Dr. Fisher - Post MWL specialist - brachio, LBL, whole leg lipo - San Antonio, TX

San Antonio Plastic Surgeon
4.9 out of 5 stars 53 reviews
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*Treatment results may vary

Expected Procedures: Stage 1: • LBL (Which...

Expected Procedures:

Stage 1:
• LBL (Which includes; Abdominoplasty, lateral thigh lift, mons reduction and lift, butt lift and auto augmentation, auto augmentation of the hips, high volume suctioning of the thighs)
• Extended arm lift. Which removes lateral breast tissue and the upper back rolls.

Stage 2:
• Thigh lift, with suctioning as appropriate ("L" incision to meet up with my LBL incision)
• Breast lift/augmentation (silicone gel implants).
• Lower lid Blepharoplasty

Met Dr. Fisher in person finally!

He is as thoughtful in person as he is on the phone and was very giving of his time. He stayed almost 1.5 hours after the office typically closes to accommodate me and my 1+ million questions. Post Massive plastics is both a specialty and a passion for him and it really shows. What is most impressive is how ego-less he is in discussing his own results and openly discussing the results of other doctors. I have interviewed a total of four doctors to do my post massive plastics, and I believe he is the best balance of skill, safety, and results (and he is also a very fair price point I may add....). I also like his "approach" to the staging of the surgeries. It makes sense to me. My legs will be the biggest challenge as I have the most laxity in this area - we are "de-bulking" the thighs and the calves. I am deferring skin removal on calves as a considered 3rd stage. Lets see.

Any of you post-massive folks (100+ lbs lost) who are considering plastics, I do urge you to only consider docs with specialties in this area. Our problems are far more extensive than run of the mill tummy tucks and breast augs. My thighs have to almost completely be "rebuilt." Really my whole body has to be "rebuilt" for that matter. I have so much laxity from 200+ lb weight loss. I go for 1st stage surgeries December 27th. So cannot wait! Updates to my planned surgeries:

Stage 1:
• LBL (Which includes; Abdominoplasty, lateral thigh lift, mons reduction and lift, butt lift and auto augmentation, auto augmentation of the hips, high volume suctioning of the thighs)
• Lower leg/ankle liposuction
• Extended arm lift. Which removes lateral breast tissue and the upper back rolls.

Stage 2:
• Thigh lift, with suctioning as appropriate ("L" incision to meet up with my LBL incision)
• Breast lift/augmentation (silicone gel implants).
• Lower & Upper lid Blepharoplasty

Stage 3:
• Skin excision from calves? (maybe....)

OK folks...here is the "before" thigh shot - it is the thing i am most worried about in terms of correction!

19 days and Counting!

So update on my review. Where to begin?? I am scheduled on Dec 27th to get:
Stage 1:
• LBL (Which includes; Abdominoplasty, lateral thigh lift, mons reduction and lift, butt lift and auto augmentation, auto augmentation of the hips, high volume suctioning of the thighs)
• Lower leg/ankle liposuction
• Extended arm lift. Which removes lateral breast tissue and the upper back rolls
• Fat Xfer to butt - MAYBE….
In terms of stats, I am 168, 5’7” and 43 years old. I wanted to lose 10 more lbs prior to SX but it does not appear to be in the cards. IMHO, the thinner you are, the easier healing goes and of course the better your results. I could probably lose this 10 lbs if I was willing to postpone until mid-2014, but I am not willing to wait. I have wanted this for too long.
Total price is ~22k, but 10k of that is hospital OR + 2 night stay, so surgeons fees are extremely reasonable, but the hospital is expensive (surprising for San Antonio - this was more than the Beverly Hills quote!). Dr Fisher tells me they are building a Doctors hospital eventually, but until then are subject to using the Methodist hospital. However I am more comfortable with two nights in the hospital. I understand Day 2 tends to be the most painful and if in the hospital I can get the “good drugs”
Dr. Fisher stages the surgeries a little different than a lot of surgeons - most tend to do all upper or all lower in one surgery, but he is going to do a “little of both” in both stages (you can see the stages above). It allows him to see the healed results of the one surgery prior to continuing the work. The approach makes sense to me as there is “a lot going on” with all of the excess skin….again (IMHO) the importance of going to a MWL specialist when you have lost 200 lbs. Getting the body lift (which includes outer thighs) will allow us to see “what is left” on the thighs to do as will the upper and lower leg lipo. The approach makes sense to me and will hopefully be able to avoid revisions (probably wishful thinking - but there is hope!)
He also does his arm incision “posteriorly” as opposed to anteriorly (most seem to do this). He says he has better scars this way for the MWL folks. I am not 100% sure, but there is less scar migration and better healing. It is a little more visible from the back view, but I am willing to go with it.
Me and hubby driving to San Antonio on December 24 & 25th with an overnight stay in New Orleans. Pre surgical markup is December 26th. Dr. Fisher has requested that I be on a liquid diet for the two days prior to surgery (yay…protein shakes on xmas day ?, but totally worth it for end result.) It will allow Dr. Fisher to “pull me tighter” if my guts are empty. See, I think this is also a massive weight loss (MWL) thing. Because of the compromised skin quality, some post-surgical laxity is bound to happen, therefore to get good results; I think surgeons have to pull as tight as possible.
My legs are simply hideous. There is fat/fullness extending from mid-thigh all the way to my ankle. There is no “shape” to them. I recently learned this is a condition called lipodema (not to be confused with lymphedema) that I am pretty sure I have. They just “are not right.” I am pretty sure most of my surgeries will end up with a good result, but I am holding my breath that Dr. Fisher can actually give me semi OK legs. He will so earn his MWL “wings” if he can accomplish this. Unfortunatley, my 1st stage only includes the lipo that will set the stage for my 2nd stage thigh lift, so they will probably look worse before they get better. During the consult, Dr. Fisher held his hands about 14” apart to demonstrate the amount of skin that will come off of each. I personally think I will need some skin excision from my calves as well, but we can defer this until we see what the lipo buys us.
I am of course plastics-obsessed and on the RS sight every day reading and reading…. A little on the OH sight as well, but more on here.
Also for those of you shopping for a PS specializing in MWL plastics do check out Dr. Fisher -request a consult via RS like I did, and see if you love him as much as I do! I have just developed a super great rapport with him. For our first consult he actually talked to me for 1.5 hours on a Saturday morning! Communication has been wonderful and he is completely egoless in discussing his results and the results of other PS. He is also very versed on current surgical procedures for plastics and esp. MWL plastics. He is a doctor first which means he will never do anything unsafe or take risks for elective procedures. I feel very safe in his hands…the perfect balance of results, expertise with MWL, and safely. I consulted with 4 PS prior to choosing him. One was local which was very tempting to recover at home, but he ended up being “the one.” The decision of WHO you trust to do your procedures is so important! Especially for those of us who have so much skin and need so much work! My body is such a mess with yards of extra skin and my legs are a nightmare. If this was merely a “tummy tuck” or a “breast aug” my answer would have been different. Also check out his answers on RS. They are among the most thoughtful and tailored to the asker. Some docs give the impression they are copy/pasting stock answers. Not Dr. Fisher’s.
In terms of surgery prep, I have:
• Rented a condo in San Antonio for three weeks
• Rented a lift chair to be delivered to said condo
• Purchased a toilet seat riser that you can actually “angle” a little as to not put stress on my back incision
• Purchased a used walker from craigslist
• Purchased several compression Garments (will add garments to another section) - Dr. Fisher is having one made, but you have to be in it 23 hours per day & it has to get washed sometime, so some “backups” are also good
• Have my supplements all together to start 4 days prior to surgery and to continue for 4+ weeks after
• STD and FLMA "all set" for work
Post-Surgical Compression Garments:
• I figured I will be wearing these well post-op as lipo produces copious swelling especially in lower legs - then I also figured the one that opens (hooks and zipper) all the way down the legs can be reused for thigh lift 2nd stage. I figured I will be living in compression for the next 8 months of my life ?. Pics posted of the garments….
• Annette Renolife Compression Arm Sleeves - Size M
• Annette Renolife Post Lipo Ankle Length Bodysuit - Size L (may need an “M”?)
• Solidea Arm Compression Sleeve - Size M
• Solidea MM Adv Truncal Compression HW Legging 18-21mmHg - Size L
• I figure these last two will be my “work wear” compression
• I also orders a “real” Columbian “faja” but this was so small there was no way I was going to be able to fasten it even post-surgery
Supplement List:
• Protein (ProcareMD)
• Arnica
• Vitamin A
• Vitamin C
• Arginine/Acetyl L Carnitine
• Glutamine
• Bromelain
• B12 + B Complex
• Magnesium
• Zinc
• D3
• MultiV
• Miralax
• Probiotics
• Wobesym N

So that is the plan folks! What am I forgetting?

Almost Forgot the other reason i chose Dr. Fisher

He is very committed to maintaining the feminine form. So many LBL end up with "flat butts" and "flat hips" - the only thing i have going for me some natural feminine curves buried under a tent of skin. Dr. Fisher is committed to maintaining this and actually does butt and hip auto-augmentation. I have a small upper body (33" around bust line) and my legs will never be amazing, so i have to go with what i have! He does beautiful "lift only" breast lifts - unfortunately, i have very little breast tissue so small implants are in my future....

OK Ladies (and any gents if reading....) what is the deal with protien?

Currently getting ~75 gm per day

Iferraro: I believe you said to increase to 100 above normal? So 170 g for the two weeks pre and how many weeks post? by your own accounts and based on pics you had great healing and completely awesome scars!

Also i was shocked on one of the Dr. Q&A - they poo-poo'ed extra protein (do a search on "protein shake" ! I thought this was sort of a "Standard of care" post plastic surgery?

I had also read on another sight that our body needs for protein do indeed increase for post surgical healing (there was a scientific sounding explanation for this even, but i cannot remember it....)

Any thoughts folks? What's up with the nay-saying docs??

Nine Days!!!! Arghhhh!!!

