29 Years Old, 4 Years After 90 Lbs Weightloss with a VSG - New Breasts and Lower Body Contouring! - Vancouver, BC

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Had my VSG in August 2010; highest to lowest...

Had my VSG in August 2010; highest to lowest weight was 228 to 136. I weighed 208 on the day of my weightloss surgery and am currently stable at 150 with a muscular build. Coming on 4 years and I have definitely reached close to the maximum amount of changes I can make to my body with diet and exercise. My #1 concern was actually saggy/loose skin on my butt and thighs, breasts being a distant second. I had seen another plastic surgeon for a consultation regarding a lower body lift; he did not feel strongly that I should or should not have it, but was concerned that the resulting improvement would not be worth the "seagull" scar. As a physician with some experience with scarring and minor procedures, I was also well aware that back scars tend to widen due to the motion plane, and lower back/upper buttock area would certainly be one of the most mobile areas. I exercise intensely, so after reading reviews saying that women who were previously able to touch their toes were barely able to get their hands past their knees after a posterior body lift, I was worried about my performance at the gym. However, the first plastic surgeon I saw did not offer any other alternative, so I had booked my posterior/lateral body lift with him.

I mentioned it to my GP, who felt very strongly that I should take the trip out of town to Vancouver and pay extra to see Dr. Demianczuk as he not only has excellent surgical skills, but also provides great post-op care. As a physician, I certainly expect the best results and follow-up, and was prepared to pay more and travel if that's what it took. While waiting for my appointment with Dr. Demianczuk, I figured I might as well ask about my breasts. I have never been pregnant and was planning to potentially have children in the future, so I was originally intending to delay my breast surgery until I am either done having children or absolutely sure I am not having any.

In regards to my lower body, Dr. Demianczuk agreed with the other surgeon that the scar would be significant and he certainly felt it was an excessive measure for the problem I have. He suggested that I will likely lose the improvement in several years, whereas the scar will remain and will, indeed, likely widen, so he felt that I would want to get a tattoo over the area if I were to go ahead with this operation. That certainly isn’t my cup of tea, so he did a pretty good job of dissuading me from getting the LBL after the other physician had already made me question the whole idea. However, Dr. Demianczuk was able to offer me an alternative, which would be contouring with liposuction. He pointed out my bulging knees, which is something I have always been self-conscious about, but since both my parents have the same feature, figured that it had to do with my bone structure and muscle attachments and there was nothing that could be done about them. Apparently, a lot of the medial bulging is actually fat, so he said he can lipo the area quite aggressively and provide me with a smooth knee contour. I’m ecstatic about this possibility! He said that there is certainly an element of laxity AND excess fatty tissue to my inner and outer thighs, so he would very carefully lipo those areas to provide improved contour without risking too much laxity afterwards.
Regarding my breasts, I was a bit disappointed, although not entirely surprised to hear that he thought I needed a lift. My nipples are below the crease, so he said augmentation alone would yield a poor result. He said he would do a lollipop lift and try to avoid a crease incision by putting the implant through the vertical incision below the nipple. While I am not thrilled about the prospect of the vertical scar, I felt that with 20 years of experience and a Harvard fellowship, I could trust his expertise. Luckily, I have very light skin and heal with white scars that contract and fade very well, so I’m hopeful that within a year, my scars will be hardly visible. Worst case scenario, if I wanted to tan topless (I am a European, after all!), I could always apply a bit of foundation to the vertical scar. He let me see a few implants and I was pretty sure that I wanted to go with an anatomical silicone for the most natural feel and shape. We decided on the Mentor 410 Gummy Bear, made of cohesive silicone which is very resistant to rupture and leaking. The salines just felt too unnatural to me, and the round shape was too fake for my taste. We discussed placement – he thought I would be interested in going under the muscle, but I exercise a lot and do heavy weightlifting and was worried about the effect of submuscular implants on my gym performance as well as the distortion of my chest with exercise. He readily agreed that the “overs” were a much better option for me. I am in good shape but not so lean that the “overs” would be obvious, especially the anatomicals.

