After weight loss: Lower Body Lift, Spiral Thigh Lift, Breast Lift. San Antonio, TX

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Hi all, I have been benefited by reading all the...

Hi all,
I have been benefited by reading all the reviews here. I am planning on documenting my experience to pay it back. I am female, 42 yrs old, no pregnancies and I have been having weight issues all my life. I have lost over 130 lbs and I am now at about 170 lbs, 154 lbs is the lowest I have ever been. I am 5ft 8in and I am pretty fit overall. I like exercising, I run regularly 4-7 miles, have been doing Yoga for 5 years now so I am pretty flexible (3-4/week regularly) and I do weight training, swimming, fitness classes (FIT, TCX) as often as my schedule permits (from a couple of days/week to a couple of days/month). Up to a year ago, I wasn't thinking about plastic surgery just because I always thought that it is for other people without really ever having looking into it. I have quite a bit of loose skin as most of the MWL patients that go through plastic surgery, mostly on my abdomen and my inner thighs. It bothers me quite a bit when I see myself naked, when I try on clothes and especially when I wear "special" underwear that smooth my tummy and hold it in. I look OK with clothes but the two layers underneath ( "slimmer" panties and camies) really annoy me.
So, I started looking into plastic surgeons. A friend recommended very enthusiastically a surgeon in Austin. She is quite young (mid 20s) and she had a tummy tuck and arm lift. I saw her incisions and scars (9 months post-op) and they looked good, still red but straight and well placed, low on her hips. As a result, I started with her recommendation and went in for a consult with her surgeon. My inquiry was for a tummy tuck and an inner thigh lift since these are the two areas that bother me the most. The first surgeon recommended the tummy tuck, didn't think that I need a body lift and was very reluctant to do the inner thigh lift at the same time. The only option they gave me was to get a vertical thigh lift, the one that the incision was down half-way to my knees. I asked about how many thigh lifts they perform per year and the answer was about 5; that explained their hesitation. I thought that the first surgeon was very qualified for a regular patient that hadn't lost a lot of weight and needed a procedure to perfect their body after a pregnancy but I may not be getting the results that I was looking for. The laxity of my inner thighs bothers me quite a bit and I wasn't ready to give up on correcting it.
After hours of looking thorough the pictures and reading reviews and answers of doctors at Real Self, I came across Dr. Peter Fisher located at San Antonio, TX and about 1.5 hrs away from where I live in Austin. I went in for a consult around mid-November. His office setting was more modest and "real" than the first surgeon's, no big windows with city views, designer couches or high end magazines, it felt more like a very nice waiting room for a doctor's practice and I felt more comfortable.
I am a perfectionist and I have worked really hard to lose all the weight but I have no illusions about being a model, I just want the best outcome as close to perfection as it can get... At the appointment, I saw the nurse first and answered the usual questions about how long have I been at my current weight (1.5 years) and how did I loose the weight (diet and excercise mostly with diet pills occasionally from a nearby clinic) plus medical history. Before I went in, I was only considering a tummy tuck since I never had a problem with my butt or my legs and outer thighs. As soon as Dr. Fisher saw me, he immediately recommended a lower body lift instead of jut an extended abdominoplasty. He felt that a Lower Body Lift (LBL) will address my problems more hollistically. He also recommended a spiral thigh lift (without the ugly vertical incision). I am posting a picture of the procedure that he performs from a research journal. He also addressed my breasts and recommended a breast lift. I am a size 34G even after loosing all the weight so I never really felt that I need breast implants or I even want them. He didn't even talk about implants. I asked about my arms but said that they are fine. In all, he recommended the LBL with the spiral thigh lift and breast lift. I was pleasantly surprised when he said that to his experience, after a LBL, most women have a "boxy" look without curves and that his procedure includes transferring fat from the excised tissue (that he cuts out) to the butt so that the butt has more shape. I always felt that my but was quite flat, didn't really bother me (compared to my other issues) but I would take a fuller, rounder, more feminine butt gladly. I was very excited with his recommendation, doing it all at once and I was also very worried about the length of the procedure (7-10 hrs, I think), healing and also I have to admit that I was skeptical about whether I needed the LBL. I was thinking to myself that this all sounds great but it is me who will have the surgery not the doctor and he can be excited and want to do everything but do I need it all? So I did a lot of reading, mostly research articles that I have the advantage of having access to and I will be discussing and quoting them as I write my review. At this point and from what I have read, I think that the answer is that Dr. Fisher was right. I will elaborate more on this later.
I concur with most of the reviews about Dr. Fisher at Real Self. He is very personable, matter of fact, experienced surgeon and much warmer that many of the doctors that I have interacted with. I felt that he had a vision for my body transformation that I didn't haveI and couldn't have had and most importantly that he has the experience to deliver the results that he envisions. I got the feeling that he is invested into his profession and his work and his motivation is not just financial (not that there is any thing wrong with that). Dr. Fisher gave me the impression that he is not into it just for the money and cares about what he does deeply and that to me is very important. I am having a follow-up appointment this coming week and I want to schedule the procedure ASAP. It looks like he won't have anything in December, a bummer for me since I all have time off during Christmas but so does everyone else and I should have really looked into it earlier although I have to admit that I never realized how much ahead you need to plan for this surgery. I am hoping for the earliest date possible, really early January otherwise I may have to postpone until March of May.

