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*Treatment results may vary
Week 3-6 Exercise, seroma, CG
At my 2 week check in I was given the OK to start very light walking as exercise. My PS gave me very strict orders regarding the amount of weight that was OK for me to lift (less than a gallon of water), and very adamantly "NO SITUPS". I asked about stretching and was told no, be patient.
Around the 13th day PS, I slipped on the threshold of a door, and stumbled badly in to my house. I immediately felt a strain in my lower right abdominal quadrant. I put ice on the area and hoped that would resolve the pain and any would be swelling. That night and through part of the next day I saw blood coming out in to my JP drain. The blood only lasted for 12 hours or so, and then reverted back to serum. I was hoping that meant the damaged/strained tissues were healing together and there would be no extra accumulation of fluid. During this time my legs, especially the left, swelled up acutely with edema. The swelling was worst in my thighs, but did extend down in to my calves and ankles despite CG stockings.
At day 21 PO I had my final drain removed. Within 36 hours I noticed my lower belly was swelling, especially in the area where I had felt the strain when I slipped coming back in to the house. I had an appointment scheduled with my PS early the next week, so I decided to hold off on contacting the Dr. office unless there was an acute issue. I went walking outside that weekend, and experienced horrific cramps in my hips while out on the walking trail. They didn't seem to be caused by anything specific, but they intensified as I was moving. Stretching did ease them somewhat, but as soon as I started walking again they got worse. I had not taken any ibuprofen or Rx painkillers that morning, not certain if that was a factor. I ended up taking the Tylenol 3 when I got back home, and tried to use a heating pad, but it took 2 full Rx painkiller pills before the cramps finally eased. I noticed that the swelling in my abdomen had nearly doubled the next day.
The following day was my next follow up with my PS. I told him that I believed I'd developed a seroma, and he confirmed that I had. He used a hypo needle with a large (100cc) syringe to drain the pocket of fluid. I believe he got between 60-80 cc out. I had gone to Joann Fabrics and gotten a piece of dense but soft-ish foam and cut it in to pieces a couple days before (thanks RS users for that idea). I used it as an external brace so to speak for the healing layers of abdominal muscle/skin flap. My PS was impressed with the foam, and said that was "exactly right". He wanted me to leave it inside my CG/shapewear for the next 2 weeks, and wanted to see me again a week later to check if the seroma was trying to reform. He mentioned the possibility of another drain if it was being stubborn about healing.
I had been advised to get some shapewear to use as CG during this period. I ended up with 3 Leonisa brand products that I have been quite content with. https://www.leonisa.com/en/products/power-slim-braless-bodysuit-shaper/?ColorSelectionId=4351 They gave the right amount of support without interfering with my breathing. They are a bit of a pain to get off to use the toilet but the open crotch bothered me more, so I ended up wearing a microfiber undershort underneath them to ease the friction in my crotch.
Happily when it was time for my follow up the seroma had not recurred, and I was given permission to start stretching gently to the sides. AND ABSOLUTELY NO SIT UPS.
I can already see some definition of my rectus muscles, which is amazing this close to my surgery date (and considering I literally have never been able to see them before). My incisions look awesome, they have flattened out, and the only place they seem to have spread at all is across my back. I'm not surprised about that, seeing as I have been bending forward at the waist to get dressed etc. I have a tiny bit of swelling above my waistline just above the hole opened by the blown stitches.
It's allergy season and I'm wanting to develop a cold, I really do not want to sneeze, though it isn't agonizing. Deeply uncomfortable is more than enough.
Next follow up with PS is end of the first week of April, I'm hoping to be realeased to return to work and start a more intensive workout again. What do you want to bet: NO SIT UPS!!111!!!
Around the 13th day PS, I slipped on the threshold of a door, and stumbled badly in to my house. I immediately felt a strain in my lower right abdominal quadrant. I put ice on the area and hoped that would resolve the pain and any would be swelling. That night and through part of the next day I saw blood coming out in to my JP drain. The blood only lasted for 12 hours or so, and then reverted back to serum. I was hoping that meant the damaged/strained tissues were healing together and there would be no extra accumulation of fluid. During this time my legs, especially the left, swelled up acutely with edema. The swelling was worst in my thighs, but did extend down in to my calves and ankles despite CG stockings.
