Liposuction and Fat Transfer "Mini-BBL" with Dr Fernandez Goico - Dominican Republic

Hello RS Friends! Thank you all for giving me the...

Hello RS Friends!

Thank you all for giving me the courage to write. I've enjoyed reading about everyone's successes--marveling at some truly impressive makeovers--and learning from people's disappointments. I am nearing 40, 5'5", waver between 115-118 pounds (these days anyway), and have what I like to call an aristocratic upper body and a field peasant's lower body. (Smile) I have always had robust, athletic legs, big calves, and a hefty butt. I have a naturally small waist. I exercise moderately (treadmill running and cardio trainers) but also sit a lot at work. I have no children.

My surgery is about seven weeks away and is scheduled with Dr Fernandez-Goico in Dominican Republic, thanks entirely to other RS members who have written such positive reviews. As has been repeatedly stated, Dr FG and his assistant Karel are gracious, patient, quick to respond, and most importantly, display extremely high integrity.

I queried Dr FG on multiple topics including liposuction, BBL, a surgical butt lift, and a "donut" breast lift without implants. His level of direct honesty even at the expense of losing a potential patient impressed me very much. For instance, he said there is "no way" I needed a surgical butt lift and he absolutely would not put those kinds of scars on my body for what mild correction I needed. (I was thinking more along the lines of Dr Mendieta's "butterfly lift," which pulls up sagging buttock tissue.) He was also very honest in saying if I expected a true BBL, he'd simply be stealing my money because I do not have enough fat to give my rear pronounced results (he recommended small implants instead). And with respect to a breast lift, he initially recommended implants, but once he could see I was not interested in them, he made the suggestion of a lollipop lift rather than a donut lift in order to achieve a fullness that the donut simply can't produce (without implants).

Let me tell you, Friends, sometimes you want a doctor who tells you what you do not want to hear, because only he/she really understands what procedures are likely to give you the most reasonable results to match your expectations. He could have just said Yes, Yes, Yes, taken the money, and a year later I'm writing on this site asking why my nipples are pleated and my butt lost its fat? But no. Dr FG was forthright and realistic and THAT is a doc into whose hands I'll put my body.

He is also very, very busy. I tried not to hen-peck him too much with questions and was willing to wait patiently for answers. For those interested in a consultation, I'd suggest making a very well-organized, numbered list of clear questions and he will respond within the email/text beneath each one.

Ultimately what we decided was the following (keeping in mind that Dr FG will not actually see my body in person until my pre-op appt):

1) Multiple areas of liposuction which will mainly involve inner thighs, upper hips/flanks, hopefully inner knees (as I have this annoying chunk of fat above each knee), and hopefully upper arms (if he feels it would be rewarding). A questionable zone I'd like to have touched up but have read of mixed consequences is the "banana roll." I definitely have this issue, but with a low slung buttocks, I'm concerned the butt will droop even more if this area is tampered with much.

2) Fat transfer to the outer, somewhat deflated butt cheeks to round them out a bit more, and hopefully transfer to my right breast, which is smaller than my left.

3) A lollipop mastopexy (lift). In my case, this lift will not be very dramatic. I'm relatively small breasted (small B in the right, large B on the left) but have noticed in recent years that the tissue has become slack, as age and gravity will do. The point of this surgery, for me, is to give me perky, youthful breasts that hopefully can take me into my old age. :-) I am not interested in size; I'm interested in symmetry, balance, and perkiness. However, due to size discrepancies between the breasts, I'll likely need a bit of fat in the right to even them out. Currently bras are frustrating because the outer aspect of the left breast was to ooze and bleb out of the cup. Bah!

Arguably, my overall bod as it is is really not that bad for nearly-40. My goal is more along the lines of re shaping/re contouring with reduction of that stubborn inner thigh pudge (I call it my thigh pudding...eeew!), perky boobies, and using what fat I have to plump up here and there.

What I ultimately decided NOT to do:
1) Butt implants (I wanted them but the recovery time and the inability to sit for quite a long while were major impediments),
2) Breast implants (I have never wanted them...that's just me...I admire everyone else's but I'm worried about several issues: capsular contracture, unnatural appearance, eventual sagging (which I'm *already* wanting corrected), and eventual replacement (what, I have to pay to do it again?).

I've started collecting a couple of maxi dresses for comfort (BHFO on eBay has very reasonably priced ones), a couple maxi skirts, soft stretchy, wire- and closure-free bras, and a single pair of spanx capris (once I can take the compression garment off). Dr FG recommends "granny panties" as well but since I know that the compression garment is worn against the skin, the panty would go on the outside of the garment, and thus I figured my own undies would suffice. I'll only be traveling with a carry-on, so I plan on buying absorbent gauze/pads, bandage tape, etc in DR.

