really out of it and I think that was the anesthesia and pain drugs causing terrible nausea.

I felt that way most of the evening - just miserable and wondering if I would be able to tolerate that queasiness for a whole day, much less a week. I had a rough time getting comfortable at home and was very irritable and short with my husband. I felt completely helpless and hated that feeling. I dozed on and off in between bathroom breaks. I did leg exercises every time I was jolted awake.

The two things I wasn't fully prepared for were the dry mouth - that was and still is awful! And the massive swelling. My hands look and feel like they did when I was full-term pregnant. My binder became super constricting when I swelled up. Looking on RS I see that's normal, but I freaked out that my drains weren't working and that's why I was becoming a balloon. But I made it through the night and woke up in the morning feeling so much better - the anesthesia had left my system and the nausea was gone.

Post-op Day 1

First day after surgery went okay. Lots of dozing and figuring out the least painful way to get in and out of the bed. I wanted to rent a hospital bed or recliner but my husband said that was overkill and now I wish I had done it. I am trying to look forward - this day was better than last night and the next day will be better than this one.

Post-op Day 2

It's only 10:30am but I'm already wishing this day were done and the next started. I see my PS tomorrow for my first exam and I'm just biding my time until then. My hands and arms are still really swollen. And I had blood when I wiped after peeing. My period isn't due until 8/11 but maybe the surgery triggered it early, or maybe it's just excess fluids leaking out. I tried to set myself up on a couch, but it just became too uncomfortable, so I'm back in bed. Took some pictures of the bruising from liposuction and am applying arnica cream to the parts I can see with the binder on.

The binder is very uncomfortable. I don't mind compression, but it bunches up at the top and bottom and that hurts.

Overall, though, I'm going ok. The pain is perfectly tolerable, it is just the discomfort that gets to you.

Pre-Op Pictures

Pre-Surgery with Markings

Post-Operation through Day 2

Mani-Pedi before the big day

I am not a frilly sort of person. I don't wear make-up, jewelry, do much to style my hair, or do my nails. But I decided to get a mani-pedi a few days before surgery so I'd have something pretty to look at, and I really think it has helped! Yes, my fingers are swollen like little sausages, but my navy blue polish looks pretty =). And looking down my battered mid-section, I see lovely dark purple toes peeking at the end. It lifts my spirits and reminds me this discomfort is temporary.

Post-Op Day 3: The big reveal

Had my first post-op appointment today where Dr. L removed the bandages and I could see my new breasts and stomach. It was unreal. My breasts are so small, and they are still very swollen! I couldn't be happier. My stomach is very swollen, so it's hard to tell what the final result will be, but the big pooch of fat at the bottom? Gone, gone, gone! The sutures are all taped, but the line underneath is smooth and small. I'm really impressed. Got both my breast drains out, and go back on Tuesday to see if I can get one of the TT drains removed as well. I don't like the drains, but I'm in no hurry. I would rather get that fluid out of my body than have it swell up inside of me.

I've been applying arnica to my bruised areas three times a day and am still taking bromelain and arnica montana in pill form as well.

Post-Op Day 3 - Photos

Full Body Photos

Day 4 Post-op

I feel so much better with the extra padding out of the way and now that I'm wearing a compression bra instead of ace wrap. I'm trying to take it easy and not overdo things, and it's hard because I feel so good. I'm already off the oxycodone - PS said I could start alternating it with ibuprofen, but just taking ibuprofen every 4-6 hours is enough. I actually stopped yesterday, so only needed the for the first 2 1/2 days after post-op!

I'm really impressed with Dr. L's work. Time will tell, but his stitches are so small and smooth under the tape that I barely see them. I have some bruising around the places he did liposuction, but the arnica cream seems to help and it's not very painful at all. Overall, besides that first night after surgery and the brief periods I have to get up and down out of bed, I've had very little pain at all.

We checked the drain sites from my breasts and there was almost no leakage, so I'm just wearing band aids over the drain sites today. My early period ran its course too, thank goodness, so no more bulky pads to deal with.

The sweeping in my arms and hands has gone down a bunch as well. I think it's because I'm moving around more, so if you can move around those first few days as much as you can tolerate to avoid swell hell :-).

I don't want to jinx myself, but I feel really good. If this keeps up, I don't think I will need as much time to recover as I originally planned. I'm going to keep taking it easy, though, and follow the plan just to be safe.