Nerves setting in....mostly (mis)directed against myself - what if I am not small enough? What if I did not lose enough weight for a good result? How dangerous IS IT to get lower leg liposuction? What if i forget to pack...(fill in the blank....). I am gong to have ~7 feet of incisions...am i really doing this to myself? Ok I will stop now! Breathe....Breathe.....

On the nutrition/protein question, Dr. Fisher stressed there is no "number" he aims for post surgery for protien, but you should be eating more calories spread across all macronutrient categories for the first 7-10 days post op while your body is healing.

I found a good article on the subject if you google life extension trauma nutrtion it should come up. Here is a small quote from it:

"There are also pronounced changes in the way the body metabolizes nutrients and food. Under normal circumstances, carbohydrates and fat are used to produce or store energy, and protein is used for developing and maintaining lean body mass. In this non-stressed condition, 90% of energy is supplied by carbohydrates or fat, and proteins contribute only 5 to 8% of total calories.

By contrast, during trauma, proteins (including muscle mass) are broken down to yield as much as 30% of caloric needs. Even when nutrients are supplemented, proteins will be utilized to provide 20 to 25% of caloric needs.

Compared to fat, protein yields less energy per gram. The patient becomes hypermetabolic, requiring higher-than-normal levels of calories and protein. Abnormal metabolism is caused by the release of stress hormones such as cortisol and catecholamines. This hypermetabolic state contributes to rapid loss of lean body mass, even when the patient is well fed. It is critical that trauma patients maintain an adequate supply of protein and calories to protect their lean muscle mass and supply their healing body with necessary nutrients."

Talked to Dr. Fisher this past Saturday. As usual he was very reassuring and patient with my 100+ questions. Also on my "to do" list is to take some "before" pics and post them so you can see 1st stage transformation. thighs and boobs are 2nd stage!

Just Tried the Pre & Post Surgical supplement ProCare MD....

OMG it tastes like liquid feet! Maybe it is all of those lovely "free" amino acids....I keep yelling in my own head: "Free the Aminos!"

The aftertaste is NOT GOOD....but if it means a modicum of a chance at better healing, I am willing to suffer....will try to make a nice "cocktail" out of it with some almond milk, spinach, and regular ol' GNC protein powder. Life is pretty diminished when you use spinach & protein powder to dress up ANYTHING.....

OK posting the "pre" pics .....(deep breath....)

I barely post pics of myself CLOTHED to FB, much less naked pics on a website! So as much as I would love to eventually share my FACE, it is probably an either/or proposition. This website is for support and to education. I know how much I have appreciated others who have coragelously shared their before/after pics, so in the spirit of this, and despite my embarrassment, I am posting mine...hopefully within a few weeks there will be some good "afters" and we can all comment on how brilliant my surgeon is ;-). I am currently ~5 lbs lighter than in the pic (sorry those lbs are hard-won....i need to take credit for them!) - but too lazy to take new pics...but hey...if you have requests let me know!

Six Days People!!!

Leaving Atlanta on Monday to meander towards San Antonio! 1000 mile drive, with a almost day stopover in New Orleans for the "fun of it." Liquid diet on Wednesday and Thursday (boo!) - @MBL will need one of those peppermint flavored protein shakes - maybe some peppermint stevia added into that lovely ProCareMD.... >_

What do you think doc, do I need a just a TT for full LBL?

Merry Christmas Eve!

Merry Christmas Eve to my RS ladies! Three days left to go........aurghhh (sorry had to get that out....). I am so nervous. Not nervous about the surgery itself, but nervous that results will not meet my expectations. Nervous things will not turn our as good as i hope....

We are in Mobile, AL this morning...headed to New Orleans for supposedly a "fun" day - although since it is ~30 degrees out and my head is so definitely elsewhere, not sure how in the mood for "fun" I am! I guess i need to try...need the distraction!!

100 miles from San Antonio and ~36 hours from surgery!

Too real now! Too excited! So weird I'll have this very changed body this time on Friday....

Twas the Night Before surgery....ready to go under the blade, a calm fell upon her as all the Markings were Made....

OK so no career as a poet....? :-). I started the day quite anxious, but now I am very calm - my emotions may have just burned out...? Me and Hubby are now settled into our little condo in San Antonio, clothes laid out for tomorrow, overnight bag for hospital for the next day packed I am surprisingly calm! I showed the markup pics to a friend of mine who is more of a PS "vet" than me, and she was impressed with the markings! Soooo....hospital tomorrow @ 5:30am, 7:00 am start of surgery. Yep - very calm! Two days liquid diet has sucked, but also sort of a good thing, as it reminds me that being ravenously hungry sort of comes and goes....like if you can hold out for 15 minutes, you are usually OK to continue not eating. I am posting my Markup pics - I am quite fascinated with them. Wow!

As far as the markup visit, it was two full hours - standing up, face down on table, face up on table, nurse pulling me this way, erasing one mark, adding another..... Dr. Fisher as ALWAYS puts me at ease with his skill and thoughtfulness that he has put into correcting MY body specifically. I just so love that.

Too Funny....

Went to sleep last night...cuddled up to hubby as usual for warmth....lo and behold, hubby woke up with a matching mirror booty tattoo of pre LBL surgery markup! Had some brachio ink on back too.....Omg too funny....not bad enough that I drag him 1000 miles cross country and then make him get up at 445 am, now he is marked! :-) - seriously the things our spouses endure.....

In Surgery for 13 hours!

Can you believe that?! Think it was the lower leg lipo. Doing ok....got up and sat in recliner ....walked a bit up hall....tummy muscles really hurts. Day one....all is as expected. Kinda out of it from morphine....yay for the good drugs! Will be released tomorrow ...could not have imagined today! Happy for extra day.....

Few stats....will add more later

Panni was 5 lbs...only two drains not draining very much even....4 liters lipo removed from legs! Not in CG just yet. Very hot...like burning up! Not fever though...just the healing I guess!

A few pics....

Took the IV out as it was clogged...here's a sneak peek of LBL and brachio....

No naked pics yet today...life reduced to pee and poop report!

I am able to stand and walk a lot though! Getting up and down is more difficult, so once I'm on my feet, I just stay on them for awhile and meander about. Still have not gone the dreaded #2, but bowels are making noises so yay for that! Hubby installed toilet seat riser for me that can tilt forward a little when blessed event finally happens! Taking a dose of miralax with my disgusting protein shake....to help things eventually. Also have not peed down my own leg using female urinal...so hey....small victory unto itself.

The good, the bad, the swell hell....

I have been on this site for months so I know everyone goes thru swelling and days where they are less than stunningly happy....so here goes:

I a moving around well and not in pain...just swelling.

I pooped! Very uneventful thankfully...And can sit down to do #1 thanks to the seat lift.

Showered and redressed incisions and back into compression. Feeling very clean and refreshed!

Labial lips are swollen....I suspect because this is where the garment is open to the front. Looks like I have a scrotum :-/ .....really hoping this resolves where the garment is open to the front.

Brachio is fine.

Booty looks weird....I was a little afraid of this but maybe some will resolve with swelling going down. Dr. F gets such excellent pull on his LBL my booty auto aug and hips are high and tight. The v shape in the middle now looks like a droopy "dirty diaper" ( dr. Medieta's term). By compare :-/ ....hopefully some swelling or at least something in 2nd stage surgery can fix....it is unfair of me to be critical as I knew what 200+ of weight loss left me with sagging all over...only which some is fixable.....dr. F without a doubt did an excellent job...just looks funny right now! Ah well.....! I am grateful for what I do have. Good healing from a huge surgery, a terrific hubby and doc who are attentive and taking care of me. I am also going into 2014 with 100 lbs lost, a lot less excess skin, overall I am very blessed!

Have a SUPER New Year to my RS Friends!

Check up with Doc today….

Drains: I thought I was getting drains removed but no such luck. :-( They were actually partially “clogged” up inside of my body, so Dr. Fisher pulled them partially out (like maybe 6") and “stripped” the tubing, and about 50ml immediately came out of both drains. It wasn’t painful per se, but it just felt “funny” as I felt it pulling the fluid inside of my hip. The left drain lost the air seal though, so it no longer stays flattened - will run back to doc’s tomorrow to see if we can fix.

Back: Tried to aspirate fluid in back - but apparently it is more in the tissues and not really a candidate for this? It feels "boggy" - medical term apparently...who knew?

Other exciting news:

Healing Progress: I am ahead of the curve on healing and have virtually no bruising! (I have to say I feel surprisingly good and do feel ahead of the curve).

Swelling: I asked the good doc how my swelling was measuring up to what he expected and he says it is actually better - I guess if you think about it, my poor body underwent 13 hours of trauma 6 days ago...

Energy: My energy is actually pretty high to the point I am bored and have to force myself to “sit still” - I asked the good doc about walking a mile or so (really I feel up for it…) he responded very emphatically with “absolutely not!” (something about what all he did to me and a compromised blood supply having so many procedures plus so much lipo) sooo….I actually have to force myself to take it easy and let my body put all its energy towards healing. I will confess, I did walk around the grocery store with hubby tonight …I am just so bored - promise I will be good tomorrow (we’ll see if Dr. F reads this and gets after me tomorrow ;-) )

Standing upright: I can pretty much stand up straight…the walker was a complete waste of money and valuable car space. I feel the “pull” in my tummy and have virtually no side to side stretch, but I am definitely upright.

One spot to watch: The crescent on my right back looks a little darker in the middle and a little red and angry on the sides - probably not a coincidence that I am right handed and use this arm more? I really need to try to take it easy and hope this resolves and does not result in separation or dehissance.

Scar Care: Doc seems to think wounds are closed enough I could be ready for silicone?? I was not expecting this so soon, so just ordered a gelzone wrap from amazon for my mid-section and also some silicone sheets and some silicone “tape” for arms/back. I don’t know if it works better than paper tape…many of the docs on here do not seem so “into” the silicone and still support the paper tape - especially given how expensive the silicone is.

