Surgery of the Abdomen "Abdominoplasty"
If you're considering abdominoplasty... Abdominoplasty, known more commonly as a "tummy tuck," is a major sugical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. But bear in mind, it does produce a permanent scar, which, depending on the extent of the original problem and the surgery required to correct it, can extend from hip to hip.
If you're considering abdominoplasty, this will give you a basic understanding of the procedure-when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on the individual patient and the surgeon. Please ask your surgeon about anything you don't understand.
The best candidates for abdominoplasty are men or women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won't respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved.
Patients who intend to lose a lot of weight should postpone the surgery. Also, women who plan future pregnancies should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. If you have scarring from previous abdominal surgery, your doctor may recommend against abdominoplasty or may caution you that scars could be unusually prominent.
Abdominoplasty can improve your quality of life with conditions making it a medical neccesity and to enhance your appearance and your self-confidence, but it won't necessarily change your looks to match your ideal, or cause other people to treat you differently. Before you decide to have surgery, think carefully about your expectations and discuss them with your surgeon.
All surgery carries some uncertainty and risk Thousands of abdominoplasties are performed successfully each year. When done by a qualified plastic surgeon who is trained in body contouring, the results are generally quite positive. Nevertheless, there are always risks associated with surgery and specific complications associated with this procedure.
Post-operative complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics, but will prolong your hospital stay. You can minimize the risk of blood clots by moving around as soon after the surgery as possible.
Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers should be advised to stop, as smoking may increase the risk of complications and delay healing.
You can reduce your risk of complications by closely following your surgeon's instructions before and after the surgery, especially with regard to when and how you should resume physical activity.
Planning your surgery: In your initial consultation, your surgeon will evaluate your health, determine the extent of fat deposits in your abdominal region, and carefully assess your skin tone. Be sure to tell your surgeon if you smoke, and if you're taking any medications, vitamins, or other drugs.
Be frank in discussing your expectations with your surgeon. He or she should be equally frank with you, describing your alternatives and the risks and limitations of each.
If, for example, your fat deposits are limited to the area below the navel, you may require a less complex procedure called a partial abdominoplasty, also know as a mini-tummy tuck, which can often be performed on an outpatient basis. You may, on the other hand, benefit more from partial or complete abdominoplasty done in conjunction with liposuction to remove fat deposits from the hips, for a better body contour. Or maybe liposuction alone would create the best result.
In any case, your surgeon should work with you to recommend the procedure that is right for you and will come closest to producing the desired body contour.
During the consultation, your surgeon should also explain the anesthesia he or she will use, the type of facility where the surgery will be performed, and the costs involved. In most cases, health insurance policies do not cover the cost of abdominoplasty, but you should check your policy to be sure.
Preparing for your surgery Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins, and medications.
If you smoke, plan to quit at least one to two weeks before your surgery and not to resume for at least two weeks after your surgery. Avoid overexposure to the sun before surgery, especially to your abdomen, and do not go on a stringent diet, as both can inhibit your ability to heal. If you develop a cold or infection of any kind, your surgery will probably be postponed.
Whether your surgery is done on an outpatient or inpatient basis, you should arrange for someone to drive you home after your surgery, and to help you out for a day or two after you leave the hospital, if needed.
Where your surgery will be performed Many surgeons perform both partial and complete abdominoplasties in an outpatient surgical center or an office-based facility. Others prefer the hospital, where their patients can stay for several days.
Types of anesthesia Your doctor may select general anesthesia, so you'll sleep through the operation.
Other surgeons use local anesthesia, combined with a sedative to make you drowsy. You'll be awake but relaxed, and your abdominal region will be insensitive to pain. (However, you may feel some tugging or occasional discomfort.)
The surgery Complete abdominoplasty usually takes two to five hours, depending on the extent of work required. Partial abdominoplasty may take an hour or two.
Click on the below link for an actual video of an abdominoplasty surgery.
An incision just above the pubic area is used to remove excess skin and fat from the middle and lower abdomen.
Most commonly, the surgeon will make a long incision from hipbone to hipbone, ,just above the pubic area. A second incision is made to free the navel from surrounding tissue. With partial abdominoplasty, the incision is much shorter and the navel may not be moved, although it may be pulled into an unnatural shape as the skin is tightened and stitched.
Skin is separated from the abdominal wall all the way up to the ribs.