At day 21 PO I had my final drain removed. Within 36 hours I noticed my lower belly was swelling, especially in the area where I had felt the strain when I slipped coming back in to the house. I had an appointment scheduled with my PS early the next week, so I decided to hold off on contacting the Dr. office unless there was an acute issue. I went walking outside that weekend, and experienced horrific cramps in my hips while out on the walking trail. They didn't seem to be caused by anything specific, but they intensified as I was moving. Stretching did ease them somewhat, but as soon as I started walking again they got worse. I had not taken any ibuprofen or Rx painkillers that morning, not certain if that was a factor. I ended up taking the Tylenol 3 when I got back home, and tried to use a heating pad, but it took 2 full Rx painkiller pills before the cramps finally eased. I noticed that the swelling in my abdomen had nearly doubled the next day.
The following day was my next follow up with my PS. I told him that I believed I'd developed a seroma, and he confirmed that I had. He used a hypo needle with a large (100cc) syringe to drain the pocket of fluid. I believe he got between 60-80 cc out. I had gone to Joann Fabrics and gotten a piece of dense but soft-ish foam and cut it in to pieces a couple days before (thanks RS users for that idea). I used it as an external brace so to speak for the healing layers of abdominal muscle/skin flap. My PS was impressed with the foam, and said that was "exactly right". He wanted me to leave it inside my CG/shapewear for the next 2 weeks, and wanted to see me again a week later to check if the seroma was trying to reform. He mentioned the possibility of another drain if it was being stubborn about healing.
I had been advised to get some shapewear to use as CG during this period. I ended up with 3 Leonisa brand products that I have been quite content with. https://www.leonisa.com/en/products/power-slim-braless-bodysuit-shaper/?ColorSelectionId=4351 They gave the right amount of support without interfering with my breathing. They are a bit of a pain to get off to use the toilet but the open crotch bothered me more, so I ended up wearing a microfiber undershort underneath them to ease the friction in my crotch.
Happily when it was time for my follow up the seroma had not recurred, and I was given permission to start stretching gently to the sides. AND ABSOLUTELY NO SIT UPS.
I can already see some definition of my rectus muscles, which is amazing this close to my surgery date (and considering I literally have never been able to see them before). My incisions look awesome, they have flattened out, and the only place they seem to have spread at all is across my back. I'm not surprised about that, seeing as I have been bending forward at the waist to get dressed etc. I have a tiny bit of swelling above my waistline just above the hole opened by the blown stitches.
It's allergy season and I'm wanting to develop a cold, I really do not want to sneeze, though it isn't agonizing. Deeply uncomfortable is more than enough.
Next follow up with PS is end of the first week of April, I'm hoping to be realeased to return to work and start a more intensive workout again. What do you want to bet: NO SIT UPS!!111!!!
PO days 1-14 the learning curve of no core muscle usage
TMI at the beginning:
I used the bathroom shortly after arriving home from the surgery center, it was an odd and somewhat shocking experience. Firstly, I was so swollen (internally & externally) that urinating took a lot of time, concentration and effort to relax enough to let loose. When I was finished I went to clean up, and immediately noticed a significant change between my legs, fore and aft.
I had no idea that my labia majora could be affected by this surgery, but they were. They had been pulled very taught (along with my perineum/rectal area, mons & butt crack). I didn't quite have Barbie Crotch, but I wasn't too far off from it. I guess I never realized that I actually had excess skin in between my legs, but apparently I did. Aside from the pronounced change to my lady bits, my rectum was in sorry shape. I had issues with hemorrhoids for about 10 years, stemming from the time when I had been significantly heavier. Those hemorrhoids had popped out to a degree that I had never experienced before. Happily I was on hefty Rx painkillers, so I didn't feel them much.