Surgery scheduled for Jan. 06

Happy New Year! I am having the surgery on Jan. 06, I have been counting down the days. I can't really wait to have the operation and just for this reason I think that it is definitely worth it. It will be interesting to see how I feel about it post-op when I am all cut-up and swollen.

10 weeks after the surgery - Outstanding Result!

I had the surgery or I should say surgeries about 10 weeks ago. I had a lower body lift with autologous augmentation of hips and butt, basically the pieces that were removed from my lower back and sides were cleaned-up (surface skin layer removed), were cut to something that resembled a huge burger and were inserted on my but and my sides so that my butt and hips become larger and the overall shape more hourglass-like. I also had a thigh lift with a groin incision, instead of the medial thigh lift where the incision goes vertically, towards the knees and on top of all I had a mastopexy, or else breast lift without implants.
I was under general anesthesia for about 11 hours, he removed about 5-6 lbs from my tummy and did lipo on my upper back and wherever else I needed it. I stayed in the hospital for two nights and the whole first week is a blur. I don't remember much because of the effects of general anesthesia and morphine. I recall a lot of pain and moving really slow and during the ride home three days later every bump on the road or hitting the brakes was bothersome, painful and from what I hear I complained a lot.
The second week is blur as well only a bit clearer, still in pain, I was taking percocet every few hours and was sleeping and hanging out on my recliner. I slept on the recliner for about 4 weeks. The pain gradually subsided and switched to just Tylenol around week 4, I think. I didn't go to work until the third week and that was real hard initially but got better.
Although, it has been a long and gradual recovery and had to take care of some skin openings, I never, not even for a minute did I regret going trough with it! I am very happy with my new figure and looking at the before and after pictures, I cannot believe the transformation. I would say that I am now about 80% recovered and I work full time but I am not back to my full exercise regimen, mostly because I have trying to catch up with work and life in general.

Before Pictures

Here are the before pictures, showing Dr. Fisher's intended plan of action, what was to be removed and suctioned! He spent 1-2 hours drawing lines and curves and erasing and marking up again. There is science in it but there is also a lot of art from what I gathered. The final incisions maybe a bit different in general but this is where you start. It was a real pleasure to see Dr. Fisher working on it and knowing that he will be correcting all that stuff on my body! I did admire his extended experience and realistic vision and I was excited to see that he was into it and deeply cared about the outcome.
On the second picture, the area that was circled with red, near the armpit and down towards the chest was something that was not included into the original consultation, plan or quote but Dr. Fisher decided just the day before that if there was enough time, he would do that as well since there is a lot of extra skin around there. I couldn't have agreed with him more and I was excited to get rid of this extra skin but the planned surgery was already long enough and complicated enough and it didn't happen. At the end, I was glad since I had to take care of enough incisions and didn't need any more. I would like to go back eventually and get it done though, at some point.

Pictures: 5 weeks after the surgery

Both of these pics were taken with my phone, at home, about 5 weeks after the surgery. I think I am about the same weight as before the surgery, give or take a few pounds.
I think that Dr. Fisher did an amazing job. One of my friends was stunned and said: "You are not square anymore! You have hips!" I picked the right doctor for me and I feel really lucky that he was within a 2 hrs driving distance from where I live.
I can keep going about how great of a job Dr. Fisher did and how I feel about the results but a picture is worth a thousand words, sometimes more!

