Post MWL Lower Body Lift, Spiral Medial Thigh Lift and Breast Lift with Augmentation - San Antonio, TX

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*Treatment results may vary

Through diet changes (weight watchers and cleaning...

Through diet changes (weight watchers and cleaning eating) and lots of exercise, I lost around 110lbs. As someone who had been overweight/obese since childhood, I knew excess skin would be an issue for me. Although, I was told by many people to give it time and exercise, the reality was such that the skin would not simply go away. After much consideration, I decided that I was interested in getting surgery to remove the excess skin. Mentally and physically, the excess skin was just as "damaging" for me as the excess weight was. Physically, the skin would interfere with my demanding workouts (that I loved). Also, as I became closer to my goal weight, the lack of physical changes became disheartening and demotivating. I knew I had worked hard to get great abs and improve my fitness, but the skin hid my results. These factors made the mental game very tough for me. I still saw the same overweight person in the mirror, despite going from a size 26 to a size 10, sometimes 8 or 12 (FYI I am 5' 10" with a large build). These were the factors that led me to seek out a plastic surgeon.

I first met Dr Fisher back in May of 2014. He was strongly recommended by my fertility/gyn, whom I have a very strong bond and trusting relationship with. (He had performed two surgeries on me in the past and I valued his option dearly.) Upon first meeting Dr Fisher, I was very pleased with both the friendliness of the staff and Dr Fisher's kind but very realistic manner. I felt confident in his abilities and also relieved by his honesty about the results and limitations within them.

Prior to surgery, I had my labs/EKG done and met with Dr Fisher again to reconfirm what implants would suit me best. (I had gone from a 44F to a 38B, with most of that being excess skin). I started a liquid diet two days prior to surgery and had stopped all Meds/nutrition supplements two weeks prior.

The day before surgery at my pre op appt, Dr Fisher answered all of my last minute questions, spent a long time meticulously marking me for surgery and reassuring me of things. I did not feel rushed and was put at ease. I also did not feel too uncomfortable with the actual marking up. It is awkward but Dr Fisher looks at his work like art and I appreciate his diligence in trying to review old cases and give me the best results I can get.

On the day of surgery, I arrived at the hospital at 5am. In the pre op, my IV was started. I spoke both with my anesthesiologist and Dr Fisher, who held my hand and reassured me all would be ok.

My surgery lasted 11 hours. Everything went well during surgery. (Dr F did have some trouble with the breast lift/Augmenetion due to constricted breast tissue, but he was able to perform the operation.)

Upon waking in recovery, I was in a great deal of pain. We switched pain medications I the PCA pump and this helped some, but the new medication left me feeling loopy and with hallucinations but still in pain. The first few days of recovery were very difficult. I was in extreme pain that was hard to control and had a lot of leg numbness. I believe a lot of that was due to my own body's reaction to being under general anesthesia. (I have atypical reactions to a lot of medications). I think the anesthesia just took longer to wear off and allow me to feel "normal" again. One thing I feel is important to mention is how caring and attentive Dr F was during my first few post op days. He came to see me every morning and called to check on me in the evenings. He would come and hold my hand and reassure me that each day would get better and that he was there. I greatly appreciated his caring manner. It meant a lot when I was so miserable and quite frankly scared.

The ride home from the hospital was absolutely brutal. I was in the worst pain. Once home I had a very difficult time finding any position to sit or stand that wasn't painful. (although, I will say that the oral narcotics did control the pain much better than the PCA) I think it was on the evening of day 4 post op that I started to kind of turn the corner. I was able to sleep for a few hours at a time and find somewhat painless positions to sit in. I sleep and sat in a recliner with additional pillows for cushioning. I also used an inflatable medical "do nut" to place on top of the raised toilet seat to help with the under the buttocks incisions. (those under the butt incisions from the spiral thigh lift were the worst part by far.). The breast and circumferential incisions did not really hurt too severely.

I had two JP drains that were removed at my first post op at day 6 PO. They did not produce very much the entire time. It was at that appt that Dr Fisher inspected all my incisions, answered any questions and told me what to expect.

Since, my recovery has been as expected. Slow and swelling awfulness. But I have been off of pain Meds since day 10ish. My incisions are healing pretty well, with one very small open area that is resolving very nicely it seems. The hardest part is being sedentary and having low energy when I am so used to the opposite.

I have had some questions and concerns popst op and Dr Fisher has told me not to hesitate to call. He returned my after hours call quickly and responded quickly after sending email pics of my concerns. It helped to ease my concerns to know he was both taking my questions seriously and there when I needed him.

I am currently 13 days post op and will "update" my review as time goes on. And when I get my before and after pics, I will add those as well.

