My Plastic Surgery Story:
On August 29, 1999 I had an abdominoplasty,
hernia repair with mesh and appendectomy.
This is my experience.....

Pre-Op Appointment with Plastic Surgeon - 8/10/99

My surgeon, Dr. Dooley (Reading, PA) answered all of my questions which I wrote down before my appointment. The following are my questions, along with the answers:

B-12: I had some circulatory problems last month and had my general physician test my levels of B-12. The tests showed they were low. This was because of my own doing since I wasn't taking my vitamins or eating properly. I was concerned this might be a problem with my recuperation from surgery so Dr. Dooley agreed that it would be best to have my B-12 level tested again along with my other pre-op tests.

Recuperation time: Dr. Dooley stated that it would take 3-6 weeks for recuperation, with my hopeful return to work at 4 weeks not being out of the question.

Drains: Dr. Dooley explained that the JP drains will stay in from anywhere from 3 days to a few weeks, depending on how much fluid is being collected in them. He explained that I would not have any trouble emptying the drains by myself (I live alone) and that it was a suction-type system using a bulb-type manual mechanism. I would have 2 drains.

Time in the hospital: I was told anywhere from 3 to 7 days, depending on my bowel function and ability to resume eating.

Pain Medication: Dr. Dooley said they would likely use what worked with me before, which was a Morphine Epidural along with Toradol. I will speak to the Anesthesiologist before I agree to this since I had problems with the Morphine after my RNY surgery.

NG Tube: I was told by Dr. Carter (the surgeon doing the hernia repair part of my surgery) that he would not be using an NG tube because of my RNY surgery. He did not want to take any chances with my stomach. Dr. Dooley agreed.

Birth Control Pills and Vitamins: Dr. Dooley told me to bring them along with me to the hospital, but I would be fine for a few days without them.

Type of sutures: Dr. Dooley uses internal dissolvable stitches and uses surgical tape on top. I will have some stitches around my belly button that will need to be removed but that is all.

Insurance Coverage: I have Blue Cross/Blue Shield Personal Choice PPO (Pennsylvania) and I was hopeful the insurance would cover the plastic surgery part of my surgery. After discussing it with the surgeon's office I was told that it was likely to be covered because of my history of medical problems related to hernias, but coverage was not guaranteed. They submitted the insurance request along with a letter from the plastic surgeon and a letter from the surgeon doing the hernia repair, both stating the medical necessity of having the Abdominoplasty. Within a month of the request I had approval for my surgery, including the hernia repair with mesh and the Abdominoplasty. If my insurance did not cover the Abdominoplasty part of my surgery, the hernia repair surgeon said he would do his mini-tummy tuck procedure at no additional charge to me since it was so necessary.

Time of surgery: August 26, 1999 - 8:00 a.m., I need to be at the hospital at 6:30 a.m.

After these questions were answered he left the room and I disrobed and donned the infamous "one size fits none" paper robe. He looked over my abdomen carefully, pointing out where the incision line will be. He said that once the hernia repair is done and my skin pulled taught (down), the incision line will be approximately where my belly button is now with all of the skin below that removed. I will have a new belly button made. I expressed concern and a strong desire to have a lot of my stretch marks removed (they are everywhere), along with my RNY incision which had spread in some areas to a 1" scar. He said he would be able to take care of a lot of the scaring and stretch marks, but there would still be some in the upper regions of the scar since he did not want to cut me that far up. He did say that I needed to be realistic and realize that my stomach will not be perfect. It will most likely still have a lot of stretch marks and scaring from my multiple surgeries, weight gains and pregnancies.

We also spent some time discussing a future thigh lift and breast reduction/lift:

Thigh lift: I had heard from an online friend that her thigh lift scar went from her knee upward to her panty line on the inside of her thigh. That scared me to the point where I wouldn't even consider the surgery. My plastic surgeon explained that he does not cut up the thigh, but along the panty line and pulls the skin upward. The scar is mostly hidden this way. I will consider this surgery in about 3 years.