I am SO looking forward to lying (on my sides???) on a sun lounger and at least getting a bit of tan on my shoulders, arms, and lower legs. I'm a great walker, too, so it will be a wonderful week in Santo Domingo!

Before Surgery Pictures (breast lift + lipo + fat transfer here and there)

Eagerly awaiting June 16th!

Breasts will not be done, lipo and mini-BBL still in the works.

After extensive thinking, looking at reviews, looking at pictures, and Dr Fernandez-Goico's advice, I've decided against the Breast Lift. A couple of people have also responded in the negative. While I think I could use some improvement, I realize that my breasts are really not that bad, and since I'm still unwilling at this point to consider implants, there is probably not a lot of scar:benefit trade off. I do wish there were a reliable, permanent suture or internal sling technique where small breasts like mine could just be pulled up a bit. Sigh.

The lipo and mini-BBL are still a Go. It is still possible Dr FG will say I don't have enough fat to transfer, in which case I will just gracefully accept. I would love to reduce my inner thigh bulk and inner knees. One week to go and looking forward to the DR. I'll spend some time at Boca Chica even though I won't be able to swim. Just lying on the beach and reading sounds fabulous!

Very impressed with Dr Fernandez-Goico and Karel!

Dear Friends,

I had my pre-surgery consultation at Dr Fernandez-Goico's office today. The consultation included a blood draw for labs, a urinalysis, an EKG with a cardiologist, and a long discussion with "el doctor muy guapo" Dr FG. He thinks it's funny that I call him guapo, which is Handsome in Spanish, but he has got to be the one of the best looking men I have ever seen. And his wife is equally, indescribably beautiful. Then there's Karel, who is not only sweet and charming, but petite and beautiful, with amazing skin and lustrous hair. Seriously. These people should be on TV. Ask Karel about her mother's puppies...she loves dogs!

Everyone, as you know by now, speaks perfect English. The office is very clean and modern. And of course the doctor instills confidence.

In person he re-evaluated my breasts and agreed with his first impression that they didn't need his assistance at this point. Even though I told him I had PMS and they were fuller than usual, he didn't not think they warranted scars.

He also evaluated my thighs and butt and we made a plan for lipo of the inner thighs, a tiny touch up of the outer thighs (I'd had lipo about 14 years ago), a little under the cheeks to better define them, muffin top, and a little waist to create that cinched look. He thought it best to inject fat into the outside aspects of the cheeks where it would create a round buttock (instead of my square buttock), and also be more likely to stick. He said far grafted to the middle of the cheek (where you actually sit) doesn't stay as well probably because it doesn't grow enough blood supply before pressure causes the cells to die.

He of course had to remind me that my body looked fine the way it was, and I was also clear to tell him that I knew in the "big scheme if things," my body is doing well for nearly 40, but I sure don't like all my inner thigh jiggle.

Dr FG is both funny and humble, and I was really touched when he told me he says a prayer for every patient before they go to surgery. Bless him and his big heart, his artistic talent, and his kindness.

In his office I met another RealSelfer who looked AMAZING. She was so pleased with her results. I wish we lived close, as we were about the same age and I knew we'd be friends. I also met another younger woman without a posted profile who learned of Dr FG through RS. This woman had a beautiful face and wanted perkier boobs.

HELPFUL HINTS:
If you're not staying in a recovery house, Aladino Hotel is only about 1/2 mile from the doctor. My room is very clean, a/c works, I have a tiny fridge, and the workers are very attentive. All for about $90/night (includes taxes).

Less than a quarter mile from Dr FG is a supermarket (supermercado) called Supermercado Amigo. I walked there after my consultation, loaded up on water, fruit, and snacks, and took a taxi back to the Hotel. If you ask, they will call a taxi for you. I paid $5 US for the ride back.

Dr FG has a driver that can pick you up at the airport. I missed him and the legal city taxi cost $40 from the airport to Aladino Hotel.

I tip everyone who helps me a dollar or two (for instance, the boy that called the cab, the man who carried my groceries to my room), and I tip a couple dollars when I pay my restaurant tab. People here are generally poor and depend on tourists.

Tomorrow my surgery is after the young woman getting the breast lift. My chest X-ray is at 945 and then I'm probably going to be induced for surgery around 1030. No food or water after midnight tonight...for some reason I'm more afraid of being thirsty than I am of general anesthesia.

I did ask Dr FG what protocol will be used. Induction is IV with midazolam and Propofol. I'll be on a total intravenous protocol with ketamine. Hmmmm. Ketamine is an interesting choice...keeps BP and HR up but definitely hallucinogenic. I use all these drugs in animals and am familiar with their mechanisms. I forgot to ask what analgesics are used (fentanyl, hydromorphone, hydrocodone, etc). So I'll let you know how the anesthesia goes!

Post surgical update!

I'm currently in the hospital recovering, and it's been about 12 hours since they wheeled me into the OR.