My lower abdomen/hips and butt were unfamiliar territory now. Literally for the first time in my life my lower belly was flat...that took some real mental adjustment, but it felt good. My hips were much less inherently rounded than I had always believed, but I still had a soft hourglass curve that blended smoothly in to my upper thigh now. I've always had a defined waist, even at my heaviest, so the change to my waistline was less dramatic. I also did not have as thick a subcutaneous fat layer on my upper abdominal region, so that was a bonus for my new shape. My upper abdominal area-the top of the FDL incision-was a bit poofier than I would have strictly liked, but I was happy to see the changes that were obviously present. Dr. Sinha had warned me that my butt would "be fairly flat" post surgery. It was to a degree. My crack had become extremely wide and shallow, and each buttock was flatter in profile (not much projection, not very rounded) than they had ever been. I wasn't very bothered by this, I can always do squats and lunges to build back up a more plump rump, not to mention an athletic bottom is my personal aesthetic.
The painkillers seemed to affect me differently than they had the year before (PO BR/brachioplasty). I had trouble falling and staying asleep, and I noticed a high pitched tinnitus noise the first day PO that proved to be tied to my taking the painkillers.
My first PO follow up was on friday 2/16, 2 days after the operation. I had already noticed that there was an area on my backline incision (the trampstamp incision) where I was leaking a lot of fluid. The NP remarked on it as well, and I speculated that it might be a small seroma or pocket. A couple of stitches had been ruptured there even before I left the surgery center, so it apparently was being stubborn about its new neighborhood on my body. Apparently that tissue really wanted to be a buttcheek, not my new waist.
I was instructed to come back in again the following monday, and sent home without the blessing to shower -_-. I had 4 drains coming out of my upper thighs 2x2. The procedure itself hadn't involved any lipo, again Dr. Sinha felt it would be unnecessarily aggressive, and would lead to a less desirable outcome for me to pursue it.
I guess I never realized how much excess skin I had on my butt/lower back/hips. The secondary site-the axiliary skin removal was looking good too, but the change wasn't quite as dramatic there. Again I had roughly 10 pounds of excess skin removed, combined with the prior years surgery, that was nearly 17.5 pounds of skin...that's about 15% of my body weight....
Getting out of bed was easily the worst thing about my immediate PO experience. I ended up rolling on to an elbow, pushing myself backwards on to hands and knees and stepping off the bed, usually backwards. I was instinctively trying to stand up straight almost immediately. I had been instructed to not really try for a week or so, but I really wasn't trying to push myself in to pain or major discomfort. I did notice an odd sort of muscle spasm in my abdominals, it was as if the muscles were contracting and not letting up. I've seen it compared to braxton-hicks contractions. I've never been pregnant, so I have no idea if they are similar. All I know is that they are deeply unpleasant, if not outright painful.
My back really didn't hurt me during this time, not certain why unless I wasn't as hunched over as I could (should?) have been.
My second follow up PO they pulled 3 of the 4 drains & I was given the blessing to take a shower. Bathing was actually a lot easier following this surgery than it had been PO from the BR/brachioplasty. I was able to use my lanyard again, and getting truly clean was just as happy an experience as it had been the year before.
That persistent 4th drain ended up staying in for 21 days, I was beginning to wonder if I would ever get rid of the damn thing.
Things were fairly uneventful until day 10 PO, when I was leaning forward slightly as I was getting out of a chair, and I felt several stitches give way on my back. It was that same area which had been consistently leaking fluid, and was missing stitches the first day PO. I had torn a walnut size hole just off to the side of my crack. I tried to not panic-of course this happened at 8PM. I got ahold of the Springfield Clinic TeleNurse, who contacted Dr. Sinha, to get instructions. She promptly called me back, and gave me explicit instructions on wet-to-dry bandaging. Because the surgical site was already nearly 2 weeks old, they couldn't re close this wound, so it was going to have to heal from the inside out.
This type of bandage uses the bodys natural immune response and the debriding action of gauze to keep a wound clear of infection. You soak in saline solution then squeeze out thoroughly sterile gauze, then pack the gauze in to the wound, cover it, and allow it to dry. When the gauze is dried (or 2x per day for me) you remove it from the wound with clean hands, then wash the wound with soap/water, then redress it in the same manner. Rinse repeat until the wound is fully closed up.
I'm thankful that I'm not squeamish, and that I had experience with this type of wound dressing on horses and cats I've owned. I'm guessing it's because of the lessened sensitivity due to severed nerves, but the wound care really hasn't been painful.
Fortunately for me there has been no sign of infection and the wound is closing quickly.