I then went to see his booking assistant, Joanne, who was very helpful and spent a good hour with me. We started by trying on various implant sizes, using the round sizers as she said their experience was that they are better for sizing than the anatomicals. Dr. Demianczuk said he suspected I would like the 225-250 cc implants. He would then go with an implant that’s 25cc bigger to achieve the desired look. I tried on everything from 200 (WAY too small) to 300. I felt that the 300 looked lovely, but I was concerned about the weight of them on my chest when I exercised, especially since I was not getting the implant under the muscle, so the impact would not be absorbed by the muscle. I settled on the 250s after much deliberation, so Joanne put me down for 275s. Dr. Demianczuk said this would result in a full C cup. I spent a good 45 minutes filling out paperwork and Joanne booked me for just 10 days away! I was offered an even earlier date, but I had work-related commitments. The cost for the breast surgery was $9800 CAD and the cost for liposuction was $6800, with a $2000 discount if I did both on the same day, as they would not have to book the OR for as long.

I then spent the whole weekend on the breast implant forum agonizing over my decision and looking at pictures of women who went as big as 300 and did not have a particularly impressive cleavage. The 250s looked great on ladies that are 5’1” and 105 lbs, but I am 5’5” and 150 with a large, muscular frame, so I felt that the 250s might get lost on me. Not to mention, I have not been a C cup since I was 11 or 12 years old! I have always been a D or higher. So with my lift and augmentation, I was going to end up smaller than I have ever been! Joanne did mention that I could always still wear a padded push-up bra on days that I felt I needed more oomph, which was certainly a valid point. I hemmed and hawed over this all weekend and then called Joanne on Monday and asked if I could come in with my husband to try the sizers on again. He was not there at my first appointment, so I figured I should ask for his input. Unfortunately – or should I say, fortunately! – my husband is a pretty laissez-faire kind of guy and really did not care much as long as I was happy. Joanne readily accommodated me and spent another 30 minutes or so with us. We tried on the bigger sizers and my husband had trouble telling apart the 250s and 300s. However, I really liked the look of the 300s, so I took the plunge and asked to Joanne to put me down for the 325s, since Dr. Demianczuk generally goes for 25cc more than what his patients choose.

At this second appointment, I also tried on the post-liposuction compression garment as I was curious to see what it felt like after reading all the horror stories here. I tried on the large and it honestly was not that tight! I decided that a medium would probably be best and Joanne said she will order that one for me. I hope I don’t regret this decision a week from now.

Wow! My husband flew home today and is hoping to come back next weekend to be here for my surgery. I told him to spend lots of time on my boobs right now, because a week from today, they will never be the same!

Stay tuned for photos and more updates...

Surgery day!

Stayed with the in-laws last night as they are about 50 miles closer to where I was going to have my surgery. The only comment from my MIL when I said I was getting boobs was "Isn't that so expensive??!!" Not sure what the point of that was, but I said, "I guess. I've already paid." For whatever reason, I felt really nauseous in the morning and even threw up before heading out, but once I threw up, I felt completely fine. Not sure where that came from - my husband had a bad stomach flu last week, so maybe that was my one and only episode of puking from whatever bug he had given me.

We got to the surgical centre way early and had to wait a fair bit. I got a bit worried when I saw that my ID band said "BA/BL, inner knee, and inner thigh liposuction," since I had clearly indicated to the surgeon and his assistant that I wanted my outer thighs and hips done, too! I had looked up my consent form last night, and the consent form did include the outer legs. Once the nurses and the anesthesiologist were done with their respective tasks, Dr. Demianczuk came in with a plastic surgery resident and he marked me in front of the resident and my husband. I made sure he was aware that I was hoping to get my outer thighs/hips done, as well, and he was fine with that. He said he did not think he would get much off them - I got the impression he thought much of my outer hip bulge was due to skin laxity. I had my husband take some pictures of his markings.

