How my Hysterectomy Will End with a Tummy Tuck - Thibodaux, LA

I'm 45 with three children, two born C-section....

I'm 45 with three children, two born C-section. The skin of my belly and pons pubis (the area of fatty tissue above my vagina) were stretched badly during the C-section. For the last 15+ years I've hated my belly, it hangs over and makes me self conscious, but even worse was the pons pubis. It is a badge of honor my ex-husband said, it doesn't bother me. I learned to live with it. The last few years I started getting rashes under the Mommy Apron, as I call it. Everytime I work out, cut the grass, walk a fair or festival, it gets red, inflamed and irritated. Just another thing I have to live with I decided. I also started to have stress incontinence, another lovely thing to live with. If my friends made me laugh, I pee my pants a little, or a lot, sometimes...super embarrassing. Coughing or sneezing made it happen too. I was told by my Mom it was just something that happens after having babies, nothing to worry about. I started bleeding heavier and between periods. Yuck...Then pain during intercourse...this was the last straw...I just remarried and can't enjoy sex? Time to see a doctor. My Gynecologist was amazing and listened to all my concerns. He ordered blood tests, ultrasound, referred me to a uro-gynecologist. I didn't have one of my dreaded rashes when I went to see him so I didn't mention it, seemed to me there was enough to deal with already.
The ultrasound showed that I had a cystoocele (prolapsed bladder) and prolapsed uterus which was causing the stress incontinence. Then I had a DNC to check for uterine cancer since the bleeding had gotten so heavy. Not a fun procedure, had to go under general and the anesthesiologist nicked my esophogus, causing my throat to hurt for two weeks afterward. The doctor didn't find cancer so said we would go ahead with a hysterectomy to deal with the bleeding and hopefully resolve the painful intercourse, as the position of my uterus could mean he's hitting it resulting in pain.
At the same time, I'm visiting the uro-gynecologist who has given me meds to try to control the incontinence. Helpful, but makes me super-constipated and I already have IBS. When I let him know about the hysterectomy, he gave me questions to ask my GYN about the procedure and when I did, he suggested the uro-gynecologist do the hysterectomy since he will be able to surgically correct the bladder and urethra issues, which my regular GYN isn't comfortable doing. At one of my visits, I had the dreaded rash, from trying to work out again, to lose some weight. I'm 5'8" and weigh 250 pounds. I carry the weight well, but it would be nice to be a bit smaller. As usual, my belly gets inflamed. My uro-gynecologist sees the rash and prescribes me nystatin powder. The next time, I went to see my primary care for the rash, and they say the same, use the powder and put gauze over the sores. When I discussed having my uro-gynecologist do my Hysterectomy, I jokingly said can you cut off my mommy apron at the same time? He said no, but if you have a plastic surgeon in mind, I'll work with him to do that. Wow, just the idea that I could have a future without that apron of skin and rashes when I walk too much or sit outside in the heat, its just wow...
That's how I found RealSelf...researching Mommy Apron Excision, aka Panniculectomy. Under my circumstances, it might be covered by insurance. I looked up surgeons that had the same hospital affiliations as my uro-gynecologist and came up with Dr. David Jansen. After asking my PCP for a consult request, the insurance company called and asked if I had someone in mind, I gave them his name and they got him credentialed and made the appointment. Not that it was hard to get the Plastic Surgeon approved, since he's the chief of plastic surgery at Tulane. I had my consult with him yesterday.
Dr. Jansen was very kind, listened to my story and took a look at my Apron and said he could fix it. He's submitting a letter to my insurance to try to get the panniculectomy approved. He also quoted what it would cost for him to tighten the muscles and raise the pons pubis, that nasty stretched skin above my vagina. Coming up with the money in a short time frame is hard, but I'm so excited by the prospect of having a smaller flatter belly that I'm going to try my damnedest to get it. If the panni gets approved, I'll at least not have to worry about rashes or incontinence anymore. The Tummy tuck would just be a bonus. I told my Mom and she is happy for me. My Mom told my sister however and she asked why I want to do this to which I promptly said mind your business, then explained that I'm going to be in pain from surgery anyway, may as well get it all done and out the way. She told me about horror stories her friends experienced about not healing. I guessed that her friend didn't stop smoking. Right on the money, she didn't. Smoking is the number one way to ensure complications in any surgery. It restricts oxygen flow to tissues and slows healing. If you smoke and have to have any surgery, quit...I quit three weeks ago when I was told I needed the hysterectomy, and I'm so glad since I may now be having an even more heal intensive procedure. It is totally worth giving up to gain so much. Plus I'll save money. Now I wait to see if the insurance will cover the procedure...and for my rash to heal, which means no walking long distances for a bit.

Getting Ready

Both Doctors are looking at dates that work for them and the hospital. Will post exact dates as I get them. In the mean time, working on making meals, getting supplies, researching what to expect. And...taking before photos...

30 Days til Go time

Pre op appointments are set for both docs and surgery is scheduled for November 1st. Doing preparatory shopping, gotta get granny panties and Milk of Magnesia. Two things I forgot last shopping trip. Really want to buy a compression garment that covers the mons pubis area since the PS is going to do a lift there. I feel the compression belt I used after my c-sections could have contributed to the collection of fat at that area in the first place, after all my research that says the compression garment closes the gap between skin and muscle. The mons tissue was separated from muscle during my c-section but got no compression after since the compression belt went from the top of my bikini line to under the breast. Only problem is what size to order, since I'm not sure what my waist size will be after the procedure. I'll probably wait and order it shortly after surgery, when I can get more accurate measurements. I'll bring it up with the plastic surgeon as well, perhaps they can give me an idea what to buy or they will order it for me. These last few weeks are a challenge because I have to be completely rash free before the surgery. That means no walking more than across my house and no sweaty activities. Hard to do when you want to do so much for Halloween...I love haunted houses. But I guess one holiday is a good sacrifice to gain a life with no more rashes. Uploading more before pics so I can see the difference after the surgery.