Breast reduction: I was told that I really didn't need a breast reduction as much as I need a lift with redundant skin removal. My main concern was losing nipple sensitivity and he said that although there were no guarantees, he felt that he could work around that issue and hopefully have good results. I will consider this surgery in about 3 years, along with the thigh lift when my body has more or less finished adjusting to the weight loss and after I have had some time to do some weight training.

Pre-Op Testing - 1 week before surgery (8/19/99) :

I was taken into a room and my height, weight, blood pressure and pulse was taken by a nurse. She then handed me a pamphlet on Living Wills. The anesthesiologist came in to talk to me. We discussed the pre-op medication that was given to me before my RNY to help avoid post-op nausea (Zofran) and I asked to be given it once again. He listened to my lungs and we discussed the fact that my surgeon requested no NG tube because of my gastric by-pass. We briefly discussed the Morphine Epidural and it was decided not to use it since it would mean longer recuperation and I would have to spend the night in post-op. I will be given a Morphine pump along with Toradol by IV. I was told not to eat or drink after 12 midnight the night before my surgery. I moved on to the registration desk and they took my personal and insurance information, then on to the blood work. They only took 2 vials of blood: The B-12 level (at my request because of my low level last month) and a blood count. Then I was free to go! I was amazed that there weren't more tests done, but this is all my surgeons requested.

Date of Surgery - 8/26/99 :

The pre-op process in the hospital the morning of surgery was exactly the same as when I had the RNY in November, 1998.

When I woke from the surgery I had a catheter, 2 JP drains, an IV with morphine, an abdominal binder, surgical stockings and venodynes, (the inflatable leg boots that inflate and deflate to a certain time pattern set by the surgeon for circulation). I was kept in post-op for a few hours then moved to my room that same afternoon.

I was visited by both surgeons each day. Dr. Carter (the hernia repair surgeon) explained to me that he had opened up each of the hernia areas, making it into one large hole, approximately 10" wide and repaired it with a large piece of mesh. He also removed my appendix as a precaution against future surgery and possibly having to reopen my abdomen and mesh and start my problems all over again. Dr. Dooley (the plastic surgeon) told me that he was able to save my original belly button and that he was very pleased with the way everything looked.

I was on bed rest for 2 days to give my tummy time to heal before stressing my abdominal wall with moving to get up and walk. The venodynes kept the circulation in my legs going so there was little worry for blood clots. By the end of the second day I was finally able to get up and walk. I was stiff from laying in bed for so long and I welcomed the chance to get up. As soon as I was able to get up on my own they took off the surgical stockings and venodynes. By the end of day 2 they removed the catheter. The morphine pump didn't seem to be working for me and I was in a great deal of pain so they removed it on day 2. They continued to give me Toradol for pain which helped to relieve the pain greatly, but every time I moved the muscle pain was excruciating. I still forced myself to get out of bed every few hours or so when I was awake. I even went to go visit with some of the new gastric by-pass patients! It was fun to talk to them right after surgery and offer a listening ear.

By the time I went home on day 4 I was still in pain when I moved around, but I didn't need any more pain medications since day 3 in the hospital. I had to go home with the JP drains still in place with instructions on how to empty them and to keep close track of how much output was coming from them. I also had strict instructions to keep wearing the abdominal binder for at least a month post-op. Both of my surgeons were amazed at how quickly I healed and how fast I was able to be discharged from the hospital. I was very pleased as the hospital is not my favorite place to spend time recuperating!

Post-op care:

I had to empty the JP drains 2-3 times a day and record the amounts of the drainage carefully. When I went to my first post-op appointment (1 week), I was disappointed to find out that the drains were still putting out too much fluid for them to be removed yet. I was getting frustrated with the drains since anytime I sat down they would pinch against the abdominal binder. 1-1/2 weeks post-op I returned to his office once again and he removed one of the drains and the second drain was removed 2 weeks post-op. He also removed some of the stitches around my belly button. (The rest of the incision was closed with surgical tapes. The stitches inside were all dissolvable.)