There were some hiccups along that way you should be prepared for: I was Dr FG's second surgery. If he has a long procedure, like a mommy makeover, he'll only do one surgery. If he has two short ones, in this case one woman's breast lift and my lipo-BBL, he will do two.

I did have to wait longer than I expected, but I think it only felt long because I didn't know when it was going to start. It also felt long because I couldn't eat or drink after midnight, and I didn't actually take the famous blue pill (15mg midazolam) until 2:30pm with the *tiniest* amount of water that I could barely swallow. I was starting to feel very bitchy from hunger and headache.

The nurses on the surgery floor do not speak English, which really isn't too much of a problem. My anesthesiologist, a woman, also didn't speak English, but she asks you the same questions you've answered all along: hepaticas? (Liver) renales? (Kidneys) Diabetica (diabetes) etc. Bring a written list of all drugs and supplements, esp birth control pills--it makes it easier. You will answer the same health questionnaire for various people several times. The anesthesiologist set my IV catheter and initially tried one too large. Not funny. I was already dehydrated from 14 hours without water.

Once they wheeled me away, I got an IV injection of something clear that I forgot to ask about (but was not Propofol because that is milky white) and then I was out.

I distinctly remember talking during the procedure (probably under ketamine) and dreaming amazing, colorful, vivid dreams. It was like a freaky peyote trip. Not that I know what that is, exactly.

In recovery, the Dr told me I was singing along to Maroon 5 and saying "I love you, I love you Dr Guapo!" How. Freaking. Embarrassing! At least I didn't say ugly things (hopefully).

There was no pain during the surgery. 12 hours later, my thighs don't hurt, they're just stiff and sore like working out. My belly button hurts a bit because it has an incision to do a little high def lipo on my abs. My butt cheeks do not hurt from the BBL. The only thing that is really comfortable so far is the lower back/muffin top lipo.

The doctor put 450ccs of fat in the outer sides of each cheek. That's all I had to give. I asked it it's possible not to have a drain in the back because everyone says they are SO painful. I even met a woman at the Drs office that was carrying herd around and she said it hurts.

Dr FG instead installed a penrose drain, which is essentially a rubberband stitched into an opening in the skin to allow free fluid to drain for a couple days. No suction, no collection kit. You just keep pads on it. I can still feel this but I know it's not as bad as it could be. He could only do this simpler drain because my lipo was limited, so ladies, take note! You will prob have a proper drain.

Received my anti thrombosis shot a couple hours ago and now just waiting for sleep to find me.

Here's a picture of the snack I smuggled in and ate once I woke up. There's no separating me from food!

There's No Ha-ha in the Faja. It's Fa-hell.

Two days post-op and I feel more painful than ever. Poor Ana and Karel had to put my faja on me today (the doctor wanted me in leg wraps and a belly band for the first day), and I shamefully have to admit I cried. I actually almost had a temper tantrum. It was SO tight, and even now, six hours later, you can see by the picture that I can't close it up. Well...they closed it up but I couldn't breathe and I couldn't eat anything, so I've opened it to a barely tolerable level. The white object is lipo-foam...it distributes pressure to keep the skin even. You can see the bruising at the top of my abs...I had a very small amount of "high definition" work on the front.

Dr FG removed my pentode drains and it didn't hurt at all. The massage was also a little more tolerable today.

My hips are hugely swollen but my butt grafts aren't terribly painful. My inner thighs don't really hurt at all. In order of lipo pain I'd say:
Most: mid to upper back, them lower back (muffin top), followed by abdomen, hips, and least: thighs.

The back lipo burns and "zings" in a nerve pain kind of way when I twist. It's very hard to go from lying to standing when you can't use your back or abs.

I do not know how ladies get lipo, bbl, AND tummy tuck AND breasts done at the same time! Mamma Mia. I'd need an opioid drip to survive it.

Currently I'm taking Cefadroxil (antibiotic prophylaxis) and Dexketoprofen. Honestly, the profen doesn't cut the pain, but at least I'm clear headed.

I do feel like I bit off more than I can chew, but nothing to do except move forward. What, I'm gonna ask for the fat back? ;-)

Dr FG and Karel were wonderful again today and remain ever sweet and positive! And my butt IS rounder and much less square!

Dr FG is the best Fat Micromanager!

I now call Dr FG the "fat micromanager." He takes your body and redistributes the assets, carving curves from straight lines, adding hillocks where before there were depressions.