Before Measurements

Under Bust - 41"
Waist - 44"
Hips 52"
Thighs - 29.5

I include the thighs because I read in another review that their thighs swelled as much as their abdomen, just want to keep track. Definitely will order a compression garment that goes down to the thighs just in case...attaching a couple pics in my bathing suit, haven't worn a bikini since I was 24, so doubt that is gonna change, but maybe I'll look better in my bathing suits after this is over.


Things I purchased
Arnica Gel
Protein shakes
Fajate Post Surgical Abdominal Compression Lipo Board
Bowink Female Urination device (don't laugh, if you don't have a raised toilet seat, this is the way to go, I've read.)
MyM Hair Removal System for Home Use (Home laser hair removal to get rid of pubic hair which might cause infections with the mons pubis lift)
Bromelain tablets (reduce bruising and inflammation)
Surgical Pads (can also use maxi pads)
Paper tape
Butterfly stitches (just in case of incision separation)
Dial Anti bacterial soap (will start using daily after pre-op, normally like shea butter dove)
Milk of Magnesia (for narcotic induced constipation)
Azo Urinary Pain Relief (don't know about you, but I get pain after having a catheter)
One A Day Womens multivitamin 50+ has all the recommended vitamins for healing. Only problem is it does contain some that might have to be stopped just prior to surgery due to the increase in bleeding risk. Will let you know what they say about them in pre-op

Things I already have that I plan to use:
Wedge pillow
lots of regular pillows
tv tray table
tablet (electronic)
Hi waisted girdle
Shower Chair

Ok so Food prep I consider very important, since its the thing that will help you heal faster

I got enough Protein shakes for two weeks, just in case I don't feel like eating, they say appetite sucks just after. And protein is essential for healing. You body needs about 60 g of protein a day normally and healing bodies need it even more. So I'm trying to get about 75 a day
I got 15g protein shakes, but wish I'd gone for the higher ones now, might make a trip back to SamsClub for the 25 g shakes I saw there. Bonus is the shakes have lots of vitamins, so no reason to take extra as long as i'm drinking those.
For when my appetite returns, I wanted super healthy meals, but not something my husband would need to work hard to make for me as he only likes unhealthy food and I don't want to inconvenience him with making his junk food and my healthy food.
Family pack of Chicken Breasts from SamsClub
Brown Rice
Mixed Frozen Vegetables (broccoli, sweet bell pepper, zuchinni, squash, edamame, wax beans)
My husband grilled the chicken breasts, in a few different flavors, bbq, lemon pepper, and italian dressing, and I cut them into halves and packaged them with 1/2 cup brown rice and 1 cup veggies per quart sized ziploc bags. I pre-cooked the rice and veggies too so all he has to do is pop a bag in the microwave for 2 minutes and pour it on a plate for me to eat. I'm not picky about my food touching so its a great way to have healthy dinners at the ready. Each packet has about 25-30 g protein. YAY
I also think before my surgery I will start to drink protein shakes for a few days prior to clear my digestive system of solids, to hopefully make constipation less of an issue. I'll let you know how that works out for me.

There are a few more things I'd love to have prior to surgery, but I'm stretching my budget as is, so I'll just have to make due with what I have. As you can see, I'm a planner and a researcher, I've been doing my best to be prepared so that I'll have optimal results. Its 23 days away and I've gotten most of my prep work done. Will do some cleaning and organizing just prior to the big day, but I'm just about ready. Its kind of a bad thing though, because I'll be reading reviews and thinking of whether I forgot anything non-stop until then. Gonna drive my husband bonkers, I'm sure...

Pre-op Urogynecologist

1st pre-op appointment done. My Urogynecologist is pretty freaking amazing. He explained the entire surgery and ended it with a procedure I wasn't familiar with. When I asked what it was he said it would tighten things up. My best friend went with me and when we left we couldn't help but joke that I was getting a designer vagina. Vagina by Hallner, Barry Hallner. Yes, I am easily amused. Anyhow, it will be excruciatingly painful, but I was assured that most of the pain would be from what my plastic surgeon will do to me...


Jenny at Dr. Jansen's office went over all the pre-op and post-op instructions line by line, wow did it take forever it seemed. The worst one was she said avoid caffeine for 2 weeks prior and 2 weeks post...even chocolate. I have given up smoking (8 weeks now, I think), I had my last drink last weekend, but now even my coffee and chocolate have to go? I suppose I won't have any vices for the next month. Waking up without coffee is so hard...but I digress. Dr. Jansen came in and I signed all the consents, and he said he may do a little lipo as well on the upper abdomen. I figured he would have to to get the belly button right. He can do as much as he likes as long as I have a good outcome :D. My husband asked if he could drop me off at the hospital early after I told him I couldn't have any coffee or chocolate...poor guy
Metairie Plastic Surgeon

David A. Jansen, MD was my first choice and thankfully my insurance approved him. He's one of the top plastic surgeons in Louisiana and he's earned my trust. My issues are a little different than those who just want to look better. I get horrible rashes when I exercise or just sweat for too long in the Louisiana heat. I have to have a hysterectomy with urology repairs, and my surgeon advised me to contact a PS when he saw the rash under my Pannus (mommy apron of fat). Dr. Jansen evaluated me and submitted a letter to my insurance to get the panniculectomy approved. He also quoted how much it would be to have the muscles tightened and skin manipulated to create a flatter waistline. Thankfully the other surgeries cover most of the expense, so I was happy to come up with the difference. Can't wait, never thought I'd be excited to have surgery...

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