Complication:

I had an allergic reaction to the IV antibiotic they gave me in the hospital and I woke up 8 days post-op with my eyes swollen shut and a red, itchy rash all over my body! I called my surgeon immediately and he prescribed Prednisone and prescription strength Benedryl for me. The Benedryl worked almost immediately to help alleviate the itching, but it totally knocked me out for 2 days.

3 weeks post-op doctor visit:

The surgeon removed the rest of the stitches from around my belly button and I was able to take a shower....FINALLY! YEAH! It felt SOOOO good to take a full shower - no more sponge baths for me!

The Final result:

When I was in the hospital laying down, the nurses would come in a number of times a day to open my stomach binder and check my incision. The first time I saw my new tummy my mouth must have dropped open. I was so shocked at what I saw! It looked incredible - and it was FLAT! I was on the verge of crying with tears of joy at how fortunate I was to have been able to have this surgery. The incision was from hip to hip, just above my pubic area and also from the middle of that incision upward to about 2 inches above my new belly button. (He was able to save my original belly button and just moved it up to its new place.)

During my first post-op visit to the doctor's office he had me stand up and he removed the stomach binder for the first time while I stood. His examination room did not have any mirrors in it, so I had to look at my new tummy by looking straight down at it. This was the first reality check I had. I almost burst into tears at what I saw - this time from disappointment, but I didn't say anything to the surgeon.

What I saw was that my tummy was still a little droopy and especially my private area was really sagging horribly. I had discussed this area with the surgeon at one of my pre-op office consultations and he told me that he wouldn't be able to do much with it, but somehow in my mind I still thought he would do something during the surgery. After thinking long and hard about my reactions since this surgery, I realize that I had a lot of preconceived notions about what I would look like coming out. For some bizarre reason, I honestly thought I would come out looking like I had never been obese - that all of my stretch marks would magically disappear and that my tummy would be flat and toned looking. After doing much thinking about it over the next few weeks, I realized that the surgeon really did the very best he could, considering what he had to work with. I have had 5 other abdominal surgical procedures done, 2 pregnancies, multiple and major weight losses and gains, and multiple hernias that pushed my abdomen out so far to the point where I looked like I was 8 months pregnant. I had to realize that surgeons are not miracle workers and that I need to accept the fact that my body will never be what it could have been if I had never had so many problems.

I am very pleased with the result, considering all my body has been through. Over the next few years I will be giving careful consideration to more plastic surgery.

6 Week Post-Op update: (10/7/99)

When I first went shopping for a pair of jeans to wear (2 weeks post-op) because my pre-op jeans no longer fit, I was devastated to learn that I had to buy a size 16! I thought for sure this was going to be my permanent size. 2 weeks after that I realized to my delight that my jeans were too big! Back to the store again, this time I bought a size 14 and they fit beautifully. Again, I was feeling better about being a size 14, but I was not thrilled yet! Then low and behold 2 weeks later my jeans were loose again! I went back to the store and came out dancing wearing a size 12! Do I dare dream of that size 10??? Either way, I am thrilled!!!

For those of you who are going to have the abdominoplasty or panniculectomy, I highly recommend waiting to buy ANY pants until at least 6 weeks post-op! I thought I wasn't swollen from the surgery at 2 weeks and again at 4 weeks, but apparently I was. I'm so happy! It was definitely worth it!

1 year (+) update (11/00)

It's been over a year now since my Abdominoplasty. Since then I had "touch up" plastic surgery on my pubic area in July of this year (story below). Looking at my tummy now I have to say I honestly am very pleased with the results. Considering what it looked like going in, I couldn't be happier. After my surgery, I lost 15 lbs but since then have gained 10 lbs back. It didn't make any difference with how my Abdominoplasty held up over time.

Muff Lift (7/14/00)

I hope the title of this procedure doesn't offend anyone! I had a conversation about my "muff lift" on an on-line discussion list and this name just held. I have a big laugh every time I think about it.