Need to ask Doc: When can I start scar self massage and/or any lymphatic massage? I have already lined up a lymphatic massage therapist back in Atlanta.

Compression Garment: doc is really liking the one I have that has hooks/zips up the legs - it is quite easy to get on and off with all of the swelling and provides very nice compression. I have the garment listed in an earlier post. I was also thinking/hoping I can use this during the thigh lift as well. I ordered another one to use on alternate days.

What is aiding the good healing: I have no clue if it is the Arnica, extra protein (including the yucky ProCare MD), all the free aminos, bromelain, wobenzym n (whose main ingredient is Bromelain) or just good genetics….it is such a guessing game to know what actually helps and what is just a waste of time and money. You would need your own identical twin as a control group!

Pics: I will post more pics later as there is anything “new” to see! I am still waiting to get my “on the table” pics from Dr. F. In these you can really tell the thigh deflation as no swelling has occurred yet - (in the pic you can actually see the deflated skin laying on each side of the thigh). I can only minimally tell right now on the legs with all the swelling…and the KNEES! They are huge! Did we really think those monster knees were going down without a fight?? I am sure they will terrorize both me and the good doc for months and surgeries to come.....

Maxi dresses a MUST to covertly smuggle your "grenades"!

Had awesome shower, had hair washed and blown dry at local salon school...had good dinner with hubby on the scenic San Antonio Riverwalk...what more can a girl ask?

Maxi Dress - smuggling grenades on Riverwalk - San Antonio!

More pics of incisions....

7 days post op.....Sorry about the shadows...we were in a hurry and didn't get the lighting quite right. I am still a tad disappointed with flat part on booty, but Dr. F says the auto aug booty should drop a bit...only time will tell! I will be more than thrilled if I continue to heal without complications!

The Procare MD protein powder....

It is from Nutressential.....if you check the amino profile, you can probably replicate it in other supplements....RWL turned me on to using Histidine as a single thread...it is important to rebuild tissue and skin....I am using a 1.5 scoop per day of this stuff....hocus pocus or not, I am so far having good healing!

The On the table shots....!!!

Wait for it ladies....These are fabulous!

1 & 2) the legs - one deflated one is not - unsure what is going on with the knees?
3 & 4) The butt auto aug - the deepithalized skin is "sewn into a teepee shape (that is what i call it anyway!)
5 & 6) completed "on the table" shots

here is a copy/paste of the auto-aug conversation below - thought it bore repeating for those that didn't read the comments:

Auto Augmentation of the Buttocks: Different from Fat Transfer to butt and is a procedure that is offered sometimes as part of the Lower Body Lift package procedure. They are basically cutting a wedge from your flanks on your backside. This is skin with a nice chunk of fat attached to it. Rather than discard all this nice this flank fat, it is deepithalized, folded down, and sewn (my surgeon does this teepee shape on each side) and "folded down." My surgeon also uses the hip fat to auto augment the hips! He is the only one I know that does this hip thing. The fat at the time of surgery has an attached blood supply, so the theory is that this fat has a much better rate of survival than fat transfer, where it is dependent on the fat re-vascularizing, therefore some percentage is lost. It is kinda cool right??

....probably bordering on TMI, but two surgeons I talked to do BOTH auto augment and fat transfer at the same time of LBL! Dr. Fisher was not a fan of doing the fat xfer at the same time as you really should not have pressure on your booty for the fat xfer to survive, and he needed me flat on my back to heal from everything else! I do put a pillow under my lumbar to ease pressure on the auto aug even. Also, for me there I believe was a missed opportunity as my only eligible fat ...which is tummy fat....was removed via my pannus removal at the time of the front tummy tuck portion of the LBL. He did very little lipo to the rest of my tummy, so I think I would have to deliberately gain weight for a surgeon to harvest belly fat (I think this is the preferred fat, but Iferraro says they can harvest from other areas!)....which I don't plan on doing, plus my general body type ...bottom heavy...dictates that I don't gain fat on my belly anyway, so let's hope my auto aug drops and fluffs appropriately!

Final on the table shots...

Darn, hit "update" too soon! Here are the rest.....

More pics!

Not a ton of news here....just healing....things still looking A-ok. I just have the attention span of a flea, the energy of a three-toed sloth, and am narcoleptic for most of the day. Hubby has been asleep in my recliner for the last hour....poor guy! think caring for me is wearing him out.

By the way....how long before I can actually pick up stuff from the floor?? So annoying....

I started doing gentle massage to the arms with Tripple antibacterial ointment - arms are quite puckery at the junction of the arms to the Back....

Notes on pics:

I think swelling is finally subsiding a bit in my back and on tummy! I can see some top booty curvature.

Ankles and knees still swelling to the MAX - calves are smaller but they are double compressed with knee high compression hose plus the compression garment.

Arms are starting to have that puckery zippery look! Not cute....

Fun with compression.....

"Shhshhhh....Skin Knitting in Progress...."

Well i have to say my healing is going along quite well - all 8' of incisions are busily knitting together - some swathes are entirely closed with no scabbing even - other are still lightly scabbed but are closing very nicely. I do realize if all this knits back together with no wound issues, that will be a small miracle unto itself.

I wonder when i am "out of the woods" for the complications of wound Dehiscence, superficial necrosis, and even "spitting" stitches? Are the spitting stitches inevitable?

Dr. Fisher does not miss an opportunity to tell me my main job right now is to "take it easy" - hence the joke around here is "shhshhhh....Skin Kitting in Progress...."

Apparently this rules out Pogo Sticking, Unicycling, Six Flags (which is all of 10 miles away from me), Underwater Hanggliding, and all other "fun" activities (including leisurely strolls along San Antonio's scenic Riverwalk :-( ....sheesh recovery is boring!

It IS all about the Pooping…..

Due to the effects of anesthesia and ongoing pain medications, bowels are greatly slowed down during the surgery and post-surgery processes.

Appropriate Bowel Management is a “must” post-surgery. If not addressed, this part of your life can quickly become a nightmare, resulting in painful constipation, traumatic movements, passing out, and even “popping” stitches due to straining! (refer to my girl “BeachGirl’s” story on this!) - and there are several other tales of warning and woe to be found all over RS on this issue….

I have had some success with this post surgery and thought I would share my “formula” that seems to have worked well for me. I have approached this with the attitude that I wanted to use only “gentle” products and use a multi-faceted approach to ensure things “go smoothly” (pun intended). I figured this was a tightrope to walk, as I did NOT want to use harsh stimulants that would cause “emergency” situations, dehydration, and muscle cramping - all undesirable in that I move with the land speed of a box turtle marching through peanut butter and have muscle plication.

So here is my “list” of approach, products and frequency at which I have used them:

• Liquid Only diet two days prior to surgery - this not only allowed the good doctor to “pull me tighter” on the TT due to an empty colon, but also allowed my colon to actually BE empty as there are no signs of life from your colon a couple of days after anesthesia - better for it to “quit” empty than “quit” while full (the good doctor pointed this out as well….)

• Miralax Daily - started two days pre-op and resumed one day post-op ….without Fail…..I add it to my protein shake in the mornings

• A “good” probiotic twice daily pre and post op …without fail…the one I used is pictured here….

• 2 Fiber Gummies - used after one day post-op…most days, not all….plus they are just yummy!

• “Natural Calm” Magnesium supplement - I would like to take this every day, but sometimes I forget as it is a “bedtime” thing, so I really am using about two of every three days (also depending if I have had a “total tea” that day.) This stuff is great for everyday use when not “under the influence” of narcotics. I can vouch that the Raspberry Lemon is not half bad in taste (it is not stellar…but it is drinkable…)

• “Total Tea” - this is one of those senna based teas - used once every two or three days - I would not go over a max of one bag per day as used in excess, this can start to cause cramping!

So that is it folks…my personal formulas for error free defecation in desired intervals and consistency. Hope any of the above helps my pre-surgical RS sisters!

Scar Management

Ok too tired to post the update I wanted to, so here is the cliff notes version....will post more tomorrow.

Went to docs today, drains are out, everything healing exceptionally well...maybe my imagination but he looked pretty pleased with his work today ;-)

Started scar management with massage and silicone. Put scar away strips down one arm add mepitac down the other. Biocorneum in elbow incision....little experimentation at this point!

Gel zone wrap at midsection provides compression and silicone. So far it is a no-brainier....works brilliant from the dual standpoint.

On tummy swelling, I have a "ken doll" going in Mons area to add to my scrotum issue :-(.

Doc prescribed some LASIX....picking up in morning.

Arm pucker may or may not go away on its own :-/. Lots of massage recommended.

And now for the post-plastics depression setting in…

The below is a glimpse of what I have been going through emotionally. The post-plastics “blues”

This seems to happen to many of us who have extensive plastics….I think the only ones that *may* like their plastics right away may be the Breast Aug crew ….and then only the subset of those that are not complaining about their boobs riding collar bones!

Sooo back to the depression….it sort of “set in” this past Saturday and Sunday. I think the first week post plastics healing I was improving fairly rapidly had that to look forward to each day. Plus I think I may have been in a bit of a Percocet haze (the elephant tranquilizer strength) of false bravado. I wanted to walk and move around and “get on with it” but the good doc warned me to “take it easy” …which is depressing and boring to lay around all day with your feet in the air. The second week…the “improvements” are not so dramatic yet you are still very confined in activities. I also tire very easily (part of the false bravado deflates quickly). Plus the second week, I was trying to reduce my pain meds…no longer in a full-on Percocet haze of false bravado, I halfed my dose and occasionally went 8 or 9 hours without ….let those babies fully wear off then you know how you **really** feel!

….I was just looking in the mirror thinking I looked like a swollen Frankenstein. I was depressed all weekend and by Sunday even went on a full-on midnight crying jag (my poor husband…I woke him up to hold and console me).