At our final meeting yesterday (*sob*), he reviewed what he did:
---I had more inner thigh fat than he'd initially thought, and he removed a lot of it but was careful to say he had to stop when the skin looked like it wasn't going to be well supported. Otherwise the inner thighs would sag. He said inner thighs are difficult to do...how to make the thighs symmetrical, how to take out similar amounts of fat at the same places on each thigh. Bless him for his diligence!
---The lower back and love handles were also lipo'd.
---The abdomen had a very small amount of work mainly to define abs.
---450 ccs were injected on the outer aspects of the cheeks. Really, the fat was placed in an area to give the appearance of a wider "low hip" region.
---The effect is a longer torso, a smaller waist, and rounder hips.
---He was happy to report I didn't need the "banana roll" region under the butt cheeks lipo'd because once the inner thighs were reduced and the fat added to my hips, this area seemed to kind of meld together without work. (This is good since lipo'ing the banana roll may cause the cheeks to sag.)

The pictures are not the best under fluorescent lighting in a beach town budget motel. (No sun exposure is allowed...I'm well covered.) The results are already apparent despite my puffiness. Today is five days post-op. I'm now only really painful when I wake up (back still hurts) and if I'm jostled and anything presses into the lipo'd areas. I can almost bend completely over (but not quite).

I feel very blessed to have put myself in Dr FGs talented hands, all thanks to other Real Selfers before me who paved the way!

Two weeks post-op Lipo & Mini-BBL

Every day I feel better and better. The flank and back lipo areas are the only regions still swollen, warm, and tingly. I get those nerve "zings" if I twist too quickly. My lower back and hips and still numb and will be for a fee more weeks.

The bruising of the thighs has improved tremendously. My former drain site is still a little irritated and weepy. I'm keeping it bandaged...I wasn't before, and everytime I pulled up my garment, it rubbed this incision.

I stopped wearing the super-intense Marena compression garment after a week because I couldn't work in it. I'm now wearing a size small Taylor & Taylor stage 2 capri with an open crotch (eBay $77, great quality) plus a size medium "extra firm" Spanx Star Power open bust tank ($10 TJMaxx, bought a second on eBay for $25). This tank is extremely tight and compresses the flanks very well. It doesn't ride up. I highly recommend it. Even though I'm a small, there's no way I could get the small on. It's *that* tight. You wear your own bra with it.

At night because of the heat, I'm wearing a lightweight Spanx capri...it doesn't offer much compression, but since I'm lying down, I'm not as concerned.

My inner thighs are MUCH thinner even with the current swelling and I'm delighted! Waist looks much smaller, too. Butt still looks round. Yay!!!

Six weeks post Lipo and Mini-BBL with Dr FG

Very happy with my inner thighs, so very glad I had liposuction. Even though the results are subtle, to me they are very apparent. I was worried the skin wouldn't re-adhere well but I think the opposite had occurred--I think the process of creating that trauma has kind of "tacked" the tissue in place and my inner thighs look firmer and less saggy than before. (And just FYI, I was not compliant in wearing my garment continuously after the third week.)

The outer buttocks still looks rounded, though I can tell not all of the fat "took." Or perhaps the fat just "settled" in. That's okay because I still have enough to maintain a rounder contour. I'm also very happy with how trim my waist looks after lipo. The back lipo STILL stings/burns and still periodically swells up.

The *only* negative has been the increased appearance of two dimples on my upper left thigh. These were barely visible before, but I think once the added fat created a larger outer butt cheek, the skin was weighed down a bit more, accentuating this problem.

Dr FG successfully performed subcision on a similar dimple on the right thigh...it's totally gone. On the left, the subcision missed the mark a bit. I'll need to find someone that can subcise those two little divots.

Otherwise, I'm delighted and feel it was all worth it. I'm wearing shorter shorts now!

6 months post Lipo + Mini-BBL

These pictures were taken 6 months after lipo and fat transfer to the outer buttocks by Dr F-G. My inner thighs have a better contour (not "thin" because that's just not my body type) and my rear end is rounder and more shapely, less square. I'm still very pleased with the decision, though I would say the contouring on my abdomen didn't really accomplish much and left canula-insertion scars in the bikini area that I thought were worse than just leaving the area alone.

I recently corrected the cellulite with Cellfina, very happy with those results as well.
Dominican Republic Plastic Surgeon

Dr Fernandez-Goico is funny and warm, approachable, honest, and extremely meticulous. He's very human and humble despite his amazing looks and even more amazing abilities. When he explains what you need or what he did, it's with exacting detail, and it becomes very apparent he deeply considers every move. He said he has a passion for surgery, and I think you can see this is all his results, most more substantial than mine. The staff is wonderful and the facilities are clean. Karel is amazingly helpful, and when I teased him about how Karel keeps everything under such good control, Dr FG joked, "My wife can leave me but Karel can't leave me." His fees are unbelievable for the quality of care and artistry your body receives. It's very helpful that most things are included: labs, urinalysis, chest X-ray, EKG, overnight hospital stay, anesthesiologist, and compression garment (aka faja, aka torture device :-). They also have a couple of drivers. Please remember to tip them, as well as Ana the lymphatic therapist.

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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