I used the bathroom shortly after arriving home from the surgery center, it was an odd and somewhat shocking experience. Firstly, I was so swollen (internally & externally) that urinating took a lot of time, concentration and effort to relax enough to let loose. When I was finished I went to clean up, and immediately noticed a significant change between my legs, fore and aft.
I had no idea that my labia majora could be affected by this surgery, but they were. They had been pulled very taught (along with my perineum/rectal area, mons & butt crack). I didn't quite have Barbie Crotch, but I wasn't too far off from it. I guess I never realized that I actually had excess skin in between my legs, but apparently I did. Aside from the pronounced change to my lady bits, my rectum was in sorry shape. I had issues with hemorrhoids for about 10 years, stemming from the time when I had been significantly heavier. Those hemorrhoids had popped out to a degree that I had never experienced before. Happily I was on hefty Rx painkillers, so I didn't feel them much.
My lower abdomen/hips and butt were unfamiliar territory now. Literally for the first time in my life my lower belly was flat...that took some real mental adjustment, but it felt good. My hips were much less inherently rounded than I had always believed, but I still had a soft hourglass curve that blended smoothly in to my upper thigh now. I've always had a defined waist, even at my heaviest, so the change to my waistline was less dramatic. I also did not have as thick a subcutaneous fat layer on my upper abdominal region, so that was a bonus for my new shape. My upper abdominal area-the top of the FDL incision-was a bit poofier than I would have strictly liked, but I was happy to see the changes that were obviously present. Dr. Sinha had warned me that my butt would "be fairly flat" post surgery. It was to a degree. My crack had become extremely wide and shallow, and each buttock was flatter in profile (not much projection, not very rounded) than they had ever been. I wasn't very bothered by this, I can always do squats and lunges to build back up a more plump rump, not to mention an athletic bottom is my personal aesthetic.
The painkillers seemed to affect me differently than they had the year before (PO BR/brachioplasty). I had trouble falling and staying asleep, and I noticed a high pitched tinnitus noise the first day PO that proved to be tied to my taking the painkillers.
My first PO follow up was on friday 2/16, 2 days after the operation. I had already noticed that there was an area on my backline incision (the trampstamp incision) where I was leaking a lot of fluid. The NP remarked on it as well, and I speculated that it might be a small seroma or pocket. A couple of stitches had been ruptured there even before I left the surgery center, so it apparently was being stubborn about its new neighborhood on my body. Apparently that tissue really wanted to be a buttcheek, not my new waist.
I was instructed to come back in again the following monday, and sent home without the blessing to shower -_-. I had 4 drains coming out of my upper thighs 2x2. The procedure itself hadn't involved any lipo, again Dr. Sinha felt it would be unnecessarily aggressive, and would lead to a less desirable outcome for me to pursue it.
I guess I never realized how much excess skin I had on my butt/lower back/hips. The secondary site-the axiliary skin removal was looking good too, but the change wasn't quite as dramatic there. Again I had roughly 10 pounds of excess skin removed, combined with the prior years surgery, that was nearly 17.5 pounds of skin...that's about 15% of my body weight....
Getting out of bed was easily the worst thing about my immediate PO experience. I ended up rolling on to an elbow, pushing myself backwards on to hands and knees and stepping off the bed, usually backwards. I was instinctively trying to stand up straight almost immediately. I had been instructed to not really try for a week or so, but I really wasn't trying to push myself in to pain or major discomfort. I did notice an odd sort of muscle spasm in my abdominals, it was as if the muscles were contracting and not letting up. I've seen it compared to braxton-hicks contractions. I've never been pregnant, so I have no idea if they are similar. All I know is that they are deeply unpleasant, if not outright painful.
My back really didn't hurt me during this time, not certain why unless I wasn't as hunched over as I could (should?) have been.
My second follow up PO they pulled 3 of the 4 drains & I was given the blessing to take a shower. Bathing was actually a lot easier following this surgery than it had been PO from the BR/brachioplasty. I was able to use my lanyard again, and getting truly clean was just as happy an experience as it had been the year before.
That persistent 4th drain ended up staying in for 21 days, I was beginning to wonder if I would ever get rid of the damn thing.