Next, the surgeon separates the skin from the abdominal wall all the way up to your ribs and lifts a large skin flap to reveal the vertical muscles in your abdomen. These muscles are tightened by pulling them close together and stitching them into their new position. This provides a firmer abdominal wall and narrows the waistline.
The surgeon draws underlying muscle and tissue together and stitches them, thereby narrowing the waistline and strengthening the abdominal wall.
The skin flap is then stretched down and the extra skin is removed. A new hole is cut for your navel, which is then stitched in place. Finally, the incisions will be stitched, dressings will be applied, and a temporary tube may be inserted to drain excess fluid from the surgical site.
Abdominal skin is drawn down and excess is removed. With complete abdominoplasty, a new opening is cut for the navel. Both incisions are stitched closed.
In partial abdominoplasty, the skin is separated only between the incision line and the navel. This skin flap is stretched down, the excess is removed, and the flap is stitched back into place.
After your surgery For the first few days, your abdomen will probably be swollen and you're likely to feel some pain and discomfort which can be controlled by medication. Depending on the extent of the surgery, you may be released within a few hours or you may have to remain hospitalized for two to three days.
Your doctor will give you instructions for showering and changing your dressings. And though you may not be able to stand straight at first, you should start walking as soon as possible.
Surface stitches will be removed in five to seven days, and deeper sutures, with ends that protrude through the skin, will come out in two to three weeks. The dressing on your incision may be replaced by a support garment.
Getting back to normal It may take you weeks or months to feel like your old self again. If you start out in top physical condition with strong abdominal muscles, recovery from abdominoplasty will be much faster. Some people return to work after two weeks, while others take three or four weeks to rest and recuperate.
Exercise will help you heal better. Even people who have never exercised before should begin an exercise program to reduce swelling, lower the chance of blood clots, and tone muscles. Vigorous exercise, however, should be avoided until you can do it comfortably.
Your scars may actually appear to worsen during the first three to six months as they heal, but this is normal. Expect it to take nine months to a year before your scars flatten out and lighten in color. While they'll never disappear completely, abdominal scars will not show under most clothing, even under bathing suits.
Your new look Abdominoplasty, whether partial or complete, produces excellent results for patients with weakened abdominal muscles or excess skin. And in most cases, the results are long lasting, if you follow a balanced diet and exercise regularly.
After surgery, the patient has a flatter, trimmer abdomen. Scars are permanent, but will fade with time.
If you're realistic in your expectations and prepared for the consequences of a permanent scar and a lengthy recovery period, abdominoplasty may be just the answer for you.
Now about my abdominoplasty surgery...
This picture taken August 2000 when I started the ball rolling for this surgery.. I was approx 240 pounds here when I filed my appeal for the abdominoplasty. I'm literally holding the panni in my hands..
Below click on a link to my appeal letter that won my approval Appeal Letter
for the abdominoplasty on November 3, 2000. Yes, It took that long to appeal it, I knew that would be the case so I started the ball rolling on getting this approval as early as May 2000. I had to go through two local appeals and won at federal level.
Abdominoplasty 1/2/2001
I was scheduled at 7:15 am Tuesday, January 2nd. The morning of surgery I was told to shower with liquid dial soap for 30 minutes concentrating on surgical site for 15 of those minutes. This was a good eye opener and got the blood pumping. I arrived at hospital at 6:00 am per instructions. I was somewhat calm (well I was trying too stay calm) I was keeping my thoughts on how much I needed this for my overall health the weight of the panni was causing lots of pain and back spasms.
As soon as I arrived at the hospital in the surgery admitting area I was asked to strip and then was given a gown (boy these gowns fit so much better now that I weight 200 pounds less) The nurse gave me a WARM blankee to snuggle to as I as shaking my tush off. The nurse tech started an IV drip then around 6:50 am some cute guy came after me with the standard GI issue net hat to put all my hair up into, then wheeled me down some rather narrow halls with lots of people in scrubs walking and standing around. Just outside of the operating room the anesthesiologist introduced himself and asked me if I was familiar with an epidural. I told him yes I did well with in on 12/8/99.
We talked briefly as he described the process to me again. I was then wheeled into the operating room and placed on the tiny narrow operating table. The anesthesiologist had me sit up and lean forward as he inserted the needle in my spine carefully spacing and measuring and telling me I had scoliosis, something I never knew, maybe because I was always heavy (see I still can't call myself fat) no doctor could ever see my spine. Now it's very visible. Once the needle was inserted it is removed and replaced with a tiny plastic catheter like tube with narrow tubing that connects to a bag. Much like an IV. Tell you the truth after that, I don't remember anything else until I was being moved to my regular room at around 2pm.
