Through VSG, therapy, diet and exercise I have...
Through VSG, therapy, diet and exercise I have managed to lose ~215 lbs. Of course, with this amount of weight loss on my resume, this left me looking like a deflated mess that nothing but surgery will fix. I get so tired of folks thinking you can fix all loose skin through diet and exercise and/or maybe some magical cocoa butter concoction! Just had these conversations recently…once on a FB board for weight loss and once with a personal trainer who promised he could take care of my loose skin through weight training (needless to say all of his credibility was for the most part lost at this point….). December 27th 2013, I had performed by Dr. Fisher a Lower Body Lift, Brachioplasty, and Whole leg liposuction (in part as a staging for the thigh lift). You can see my review and more pictures of my surgery by clicking hereI was pretty sure my LBL would turn out well as I have a fairly shapely upper part of my body…my legs on the other hand have always been very unfortunate (Even thin and in high school….) the stuff nightmares are made of….fat and tissue clear to my ankles. They are the biggest challenge to reconstruct out of all the procedures I am having/have had performed. Apologies to those of you who followed my body lift review for my tardiness in creating the new reviews; I just have not had a lot of time. I am truly enjoying my life in a lot of ways that was not possible prior to the body lift and brachio. Seriously - surgery has changed me and has changed my level of self-satisfaction and happiness. On July 29th, (yes Tuesday!) I am having several different procedures performed:
• Thigh Lift (Long + Spiral + Calf Skin excision)
• BA/BL - Anchor Incision, click here to read my review.
• Bletheroplasty (Eye-Lift) - upper and lower lids
• Minor revisions to Arm lift (little sag on the left near the elbow, little more skin off of the right)
• May have hips re-pulled a bit tighter - lateral thigh (this tissue naturally relaxes after LBL, especially with the compromised post massive weigh loss skin quality!)Whew! It makes me tired thinking about it and I am the one who gets to sleep though it! But seriously…this is maybe 6 feet of NEW incisions and I know from my first “go” recovery is just not fun, but hey…the other thing I realized from the first surgery is that it was entirely worth it! ENTIRELY WORTH IT!Sooooooo …the thigh lift…. (aka, “Big Scary Thigh Lift”) I am getting the “works” ….the “mac-daddy” correction….the super-duper deluxe model of a thigh lift. Seriously I have never EVER heard of anyone getting done what I am having done (much less at one go), but I trust my surgeon implicitly to balance what is safe, to only do what will provide benefit for the cost of the procedure and scar, and also provide maximum correction. My thigh lift will be:
• An extended “short” thigh lift procedure that has been modified for MWL patients called the “spiral” thigh lift - it basically is a longer groin incision that allows the surgeon to remove more skin (a larger “wedge” of skin than on someone who has less skin to remove - typically NOT MWL) - the incision will extend to meet with my existing LBL scar in the front and extend to under the butt cheeks.
