Tummy Tuck with Botox & Brazilian Butt Lift for 39 Year Old After 2 C-sections - Vancouver, WA

My pregnancies left me with stretch marks that radiated from my belly button and a saggy flap of skin that hung over my c-section scar. When I first considered getting a tummy tuck, I only wanted to get the loose skin removed. What I received is 1,000 times better!
Summary: I was extremely fortunate to get more than 2 weeks off (from work/responsibilities) post-op for recovery. I had excellent at-home care for a full week. I followed my doctor's instructions closely with great results. What follows is a detailed account of my experience for the first 5 weeks after a T.T. and B.B.L.
Pre-Op Measurements:
Ht: 5'9"
Wt: 185lb
Waist: 34"
Belly: 42.5"
Hips: 42.5"
Butt: 45"
At the consultation appointment, I met with Dr. Gabriel and shared my request (just a Tummy Tuck) while he offered additional options (Botox in the abs to aid in recovery and a Brazilian Butt Lift) and explained all of the procedures to me. At that same appointment, I had my "before" photos taken, I was given a complete price estimate (including hospital fees), and I was able to schedule my surgery date.
I began my pre-op preparations 2 weeks before the surgery date. I received a detailed list of supplements and instructions to help prepare my body for surgery and recovery from the doctor's office. I filled all of the prescriptions and followed the instructions exactly. I made a 1-week post-op medication schedule and preloaded a 28-pocket pill box. The total for the medications and supplements was around $150. (The most expensive was a $40 prescription for anti-nausea medication.)
On the surgery date I arrived at the hospital 2 hours before my scheduled operation time. I had to take a (urine sample) pregnancy test before getting prepped. I took a sterilizing cloth bath and put on compression stockings with my hospital-issued gown. The nurse then hooked me up to an I.V. and Dr. Gabriel came in to the prep room and marked me up with "guidelines". I was wheeled to the O.R. where I met the anesthesiologist, P.A., and other nurses that assisted during the surgery. ***I made a special request that may not be available or advisable to many patients: I asked that the catheter that is used during surgery be left in post-op. All the people in the O.R. thought it was a strange request, but I knew I would rather sleep as much as I could that first night instead of get up every few hours to use the restroom.*** Once the general anesthesia was put in my I.V., I just closed my eyes and listened to their pre-op chat for all of about 5 seconds.
The surgery consisted of removing about 2.5lb of skin and closing an almost 2" gap between my ab muscles. I had fat liposuctioned out of my back and a little from just below my butt and all of it was used in the B.B.L. Two drain tubes were stitched into my pubic area.
The next thing I knew I was in the recovery room. When I woke up I wasn't groggy or disoriented. I was then taken to my "overnight suite" at the hospital. My request to leave the catheter in was honored, and my stay at the hospital was uneventful. I was given one dose of pain medication via I.V. just after I arrived in the room, and I was relaxed, painless, and drowsy. For the rest of the time I took oral medication to regulate the pain (I never got above a 4 on the pain scale). I didn't get out of bed until about 16 hours post-op. ***The nurse removed the catheter at this time. It wasn't a pleasant sensation, but it was worth it to me to have it in during my hospital stay.*** I was then able to use the restroom and take a nurse-assisted shower. The nurse showed me how to deal with the 2 drains I had in my pubic area. (The drains must be emptied and the fluid measured daily.) I was wrapped in a compression band (not a body garment) and then released to go home, roughly 24 hours after my surgery time. ***My husband took the week off from work to be my in-home nurse. He also took care of all of the day-to-day needs of our family.***
I had set up a little "recovery center" in my living room prior to surgery. I used a reclining chair as a bed and had an easy-access table with the pre-loaded big pill box, a large water bottle, crackers, lamp, and cell phone charger. I used hiking poles (they are like adjustable-height ski poles) to get up and move around. (I had instructions to get up and walk around every 2 hours.) I was pretty bent over the first few days, and my back muscles got really sore. My butt was tender and there was a lot of bruising on my back that first week. My tummy tuck and incision never bothered me, and I believe that is due to the Botox that was injected into the muscles during surgery. ***I took a stool softener 3 times a day instead of 2, and I used Miralax powder, not the Ducolax pill. I only took pain medication for the first 2 full days I was home, which is what causes constipation. However, I knew my body would need the extra dose of stool softener. I was fortunate to have no problems with B.M.s post-op. I went down to 2 doses per day after day 4. After the first week, I went down to 1 per day.*** Instead of pain medication, I took 1 muscle relaxer at bedtime for the first week post-op. I was consistent about taking the prescribed anti-inflammatory, which probably helped regulate pain as well. I didn't need the anti-nausea medication at all.
I had 2 follow-up appointments scheduled in the first week. The hiking poles ($30 at Costco) were great because I could adjust the height as I was able to stand more upright over the first several days. My husband helped me bathe in the bathtub by putting a camping cooler in the tub so I could sit on it while he poured water over me with a pitcher. The sitting position allowed me to keep the incision line dry. I was able to get in and out of the tub myself, but it was nice not to have to reach up and wash my hair. I was bent over pretty far at the 2nd-day appointment, and almost completely upright at the 7th-day appointment. I had one of my drains removed at the second appointment. Still no abdominal pain, just a tender tush.
After a week, the bruising on my back was mostly gone, and I was walking upright without assistance. The places on my butt where the fat had been injected were hard lumps. I was released to drive, as long as I wasn't taking pain medication or muscle relaxers. The only exercise I was allowed to do was walk.
At the 2-week post-op appointment my second drain was removed. I received a small marble to help shape my new belly button. I was still wearing my compression band at all times. Dr. Gabriel suggested buying some Spanx compression undergarments. He was quite pleased at how the Botox had given me back my mobility so quickly. I was happy that it didn't hurt!
I started massage therapy to soften the scar tissue and help speed my recovery at 2 weeks post-op. The nerves in my back and butt started to "wake up", and I would get the odd pins-and-needles sensation in my back. After my first massage therapy appointment I had absolutely NO pain or skin-tightness anywhere on my body. For a day I felt like my pre-surgery self. It was recommended that my husband repeat the massages daily. He ended up giving me 3 massages that week (1 every other day).
At the 3-week appointment, I was given clearance to wear the compression garment 12 hours at a time. I preferred to wear it at night while I slept, or when I was sitting for long periods of time. Often, I would wear compression undergarments under my regular clothes. ***While clothing fit differently, I still wore the same size.*** I had regular massage therapy appointments (1/week), with my husband filling in the other days of the week. At 3 weeks post-op the massage therapist started working on the incision scar (with steri-strips in place). It was really uncomfortable and I waited 2 days before massaging my tummy and incision line. I only had the one at-home massage during the 4th week.
5th-Week Post-Op Measurements:
Wt: 183lb (same)
Waist: 32" (-2")
Belly: 37.5" (-5")
Hips: 41" (-1.5")
Butt: 45" (same)
I had my 4th massage therapy session at 5 weeks post-op - the scar tissue and skin moved by the T.T. continued to get soft and pliable. I believe that the massage therapy has really helped with the overall recovery so far.
The change in the shape of my body exceeded my expectations. All I wanted was to have the excess skin removed along my belly. Dr. Gabriel gave me a shape that I could NEVER achieve with diet and exercise.