I was whisked off to the OR and within 5 minutes, I was asleep! The nurses and the anesthetist were very friendly and efficient. I didn't get nervous at any point, my heart rate stayed in the 50s (which is normal for me) every time they took my vitals. I woke up when I felt my bed being wheeled into the recovery room spot. I felt a bit woozy and high, but not dizzy or nauseous at all, it was amazing! I was especially worried about being nauseous given that I had vomited in the morning. I had pretty strong pain in my posterior thighs, which I would describe as a burning pain. I was surprised, since Dr. D never did liposuction on the back of my thighs! I told the resident about it and she said it was nothing to worry about. The nurse did give me a bit more fentanyl IV and I also took a Tramadol for longer-lasting relief. Within 5 minutes of waking up, I was wide awake and able to chat with all the staff. The surgery ended up taking less than 3 hours - Dr. Demianczuk had expected around 4. He came by a little while after I woke up and told me he removed 1500cc of fat from my legs, and that a lot of it actually ended up coming from my outer thighs/hips. So I guess that was a bit of a surprise for both of us! Sounds like a lot of the bulk in that area was fat rather than loose skin. He said he was very gentle with lipo in my inner thighs because of his concerns about creating more loose skin. However, looking at them, I can see a pretty dramatic difference! Dr. D told me that everything looked great and he was very happy with the results.

I was extremely thirsty and hungry when I woke up! I drank 3 glasses of water in an hour. Since I recovered from the anesthesia so well, the nurses got me to the bathroom within an hour. Sitting down on the toilet was VERY painful! Then we went to the pre-op area and put on my Marena compression garment before calling my husband up to come get me. I'm glad I told the surgical coordinator to order a medium instead of a large - it honestly doesn't feel that tight! It fits well, but isn't uncomfortable. I'm very relieved after reading so many posts about how the compression garment is the worst part of this whole thing!

The nurses were pretty shocked to hear we were going to Whole Foods and grabbing a salad! I think they were pretty impressed by how well I was feeling just two hours after surgery. I had to walk slower and with small steps, but we got to the store and I filled up my box with salad without a problem! Sitting down in the car was probably the worst part of all this, and getting out of the car was quite painful, as well. Again, most of my pain was in my posterior, and one of the cannula insertion sites in my groin was burning and hurting quite badly, too. The drive home was pretty uneventful, we even stopped at Costco to pick up a few things and I was coping with the pain quite well.


Adding some pictures of the surgeon's markings pre-op, as well as post-op pictures with Marena and dressings on. I am not allowed to remove the breast dressings until our post-op appointment a week from today. In clothes, they don't look any bigger than my old boobs did in a bra, but when I took my clothes and compression garment off, they look huge! I kind of like it, because I was worried my boobs get really huge and swollen and then people would be able to tell right away that I got implants, but no one will be able to tell when I'm dressed. My boobs also looked really good in padded push-up bikini tops before the operation, so I don't think it will be obvious in swimsuits, either! The swelling has certainly increased throughout the day. When I first felt them in the recovery room, the swelling ended about 4"/10 cm below my clavicles, but within a few hours, it rose to just 1" below my clavicles. The pain is manageable. I got subglandular implants and I'm very happy with how I can move my arms. I can easily reach for anything at my eye level and when I want to pick something up off the floor, I just gingerly squat and reach for it without too much problem. I'm planning to do some cooking tomorrow and I think it will go just fine!

I'm very happy with the contours post-liposuction, too. The difference in my knees is dramatic! I can't believe I now have a totally smooth inner leg with no awkward bump and pronounced transition at the knee. Even though Dr. Demianczuk did not take too much fat off my inner thighs, I can tell the difference in the mirror. I imagine my inner thigh measurements have decreased by a good inch or so. The mild saddlebags I had are gone, and so are the weird lumps over the sides of my pelvis where my belly transitions into the hips (not sure what to name it!). Very happy so far! Hopefully, no lumpiness or loose skin post-op.

20 hours post-op - worst morning ever!