• A long thigh lift incision on the thighs going past the knee caps
• (Drum Roll please….) an incision that extends all the way onto my calves and almost to my Ankles!Wow that is a lot of incisions but most folks don’t have legs quite like mine. I carried my weight throughout my whole leg and this has left loose skin all the way down.A few mussings on thigh lifts and different surgeon approaches:Liposuction as a staging procedure: While investigating the thigh lift procedure, I spoke with many surgeons - many who, if you have bulk left to your legs after weight loss, will do liposuction prior to thigh lift surgery - but not all. I spoke to one MWL specialist that was very against doing Liposuction prior to the thigh lift and preferred to do it at the time of the thigh lift (his results were amazing - so this technique apparently works for him). Dr. Fisher seems to prefer to do this as a pre- thigh lift staging procedure. With how oversized my legs were compared to the rest of me, it just “made sense” to do a de-bulking first, let the lipo “settle down”, and then tackle the thigh lift procedure. Indeed when I saw Dr. Fisher for my consult in June, he was very pleased with the results of the lipo as this meant he could concentrate on the skin removal for this go (and as you can see, I am having a rather complex thigh lift performed). I am pleased with the results of my liposuction but never posted as review on it as it was never intended to be an “end stage” procedure (and lets face facts…my legs would impress no one after lipo alone). I Also had lower leg lipo at the same time ….and the contour (excepting of course the loose skin) is VERY good actually….I see many calf/ankle lipo results that look less than natural - and I do think Dr. Fisher did an excellent job in this hard to contour area. I don’t have “great” legs and most likely never will, but….given where I started? Even with the excess skin, these are the most normal legs I have ever owned! Incision going onto Calves:
I have loose skin on my calves from the weight loss, and somewhat exacerbated by the lower leg liposuction (trust me, I have no regrets and knew additional loose skin was a consequence). I had inquired some online about calf skin removal and the vast majority of docs will NOT do this (seriously….i asked a question on RealSelf and one guy called it a “Charles Procedure!” The other MWL surgeon I talked to would do it, but sort of expressed gravity about it - would only do it as a third stage operative seeting. Dr. Fisher has done skin excision on calves before and seems entirely comfortable with the procedure. It is a lot to think about accepting a scar that goes clean onto your calves! But, when I consulted with Dr. Fisher this last in person consult, he seemed to think the benefit warrants the procedure and I do trust him to only do what is warranted in a Cost/Risk benefit analysis. Spiral Thigh lift:
A newer technique known as spiral thighplasty reshapes the front, back, inner, and outer areas of your thigh. During the spiral thighplasty procedure, an incision is made below your buttocks, extending to your groin crease where your thigh and pubic area meet. This plastic surgery procedure may be beneficial for those who have lost massive amounts weight.
My tip of the day for MWL patients seeking plastics - if your surgeon during the consult does NOT know this term, this indicates they are not familiar with the published techniques on “our kind” - granted this is coined term from Dr. Agha - but if you are at ALL familiar with MWL plastics, your surgeon should know this term and hopefully the techniques. When I went to the ONLY plastic surgeon in the vast metropolis of Atlanta who I was considering for my LBL and Brachio (remember with this amount of weight loss, I consider myself ‘extra special’ in the amount/type of reconstruction needed) - she was unfamiliar with the term and was dismissive of it. I think for me it was the “nail in the coffin” for the consult as I ONLY wanted a surgeon who specialized in MWL procedures. At this point I knew I would be traveling for surgery. Other Surgeon Approaches: The one MWL surgeon I consulted with wanted to do the Spiral and long and skin excision from Calves during THREE different operative setting (Trust me …I was close to using this person too.) Dr. Fisher will be doing all at ONCE…pretty wildly ambitious in my book…and I certainly would not go this route with just any doctor… Combining all three:
Well this is one “Big Scary Thigh Lift” and it is coming up faster than I can fathom. Will keep everyone posted on results!Note on pics - had markup today (pics also above), but something went wrong with posting my review (which I wrote two days ago)…hopefully tomorrow while I am in surgery you will be reading this!! :-)
Easiest day 1 in the HISTORY of post op day 1's....
Surgery was 12 hours! Doing more than great! Like blowing the curve great......no pain, just an uncomfortable booty (butt incisions). Thighs look AMAZING .....like miracles attached to my body ....so emotional when I look at them.....so many years of hating my legs....feeling like they are deformed.....and to see them now ....really really reverent and grateful. And cannot believe how good I feel! Pain well under control with morphine pump....like 3mg very hour or so. Post more details later!
Day 2 post op pics
Thighs are looking pretty amazing! Took a few snaps during dressing changes!
