Breast Aug and Full Abdominoplasty - Scottsdale, AZ

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June 30, 2013- I month away from my scheduled...

June 30, 2013- I month away from my scheduled surgery. ALREADY nervous! Even nervous just to have the consultation a couple weeks ago. I felt so relieved when I was handed 250cc as my first try-on. I am 5'2" and weighing around 100 lbs. I am done having children, and I just want to look "revamped and natural." I am not wanting for people to see me post-op and wonder to themselves (or out loud) "Where did THOSE come from?!" 300cc looked a little too large on my frame for the look I am going for. I am also having full abdominoplasty done at the same time to bring re-tighten my abdomen, fix a herniated umbilicus, and remove some left-over excess skin. My pre-op appointment is VERY close to my actual surgery because my Doc is on vacation a couple weeks this month. I really wanted to have my surgery the end of July because I already made arrangements to get help with my children at home so my other half can be MY helper! I am concerned about returning to home post-op: I have an energetic 8 year-old daughter and 17 month-old son. I am thinking of staying in a friend's guest house or doing a local resort to just sleep/rest for the first several days after the surgery to be away.

My pre-op I am a deflated A cup, and normally (before finishing nursing baby #2) have always been a full B or a small C. I have very little body fat on my abdomen, so I am pretty sure there will not be any lipo. I am electing to do the full tummy tuck mainly so the hernia can be fixed and I can have a flatter, prettier abdomen to match my new pair of breasts.

4th day post-op

Well, the procedures happened on schedule this past Monday. I spent one night at the surgery center and my pain was well controlled while there. They want you to switch to oral medications before they discharge you to make sure your pain will be controlled well enough to leave. I basically slept on and off the entire time. The worst part of the stay was when the catheter was removed and I had to get in and out of the hospital bed to use the bathroom. It was awful.

I was surprised that I had the ability to eat some breakfast the following morning. When at home, I had to see if I could make it up a flight of stairs to our master bedroom suite in our house, where I planned to camp out until my 1 week follow up appointment. If I couldn't make it up the stairs I had a couple back-up plans in place with where I would go. But I did it, so I got to stay home.

Pain level overall has been up and down, and my right breast has been more painful than my left consistently. I have been applying ice packs/bags to it. I cannot shower, so I am doing regular wipe-downs of my exposed skin areas with baby wipes and my fiancee used a lightly soaped damp cloth and washed me yesterday. I have 2 drains in for because of the TT that need to be emptied several times a day. I can tell the fluids are already less in volume and becoming less bloody and more a straw color, which is what I was told. I don't seem to need to take the full strength of demerol for pain control, and I'd say today (at day 4 post-op) the biggest annoyance I am dealing with is itching.

I also decided to venture downstairs once yesterday, and a couple times today... just taking it VERY slowly. I am really surprised I am already able to do this. As tempting as it is to see what else I am capable of, I am being a good patient and am back resting in my recliner (which I have been sleeping in the past 3 nights). I took my compression stockings off yesterday, but noticed my feet and legs were puffy today, so I had my fiancee put them back on. I was prescribed ambien for sleep and I haven't needed it because the demerol makes me sleepy enough.

The pain and discomfort of the subpectoral breast aug has been far less than the pain and discomfort of the abdominoplasty. I will post pictures.

2 weeks post-op

Well, I planned for the worst and hoped for the best, and I feel like I am healing very well. My surgery was 2 weeks ago today, on a Monday, and I think I was off my pain medication after Friday, so about 4.5 days. I am left with half my prescriptions or more untouched. I basically slept most of the day while using the meds in the recliner. I no longer used the recliner and slept on my mattress on the floor (so I could easily roll out of bed, not worry as much about injuring myself) a week out. After stopping the pain medication, I had trouble sleeping because of extreme itching. It turns out I am allergic to adhesive in bandages and developed an allergic atopic dermatitis. My PS removed my bandages and 1 drain at my 1 week (8 day) post-op appointment. I returned 2 days later to get the other drain removed (the Thursday of the week following the surgery). I was then cleared for driving and a REAL SHOWER! No swimming pool for a few more weeks though :( Today was the first day I had my baby alone, and I decided since my energy has been low and I have a new pain (it's not severe, but I don't want to push it) on my lower left abdomen near the area of the incision, to put my kids in childcare today and make sure I didn't do a lot of running around or anything physical. I am also off blood thinners for almost a week now, and in lieu of that and pain meds, was instructed to take 400mg of ibuprofen BID (twice a day). I am still very much swollen in my abdomen, and the surgical tape is starting to fall of my incisions on my abdomen more. I am trimming the lose pieces carefully with small scissors. I accidentally caught a loose piece scratching on myself yesterday and tore an extra couple inches of the tape off the incision. I don't want that to happen again. The tape seems to be falling off starting at the ends/edges, such as up at my new navel, and out at my hips, and working it's way inward/downward. My abdomen is not flat yet, I am having patience with this since it took quite a while for some others who had the same concern to see this effect. I'd say since I was mainly doing the procedure for muscle repair, that I'm the same size I was pre-op still, just shaped a little differently!

As far as my breasts, the swelling in them has been assymetrical. They are swollen in different areas on each side. I am right-handed, and have had more swelling and pain in my right arm/the brachial plexus. I even have patches of sore/sensitive skin where certain nerves branching from the plexus innervate the skin. I am trying to ice when I can, and it does help. So does the ibuprofen.

I plan to get cleared to return to work on schedule next week since I am doing so darn great. Not to say this is a walk in the park, but I feel like I have been doing a lot better than expected! I have not been the perfect patient. Since I am so healthy and have trouble sitting still, I think I have had more activity than is recommended. I have not strained or exerted myself, though. Just moving a lot throughout the day, day in and day out. I think it's caught up to me the past 2 days, I've been somewhat tired, no napping though. I need to post some pics!

Cleared for work next week- 17 days post-op

Doc says I'm healing up nicely, things look great, and that I may return to work next week wearing my compression garments. I do cosmetic injectables (dermal fillers, BOTOX, Dysport, etc and will need to be raising my arms up a bit.) Since I have no noticable tightness in my pectoral muscles except if I raise my elbows and bring them back (contracting my back muscles) I don't think I will have any trouble doing treatments on my patients. I NEVER had any soreness with driving, but still have painful hypersensitivity of my nipples. Today I was instructed how to do breast massages in the shower to help settle the implants correctly. I was also told I no longer need to wear my abdominal compression garment while sleeping at night, which is GREAT NEWS to me! I may also do scar treatments on the incisions where the surgical tape has already come off (I continue to trim it with small scissors as it detaches on it's own from the incisions.) My next follow-up appointment is not for another couple weeks.

My right upper outer breast has an indent, doc says it is swelling and will go away. I have been consistently sore and swollen in that quadrant of my breast, so I am trusting his judgement that it will go away. Trying to stay patient with that. I also inflicted some self-torture and weighed myself this morning, suspecting I'm gaining weight (I can see it in my thighs)... I'm up 7 lbs since my pre-op weigh-in. I need to back off the heavier foods. Some of it is probably still from fluid retention from the swelling, and I probably could have stood to gain a few pounds. I was lighter than I thought I was at a whopping 98 lbs (sarcasm). I'm at 105 as of this morning, and that's without eating any breakfast yet. Since I'm short (under 5'2") I can't afford to go too far or my clothes won't fit. I need to budget for new bras, I don't think I want to go buy a whole new wardrobe though! :)
Scottsdale Plastic Surgeon

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