I had a very rough night last night, I took two Percocet before going to bed which I thought would knock me right out, but two hours later, I was wide awake and in pain. The pain was bad enough that I couldn't sleep, but I was too exhausted and zonked from the Percocets to really do much. I tried reading a magazine, but 20 minutes in, I was too exhausted. Spent all night going in and out of bad quality sleep and waking up in a lot of pain. The pain in my breasts was a good 7/10, while my lower body was approaching 9/10, everything felt on fire. This was very surprising to me, as I had a very easy recovery from my VSG four years ago and I thought this would hurt less, since there was no cutting through the muscle or messing with my internal organs. Plus I was told my boobs were unlikely to give me much grief post-op since we went with subglandular implants! But they were extremely swollen and quite painful.

I woke up for good around 9 in the morning, drenched in sweat - my bedroom was a bit warm, but I think a lot of the sweating was just from being in pain. I wanted to shower since I was soaked in sweat, so my husband helped me out of the garment and helped me wash my hair. I think the showering pushed me over the edge a bit - once I got out of the shower, I had to sit on the floor for a bit and putting the garment on seemed like an impossible task. I suddenly began to feel really nauseous and my stomach felt quite upset, as if I had to have a BM. I barely got up to the toilet, where I spent a horrible half an hour or so with my husband holding a barf bowl in front of me as I had the world's biggest BM (sorry, TMI!). On the upside, I guess I don't have to worry about getting too bunged up in the next few days anymore. I didn't vomit, thankfully, but I did find the reason for why I felt so horrible - I got my stupid period! SERIOUSLY! What are the odds?! I knew it was coming soon, but that sure explains the extra boob pain and horribly upset stomach! The only thing that helps me with my period pains is extra-strength Advil. My surgeon advised me to avoid NSAIDs post-op, so I called his cell and left a message asking if it were ok for me to take a few because the Tramadol and Percocet wouldn't touch my period cramps. I almost threw up the second I ended my message! My husband said I was white as a sheet and looking like crap.

Thankfully, the nausea passed enough that I could take my Zofran (anti-nausea medication), and once that was in my system, I just went ahead and took the extra strength Advil. Half an hour later, I finally felt good enough to get up and lie down on the mattress in our living room, and a little while later my husband helped me back into my garment and made us breakfast. I had coffee and some oatmeal and finally felt human again. The Advil helped so much!

The surgeon called me back later and said Advil was fine if that's what I needed. At this point, I honestly didn't care what he thought, I was gonna keep taking it regardless! It usually takes about 36 hours for my period pains to resolve, so I'm continuing with Advil until at least tomorrow morning.

The afternoon was much better, the husband and I actually walked about 3 miles round-trip to the grocery store. I was walking slower than normal, but otherwise, everything was good. I thought I'd need to sit on the bench once we got to the store for a bit, but I was able to make the whole trip without resting and was feeling quite well. I did some light cooking tonight and we went for another 1-mile walk in the evening. I'm feeling much better! Definitely taking another Advil before bed tonight, along with a Percocet. I think tomorrow will be a much better day!

Day 6 post-op, back to work!

Just checking in. Things are going quite well. I chose to go back to work today, a day early, so that I had a day off next weekend instead. I drove 1.5 hours out of town one way for some shopping and to see friends on Friday, so I figured if I can do that, I might as well go back to work! Boobs are getting better by the day. The swelling decreases daily, I now have a well-pronounced gap between them. I move my arms completely freely now, there's very slight soreness when I put them all the way up, but nothing worse than after a decent push-up session. I looked at the surgeon's post-op instructions and they say the dressings can come off after 5 days, but then I'm pretty sure he told me in the recovery room that he will take them off himself at my post-op appointment. It's coming up in 2 days, so I decided to err on the safe side and leave them on. I haven't seen any bleeding since the 2nd day, though.