Follow up visit #2 (17 days PO)

Saw Dr Fisher yesterday for my post op. Everything looked good. He said my shape looked great and the swelling was to be expected. He said my incisions were healing appropriately. The inner groin incision from the spiral thigh lift are a little slower than the rest due to the damp, dark nature of the "area" but should catch up. I do have a small opening right at the "y" incision about the buttocks. This area hasn't been painful but very uncomfortable. Dr F said this is very common and should heal up just fine with some antibiotic ointment and non stick telfa. The rest of my incisions are switching from Vaseline gauze dressings to dry dressings and moisturizer. (This saves so much time during after shower dressing changes!)

I have a slight double bubble on my left breast due to how constricted the tissue was (surprising considering how large my breasts were pre weight loss). This may resolve itself some or end up needing revision, only time will tell. I also have a small opening under the right breast where the instrument punctured through during surgery (as a result of the attempt to release the constricted tissue). This area seems ok and has stitches that will eventually be removed. Right now, we are just keeping a close eye on the spot and hoping it heals well.

Other than that, just more taking it easy. No lifting or bending. I do walk often to relieve pressure areas, but try not to do much else. I will say that is proving difficult. I miss my routine and workouts, but I know this rest is necessary and will be worth it in the long haul.

I do have one "tip" that has worked for me for compression. I found the spanx to be very bothersome to the "y" incision area and the crotch opening irritated my under bum incisions. (Maybe because they lift the bum?). Anyhow, what has worked great are my compression workout capris. I put my abdominal binder on first (with a soft tank top underneath) and then wear my capris over. They are a slight pain to tug up after going to the restroom, but provide excellent compression of the legs and hips. And the abdominal binder takes care of the upper area. Plus I can then just toss on a top and be dressed. Another nice thing about the compression capris is that they are designed for working out, so they are breathable and wick away moisture which is very important for the groin and under bum incisions. So far, they've proved successful. (If interested, they are from Target (champion brand) and are the tight fitting compression workout capris. $27.99) Dr checked them out at my visit and thought they were great and even asked what brand and such. Maybe others will find them useful too.

That is all for now. I forgot to ask Dr for before pics and I didn't really take ones myself that are decent, so I will try to remember next time. And I don't feel that the afters this far as served any justice without the "befores" to compare to.

Pictures Finally and an Update

This update is a bit overdue, but life happens. Healing has gone well for the most part. My thigh lift incisions are all closed and healing very well. My breast incisions have been closed and things seem to be "settling" in and improving there as well. My lbl incision is all healed with the exception of two spots. One very small opening in the front "y" area and then a large opening on the left hip where my drain exited. At around 4 week PO, the left scab where the drain exited started to ooze. At the drs, the scab was removed and the small opening cleaned. Over the course of the next week or so, the opening just continued to grow and deepen. It ended up being about 3" long and 1.5" wide and had a "pocket" where the outer skin layer was separated from the inner tissue. I've been packing the wound with wet to dry dressings twice a day and things are healing well. It is a pain and not something I anticipated, but the reality is that dehiscence is very common with so many incisions. Hopefully, things will to continue to heal nicely and the scar will be minimal. I have spit quite a few dissolvable staples and stitches, but without any real issue. Just more odd than anything.

As for results, swelling is starting to come down quite a bit. My thighs are slower to come down and my saddlebag area is still boggy. Both my PS and I are hoping this is fluid and that the final result will show improvement, but we have to wait and see.

Other than that, I am feeling well. It really did take around 6 weeks for me to start feeling like myself again as far as energy and movement. I am starting to work out again and look forward toning back up after 6 weeks of no exercise. I feel little twinges of pain here and there when I really stretch or pull the wrong way, but they are short lasting and minimal. I'm definitely very pleased with my results and hope things will continue to improve as the swelling decreases and time passes.

I have seen Dr Fisher often and I am very impressed with his after care. He has been readily available by both office visits and emails to answer any questions or even just reassure me (that large opening is a bit daunting). I know he is probably more of a perfectionist that myself and that he is every bit as concerned that I am 100% pleased with my results as I am, which is very reassuring.

Quick update

Just a brief update at 3.5months post op. Doing very well. Back to aggressive workouts. Had my dehiscence area revised/restitched in office about 5 weeks ago and it is healing beautifully. You can barely even tell the scar from the rest of the lbl scar. I'm pleased with the overall results of everything, less some laxity in my outer saddlebag area (this area was bad pre surgery). However, giving things more time as I know for a fact my thighs are still swollen. Apparently I am one of those people who swell longer than most. Now, I am just working to tone more.

More pics

Here is the revision spot pre and post in office revision. And a before and current front shot.
San Antonio Plastic Surgeon

Dr Fisher is both kind and competent. He is dedicated to researching and providing post massive weight loss patients with the best possible outcomes. I trust his expertise and opinions and I am very confident in his abilities to help me obtain the best results within my own limitations.

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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