I ended up not needing any of the stuff I bought. If I didn't have my husband helping me, I would have needed the shower chair and maybe the walker. And only for the first night and day. If you can make it to day 3, you'll be amazed how quickly you start to recover.

Day 4 (end of day)

Well, I probably overdid it a bit today and have some swelling in my upper belly now that I need to get down. I swore I wouldn't be another person who overdid it and had negative results, but it's hard to stay still and just heal when you feel so good. Heed the advice - take it super easy and slow even if you feel amazing! It will come back to bite you ;-).

Also, I keep forgetting to say that I have full feeling in both my nipples - from the moment the PS unwrapped the bindings. That's a relief! I'm seeing the OS again tomorrow afternoon to possibly get one of my TT drains removed, and I have my first post-op lymphatic drainage appointment that morning. I'm really hoping it will help with all the swelling.

MLD and 2nd Post-op appt.

I had my first MLD this morning and I feel like it's helped. The swelling hasn't miraculously disappeared, but it's definitely down in several areas. I go again on Thursday and Saturday so I will keep posting on how much it helps.

This afternoon I had my 2nd post-op with Dr. L and I got one of my TT drains removed. Only one left to go, but I'm okay with that - it's still draining a good amount of fluid so I want to keep it in even if it's a little awkward. Dr. L says I'm doing great and so I'm going to keep with my take it easy regimen and just relax for another week. My next appointment is on Monday and if all is well, I will have the final drain removed and get the tape off my breast reduction sutures.

One week anniversary

In true "don't brag about how well it's going because you'll jinx it" fashion, I had my first problem today. Woke up this morning and as I got out of bed, my last drain inflated on its own and stopped working.

For those who don't know, the way the drains work is a catheter like rod with holes in it is inserted into the area that will need draining, and then flexible tubing is attached to that and it ends in a bulb, which, when compressed to be partially deflated, applies suction to the tubes and slowly but steadily draws fluid from the healing area and deposits it in the bulb. It works amazingly well...until it doesn't ????.

I called the PS office's answering service and they paged my doctor who called me right back. I explained the problem and he said sometimes the catheter portion slides out of the drainage field (I'm guessing here in the wording so if I'm wrong with the terminology that's my fault not his) and if I could gently wiggle it back in, it might start working again. If not, I could go into the office and get the drain removed early. Well, I got off the phone and skeptically tried what he said, and he was right - it had slid out about an inch. I gently maneuvered it back inside (after wiping with alcohol to sterilize), depressed the bulb and bam - working drain! I was more than happy - I did not relish having the drain site ooze for several days, or having liquid build up inside, so I was really glad that fix worked. The drains are a hassle and it's hard to go out and about with them, but I love them since every cc of fluid that comes out into my bulb, is a cc less to accumulate in my healing belly.

Anyhow, besides that small problem, I had a busy day - went to my second MLD appointment and I was so glad too because I had goose egg sized swelling under my arms from over exerting I'm sure. Alice reduced that back down to a little puffiness. The MLD is incredibly mild but really effective so far in reducing my swelling. I just have to stop doing too much at home. I've got help and yet I still feel the need to do laundry or help pick up after my kids. I need to step back and rest more. And take my advice if you have a BR: don't lift your arms above your shoulders and don't use your arms much at all! It doesn't hurt so you think you can do it, but then you get the goose egg size swelling and that's no fun!

All in all, though, one week post-surgery and I feel really good. I need to take pictures of the bruising - it's going away pretty fast on one side, and sliding down my body in the other. There is still no pain in the areas at all.
I'll try to post more pictures soon, but definitely on Monday when I get the tape off my breasts and can see how it looks.

Bruising update - day 8

Day 8 - Friday!

I posted my updated bruise photos, taken this morning. Apologies that they are not nearly as good as previous photos - my hubby is back at work so these were poor selfies. Today I slept in until 9am, ate breakfast and watched TV until lunch and then ate lunch and went back to bed for a nap. I tried really hard not to do anything else, but I did do a load of laundry and picked up a little. I wanted to be rested because this afternoon I went to my daughter's presentation on her last day of camp, which involved a long drive, a good bit of walking and then another drive back. I was fine the whole time but when we got back home I could feel my body swelling up on protest.

Tomorrow I have another MLD session, and then my hubby's wonderful parents are taking the girls swimming so I'll be home alone all afternoon. I love them so much!