I think in part it is the “mental” stress of realizing healing is a very gradual process…no huge changes overnight...no leaps and bounds (despite what my underwear tells me...). I did this to myself. I took a perfectly healthy functioning strong body and did this to it….um…..what was I thinking?? Where is the payoff?? Really, I actually paid to have this done to me??

Well when depressed and at my lowest here is what I am thinking…now logically I can be more positive…but these are the voices of the demons:

I see these parts of me…..like my forearms all saggy…and I realize even with the 16’ of incisions I will bear on my body when all is said and done, there are some parts of me that cannot be fixed. I did this to myself with my obesity and this is the price I have to pay….16’ of incisions and STILL own a very imperfect body that has sags and bags…Yet another realization of not being able to un-ring any bells…I will never be non-obese…..I will always be formerly obese and bear the marks of that….

….And let’s talk about being post MWL in the plastics world for a minute shall we? We have “complex” problems. We are required to pay surgeons exorbitant fees to “fix” us. We are a complex problem to be solved. Lovely! Obesity is the gift that keeps on giving apparently even after we have put in the effort to lose 200lbs. Nope…not good enough….sorry...take off the clothes and you are STILL a freak. The most we are allowed to even HOPE for is that some surgeon can fix us to the point that we can even stand to see ourselves naked in a mirror, enjoy intimacy with anything brigher than candlelight, be able to wear short sleeves, not have to “fold” our deflated origami breasts into bras. Not have to wear compression to the gym so our bellies won’t “slap” on the treadmill. All of the humiliation. All of it. I have lost 200lbs and this is what I am left with.

And we CANNOT…no…DARE NOT….. ask for GOOD bodies…NICE BODIES…this is what plastics for “normal” people are allowed to hope for. FANTASTIC BOOBS….awesome flat bellies, awesome BBL asses….no….. all we are allowed to ask for is “improvement” - not to look like total freaks, but to look like much improved freaks with 16’ of Frankenstein incisions and months of painful healing and to HOPE we have done nothing to our bodies to permanently compromise then. We have to have "realistic expectations" -- f**k that... living the life of an obese person, literally *FIGHTING* each and every lb off your body... now left with yards of skin....had all the reality i can handle.

This is the price I pay for my former obesity…will i ever be done paying for my sin?

Again, these are the voices of the demons….I don’t always feel like this…and trust me I have many many blessings to count…many more than a lot of people…..and I know it. But, if I turn the lens a ¼ turn, this is what I see …and it makes me sad….

As for my present state of mind…

I am healing well! Rapidly! Ahead of the curve! All good stuff…excellent stuff! .I have no complications, and with 8’ of incisions that is a minor miracle within itself really…..


I cannot YET see the results.

Arms: I am looking in the mirror and all I see are these long long long (did I mention long?) 23” Frankenstein zipper looking incisions that extend to under my boobs. I have arm puckers that may or may not resolve.

Tummy: I am still pretty swollen. I have a “ken doll” mons. I have labial swelling that looks like a scrotum. I see what to me is looking like loose floppy skin above my navel. I have that weird line in the middle which i am hoping will subside with the swelling. My wait/hip ratio is not back yet….shape is looking pretty square.

Butt: My “Peter built” butt looks good - however my lower butt seems a ‘lil sad and left beheld…

Legs: don’t even get me started…swollen and painful….AND this is the kicker…..this lipo was not designed to give me legs like Cameron Diaz…it will actually make them look better in jeans **maybe** If I can ever get out out swell hell, but worse and more deflated naked….it is a “staging” for the scary painful thigh lift I have to go through….again, obesity….the gift that keeps on giving. I can only wear one pair of clogs b/c my ankles are so swollen and cannot yet touch my toes (but that is my back incision….)

Nowhere near done yet: Saggy pancake boobs to be corrected and max correction thigh lift (i am sure i need the "deluxe" model there) …stage 2…..

Ongoing Dysmorphia: I barely recognized the person in the mirror after I lost 100lbs this year…much less whoever is staring at me now….and very literally I don’t even “see” anything yet as I am covered almost head to toe in compression…when I remove compression I am “covered” in swell hell. I look in the mirror and all I see is foreign right now.

Situation: My hubby is so frustrated with me being so high maintenance. He is homesick for our comfy house and comfy life. He is trying to be good, but this situation is high stress for us both. He is uncomfortable being away from home, in a crappy bed, in a crappy condo, with a crappy workstation, a crappy tiny kitchen, having to also take care of me as well as work during the day because I cannot yet even put on my own socks as I cannot yet even touch my own toes. Face it. I am a high maintenance nightmare. He is a great guy (and I really really mean that), and we will get through this, but this surgery is adding stress to both of us and our relationship. We are both homesick for our comfy bed, our comfy house, our individual home offices….our modern TV AND especially our Tivo, our well stocked and gageted kitchen…..seriously I **could** go on……

Sooo……This is some of the things I think when I am depressed. I know I will eventually like what I see. Logically I know I have a good result and I know I will be happy.

Some notes on surgery and depression: This seems to be common enough in the post-surgical healing process. Unsure if it is 100% situational or is there are hormonal aspects. We now know that fat is metabolically active, and removing so much skin and fat it may send your body into a hormonal tailspin where it is struggling to re-balance. Then again, maybe it is the pain meds?? Then again, maybe this IS all VERY DEPRESSING in the short term.

I have to admit some of the crying jags have felt sort of like PMS emotional roller coasters. I am normally not an overly emotional person…I tend to be more so this is definitely NOT my typical MO.

Shout out to Dr Fisher: If you are reading this please do not take offense at my comments on my body….it is just my emotions talking…logically I am very sure I have a good result …healing is just hard and patience is unfortunately not my strongest suit.

Few new pics ...

Forgot to get the snaps of the arms prior to silicone tape application....but here is the latest and greatest for the LBL.

Darn it....trying upload again.....

Journey of a thousand miles starting.....very literally...that is how far Atlanta is !

Just left San Antonio headed back to ATL! We are doing the drive in three days (hubby had to work until 2ish today). I am sooo ready to get home! I know my hubby is as well as he has been taking care of me, but he is far from a cheerful guy...his back is hurting from the crappy bed :-/.

I had my last in person follow up with Dr. Fisher yesterday. "Incisions look good...don't think they will open" ...and of course I wake up today and there is a small opening in my butt! He jinxed it for sure by saying it out loud! Pic above of the opening...no way of knowing if it will stop there as far as severity or get worse. Doc said to put a thin layer of anti bac ointment on it + nonstick gauze (i have some Telfa i used)

I may have strained it a bit trying to take off my own compression hose last night :-/. I am just very weary of not being able to reach my own toes or the floor. Or it may have happened despite any actions on my part....no way to tell for sure.

Also discussed my 2nd round with Dr. Fisher:
- Picked out some boobies (yippie)! ~375 HP Mentor ~12.2 diam. (somewhere along those lines)
- discussed Blepharoplasty for upper and lower lids (really need to figure out how to pronounce that!) - he agrees it is my most pronounced "aging" feature - these darn bags showed up around age 34 and never went anywhere
- discussed fat xfer to face just under those bags - little fat loss on my face - aging + weight loss...definitely liked my face better ~190 lbs
- discussed Big Scary Thigh Lift ...it will most likely NOT be a full spiral plus long, but rather an "L" incision that only goes forward on the groin region, but not "back" up under butt cheek

We also discussed the possibility of lower leg skin excision (the most controversial of everything i may want) but Dr. Fisher thinks i will be content enough with the lower leg lipo once the swelling subsides. I hope this is true! Skin excision on calves is very controversial and has a very long recovery not to mention the scar!

With this lower leg lipo, 2014 will be the Year of Compression! It is not as if I am not used to it....just trading my tummy compression to hold the panni in check for leg compression....I wonder when running will be comfortable for me any time soon?

Round 2 Surgery is scheduled for June 16th. I am begrudgingly waiting 6 months, but after this recovery, I am sure it is the right thing to do....we will have "final final" results of the present surgeries by then.

I have no idea what i weigh, but i was intending on losing 8-12 more lbs prior to this surgery which I never did ;-/. I may take another crack at that after the 7 week mark....i have NO IDEA what i weigh, what size i wear, or what i will look like once the swelling has subsided. There was no scale in San Antonio and to tel the truth I am a little scared with all the swelling! I can wait a little bit I guess...

So that is it! It was a little hard to say goodbye actually as this has been such a focal point of my life and Dr. Fisher has felt like a partner in this big life plan of mine every step of the way....

In other, more mundane news, i finished the LAST of that disgusting protein drink ProCare MD - OMG that thing was the BAIN of my mornings to choke down. It may have aided in healing but GEEZ it was nasty. Just so i can be clear, i am NOT RECOMMENDING IT.....just look at the label i posted and single thread all of those aminos in supplement form (Isopure i hear has a good amino profile) - RWL assures me it is the 4g of Arginine that make it taste so bad, but i would rather take a handful of capsules than to suffer like that ever again.

I have been so weight loss and plastics obsessed for so long (really all 2013 was focused on this...)....I just now need to figure out WHAT ELSE I want to do with my free time going forward?

Jackson, MS or Bust + New pics!

On the road still too Atlanta....road food...ugh! Will be sooo happy to see my own kitchen....I am going to make some giant veggie smoothie with my vitamix pronto!

Sooooo I'll keep this short most likely since I am typing on the iPad, plus hubs looking a little cross eyed at me for spending all my time on RS....need to entertain him while he's driving!

So updates:

1) spent my first night sleeping in a bed....I had a lift chair recliner I was sleeping in while in San Antonio....really missing it....tried to sleep on back, but was aware of just how much pressure that was on my butt incision compared to recliner, so had hubby put pillows under me to try my side...while no pressure on booty...that didn't work so hot either and I COULD NOT ROLL OVER! I simply don't have the strength in my tummy yet! So yet had to wake hubby once again as I could not move! That sucked. Back onto back....those of you with TT.....how did you do this without a recliner?? Am I just simply more cut up with the brachio and LBL?