Things were fairly uneventful until day 10 PO, when I was leaning forward slightly as I was getting out of a chair, and I felt several stitches give way on my back. It was that same area which had been consistently leaking fluid, and was missing stitches the first day PO. I had torn a walnut size hole just off to the side of my crack. I tried to not panic-of course this happened at 8PM. I got ahold of the Springfield Clinic TeleNurse, who contacted Dr. Sinha, to get instructions. She promptly called me back, and gave me explicit instructions on wet-to-dry bandaging. Because the surgical site was already nearly 2 weeks old, they couldn't re close this wound, so it was going to have to heal from the inside out.
This type of bandage uses the bodys natural immune response and the debriding action of gauze to keep a wound clear of infection. You soak in saline solution then squeeze out thoroughly sterile gauze, then pack the gauze in to the wound, cover it, and allow it to dry. When the gauze is dried (or 2x per day for me) you remove it from the wound with clean hands, then wash the wound with soap/water, then redress it in the same manner. Rinse repeat until the wound is fully closed up.
I'm thankful that I'm not squeamish, and that I had experience with this type of wound dressing on horses and cats I've owned. I'm guessing it's because of the lessened sensitivity due to severed nerves, but the wound care really hasn't been painful.
Fortunately for me there has been no sign of infection and the wound is closing quickly.
1 Year following my BR/Brachioplasty surgery, I...
1 Year following my BR/Brachioplasty surgery, I was ready to complete my transformation in to the body I always should have had. (for my backstory and why I had weight issues please see part 1)
I also needed repair to the abdominal muscle wall, with defects in the for of diastasis recti wide enough for me to stick 4 fingers between the inner edges of the muscle, and a small umbilical hernia.
I knew underneath the excess skin and its subcutaneous fat, the actual dimensions of my body were very nice. It was maddening to know that the shape I had always aspired to was so close, and yet there was nothing I personally could do to make myself look the way I was supposed to.
I had my presurgery consult at the beginning of the year. We discussed what form of TT and skin excision I would get the best results from. Dr. Sinha felt that I needed a full 360 degree incision with excision of skin from literally every part of my lower torso. We spoke briefly about the excess skin on my upper abdominal area, and at that time he was ambivalent about preforming a fleur de lis incision, given that there are more risk of complications and much more prominent scarring resultant. He promised to revisit this in presurgery, b/c I did have a significant amount of excess skin between my navel and sternum.
I had decided to try to loose a bit more weight prior to my operation, I was starting out at 152, and wanted to drop appx 5-10 pounds if possible in the 6 weeks leading up to my procedure. For reference I'm 5'4 and my goal weight is a muscular 135.
I intensified my daily workouts a bit, doing cardio, working with free weights, and pilates/yoga/dancer flexibility matwork. I was able to drop about 7 pounds and felt very fit going in to my operation.
The day of my operation I noticed that the surgery center seemed short handed, I'm guessing that the flu epidemic has taken it's toll on the healthcare community, and every department was running short on help.
I was Dr. Sinha's second patient of the day, my OR time was 730. He came in to mark my body, and there was no other staff present-which seemed odd but again there was nobody else in that part of the presurgery staging area. (My champion caregiver mom was there)
I don't know if it's typical, but having my excess tissue moved and manipulated in order to be marked for the incision lines was unexpectedly painful. Dr. Sinha did warn me of the discomfort, but it still hurt much more than I would have ever expected. Basically he was pulling and stretching each area to be excised as far as it could go. You can actually see red marks from the force of his grip on my skin in the presurgery photos for the incision lines. Please understand-I'm not upset that there was discomfort involved, it's just something I had never seen referenced before in any review of a TT/belt lipectomy/lower body lift, and I know this wasn't done to make me feel any pain.
As we had discussed prior, Dr. Sinha revisited the possibility of skin excision on my upper abdomen. He left the decision up to me, and I told him, yes, I wanted it removed. He made the vertical marks for a FDL, and it also had a roughly triangle wedge off to the sides. At this point I started giggling, b/c he had basically just drawn the Deathly Hallows -from Harry Potter- symbol on my upper abdomen. (Yes I am an unabashed nerd).
I also had axillary skin marked for removal, it was pushing in to my armpit and being in the way.