Day 10 Post-op update: lazy Sunday

Today the grandparents took the girls to the park all morning so I lazed around, and watched a Bollywood version of Pride and Prejudice on Netflix. I have a really hard time doing nothing, but I'm forcing myself to do as little as possible. I did a load of laundry and folded some clothes, and out away clean dishes...but that's it ????.

I am pretty sure I'll get my final drain out tomorrow even though I'm still putting out more than 30cc in the evenings, mainly because it keeps slipping out and I have to sterilize and wiggle it back in place. My PS is super careful about infection, so I suspect he will deem this too risky and remove the drain. I am hoping I can avoid sermoas with my continued MLD visits and efforts to do very little exertion.

I realized today I've become super lax on applying the topical arnica to my bruises. I think I've done it once in the last three days when before I was doing it diligently 3x a day. There's no pain and I can't see the bruises since they are mostly under the binder or behind me, so it just hasn't been a priority. Plus, my hubby is back on Tuesday and it's so much easier when he does it than me twisting and contorting to reach around ;-). Yes, I am letting this laziness go to my head!

I also realized I never said what post-op garments I used. I have the binder the PS gave me for my abdomen, but I also purchased two corset like waist cinchers for when he gives the ok to move from the binder to phase 2 compression. One is a Maidenform Flexees Women's Shapewear Waist Nipper Firm Control, that the PS recommended (around $20) and the other is one is Vikoros Waist Tummy Breathable Body Shapewear Belt Corset Cincher Trimmer Girdle (around $15) that I found on Amazon. Once I'm given the go ahead, I will try both on and decide if I need them both or which one is better. I had to order based on my pre-op waist size, so I may need to return and size down depending on how much swelling has decreased. My waist is much smaller but my hips are still pretty wide ????.

For breast compression, I purchased a Playtex Women's Play Zip Zip Hooray Wirefree Racerback Sports Bra (size small!!!) and Valmont Zip-Front Sports Bra #1611A from Amazon for $22 each. I really like the Playtex one, the Valmont is okay but not as nice. My PS seemed to think they provided good compression without being too restrictive.

I ordered several more bras, some a lot more expensive, but these ended up being the best for me. My actual breasts don't seem very swollen at all, but my sides where he did a little lipo are still puffy. I'm curious to see if my breast size goes down any or not from this initial 34 B/C result.

Day 11 - Final drain out, tape removed

Got the final drain out today and Dr. L removed the tape over the sutures and clipped some external stitches around the breasts. Everything was painless and easy. He said I look good but now that I'm drainless I need to be vigilant about not agitating the TT to give the layers time to heal and reattach to each other. That means: no bending over at the waist, no twisting around to either side, and wearing pads under my binder to add extra pressure to that area to prevent seromas. Dang, it's freaking HARD to not bend over or twist! I'm going to do my best though because I want the optimum result possible.

Anyhow, here are my terrible selfie pictures. A few notes - one breast looks bigger than the other but they are perfect - it's just one arm is raised to take the photo and that distorts the breast. Also, it looks like the scars under my breasts are in the middle instead of at the bottom of the breast but that's a result of the swelling on the sides - once that goes down the scar will lay flat at the crease.
I'm incredibly impressed with Dr. L's work so far - I could barely see the TT stitches - compared to some big red lines I've seen on other results. I feel like he's a master tailor ;-). And my breasts are da bomb! He says they'll be even smaller once the swelling reduces!!! I'd do a happy dance, except I can't bend or twist ????.

Day 12 - lots of good and one minor issue

Today I had another MLD session and the first without my drain! It was the best yet - you don't feel fluid moving through your skin or anything, but today I really felt a release of tightness in some areas and a noticeable decrease in swelling in my breast lipo areas and my lower abdomen.

After the session, I was really tired though, so I took a nap as soon as I got home. That afternoon I woke up and felt a little queasy, or gassy or bloated, just off. This continued until the evening - it didn't get worse or better and I thought maybe I was getting sick.

When I was getting ready for bed, I was applying neosporin and whatnot and noticed a little bit of raised skin sticking up at the last drain site. I tugged it thinking it was just some dead skin, but it lifted a scab off the little hole, and fluid just started running out! Yikes! I got some padding and it continued to flow for a while. Once it had slowed down, I decided to jump in the shower and gently compressed my abdomen and release any more fluid that had collected. Now I've got the drain site covered with gauze to collect the fluid and all is well again.