Now, that is a whole new experience The pain had got ahead of the epidural drip and I was in a lot of pain, the nurse responded rather quickly with a Demerol shot in the hip awwwwwwwwwwwwwww much better.. My daughter, and granddaughter, were all waiting for me in my room and both wide eyed, taking all this in. The nurse saw that my granddaughter was in a bit of distress seeing me like this so she gave her a chore to keep her busy. She told her NOT to let me fall asleep to keep me awake and talking. Trust me that was not an easy task every few seconds she was poking me "Grandma wake up Grandma wake up"
The nurse apparently told her this with the combination of the pain shot and the epidural I needed to stay a wake for at least 3-45 min. of course it seemed like hours that Marissa kept poking me awake LOL
Now shortly after that difficult first hour the epidural kicked in just fine. I was semi awake and asking questions now like how much weight did he remove? And what time is it? And why am I just now getting here? Don’t worry I got my answers many times seems I asked these same questions many times. The surgery started on time, however, they had to "stabilize me" I never got an answer on that one yet. . Also I was told I had three hernias that had to be repaired first...And that the surgeon had told Larry that they measure in ml but thought it was somewhere between 10-11 pounds...
During that first night and the next few days that followed my blood pressure had dropped staying around the 80/35 to 85/44 range. One nurse told me that my pressure was staying low because of the epidural, so I took it upon myself to not push the epidural injection button all Weds night. The anesthesiologist came in that next morning and after checking the drip unit he asked why I was not using it. I told him what the nurse had said and he said BS, that my blood pressure being low was because my tank was running a little empty and not the fault of the epidural so he handed me the button and said knock yourself out. I DID!!!
I walked to a chair the day after surgery I wanted to the same night, however, the said "NO WAY!!" Ok, I was a little weak and yes it was very difficult.. As soon as they located a binder for me, it made walking much easier. The surgeon told me 150-200 internal stitches no external other than my new belly button and where the drain hoses were attached. I was closed with steri-strips and what looked like was small wicks.. As you will see in the PICS (that will follow) the drains were located one on each hip and one located in the center of my pelvic region. These will stay in for 2-3 weeks I was told depending on the drainage.. I'm 7 days post-op now and the center one is still draining about 50cc every two hours the sides ones have slowed down quite a lot.. I call these my Christmas ornaments as they hang from me and when filled are red .. ok gross I know.. Got to have something to laugh about!!!
1/7/2001 Changing Bandages: I do this twice a day I’m not taking any chances of infection. I just finished doing it matter of fact and had to share some thoughts and a picture.
My surgeon gave me a pamphlet detailing the surgery pre-op doing and post-op all to expect care of incisions drains, and emotions. He described a period of depression that usually hits day or two post-op “Asking yourself “ WHY” did I do this” Then when out of the hospital and your first real look and the incisions and swelling thinking “ Is this it?” Yes, I thought that today. My hips and sides, :-0 Well, actually the whole abdomen is VERY swollen; the thought crossed my mind that I saw no change... “What did I do?” “Why did I do this?” “Is this what I’m stuck with?” But you know something. I’m smarter than that. I won’t let those fears and questions creep into my mind. I know this is temporary. I will look at the whole picture and not be so judgmental so soon. And I have noticed when I sit up, that my lap is not buried by my panni. So that is my light bulb moment and I will be patient :-)
1/8/2001 Dr. Miller’s office called changed my post-op surgery appt to Thursday at 12:15 pm .. I’m hoping some of my drains will come out, but I won’t count on it.
1/8/2001 Today was pampering me day.. My bedroom was filled with scented candles, (my favorite buttered pecan), fireplace was burning a warm glow.. I can’t take a shower or bath yet per surgeons instructions, but no one said I couldn’t bathe every inch of my unbandaged flesh in warm and totally sensual bedside sponge bath with hot oils to follow. You would not believe the overall affect of this pampered treatment had on my mind and soul. I am so relaxed ............