2) back incision is closing I think!! Sooo happy this does not appear to be the start of a dehiscence episode.....rather I'll bet I overstrained it trying to get stuff off the floor on my own, put on pants, etc....so no more of that! The auto aug puts even more pressure on back incision.

3). Posting pics...IMHO, the incisions are looking friggin' awesome!! The elbow pucker on the left is GONE and that was the worse of the two...right is improved. I think I can see swelling down some in tummy....and you can at least start to see my waist again. Still have a ken doll going...still have labial swelling....knees and legs still very swollen, but all is just a little better!

Take a look at pics and tell me what you think?

Getting happy about tummy!

Just posting a quickie ipad update....

1) had very first lymphatic massage today...went well! She has me drinking parsley tea to reduce swelling. The gastronomic insults I endure in the name of healing. :-/

2) small opening on back still there...is shorter, but I like a mm wider...like one drop of fluid per bandage change.

3) leaving off compression for a few hours per massage therapist and have feet propped in trendelenberg.

4) tummy swelling subsiding! See pics....

All for now! Pleased with healing and more pleased with reflection every day....

Update + Pics ….little depressed!

Wednesday I was “blue” all day, with the day ending in tears. Thursday & Friday were OK….last two days I have been depressed. I hate to say it is also after I saw the attached pics, but I had not worm my compression garb for 8 hours prior to the pics (I had a lymphatic massage in the morning), and I was paying the price in leg swelling. I am convinced liposuction is the devil! My knees were hard as rocks. My ass still looks “sad” on the bottom booty, my labia is still hanging and swollen….my arms are two different sizes. My ankles and calves are impossibly swollen. I have to say for the most part I am not encouraged by the pics....

I guess the overall feeling is the one I mentioned in an earlier post. I just feel like I traded one freaky melted candle body for another freaky cut-up misshapen dysfunctional Frankenstein body. I just have to trust that maybe I won’t always feel like this…but for now I cannot “feel” what I don’t “feel” you know?

So yeah…sad…and feeling limited….and weepy

I know most of you say very nice things about my pics, but I cannot help but feel you are blowing smoke…I am tired of the asterisk of “you look great - look at your befores” - part of me just wants to look normal - PERIOD - no asterisk - no parenthesis - no butts….and certainly no knees and ankles that are swollen and hard to the point of misery.

I know I am being a brat right now. I know I am being impatient. I know objectively I am healing well and on schedule if not ahead.....It is just how I feel….

Additional Notes....

Compression Garment is bothering me - eventually you just get fed up with being compressed almost every single cotton-pickin' minute of your life. I had switched to a sized Medium in the same garment i have been wearing which provides more appropriate snug compression, but last night had a big "freak out" as CG was pushing on my sore plicated tummy - so off it went and on the large went!

Also slept in a full trendelenberg position last night - legs at a fairly straight 40 degree angle (not super comfy but effective)- woke up to less swolen ankles and feet - so far today the swelling is a little more under control, so outlook a little better in that department......

That Damn Scale + Energy + Return to work.....

I have yet to get on a scale - too damn scared with all the swelling.....it sucks because whatever it says i can do little about right now as I cannot exercise + I am still healing so cannot cut calories now let alone do anything more extreme. I just cannot afford to get on that scale and see a number that may make me more depressed. I guess all i can do is religiously track my calories like i used to and be sure I am getting into the 1500-1800 calorie range + ~100 g of protein range? Any suggestions appreciated....

My energy still feels so low....and I think when i go back to work it will be all i can do to make it through a normal workday, much less all my "extra" needs in terms of compression and scar management. Much less energy for exercise at week six??

Speaking of work, I am planning on returning remotely (work from home) on Feb 5th. As my job is 100% travel, i will most likely start flying out to my client site on Feb 17th - typically a four night stay in a hotel. I am scared to do this by myself as I am so dependent on hubby for everything right now. i am trying to figure out **how** I am going to manage without him...from compression garb to getting these darn long strips of mepitac situated on my long arm and back incisions....washing all this crap in hotel sink....hoping i can wear a "normal" bra by then that won't irritate incisions...all the softie bras i can wear now don't do sh** for my boobie look. Let alone being able to get back to the gym which in and of itself is a natural anti-depressant for me? My job is pretty high pressure as well....12 hour days are a "norm" with daily calls with my offshore team in India @ 10pm and 7am. All of this is three weeks away and all i can do is the best i can do and try, but it still is on my mind as the time to return draws near.

OK my PS vet buds...need some guidance here....

What is the "deal" with "Stage 2" compression garments? Aren't they supposed to provide more compression? Keep in mind i had whole leg lipo, so i need compression down to my #$@%$$#@ feet.

So here is the issue i am having: My garment goes to 8" above the bottom of my ankles - they all seem to do this actually - as opposed to covering to the bottom of the ankle (I have no clue why they make "ankle length" compression so short??) - if i wear my compression hose (or not), it creates a "bubble" at the exposed 8" of my ankle of swelling as that area is less compressed than the area above it. I worry that fluid is becoming sort of trapped in that area and is not being allowed to circulate via normal lymphatic drainage? Any suggestions? Thoughts?

i also have some thigh high compression stockings, but these do not give upper leg compression really - they offer "graduated" compression.

Sooo if i am investing in "stage 2" - and the assumption is that i need my compression down to my dang feet - what do i do?

Option #1 - Ankle length compression + knee high compression hose - but this creates the aforementioned issue of "ankle bubble" as the calves are now double compressed and ankle swells and fluid cannot escape.

Option #2 Knee High Compression hose + "capri" length garment - hopefully calves wont do a "bubble" where the garments do not overlap? Are ya'll getting the picture?

Option #3 Thigh high compression hose - these bad boys go up to my whohaa but only offer "graduated" thigh compression - not much at all + a mid thigh length garment?

Option #4 thigh high compression hose + GelZone wrap on mid section (offers compression there) - obviously will leave some hip, butt, and upper midriff exposed.

Option #5 - the Solidea Truncal Compression Leggings (already own a pair) - i may be able to "Stretch" these to come to mid foot area - which may be enough....my feet appear to be going down in swelling...(pic posted above)

Obviously leaving the ankles compressed is a complete non-negotiable as they are by far the most affected by the lower leg lipo - also my knees...these bad boys can get hard as rocks left uncovered as i found out yesterday.....

open crotch is also a non-negotiable as i cannot be "hiking" up and down CG all the live long day over my sensitive tummy and incision lines.

the leggings.....

ok trying again......

these give 18-21mmHg compression

At the risk of sounding crazy....

I am actually super happy today! Ya'll are going to think I am manic after my last "set" of posts....

Shout out to MBL - I know YOU already know I am manic today, as I posted lots of crazy stuff to your blog already ;-)

Now onto the good stuff

• Belly is super flat - like almost TOO flat….my ribcage and mons enter the room before my belly….(see pic)

• Speaking of mons, my “ken doll” is WAAAY DOWN - it is just a little mound now - like it is a Ken’s little brother now….is there a Ken-equivalent as Barbie to Skipper?

• Brachio scars are getting very light - they still have a little of the lumpy/bumpy pie crust look, but I am happy they seem to be “on track” for thin attractive scars (see pic)

• Legs are looking thinner and less swollen all the time…now I realize I am not going to receive a call from Cameron Diaz asking for her legs back any time soon, but hey…..they are by far the most normal set of legs I HAVE EVER OWNED - see pics in compression thigh highs!

• My mood is good, energy is high, made the decision to postpone going back to work another week to alleviate stress - and NO I am not on drugs! - I have kicked all the "hard" stuff except for 1/2 perc prior to lymphatic massage to ensure my therapist can do whatever she's gotta do!

I am starting to dream about CLOTHES! I am threatening to buy some of those hideous print leggings - the ones with flowers or zig zag prints - just BECAUSE I CAN. Also scheming to get a (non-skirted) boyshort swimsuit post thigh. Oh! And also a corset….just for the fun of it!

Shout out to Beach (aka Chica) for the Venus website for swimsuits! I already have a couple picked out. :- )

Now for the one blemish:

I do have a small opening on my butt (booo!) but it is not painful - guess I will be babying my bootie for a little longer - it is actually very small, like head of q-tip small…it is in the center of my A$$ where there is a “Y” incision. Doc says 2-3 weeks for it to close. I realize overall I have been fortunate in my healing giving that I added 8’ of incisions to my body and the Good Doctor stuffed my own fat back into by booty -- an already high tension area….so overall…grading of the curve, I have been extremely fortunate in healing.

Shout out to my Baby Girl RWL as she has had a rocky road getting so close to surgery and has to get her uterus nuked tomorrow @ 7am. She is one of the ones who can understand the heightened stress of actually planning travel and traveling for your surgery - (plane tickets + lodging + surgeon fees + packing + that massive amazon cart!) - and now a firedrill surgery! I will be thinking of you!! XOXO

I cannot THANK my girls enough for all of the support you have shown! Thick and thin…. Little did the newbie plastics virgin know what a major TRIP this would all be!

Oh i forgot....

*I can now put on all my own clothes and mepitac tape all by myself

* the exception to that being my compression stockings...those babies are like wrestling alligators......

Five weeks out - new pics!

Today marks my five week surgiversary. I have to say I am happier with results all the time. The only outlier is the sad 'lil left-behind lower booty cheeks, and a) still hoping they will somewhat resolve and/or hanging in for spiral thigh lift + fat xfer to butt to resolve, so trying not to sweat it.

The only issue with fat xfer (aka BBL), is the way I understand, belly fat is preferred, and I would not have a lot of that to donate (that would have been the five lb panni I had removed...). Second, my plan was to lose an additional 10 lbs or so prior to the thigh lift to improve results / staying power for that surgery. So were now at cross purposes on surgical outcomes. ***sigh*** guess I don't have to figure out today I will soon....