I looked it up on RS and this is a common and normal thing to happen (thank you RS!) and it can continue to drain for a while like this - just a part of healing. I'm thinking my neosporin application may have trapped the fluid long enough for it to scab over, so I'm going to be less generous in applying it there and will use warm compresses to make sure it's healing and not just scabbing and trapping the fluid again. As long as it's draining I'm avoiding seromas so yay body :-). I also think it was so much at first because the MLD got things moving, but since the drain pathway was still open it pooled up there instead of heading for my lymph drainage sites. My stomach was noticably flatter and less rigid, but my pubic mound was still really swollen, and now I know why. I also think the fluid build up may have caused my discomfort/bloaty feeling as well.

I go back in two days for another MLD session and a post-op check-in with my PS so I don't have to wait long to check in. Overall, I feel pretty good. Oh, and putting on my pre-surgery jean shorts, even with the binder stuffed with padding - it's loose up front because there's no belly there anymore. Good feeling :-).

Two weeks!

I had a busy day today - an MLD appt followed right after by my post-op check-up.

MLD went great and Alice applied kinesio tape on the swelling under my arms from the lipo. You keep it on for 3-5 days and it continues the MLD by pulling your skin as you move. Of course, I go back again on Saturday since I'm doing an intensive course of MLD so Ill get new tape then.

My post-op check went great too. Dr. L said my breasts are healing great and fast. I asked about a little area on my left areola that I thought might be separating. He said it was healing fine, there is just a tiny overlap of skin. It may resolve in its own, and if it doesn't he can snip it off in an office visit down the road. It's very small so I'm not worried.

On to my TT, which is also healing great! He felt a little fluid in my belly so wanted to use a needle to extract it. I asked if it was a long needle and he said yes, so I told him I'd be looking at the wall opposite him until it was over. I never even saw the needle :-), and I didn't feel a thing. He drew out only 20 cc's of fluid. He said that was really good - for the amount of lipo I had done, he's seen as much as 100 - 150 cc's. I attribute this low amount to my doubling down in being inactive and the MLD sessions, but I still felt like a star pupil =).

Dr. L looked at my padding and I had misunderstood his instructions - I had it long and thin and he wanted it really thick. So when I got home I doubled the pads, which is totally unattractive, but really compresses the area. I'll try to post some pictures so you can see what I'm talking about :-).

Overall, a really positive day.

Photos - 2 week post-op

Photos to go with the last post.

Day 15 Photos

Here are photos from 8/14/15, this past Friday, which was Day 15 post-op. Most of my brusing is gone and swelling is down. You can see the kenesio tape in these photos too. I tried to get a photo of the small skin overlap on my areola, but it's hard to show it's so small. It just looks a bit puffier than the rest of the areola.

Day 17 - Overdid it

Well, I overdid it yesterday and it showed when I went to the PS today for another post-op check. He drained 25 cc of fluid when there should have been less. I am glad it wasn't worse. I totally did too much and knew I was going to pay for it. Today I am taking it super easy and working on having little to no cc's to come out on my final PS trip before we head back home on Tuesday. I want to get out of the padding under the binder and I want to get back to working out, neither of which will be happening if I don't let the skin and fascia/muscle reattach!

Other than that, I feel great and my breasts seem to be getting even smaller, which is so great! My hips and thighs are also returning to their normal size. They swelled up with the edema and as the inflammation in the lipo areas disspates, it moves down and made areas I didn't have work done pretty big. I feel much better now that they're back down to normal, though I look forward to shrinking those areas even more once I can get back to the gym =).

Past the 3 week mark and back home

Traveled home with no problems and had my first MLD with my new therapist in my home town. Alice was so nice she wrote up her treatment notes so I could give them to my new therapist for continuity of care. Seriously, if you are in Portland and having surgery, look up Rose City Manual Lymph Drainage on Google. You won't regret it.

My new therapist is a guy, which I was worried would be awkward, but it wasn't at all. He was totally professional and I don't really have an attachment to my new breasts yet like I did my old ones. I know that sounds weird, but it's true. I'm sure that will come with time and as things heal and are more natural. I thought about joking with my husband that this guy felt me up before he did, but I don't think he'd appreciate the humor. Besides, I'm fairly well aware that he encouraged me to have this surgery for my sake, not really for his - he's a total big breast guy. I love him for it, but also wonder if that will be a problem down the road. Can't worry about it now, those giant boobs are GONE =).