Day Seven Post - Op Update
A few logistics:
• Surgery was 12 hours for all procedures
• Surgery was 7/29 (Tuesday) - stayed in hospital until Thursday 7/31 - (really could have left a day earlier I was feeling so good)
• Will be in San Antonio at an extended stay Hotel tentatively until 8/22 (may be able to leave by 8/15 if healing continues to go well) - for those of you unfamiliar with me, I actually live in Atlanta and travel to San Antonio specifically for Dr. Fisher
Total feet of all incisions this surgery (this number fascinates me):
Groin front to under butt cheeks 15 x 2 = 30 Inches
Long Incision 22 x 2 = 44 Inches
Breasts (Anchor Cut) 9 x 2 = 18 Inches
Eyelids 1.5 x 2 = 3 Inches
Arm Revisions (both Arms) 17 Inches
Hip Revision (right hip) 10 Inches
Grand Total 122 Inches
I will have to GT both surgeries at some point! Dr Fisher says I had well over 1000 stiches in my body from this last surgery - impressive!
I had my follow up with Dr. F on Monday and he seems very pleased with the healing. I have noticed the groin incisions seem to take longer to heal and “catch up” to how the other incisions look. Definitely not as pretty as some of my other incisions! It is a dark damp place with thin skin….so fingers crossed this groin incision heals well - especially the “T” junction where the groin incisions.
Notes from Surgery: Dr. F didn’t take any “on the table” photos (boo! I was disappointed but I forgotten to request as well). My legs (due to being so very large at one time) had a lot of redundant veins and Dr. F mentioned he spent a good deal of time stripping and cauterizing redundant veins. My boobs also terrorized him a good deal, apparently, and took longer than anticipated. I have a “convex” chest with the right side (sternum??) protruding further than the left. Apparently I am more “lax” in the chest than he anticipated (not sure why with 215 lb weight loss and the legs this surprised him, but apparently it did…). Anyway, given my less than ideal chest shape, I think I have an appreciable result. (Sorry my boobs were such a terror Dr. F….!)
Pain Management: Believe it or not I kicked the Oxycodone on Friday and have not looked back - I have been in next to NO PAIN - I can hardly believe it myself???? I probably could have kicked the pain meds earlier but I am a big baby in regards to feeling pain - I want to feel NONE (so maybe I have an average pain threshold but I think I have low pain tolerance), so I used the morphine PCA pump in the hospital every hour or so but honestly could have “cut back” sooner. Honestly I cannot fathom **why** this has been so easy as far as pain compared to my first Surgery, but perhaps it is the lack of (at least extensive) liposuction? The first day after surgery I was actually cheerful and chirpy (the “good drugs” I guess?) Truly, I am in complete astonishment…
Swell Hell: Yep it is real and I am swelling a good bit….BUT…. not **NEARLY** as bad as after the whole leg lipo from last surgery. The freaking **scrotum** (overly swollen labial lips) is baaaak! Darn it…. I have absolute proof it is a direct result of the crotchless compression garment - the liquid is just traveling to most vulnerable place - which is (of course) my uncompressed crotch. I did not start with compression until Saturday, so the labial swelling showed up then, but not too bad with the Size Large garment. On Monday I switched off to a Size Medium garment and holy guacamole….my tortured labia is hating me for it. My legs are nicely compressed though!
Shower and Redressing: that is also wearing me out between having to redress all of the incisions and compression; this entire process is taking 1:45 hours to complete.
Body Lift/Lymphatic observation: Since I did the body lift only seven months ago, my lymphatic system must still be compromised. Although the lower back swelling had subsided from surgery #1, at this time I have a huge “poof” of swelling right above the back incision from surgery #2 - just systematic swelling taking advantage of a vulnerable area
Notes on pics:
• Swolen labia looking like scrotum : -(
• Swollen Everything…!
• Two drains steadily producing
• Think the long incisions are looking pretty good!
Side by Side Compare - Sept 2013 to today....reflecting....