Ruminating on BBL....FUNNY STORY

So thinking of the BBL procedure and definitely not wanting to regain any lost weight in order to gain a dream booty.....wouldn't it be great if you could use someone else's fat? You could pay (or even split the cost) with an "in need" buddy to get lipo'ed, then you could augment your own booty - that would be so perfect. So i mentioned this idea to hubby, telling him we could lipo him and he could donate his fruitful bounty to my deriere....the first thing out of his mouth is: "I am NOT wearing all that compression!" So apparently my man is willing to go under the knife for me, and I am pretty convinced he would take a bullet for me....but Compression? That is just OVER THE LINE!!!

Showing off the Cookie Cakes.....

Per request, posting a pic of the "cookie cakes" in Spanx Asset line... most likely proving i have "enough" booty - just needs to be rearranged a bit :-) - hopefully the upper "auto aug" booty and leftover natural booty can find each other and live in harmony!

Spanx Asset line provides nice booty lift....

Six Week Snaps! Getting Very Thrilled!

Today is the official magical “Six-week mark” since surgery that everyone refers to. I am so freaking happy today I could dance ….which would so not be appropriate as I am in Starbucks and there is absolutely no music. Maybe the happiness is also due to several doctor moratoriums on activities become lifted at so-called magical six week mark. We certainly won’t mention all of them in polite company, but one of those was being able to get a Chiropractic adjustment. I “flashed” my chiropractor my incisions on arms and around my body, and he was very “blown away” with how nice and neat the incisions were. He says I have seen a lot of scarring and that is absolutely beautiful work. He said he was “scared” for me when I initially told him what I was doing, but so reassured now and super impressed. He raved on about it the entire adjustment.

Indeed I have become quite the little exhibitionist as I will tell anyone who will listen about my surgery and give them the “visuals” to add to the story! My booty and hips and on occasion mons have made the rounds. I even discretely flashed my pedicurist yesterday - she knows about my MWL and the body contouring surgery. She proceeds to tell me her daughter is over 300lbs and just applied to insurance for sleeve surgery. I confess to her that I am also sleeved, and assure her that her daughter chose an IMHO a “best of breed” bariatric procedure. She wells up just a little bit saying that she hopes her daughter can one day be where I am - post body contouring. I tell her that her daughter is beginning her “journey” and while not fraught with bends in the road, will be a good one. It just goes to show if we show a little courage to share our stories how much these mean to someone else going through our same struggles. You never know who you can touch or change with your words.

Again, super happy! Beautiful day in Atlanta today during what has been an unusually bitter winter - hard to be mad about ANYTHING on a day like today.

I am getting thrilled with incisions and contours. If I am allowed a little bragging on my PS, all of the work looks so awesome and I could not have asked for a better body lift or brachioplasty. My PS is so very talented and did such an AMAZING job! And while my arm is outstretched, I am twisting it to also give myself pat on the back to for choosing him so darn wisely. ;-)

Notes on Pics:

• You can see some lower back swelling (as I have discontinued Lasix maybe?) - hopefully it will resolve, but just sitting in anticipation as it is ruining my **awesome** cookie cake contour

• Knees!!! Darn Knees!!!! The good doc lipoed the cr** out of these, and they are still disproportionally huge…my joke is they are like Hydra - cut them in half and they grow back - so hoping it is swelling

• “Dirty Diaper” butt somewhat resolved - at least now if even a little droopy in lower middle checcks, the mid-line and cheek contours on either side are a little more natural between “Peterbilt” auto-aug booty and natural booty

• IMHO, brachio is looking awesome! I am so grateful to be able to have the “J” brachio that resolved the excess back skin thereby avoiding a bra line UBL or leaving it unaddressed

to all of my ladies!!!

If Ya'll can stand a little more Unbridled Gushing.....

I took my measurements yesterday. They are 38" x 29" x 41". Thighs at their thickest are 23"! The smallest they have ever been in my adult life - bad news is above knee-cap is 19" - LOL- these darn knees - almost cylindrical upper legs.....

The 38" bust is with with a softie bra on. The 41" inch hips are down from a 43" prior to surgery...mostly now on the a** as opposed to tummy. Hip width when looking straight ahead is definitely less than prior to surgery. All of this also affirms my choice in Dr. Fisher and his doing the hip and butt auto-aug. Lets face facts, my legs will **never** be traffic-stopping amazing (I will be mostly happy if they don't make people turn away in embarrassment for me) - so maintenance of my heretofore waist/hip ratio was super important to me. I am too wide and my legs are too large to "get away with" a traditional LBL - picture flattened hips, flat butt, and these legs? Not cute.....works awesome for some more narrow athletic builds, but my body contour in particular would have suffered greatly. If you look at the "chunk" of back (markup pic) that would have been removed with a traditional LBL (and it would have been even more removed in a traditional LBL, my booty and hips would have been SERIOUSLY flattened. Just more happiness in my decision to go with the surgeon I chose in getting the body type that works for me. I am a "pear-shape" and i am so unbelievably cool with that!

The Problems with having an LBL....Bath time....

So on moratoriums on specific activities lifted, and hubby out of town for the weekend, I scheduled some quality "alone time" with my Jacuzzi...something I have dearly missed while healing. My typical bath-time entertainment was watching my panni and thigh skin/fat float lazily to the top of the water....and lazily float and wave at me. Well, lo and behold, i knew the Panni was a non-starter since it no longer exists, but i thought I could "count" on the thighs ....imagine the disappointment as I realized that the lateral and tops of the thighs, now constrained within appropriate skin parameters, refused to join in on the fun and the inner thighs...well they just sadly waved a little underneath the water, wondering where their "playmates" had gone....unable to break the surface all by their lonesome....

Now exiting the tub, and trying to bandage my own a$$ crack (the tiny opening) all by my lonesome....now THAT was entertaining.....

While were on the topic, I am continuously amazed to have my "bath time" routine forever changed by no longer having a panni and thighs to apply baby powder....seriously, every time i exit the shower, I think of this missing part of my routine...simply nothing left to lift up and powder under....of course my housekeeper will be tons happier that the master bath will not be covered in a layer of thin white dust....

The Devil’s Platform

So I have talked about not wanting to weigh myself with the swelling, but decided it was high-time I “womaned up” and faced the truth - swelling and all.

Pursuant to that I went through my whole “pre-weigh” routine:

• 1st thing in the morning, eyes open and feet on the floor? Check…..

• Not an ounce of liquid has passed my lips? Check….

• Started Coffee and meandered around kitchen in hopes of “shaking down” extra urine? Check….

• Urinated and checked to see if hopefully anything else pending in “that department”? Check, Check…

• Naked as a jaybird (save for silicone GelZone wrap - for which I am “claiming” a friggin’ pound if “the number” is too high). Check….

OK I’m ready…. (sigh….)

Approach the “platform” that resides on the floor in our guest bath - the one that flashes those often cruel numbers - says - the one that seemingly controls whether we declare victory for the day or end up in a sobbing pool in the corner over our failures.

(I am pretty sure all of my MWL sisters can relate to this….)

So I did it…approached with caution…only one eye open and stepped on…

And the number is….(insert drum roll)….157! I am so freaking happy with that number as it is the lowest I have been in my adult life! I know logically it **should** be about there, but I figured I would be the one exceptional freakazoid who would have 10 lbs removed from their body and **not** see it on the scale.

**Officially** 24.6 BMI! (Wish this forum had HTML, as this deserves some obnoxious flashing font)

So now back to old routine of daily weighing….which holds me accountable and will never allow me to go back to “sleep” in my own health again.

After seeing that number, I am even more determined to lose my last 12 lbs prior to my thigh lift - so that is as complication free as possible and also just because I darn want to. My body reminds me of one of those children’s twisty toys where someone has matched the top of the giraffe to the bottom of the elephant. My legs remain relatively heavy in proportion to my height and weight.

P.S. - Cannot take credit for clever moniker “The Devil’s Platform” - it was “borrowed” from a very cleaver buddy on my LowCarbFriends forum - but it has so become part of our household vernacular.

Feeling Like “Me” Again…

I have written extensively on the dysmorphia I have experienced - with a 100lb weight loss in 2013 followed by body contouring - I barely had a bodily “sense of self” even prior to plastics at this new size, let alone this strangely incised, swollen post-surgical body. Now, my incisions (just as I wanted them to look….thank you Dr. Fisher) feel like “me” - like they were meant to be there and are well into the process of integrating physically well with my body but also with my psychological sense of “self.”

I am back to work this week (remote), postponing starting exercise until next week - to tell the truth I am not 100% sure it is wise, as I am sure I am physically able to start, but most likely this will aggravate swelling and potentially redness on incisions from rubbing - I see my primary health “job” right now as being compliant with nutrition, compression and scar management plan as I have laid out for myself. It is a once in a lifetime “shot” to get this right. And even is scar/nutritional management is “hogwash” - I really don’t want red/lumpy/raised scars and always think - what if I had done something different?

Start my Road Warrior ways back up on Feb 24th - 3 nights home/4 nights hotel. Have not 100% decided how to handle the “questions” on why I was gone for so long. Not that it is secretive exactly….I’ll blab to anyone, so much as it is “elective” surgery and I didn’t want to necessarily get anyone questioning my rationale/right for taking such a long time off.

Not posting any new pics this week - not too much changing now week to week - more incremental - plus ya’ll HAVE to be tired of seeing me nakey…will post an 8 week set.

….That is with the exception of BEACH - if you want your own private iPad show of my nakey pics, let me know and we will make that happen for you :-)

… “shout out” to my Baby Girl RedWineLover as her posterior and thigh lift surgery is tomorrow …too excited for you Baby Girl! XOXO

Week 8 pics + Celebrating

Posting my eight week pics - absolutely loving the new contours.

I was back to workouts this past week with 3x Elliptical and 2x Taebo (sort of like Kickboxing with light weights for those unfamiliar) + various floor/ab exercises. I always find exercise instrumental in creating an appreciation of my body and those things of which it is capable. Exercise has always been a “happy place” of mind/body connection - communing with myself. My stamina was excellent even! So that part was good….