What else? To all the Moms of young kids out there consider a TT: when you plan help after the surgery, be sure you have someone helping with the kids even after the 2 week mark. I'm back home and my husband is back at work. The grandparents even took my oldest for a week until school starts, but my 3 year old requires me to be up and about all the time, bending down to pick things up or help her with something. Even with a grabber, I can't keep my abs/front "quiet" like I'm supposed to and I can't get any rest.

When my husband drained my belly this evening (we are checking every 3 days until I have two in a row with no fluid), I had 15 cc's come out. It's less than last time, but I really wanted it to be zero. Now I have to wait another 3 days, pray for a clean drain and then another 3 days after that before I can get out of my giant padded binder set-up and start walking (exercise walking that is). And that's also when I can start having sex again. And I really miss having sex! So, you see, it's very important not to have to take care of a toddler until you are out of the seroma risk stage ;-).

Other than that, I've started with Bio Oil, based on comments from RS, until my silicone strips arrive (I had to wait to order them online because I was traveling). My PS says to gently massage the whole breast, and then a smaller massage of the scar itself, every day to prevent a rope-y texture from forming. The MLD really helps with that as well. My breasts sometimes feel, for lack of a better word, "clumpy" inside, and after the MLD session, they felt super soft and natural. The MLD really dissipates the fluids which makes everything feel less tight and hard.

I'm taking a gazillion supplements now that my VitaMedica vitamins ran out. All my regular stuff plus Vitamin C, Zinc Picolinate and Vitamin K.

One weird thing: I have a really bad rash on the inside of both my arms. It doesn't itch or burn, it's just thousand of little red bumps. I have no clue what it's from, though I suspect I may be allergic to the dryer sheet with fabreeze my husband accidentally used in the VRBO our last few days there. I had brought all of our own laundry stuff because I'm pretty sensitive, but he just used the ones left there. I really hate it when he "helps" with the laundry. It always results in my high-end bras being dried to 2 sizes smaller, or all my whites turning pink, or items that were set aside to be stain treated first being thrown in the wash so the stain sets. You know what I'm talking about, right? I love him and his heart's in the right place for sure, but just stay away from the washing machine =).

I have so much to do, and I'm trying not to stress about it. My whole goal is all about the zero drainage...gotta get over that hurdle and then I feel like my life can start up again =).

First Zero Drain - One more to go!

My husband did my second drain since being home this morning and there was no fluid! Yippee! I feel like I'm halfway to freedom. Three more days and please...one more zero drain to go. Then I can stop wearing the extra compression pads, and start exercising I think. I really have to email my PS and make sure of what I can and can't do once that magical moment happens. I swear, I'm so desperate to start working out again, it's not funny.

Here's an odd thing I've been feeling - tell me if you had that happen too: so, when I'm massaging in the bio-oil to my BR scars, especially on the spot where the vertical line down meets the curved line under the breast, I feel this weird sensation. Like there's an air or water pocket I just popped. Or maybe like a crackle. One of those two words describes it. Anyhow, I hope that's normal and I'm not destroying something =).

One other update I meant to give earlier. While I was in Portland, I did not have a scale so couldn't weigh myself. I was between 163-167 just before my surgery and when I weighed myself the morning after I got home, I was 157. I hadn't broken the 160 mark since at least a decade ago when I decided to only drink boost for breakfast and lunch and then eat a normal dinner (I went from 180 to 150 on that "diet," but had absolutely no energy and lost most of my muscle tone...everyone I knew complimented me on how great I looked even though I was weak and completely depressed. Go figure). But I digress ;-). I'm now a little over 160 again, but mainly because I've been eating like crap. You think you won't do anything to gain weight ever again once you've had the remnants of your weight gain removed, but it's not as simple as it sounds when you are post-surgery and your body is not your own. You can't DO anything for a really long period of time, but your ability to eat is unchanged. And so it's very easy to fill your boredom, your pent up frustration and desire to MOVE, and your feeling of helplessness, with food. I wish I'd prepared better for this aspect of recovery. I'm not terribly worried right now. I'm already eating better than I was in Portland, and as soon as I can move again (3 days! Zero Drain!), I feel like the corner will turn.