The pic to the left is the pic I took and posted to Doc Q&A - this is where Dr. Fisher responded to my question very logically and thoughtfully - in such a way that I decided to reached out to him for a consult. This Dr. calls me back - on a Saturday morning no less - and just chats with me for 1.5 hours. It was a complete meeting of the minds from that first conversation. I ran in and excitedly (almost stunned even) told my hubby "I think I found my guy!" See up until this point I had consulted with three different surgeons and was agonizing **constantly** on who to pick. I was sufficiently impressed during that I asked if he wanted any more photos - which my hubby took in our well lit sunroom, edited and placed into organized PDF's. This was Sunday. I inquired via email if Dr. Fisher had received the photos, and he responded shortly thereafter "yes! Great photos! I printed them and already have you marked up for surgery!" i was so stunned that a Dr. had given me this much of his time and attention and seemed to be such a good fit. At this point, I was definitely his to lose. Every interaction after that, including the in-person consult only went to further affirm my faith and trust that I had found my surgeon. Lets face facts. I was a challenge. My body was a complete mess. My legs were a nightmare. I was well beyond a "mommy makeover" specialist. Words and feeling such as destiny, fate, kismet and even blessed come to mind when I reflect on these moments that brought me here. I am so very grateful and in awe. As I look at the pics - side by side - I dare say I have **never** seen a more dramatic result on a thigh lift than the one that i have. I have never had good legs...like EVER...even at 130lbs in high school...even at five years old!....to look now at these legs all I see are what amounts to small miracles attached to my torso. Really amazing...very reverent....and incredibly grateful...
Fun Weekend + Openings :- (
My bestie RedWineLover came to visit me in San Antonio Friday to Monday! We had a blast (as always) but most likely spent way too much time on my feet, didn’t get near enough rest, and probably imbibed just a WEEE bit too much (ok…maybe a lot too much grading on the curve of being in “recovery”).
Other than that, I continue to feel great! Had a really fun weekend would not trade it for the world…..
Saturday we did a “lap” of the San Antonio Riverwalk - 100 degree San Antonio heat, too many stairs, Margaritas at one of the 1000 Tex Mex restaurants in San Antonio. Maybe too strenuous for someone with groin incisions?? (gee you think?) - anyway still had a good time - see pic!
By Monday, my legs were swollen like balloons with a huge “ankle bubble” at my ankle bone by Monday. After 2 hours of sleep (too much red wine and giggling Sunday night/Monday wee morning hours) I had a follow up with my PS. I was very swollen and have openings at the “T” junction in my crotch :-/.
After a few Lasix later and keeping my feet up for the last three days (a.k.a., “behaving myself”) the swelling is way down. I am also faithfully wearing compression all the way onto my feet.
Openings at the “T” junction: I have a small opening on the right side and a larger opening on the left side of my “T” junction on my leg/groin incisions. My PS said it is a very common place to have openings (maybe happening more often than not) in this area when there is a “T” incision. This will most likely take a few weeks to close (the skin basically has to heal over a triangle and the skin is so thin and weak there anyway…). I am trying to stay positive - healing is not fun - I know this from the first surgery - and I would have to be an absolute idiot to think that with 10+ feet of incisions that I would NOT have something open, right? It is a very hard area to keep clean and bandaged as well…cannot put tape over the incisions or in the obvious “area” - so far managing using Telfa & paper tape with a thin layer of anti-bac ointment.
One Month Update!
Did a more extensive update on my body lift review here: http://www.realself.com/review/san-antonio-tx-body-lift-dr-fisher-post-massive-wl-specialist-excellent
However here are the thigh lift highlights:
- All incisions healing well although still some scabbing - have not started any scar therapy yet
-"T" junctions are healing A-OK...on or maybe even ahead of schedule - these just take a while to close!
-Still struggling a bit with swelling ...but hey....this is really NOTHING after the thigh liposuction from the last surgery - my legs/groin apparently are better off with 74" of incisions over the lipo...lipo is the DEVIL!
- posting some pics my doc sent me on the entire transformation (body lift, brachio, BA/BL, thigh lift) + some thigh pics. I think they are amazing!