I had a couple “setbacks” this week in scarring. It almost feels like the first “dings” you get on a new car - you have to go through a period of disappointment that your car is no longer absolutely “perfect” before you can get to the acceptance place of “Hey! It is still fun to drive…”

So “dings” on my new (s)car:

• Small amount of widening near elbow joint (common enough place) on right side
• Widening on crescent incision under right arm (adjacent to breast)
• The left side of scar for LBL is “pulling up” to be maybe an 1.5” higher than the right
• Booty scar widening some?

Also noticed some tiny bumps right below incision - assume this is where the dissolvable sutures are starting to come undone (and this I am sure is putting more tension on the epidermal layer) - no “spitting sutures” though - so IMHO this is remarkable.

I think this may be related to my exercising without the silicone tape on my arms nor the Gelzone on midsection (bone-head move on my part) as I had momentarily forgotten part of the “point” of the “tape” is not only the silicone but to distribute the tension hopefully across the skin to prevent hypertrophic and/or widening scarring. This is fairly well documented by many PS and also in NCBI: http://www.ncbi.nlm.nih.gov/pubmed/16267427

Sooo the self-directive from here on out is NO MORE exercise without tape and compression on arms and abdo.

Last Tuesday I met up for a drink with a Post MWL sister who is also pursuing plastics (shout out to Jinxy6!). She paid me the ultimate compliment of saying I had a “black girl body” - this made me grin ear to ear. I have been complaining a good bit of how the front of my pants (and even my underwear) are fitting like “mom jeans” on the front and like low-rise in the back. Good problems to have I guess.

I also on Monday, started back onsite work in Philadelphia (I pretty much do 5 days/4 nights in Philly per week). I was a bit worried about handling bags (you would think the years I have done this I would be a light packer but not so much) trekking through the streets of Philly (client site in in the city, so hotel and work site are maybe 3/4 mile distance + walk from train to hotel with baggage, etc…). Everything was A-OK. No issues.

The most **fun** part of returning to work were the reactions of my co-workers…..ranging from the side eyes to blatant up-and-down looks , jaw drops, and out and out exclaiming on how “different” I looked and how wonderful I looked …(so never get tired of hearing!). I honestly was not totally expecting since I didn’t think my work appropriate clad profile was **that** different than before (were not talking club-wear here…). I just passed it off as more weight loss (see if they were smart they may have wondered how my tummy migrated to my a**). Then they are used to seeing me as the Incredible Shrinking Woman from last year’s journey…so maybe just seemed a continuation of more of the same. My coworkers and immediate boss have been super supportive and praising of my journey.

So….also did some celebratory imbibing yesterday as well! My boss owed me a glass or two of wine for a couple of “Hail Marys” performed right before I went out for surgery. Said glass turned into a “wine flight” at a local wine bar…that was followed by a connecting 2nd “flight”… My ***favorite*** type of flight!! I have all but given up my former Red Wine hobby in favor of the diet, but still adore…. I work with almost all guys and all younger (traveling consultant tekkie crowd). I love working downtown in a major metro city! The topics of conversations were the project go-live (how great we did) and also ME. More exclaiming on the transformation and boss finally wriggled out of me how much weight I had lost since I started…start weight in Feb 3013 (261) and current weight in Feb 2014 (154). 107 lbs! They were very impressed….more exclaiming…more wine and tapas. Following that there was a hookah bar, scotch, dancing to Bhangra music, and an inebriated stumble back to my hotel…..chased the next morning with small hangover and lateness to work (I should know better than trying to “hang” with the boys). Really it was quite fun to “cut loose” some for a change (I am invited way more often on these city outings than I actually attend) :-O

My therapist used to coach me a bit on not “celebrating” my accomplishments - always looking at what I had not accomplished (e.g., those last pesky 12 lbs). The theme for me this week is Celebration. I think blogging on here is not only cathartic but also a way of celebrating with my post MWL/PS “sisters” who have “been there” and I know can relate to the struggles, the discipline, the ups and the downs. My life is most definitely in an “up” right now - I am so thrilled and so incredibly stinkin’ happy.

Pics Posted - notes on pics:
• Apologies for poor quality and shadows - meant to do during daylight hours
• Any weird “tire tread” you see on my legs and torso is due to Solidea compression and its “micro massage” texturing - I call it “Legs by Goodyear”
• Dirty Diaper still sadly present (in discussions with PS on potential fixes)
• Super happy with overall contours
• Arms a little uneven (not to the point of being terrible) but just notable…

Reflections on being at 15 weeks post-surgery + Pics

Apologies, as this has post have been a long time coming…..been busy with work and play (work hard play harder….)!

I am feeling good…full energy levels…. And (think) looking pretty good. Overall quite complication free! I am over-the-moon happy. I am singing-on-my-way-to-work happy. Thrilled even.

When you are going through the healing process, it is so hard to see what this will look like. It is harder to know how you will FEEL….This new body, this newer version self of self…..all I can say is it is incredible and better than I could have ever fathomed.

More Esoteric - Concepts of Self and RealSelf:

So at the risk of going to deep here, prior to plastics, most of my reading was on the “nuts and bolts” aspects of surgery. How thigh lifts are done, surgery vids on YouTube, Lockwood Technique, research on specific surgeons. etc.

Post-surgery, I have taken more of an interest in reading on Plastic Surgery and sociological, cultural and psychological impacts - they have become fascinating - especially questions of self and identity in relation to Cosmetic Surgery. The takeaway notion that we have of self and identity not being “fixed values” but rather the outer self, continuously informing/producing our inner landscapes as well.

“…. the very production of the self is now wrapped up in the continual transformation of the body.”
--Victoria Pitts-Taylor. Surgery Junkies: Wellness and Pathology in Cosmetic Culture

Having a Moment:

I actually had this “moment” about five weeks ago prior to a 5-day trip to Fort Lauderdale to visit my Girl RWL. (Shout out to my bestie partner in crime!! ;-))

After an unusually bitter winter, I was so looking forward to this trip. I was telling anyone and everyone that week who would listen to me for more than 30 seconds I was headed to Fort Lauderdale! (trust me, my intonation when i spoke contained the exclamation point). This memorable moment happened while I was packing the night before:

The last time I was forced to be seen in public in a swimsuit I was 200lbs, pre-plastics, and it was one of those old-lady skirted tankini swimsuits (it was Summer 2013). I tried on the two I owned from the previous year….they were so big and looked like 1950’s cheerleading outfits - I mean really terrible…but hey…I was used to that, right?…… Main objective ALWAYS being to hide as best you can as appropriate for the situation (obviously bathing suits make that directive all the harder)….I am used to looking terrible in a swimsuit, so no big deal, right? Oh well……maybe next year…maybe after thigh lift…… In the suitcase they went.

It took me a few moments to remember….. actually I **HAD** one other swimsuit…something I had never considered wearing in public…..a clearance bikini I had purchased at Target (the main considerations being I like navy blue and it was $10) - the purpose being to take “before” and “after” pics in (I had seen someone else do this and the side-by-side compare was incredible!) Now for me, I am thinking my “after” is after thigh lift and after boobs…..the wheels were spinning….”…could I possibly??” So with trepidation, I dug it out of the bottom drawer (actually had to remove the “protective” barrier from the bottoms) and tried it on. As I looked in the mirror, I realized….”hey this is not half bad”....traipsed to the full length mirror - and thought - “Hey! This is kind of good even!”

It was truly a moment. I cannot understate the utter imprinting (rewriting) of Self that happened in this single moment.

This website is called RealSelf. A “concept” that cosmetic procedures can uncover or reveal your “true” or “real” self…your real identity. To tell the truth, it has never been a concept actually I related to...almost resent even. All past versions of me are “real” and deserve my continued love and honor…certainly not to be judged by me as inferior or fake or imposters…they are all me…my life is a journey not a destination.

However, as I stood looking in the full length mirror, I felt a bit outside of myself, watching myself. In that moment I had the strongest feeling I was witnessing myself being “born.” It is the description that came to mind immediately and the one that still fits. It was absolutely powerful in a way that transcended mirrors and bikinis.

During those magical five days, I spent five days straight in that bikini on the beach (appropriately coated in SPF 110 sunscreen of course) with my really good friend enjoying the freedom of not being self-conscious of my body for the first time EVER. If the theme of that moment in the mirror was witnessing myself being “born” - the theme of that trip was “freedom” - and my limbs streamed with the pure joy of living in the moment with no regrets, no worries. Moments of sun, sand, wine, laughter, little sleep, and strong true friendship. It was a magical vacation. (…and what happens in Fort Lauderdale stays in Fort Lauderdale, eh Baby G? ;-))

Post MWL and having a “Good Body”:

I had groused in an earlier post about how being post MWL in the plastics world meant you **dare** not ask for a good body - only “improvement” - how I need to have “realistic expectations” how much I hated being reminded of that (even now I can almost get a little heated as I type this)…people continuously told me …people being either one of “ours” (post MWL sisters) or by surgeons: “blah blah….Can’t undo the damage YOU caused yourself…blah blah blah …can only expect a so-so body….” OK….GOT IT. Can we move on now?

Well guess what? I may actually **escape** plastics with a generally accepted “good” body! Not flawless, but definitely good. Wow. Just Wow. Once again, expectations exceeded. Unfathomable.

I could go on….there is no shortage of my thoughts/sentences inside of me that include the words “amazing” “incredible” “astonishing” and even “reverent” …. but I’ll end now…with Just Wow.

Notes on Upcoming Surgeries:

Thigh Lift, BA/BL and blepharoplasty scheduled for July 29th with my Dear Dr. Fisher…firming up all of that now.