5 weeks post-op and doing great

Quick update since it's almost 2am! I'm doing great and just started working out again. I was waiting to hear back from my PS but I think my email to him went to spam, so I emailed the office manager and asked her to forward it on to him. I couldn't wait any longer, so I did 1/2 hour of elliptical and then, just because I couldn't resist, about 20 minutes of low impact dance aerobics. It felt great and I didn't have any major swelling or pain after. I had MLD therapy today and he worked on the slight swelling I did get under my arms. I felt so good I worked out again tonight for two hours - all dance aerobics. I wear my binder and a sports bra of course, but otherwise, everything is normal....well, except for the fact my boobs aren't bouncing up and down like giant pendulums anymore!
I still can't get over how small they are - I have small hands and they are just a teeny bit more than a handful for me. I'm overjoyed. Working out is so much easier and less embarassing.
Scarring wise I'm doing well. I had a little red patch on my TT scar and I worried it was getting infected. I used neosporin on it every day and then tea tree oil, and it seems to have improved, but the weird thing is that half of my scar (from the red spot out to the hip) is redder and looks worse than the other half. I also have a nasty bruise from the last needle drain. It's only on the surface since there's no swelling or hardness forming there, but it's ugly and I want it to go away =). I've been putting arnica on it and it's starting to turn yellow at least.

That's about it. I'll try to post more pics soon.

Got the all clear!

Heard back from my PS - he's great. Got back to me as soon as I emailed the office manager. My email did go straight to SPAM the first time. He answered all my questions and gave me the all clear to workout...everything except core/abdominal work. Gotta keep away from that for a lot longer to allow everything TT to continue to adhere and heal. I'm cool with that. I worked out again four about 45 minutes and did 15 minutes of light arm weight lifting - all below the shoulder. Just to be safe, and not exacerbate the swelling around my breasts.

Speaking of breasts - I tried on some regular no-wire bras today and I am a 34B with a little bit of extra fabric in the cups! Picture me jumping for joy and doing a happy dance at that. Someone else on RS noted that sometimes bras don't fit well because even though you're very small, your breasts are still wider than a woman who was born to be a 34B, if that makes sense. And that is true. Some types of bras fit perfectly on me, but others are way too small width wise. I don't care - every time I go to the gym, or anywhere, I'm overjoyed with how light and unburdened I feel.

I also tried on the type of dress I've always wanted to wear, but couldn't with my bulging belly, and while I looked much better, I still have a bit of a pooch. Maybe that will go down with some residual swelling, but I think I'm also going to have to wait until I hit that magic mark where I can do core work and really try to burn off the rest of that fat before I'm totally flat in front. I have no complaints or regrets though. I knew going into it that my upper abdomen fat wasn't going to disappear. I still have to suck my stomach in, but at least now when I do it, there isn't a big bouncing roll of belly still jutting out ;-).

Pictures from 27 days Post-Op (August 26th)

I'm late getting these posted, so note that this is just shy of a month post-op. I put the tape on for the first time and didn't do a great job. I was lazy and didn't cut strips for around the areola, which was a mistake! That was the first and last time I put the tape over the whole areola. Now they go in strips around the outside, or more often than not, I just use bio-oil and massage it in.

I'm a little puffy all over in these pictures too - I didn't realize it at the time, but I started my period later that day, about 3 days early, which is why I thought the weight gain was from eating poorly. I'm currently at 157, though I expect that to go up now that I'm working out again. Gotta build the muscle back up!

I finally found some before photos in clothes that I still own, so I'm going to dig them up (one is a Halloween costume from last year) and put them on again and take photos so you can get a before/after in clothing.

Pictures 9/5/15

Here are some photos of me at just past 5 weeks post-op. For some reason, RS is saying I'm 2 months post-op, but that's not accurate.

If you go back and look at my "before" pics, you'll see how amazing Dr. Lee did on my results. I have no regrets about choosing to do the surgery even though I could stand to lose more weight, but, I did want to show how there's still room for me to improve. In two set of photos, one is with me "sucking it in" and the other with my stomach lax. I think it's good to be realistic about what you're going to get if you are not starting from your ideal weight.

Is love too strong a word?