What worked well for me during recovery

The raised toilet seat with handle bars, I still use it. It helped with not having to use the abs to sit down and up but was particularly useful with not putting too much stress on the groin incisions from the thigh lift.
The recliner is a must, slept there for about 4 weeks, my bed is a bit too high and not easy to get in and out when in pain.
The crotch-less compression garment for when you have to go and the “feminine urinary director” for peeing while standing-up, a definite advantage for men as it turns out, to keep the area around the thigh lift clean and not getting infections if an incision opens-up.
I started using Silicon sheets and gel sheeting after about 5 weeks and I prefer the silicon gel sheeting at this point because it stays in easier and it looks like it makes more of a difference with the scar maturation.

“My PS is the best!” Some thoughts:

We all want the best possible outcome, we read reviews, visit doctors, talk to friends but how can we be certain that the surgeon or the surgery we choose is the best? To start with, one can narrow down the selection to a few doctors maybe within a 50-100 mile radius of where one lives and then consult a few of them. But even then, how can you know that you are making the right decision or the best decision?
It is one of these “one of a kind” experiments, you cannot repeat the surgery, not on the same person or with the same conditions or “try out” several of the surgeons. You can of course, make sure that the surgeon has a good track record and he has performed similar procedures “hundred” of times before with better than good success. The reality of it though is that each operation is unique and no matter how good the doctor is, something can go not exactly as usually expected and there may be “mistakes” or plans that didn’t work out and I am sure it happens and it probably happens to everyone. This is something that you can’t control but what you can make certain of is that you trust that your surgeon has the skills and experience and will care enough to do what he thinks is the best for you.
It may not be the “best of all possible worlds” but it will have to be good enough for you, not as a compromise but as a significant improvement to what bothers you. It will not be perfect. I still see a small asymmetry towards the right of where my belly button is but I really, really, really like my belly button. It is not round and it is not a stretched out, vertical line. It has a really great elliptical shape and I credit my PS for it, of course. The slight asymmetry discernible only to me, my PS, and maybe a couple more people that care enough to pay attention doesn’t matter as much to me. The transformation is not perfect, nor ideal but I feel that it is the best that could be done under the conditions and my circumstances whether it is time or timing, location, finances, support system or life stage. You really do get to choose not the absolute best but the best for you, right at that point. One of the most intriguing aspects of reading the reviews and looking at “befores and afters” is how someone can be extremely happy with what I view as a mediocre result or another complaining of a detail or be unhappy with what I judge as an amazing outcome. The psychological aspects involved in "body image" issues seem unpredictable and all over the place.
The relevant question, I think, is not exactly whether this is the best decision or the best PS but whether I can be happy with the most probable outcome as envisioned from the pictures of the doc’s previous patients and from the sought-after changes and their limitations that the doc himself, realistically and honestly, described and explained to me? If the answer is yes, then the patient is happy and their PS is indeed the best!

13 weeks post-op

It has been a long recovery and I am not 100% recovered yet. I am sleeping in my bed but I am not still comfortable when I turn and when I sleep on my stomach. It feels like I am getting pulled around my incisions, it is not painful but it is uncomfortable. I have been wearing the compression garment every day, all day, so far but I am staring to take them off when I sleep and today I am going to work without wearing them for the first time.
Swelling is still a problem, especially after I exercise too much. Last week, I was ramping up my running to 8 miles, took some intense Yoga classes and did weights and I was swollen up for about 2 days. It is better this week, still swollen but not as much. Apparently, the swelling is quite common at this stage when you increase your activity because of the lymph fluid that gets accumulated and cannot drain since some of the lymph channels that drain the fluid out have been interrupted bc of the surgery. My understanding is that swelling is OK bc your body is getting forced to create lymph channels (vessels) to take the lymph fluid to the lymph nodes. Most of my swelling has been around the abdominal area or that is where I notice it the most.
San Antonio Plastic Surgeon

Dr. Peter Fisher is an outstanding surgeon that can deliver what he promises. He is a very well qualified, extremely experienced and deeply caring professional. He is not your typical, "cookie-cutter" doctor, he extensively performs a combination of intricate and complicated procedures in one surgery setting, especially beneficial for patients that have lost a lot of weight. He had a very realistic vision for my case and has gained my trust and confidence through every step of the process. He was very patient in answering questions, clearly explaining procedures and he has a keen understanding of all the underlying emotional and physical issues that accompany extensive plastic surgeries. Dr. Fisher and his staff responded to all my concerns, questions and worries incredibly fast. I am very happy with what he did for me and feel very lucky that I live within driving distance from his practice.

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