8/00 - discussion list post

My touch-up plastic surgery last month has actually so far been a bit of a disappointment and I've had a bit of trouble with it. The surgery itself was extremely painful. I was awake for the procedure and was given local injections (probably at least 10-15!). I realized during the procedure that no matter how many injections a person is given, there really is no way to totally numb nerve endings. After the procedure my entire pubic area turned a black, dark purple, including the upper part of both thighs, about a foot from the incision site. It was pretty scary and the surgeon even was surprised at the bruising I had. It made me worry that perhaps I was vitamin deficient and I ran out to have all of my vitamin levels checked. Thankfully, they came back normal. No real reason for why I bruised so severely. Another problem with it was about a week post-op, I started "bleeding" profusely from the sight. After freaking out at work because I discovered my panties, gauze pads and pants covered in blood and calling the surgeon, I found it was simply old pooled blood that was finally draining from the site. It wound up bleeding like that for almost a full week. I had to throw away a lot of clothes! The final problem I had with it was that the entire area swelled up so much that the incision line separated and re-healed in a lumpy pattern. The surgeon will now have to go back in to correct the incision line. NOT what I wanted to hear! Anyway......I know this entire thing sounds very scary, but I also know my situation was unusual. If you need to have your stomach done, I highly recommend you ask your surgeon to do your pubic area at the same time. If I had done that, it would have avoided this entire problem.

10/00 - discussion list post

The 'muff lift' was very difficult on me since I opted to have it done in his office to try and save money. It was at the limit of my pain tolerance and something I'm not so sure I would have it done again in the office if given the opportunity. I was given probably about 10-15 injections of local anesthetic at various intervals during the surgery and there were still places where I could feel it. There is nothing that can totally numb certain nerves and when they are cut and cauterized, they are VERY painful. There were some places where I could feel a hot knife searing through my skin. I also had 2 weeks where I had problems with my incision. Since he didn't use any drains (at my request), the entire area became very swollen and a very dark black purple, not only in my 'muff' area, but also down both legs and my labia. At 1 week post-op I noticed a slight bloody drainage from the incision at one spot and called my surgeon. He asked me to come in so he could take a look at it. He said all looked fine. 3 days later, the bleeding increased and was soaking through 3 bandages within an hour. I panicked and rushed back to his office yet again. This time he was able to determine it was actually old, dried blood that was finally draining from my body and was actually a GOOD thing. Of course, I wasn't in the mood to hear this was a GOOD thing since I was staining almost every piece of clothing I owned with blood! After another week of this draining, the dark bruising (probably the dried blood!) went away and the incision settled back down. The incision started to separate because of the swelling and the incision became slightly infected. After a round of antibiotics all was well, but the incision still didn't look too good. It took another week or two before the incision finally settled down and the swelling went away. Now at about 2 months post-op, the incision looks perfect, although still red. Time will fade the scar and I am very happy that I had it done. He removed about a 5" section of skin from that area. It was embarrassing since I could see a "bulge" with anything I wore that was tight. I refused to wear a bathing suit! I hope I didn't scare anyone with my story, but it really is the truth of what happened. I think my surgeon did everything right, but I just had some problems. It happens. I would highly recommend that if you need plastic surgery in your private area that you talk to your surgeon about having it done at the same time as your tummy tuck. There really is no reason why you shouldn't be able to.

11/00 update

Looking at my incision line now, it is just a faded pink line. I am extremely happy with the results and the pain and horror of all that happened after the procedure have faded. I don't need any other touch up surgery for the incision. At this point I have already decided definitely not to have my arms done since they look great and probably won't have my breasts done either. I don't want to risk losing nipple sensation. I may change my mind later on, but at this point I'm happy with the way they are. I just have to adjust my clothing and can't wear anything very low cut because I'll just fall out! I am still seriously considering having my legs done because they look so horrible, but at this point, I'm going to wait at least a year or two before going for consults. My body needs a rest!

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Before and After Pictures
My Weight Loss History Chart
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Poetry and Writings
One Year Anniversary Musings
Suggested Post-Op Medications
Recommended Items For the Hospital
Reading Eagle/Times Newspaper Article - 11/14/99

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