So, over this weekend (Labor Day weekend), I felt a rough spot under my right breast when I was massaging the scar. I looked closer and there was a small sore at the juncture of the incisions (where the vertical line meets the horizontal curve below the breast). Gah! Everything was perfect and I'm past 5 weeks. How could this happen??? PANIC!!! I asked my hubby to take a look and he was reassuring, but said I needed to immediately stop doing anything to it, as it needed to heal so it didn't get worse (he's in healthcare as well, but a completely different field) . I emailed my PS and sent some pictures (I'm long distance now), expecting to hear back from him on Tuesday after the holiday. Instead, he emailed me back right away to give me instructions (neosporin, gauze and resting the area from any scar treatment until it's healed). I was reassured and also happy to have a plan. The worst part when something is not right, is wanting to do *something* to make it better, but not knowing what to do. When I have a plan, I feel like I'm in control.

Anyhow, it's probably hyperbole, but I just love my PS. From the first time I met him, and every time I see him or interact with him, he's just so nice, unassuming and quietly confident. I have never doubted him, and he's never let me down. I feel like that's really how this relationship should be. I have seen plenty of doctors in my life, but none have so profound an affect on your body. I mean, he literally "made" me new breasts. You can see how PS more than other docs might get an inflated sense of self, or "God complex," since they really do transform their patients. And I guess that's why I am so amazed how Dr. Lee isn't like that at all. He has confidence and pride in his work, but I haven't seen any ego. And of course, there are my beautiful, small breasts, and lovely flat stomach, too. I might not like him nearly as much if my results weren't as good ;-).

A Before and After Photo

Here's a before/after photo to show the difference in clothing:

Another before/after

Here's photos from October 2015 and a few days ago. This costume (what was I thinking?) really shows the difference in breast size. You can't really see the flat tummy because it's just too big and poofs out.

New dresses

Here are some dresses I tried on the other day. I wouldn't have even tried them on before because 1) they would show my belly pooch and 2) they would look awful with my gigantic breasts. Now, I feel so comfortable with my body. I'm not even wearing a bra in the black dress. I can go without a bra and not be uncomfortable! What an amazing feeling.

Oops! Forgot my update =)

So, in all my excitement posting my pictures, I forgot to include my actual update about where I'm at 2 months post-op. I'm working out regularly in everything except core work. I started slow on weights, but have found I really didn't need to drop much from where I was lifting prior to the surgery, so that's good. I do high impact aerobics, RIPPED, TRX, yoga, pretty much everything I did before. I just avoid any abdominal work and modify when there is some included.

As for my small sore - it went away pretty quickly and was really a non-issue. I worried about it more than it really needed, but it's hard when something goes even slightly wrong. The discoloration in the shape of the scab is fading and I have been using bio-oil and other cremes, but haven't returned to silicone strips yet. I'm irrationally associating the strips with the scab since I'd been wearing them when I got it. My scars are pretty flat, mostly from the MLD massage therapy and my own massage of them, but they are a bright pink. I'm just going with the flow and accepting that this is how my body is healing. They are still such beautiful lines, even if they stayed this color permanently, I wouldn't be upset. But I know they will fade. The really ugly scars are from where my drains came out! I mean, they're not UGLY, they are just these shiny, hard round "dots" on my pubic mound. But I like to go bare and they are very noticeable. Hopefully, they will fade with time as well, or I may need to keep my hair grown out =).
My final MLD massage appointment was a week ago. I really liked my therapist, who I'd name but then that would give away what town I live in, and I'd like to stay anonymous. He was great though, and as my swelling stayed down week after week, he'd spend time working at my scars to break up any rough spots and smooth out the scar line. It really helped. I massage every day, but he really knew what he was doing and any lumps, bumps, etc. were gone by the end of a session.

Overall, I'm still so happy. Dr. Lee should be grateful I don't live closer, because I'd probably stop by at least once a week to give him a big hug.

3 months post-op update

My 3 month post-op date was 10/30, and I had my check with Dr. Lee on that day. Everything is looking good - not much to add. I will try to post some pictures soon.
Portland Plastic Surgeon

Dr. Lee is wonderful. He is considerate, always asks if I have questions, is available through email if I have concerns between appointments and most important is an excellent surgeon. I chose him because he's done extensive reconstruction work and that experience shows. My scars are beautiful, my breasts are even and you won't be able to tell I had surgery from the aereolas - it's flawless work. I am very glad I found him. His staff is wonderful, too. They went the extra mile with me to help me with a last minute insurance approval.

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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