Notes on Pics:
• Taken this past Saturday
• Have a few “whelps” on hips - I think from wrapping my silicone GelZone too tight??
• Have lost a little weight since last posted (maybe ~18 lbs) - this was a conscious effort on my part, but I **swear** the body contouring made it so it practically “slid” off my body in a way weight never has before!
• Excuse rats nest of hair from back …no, these **were not** taken directly out of bed - I just really suck at styling my own hair…

Last But Not Least....Pic From Fort Lauderdale

This pic for me symbolizes so much....joy, friendship, a new version of "me" and freedom....finally....freedom

OK i lied...two more pics...me and hubby @ Ruby Falls, TN

...day of cave exploring, Zip Lining, and See Rock City-ing.....

Surgery Tomorrow, “Coming Clean” & Shame…

So, it has been awhile since I posted. This is mostly because I have been busy (work hard, play harder), but I also have some **shame** about gaining ~10 lbs from my LOW weight back in April post my last round of HCG. I can tell from the current set of photos compared to the ones in April I am simply not as small :-(

After I have beat myself roundly and thoroughly for this (never productive), I have decided to “let it go” since there is not much I can do about it right now and certainly not until after recovery…healthy attitude? I think so…and I am trying.....

BUT…THE BIG NEWS….(drum roll please…)

On July 29th, (yes Tomorrow!) I am having several different procedures performed in one 10 hour operative setting:
• Thigh Lift (Long + Spiral + Calf Skin excision)
• BA/BL - Anchor Incision
• 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 one hip re-pulled a bit tighter - lateral thigh (this tissue naturally relaxes after LBL, especially with the compromised post massive weigh loss skin quality!)
I started a thigh lift review, so be “on the lookout” for that tomorrow.

Oh…and still THRILLED beyond belief with results of First Surgery …scars healing nicely I think too!

Notes on photos: Mark up photos taken today after my TWO HOUR markup ...others taken last week

Thigh Lift, BA/BL, and Eye Lift - Seven Day Post Op Update

This is a bit of an X-post, but i know a lot of folks still "keep" up with this review, so please forgive redundancy. here is the link to my thigh lift 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
10.2 Feet!!

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...really 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.

Still have one drain in - it has slowed down considerably though - so hopefully I can have it "pulled" soon!

Last Day in San Antonio...bittersweet

Had my last follow up with Dr. Fisher this morning...all happy noises as things are healing well and looking good. I'll take some pics when I get home and/or try to get the pics Dr. F took today. My "T" junction near my groin is granulating nicely....it will just take time to heal. Sort of sad to be leaving San Antonio as this really has been like a medical vacation and I cannot believe how good I feel! Still have a bit of bruising on my cheeks from the fat transfer but I have to say....really loving my new face and eyes! To that end, spent an afternoon at ulta getting new eye makeup! Really fun stuff! So excited and grateful this part of my surgical journey has gone so well with such great results! The staff at the hotel was so friendly and accommodating to us....it was like saying goodbye to new friends. We were quite comfortable there. When I arrived at Dr. Fisher's office this morning, it was like meeting his impromptu fan club in the lobby! One woman was there just had her LBL and brachio, the other had a consult that day for LBL redo and thighs ..all of us MWL ....had a great time chatting with these ladies! So yes, have actually had a good time while here and a bit sorry to leave! On the plane now taxiing (shhhh no one tell the flight attendant I'm not in airplane mode yet). Economy comfort is treating the incised booty pretty well. Thanks everyone on the site and reading for your supportive words and suggestions. I've met soooo many wonderful people virtually and in person by doing this surgery journey blog!

One Month Post Surgery Update + Surgeon's Pics!

Apologies for not posting in a while - nothing too dramatic to report here - just going through the healing process and trying to heal as well as I can - nutrition, dressing changes, compression, feet up and rest…old hat and somewhat boring.

Here are the highlights...

Hyperbaric Treatments: Found a Groupon for Hyperbaric Chamber treatments out of a local chiro’s office - 5 treatments for $175 (hour per treatment). It is supposed to promote healing so at that price, why not try it? I Had my first treatment yesterday…found it paradoxically relaxing and energizing too.

Compression: Where do I begin? It has been frustrating! Folks that only have incisions / work on thighs need to wear compression that is capri length (the garment needs to go a minimum of 6” below the point of the trauma to effectively control swelling. Since I have had liposuction and now incisions to my calves and ankles as well, my compression needs to be to mid foot to be effective and not create a trapped “bubble” of swelling lower than the incision. They do not make a single garment for people like me. It has been a challenge ever since the first surgery. My “ankle” length garment stops six inches SHORT of my ankle! I tried to wear compression knee highs underneath/below the garment to cover the feet and ankles, but the top bands of the knee highs were irritating the incisions to where they were re-scabbing and the right leg looked like it might even open. So I also have compression anklets - these create some leg deformity as they are tighter than the compression garment, but better than the band on the tops of the knee highs compromising the incisions. Plus being compressed from toes to under boobs 23 hours per day just gets OLD you know? Anyway…it is temporary…I’ll survive…just had to get my whine on a bit.

Openings: The “T” junction groin openings are healing on schedule, but those of you who have had openings, even with good healing, it is **never** fast enough! I am pleased though…at current rate of healing and hope they will be completely closed within the next three weeks (fingers crossed). I had a 1.5” loop of thread come out of the left hand opening (my first official spitting suture!) …but technically it was already open due to failed stiches, so maybe not so official…Also appear to have a surgical staple “peeking” out of my leg incision (skin is firmly fused around it with no irritation present). Watching it closely to see if it comes out further, and will pull it if/when it does.


I was able to start scar treatment sooner last surgery. By one month out I was treating all incisions with mepitac tape and scar massage. This time, it seems as if healing is going just a bit slower at the incision sites.

The revision sights are healing the best (arms and hip) - honesty you can barely tell where those were cut! I can start scar treatment on those whenever. I am still treating all incisions with aquaphor, so need to decide when I am discontinuing “grease” treatment and going with “clean and dry” and putting on silicone tape. Probably early next week will start silicone.

The leg incisions, while doing well, are still scabby in places, so maybe 1+ week out from being able to start any scar treatment.

Groin incisions are healing the slowest - I think this is to be expected. Everything is closed, but they are still “raised” in some areas, and while showing progress, and everything is closed, they are just slow-slow to start to make the transition from incisions to scars.

Breast incisions are still somewhat scabby as well - with the exception of the areolas, which are nicely healed.

Nutrition: I am going out of my way to get > 100g of protein in per day for the entire recovery process and supplementing with lots of single thread aminos and a host of other vitamins and supplements. I should do a review on my post-surgical supplementation routine as I think it is contributing to decent healing from both surgeries. Having an awesome surgeon plays a huge role in how we heal, but after that, how you take care of yourself in the post recovery period (I would like to think) also counts! I see a lot of posts on people (proudly) losing weight during recovery…and I get it…being MWL we are “scale watchers”…but this is NOT the time short your body on nutrients and calories. It has a hard enough time with all of the healing it is doing (IMHO our bodies are **completely** amazing being able to recover from the trauma we have inflicted) much less putting additional stress on your body. Sure I am worried about getting fat or gaining weight, but I have time to worry about that *after* I am done healing and do something about it then if i am not happy. I am looking at my pics and thinking my belly is not as flat as I would like (hoping a lot of it is still systemic swelling), but I can take care of that later. Complication free healing right now is the primary objective of my diet and supplementation. (Climbing off soapbox now…)

Notes on pics: My doc sent me the pics he took pre/post surgery - I think they are nothing short of *spectacular* results. I cannot wait to see in six weeks when more of the swelling has subsided. I posted a few more of my own pics - cannot **wait** for all of the swelling to subside so I can see my waist and butt curve again…sigh!
San Antonio Plastic Surgeon

I first consulted with Dr. Fisher after I had posted a question to Real Self and he had the most thoughtful and specific answer to my question. So many docs look like they do some copy/paste from some previous answer! To tell the truth, I was not 100% serious in considering him until after that initial conversation. After I got off the phone I ran in and told my hubby, I think I may have found my guy! Every interaction since then has only gone to reaffirm that decision as he is responsive and thoughtful and never fails to impress me in his knowledge, honestly, and attentiveness. I could gush on for a while really, but here is what happened: Dr. Fisher did my LBL, extended brachio, and whole leg lipo on December 27th. I will be undergoing a thigh lift,BL/BA, and bletheroplasty with him most likely late April or early May. I interviewed three surgeons prior to him - one local, one in MX, and one in California. I agonized over the decision until I consulted with Dr. Fisher. It was such a good fit from day 1. He is a competent plastic surgeon in all areas it seems, but he most definitely a specialist in post massive weight loss. This was a very important “start point” in the plastic surgeon as I have yards of extra skin to deal with after a 200 lb weight loss. At this point, the process is not only about excision of excess skin, but really reconstructing a body to what it may have looked like in absence of the weight gain and loss. I do believe the selection of your surgeon for such extensive procedures is the most important one. Dr. Fisher patiently answered my 100+ questions on plastics and my results intelligently, thoughtfully, and absolutely egolessly as he allowed me to discuss with him his results and the results of other surgeons. He is well versed in latest and many techniques. He has an absolutely impeccable bedside and every bit as invested in my results as I am. He was very responsive to my emails and inquiries during the pre-surgical process. He put forth a treatment plan tailored to MY body’s individual needs and my desired outcomes. One of these desired outcomes is to end up with a “feminine” curvy figure (which I started with) rather than the flattening of the hips and buttocks you see with so many LBL. He does what (I think) is a signature version of the Buttock Auto Augmentation and hip auto-augmentation using your own attached fat (the very fat many surgeons discard during the LBL procedure) - this is included in the price of his LBL! (two other quotes I had did not include this). He does really great work. He is invested in his patinet's outcomes - to this point, he actually spent 13 hours during my first surgery when the estimate was 8 hours - all to ensure I would have really good results (the thigh and lower leg lipo are actually a "staging" for the thigh lift - and i had monster legs to deal with). This spoke volumes to me and as they say, actions speak the loudest. His prices are very competitive. Please do PM me if you want additional information on my journey and experience with him (you can also read some of this in my extended body lift review). Also, do request a complimentary RS consult with him and see if this is a great of “fit” for you as he was for me!

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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