The lipo sites still hurt quite a bit, I continue to need Percocet for sleep and I have been using a Tramadol here and there during the day - the pain is not excruciating, but I would certainly find it distracting at work. The skin on my legs feels taut and sore. The bruising is certainly much more pronounced - sorry, I forgot to take pictures of the lipo area and didn't feel like taking my garment off again! I went to a formal event yesterday and wanted to wear a knee-length dress. I just sprayed some Sally Hansen Airbrush leg makeup on my shins since the bruising has tracked all the way down there, and then put on sheer hose and you couldn't see the bruises at all. I've been weighing myself daily and my weight is coming down by 1-1.5 lbs daily, so the swelling is certainly resolving. I'm down 3.8 lbs since the 2nd day after surgery, when I felt the most swollen. I've been tracking my measurements: my hips and inner thigh crease are the exact same measurement today as pre-op, my knees are only 0.25" bigger, and my mid-thighs are *drumroll* 2 inches smaller!!! I'm pretty excited. I tried on some pants at H&M and fit into a size 6! Normally, I can't wear their pants at all because they are cut for a much thinner, straighter leg than my legs.

I'm anxious to start with some light exercise soon, I have a triathlon coming up in Sep and would like to at least start with some stationary biking after my post-op appt 2 days from now. I am also hoping he'll clear me for hiking. I certainly have not had any trouble going for 2-4 mile walks this week.

First post-op check-up - day 8

Drove out of town to see Dr. Demianczuk for my first post-op follow-up - this was my 8th day post-op. Saw the first year plastic surgery resident first, and then Dr. D came in and examined me alone. He was very happy with both the lipo and the BA/BL. He gave me some instructions regarding gentle massage of the lipo-ed areas as well as some pec stretches and massage for my chest. He said I no longer need to wear the support garment above my waist, which I'm really excited about - it tends to peek through in most shirts except for a true crewneck or turtleneck, and it's HOT where I am! He suggested I could try Spanx, but honestly, the garment is quite comfortable, it's just the heat that is a bit annoying. I definitely want the extra compression that the 50% lycra garment offers and he agreed it's more effective than Spanx. But from now on, I'm looking forward to have the garment rolled down to my waist and wearing a sports bra on top. Dr. Demianczuk also said to wear a sports bra at night. The logic was apparently that the implants will tend to move laterally during sleep, and it's nice to keep them from drifting too far apart in a sports bra to avoid forming too wide of a gap between them over time. Interesting! He also said it's fine for me to wear underwire bras even now - I guess because I did not have a crease incision.

I asked him a few questions about activity level. He said I can start swimming/taking baths 3 weeks post-op (so less than 2 weeks from now!) and can do low-impact exercise like hiking or the elliptical as early as I want as long as I'm ok with the potential of extra bruising on the lipo areas. I honestly don't care about the bruising since I have to wear the garment anyway, and it covers all the bruised area. I'm anxious not to lose too much of my fitness level, so I'm planning to try stationary biking tomorrow - a bit worried about road biking for now due to the potential of falling and hurting either my lipo areas or my chest. If that goes well, I'd like to try some lower body machines with light weights later in the week. In regards to high-impact exercise such as running and heavy weights, he said I can start at 4 weeks out. This is much earlier than I expected, so I'm very happy!

I still have the steri-strips on my breast incisions and he told me to take my time peeling off those - he said once some of them start to come off at the edges, I should feel free to remove them completely, but otherwise, if they still seem firmly attached, to let them be. I peeled off a few, but most of them are still taped on pretty securely.

I am now seeing him at the end of September, by which I should assume my "final form"!

I went to Victoria's Secret afterwards and picked up some bras on clearance - one regular bra and two sports bras. Two were 34DDD and one was an M with the front zip. They fit quite well! I tried on a lot of the 34DDDs - the biggest 34 cup size they had - and a lot of them didn't fit.

I then went to Lululemon and came to the realization I probably will never be able to wear anything from there again unless my boobs seriously deflate in the next two months....I have a 34E of theirs I can barely shove myself into now (Booby Bracer), I'm hoping it will fit a bit better soon, but otherwise, their 34DD is hilariously small on me and the 36DD is too big in the band. Boo! I guess I'll be paying up the wazoo for Panache and Freya now if I want nice separation with cup sizes....
Vancouver Plastic Surgeon

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