I was taken back to the OR at about 20 till 8. I chatted for a few minutes with the staff, reminding them of my claustrophobia. The next thing I knew it was about 430PM and I felt like I had poured in to an unfamiliar body. I was told that 10ish pounds of tissue had been removed. According to the marks it was a swath about 8-10" wide around my entire lower body.
My procedure only lasted until about 1PM, but for some reason I did not come out of the anesthesia as well this time. Mom tells me that I was ranting incoherently about the wallpaper in the OR. There is no wallpaper in the OR.....Apparently I believed it should be papered with images of kittens.
The drive home was rather boring, I just felt stuffed full of cotton, brain included. I was wise enough to have soup and a bit of jell-o as my food that evening. Coughing immediately post TT/diastasis/hernia repair is a Very Bad Idea.
I also needed repair to the abdominal muscle wall, with defects in the for of diastasis recti wide enough for me to stick 4 fingers between the inner edges of the muscle, and a small umbilical hernia.
I knew underneath the excess skin and its subcutaneous fat, the actual dimensions of my body were very nice. It was maddening to know that the shape I had always aspired to was so close, and yet there was nothing I personally could do to make myself look the way I was supposed to.
I had my presurgery consult at the beginning of the year. We discussed what form of TT and skin excision I would get the best results from. Dr. Sinha felt that I needed a full 360 degree incision with excision of skin from literally every part of my lower torso. We spoke briefly about the excess skin on my upper abdominal area, and at that time he was ambivalent about preforming a fleur de lis incision, given that there are more risk of complications and much more prominent scarring resultant. He promised to revisit this in presurgery, b/c I did have a significant amount of excess skin between my navel and sternum.
I had decided to try to loose a bit more weight prior to my operation, I was starting out at 152, and wanted to drop appx 5-10 pounds if possible in the 6 weeks leading up to my procedure. For reference I'm 5'4 and my goal weight is a muscular 135.
I intensified my daily workouts a bit, doing cardio, working with free weights, and pilates/yoga/dancer flexibility matwork. I was able to drop about 7 pounds and felt very fit going in to my operation.
The day of my operation I noticed that the surgery center seemed short handed, I'm guessing that the flu epidemic has taken it's toll on the healthcare community, and every department was running short on help.
I was Dr. Sinha's second patient of the day, my OR time was 730. He came in to mark my body, and there was no other staff present-which seemed odd but again there was nobody else in that part of the presurgery staging area. (My champion caregiver mom was there)
I don't know if it's typical, but having my excess tissue moved and manipulated in order to be marked for the incision lines was unexpectedly painful. Dr. Sinha did warn me of the discomfort, but it still hurt much more than I would have ever expected. Basically he was pulling and stretching each area to be excised as far as it could go. You can actually see red marks from the force of his grip on my skin in the presurgery photos for the incision lines. Please understand-I'm not upset that there was discomfort involved, it's just something I had never seen referenced before in any review of a TT/belt lipectomy/lower body lift, and I know this wasn't done to make me feel any pain.
As we had discussed prior, Dr. Sinha revisited the possibility of skin excision on my upper abdomen. He left the decision up to me, and I told him, yes, I wanted it removed. He made the vertical marks for a FDL, and it also had a roughly triangle wedge off to the sides. At this point I started giggling, b/c he had basically just drawn the Deathly Hallows -from Harry Potter- symbol on my upper abdomen. (Yes I am an unabashed nerd).
I also had axillary skin marked for removal, it was pushing in to my armpit and being in the way.
I was taken back to the OR at about 20 till 8. I chatted for a few minutes with the staff, reminding them of my claustrophobia. The next thing I knew it was about 430PM and I felt like I had poured in to an unfamiliar body. I was told that 10ish pounds of tissue had been removed. According to the marks it was a swath about 8-10" wide around my entire lower body.
My procedure only lasted until about 1PM, but for some reason I did not come out of the anesthesia as well this time. Mom tells me that I was ranting incoherently about the wallpaper in the OR. There is no wallpaper in the OR.....Apparently I believed it should be papered with images of kittens.
The drive home was rather boring, I just felt stuffed full of cotton, brain included. I was wise enough to have soup and a bit of jell-o as my food that evening. Coughing immediately post TT/diastasis/hernia repair is a Very Bad Idea.
Provider Review