1/11/ 2001 Well, it’s been a few days since the last update. I developed an infection in the new belly button area, which, I’m told is quite common. It’s being aggressively treated and is looking much better today. I went in for a check up today with my surgeon and the three drains stay in :-( My surgeon says as long as their draining then they’re doing what their are intended for. He did take off they steri-strips and all bandages except the belly button and around the drains. That does feel much better. So that was a treat and I’ll settle for that for now.. I had to be very inventive on where to place the drains and dress at the same time and somehow hide the lumps. Good thing for long shirts..
1/12 2001 update: Yesterday wore me out I was in bed by 8:30pm lol so now I’m up at 6am time for chores; taking pills, vitamins, antibiotics, and changing the belly button dressing, empting the siphon drains then I can have breakfast pheww I’m ready!
1/13/2001 Update: Hello all thought I would update those interested in the abdominoplasty (tummy tuck) I had the procedure that not only removes the excess skin (panni) but also reconstruction to the abdominal muscle wall. I also had two rather big hernia and one small one that was about to pop through and of course enlarge in time. All were probably my fault as I live in the country and do the normal farm girl chores, so I most likely lifted too soon after my Gastric Bypass. So needless to say those lifting 50 pound sacks of feed are over for me. The surgeon gave me a 5 pound weight lift restriction for ever. I'm walking a little straighter today more upright.. I have not tried on clothes yet. The only time was at surgeon office on Thursday and I was wearing baggy clothes. I still have my three syphon drains attached to me and clothes apply pressure and irritate them so at home is loose fitting dusters. I'm so eager to see what size I am now. I was wearing a 14 in pants before surgery maybe 10-12 after maybe 8-10? Yes, I'm excited.. And each and every
1/15/2001 Update: Well, something happened and one of the Jackson-Pratt drains won't pump the stitch holding it in place came loose and came out about 4 1/2 inches.. So When I called my Surgeon he said come in at 5pm.. Gawd what did I do.. (sigh) Please tell me he won't shove that hose back in me LOL
1/15/2001 Update: Had to go into Surgeon's Office ER to remove the drains.. Two were rejecting and pushing out.. The center one was leaking all over me necessitating a pad. Dr. Miller pulled out the center one with little effort not much was left inside anyhow by the time I got there....... there was 8” hanging out... He also removed the other two; one was rejecting the other quit draining. This removing of the drains was not painful at all the clipping of the stitches was a little stingy. Glad that part is over though... I still can’t be up standing over 30 or so minutes without swelling. Feels like fluid accumulation my hip abdomen and pelvic area gets hot and puffy. Once I lay back down for hour or so feet up this go down some. Seems like I spend 70% of my day flat in bed. Today I’m a little depressed, guess it’s the post-op depression syndrome again. I’m happy with the tummy area for the most part and very disappointed in the hips DOG EARS Oman this is more than dog ears from the side view I look good head on well let’s just say I sit down and cry. The hip area are either swollen terrible or this is what I am stuck with. I’m trying to make myself believe this is swelling and this will soon pass. Will it?
1/18/2001 Update: The incision line on the right hand side sprung a leak and is oozing pinking goop calling surgeon.
1/19/2001 Update: OK I’m back from the surgeon’s office.... He inserted a needle in my tummy that I guess inserted a tube like thing that was attached to a generator or sump pump or some type of suction device. LOL The pumping was no pain the needle was much like amniocentesis just the initial stick was a bit of a smart then it was ok. I think I filled a gal jug Yuck I know! Doc says I’ll have to have this every few days. I asked him since he drained my oil did he rotate my tires also. *Smile*
1/20/2001 Update: another part of my incision opened and is ozzing. (sigh) this does not look good.
1/24/2001 Update: For the last three days I have been battling the flu I’m so weak, can’t eat anything the drainage makes me nauseous, I can’t hardly move I just lay in bed. My family made me go to hospital Larry had to carry me to the car as I had absolutely no strength to walk. The open part of the wound is seeping big time. ER: I have the flu that now turned to Bronchitis and I was severely dehydrated. RX for Levaquin (antibiotic very powerful) and others and headed back home after they packed the wound and dressed it.
1/26/2001 Update: I went into surgeon office for getting the fluid drained of again.. He got more this time then before and hurt just as bad (sigh) But I handled it. Belly Button infection looks much much better. The incision that open seems a little wider now ACK!!! This scared me so much ..Also a pain in the ass.. I’m thinking this is not going to be a quick fix.
2/2/2001 Today the surgeon cut away old stitches and God knows what else.. He had to peel me off the ceiling when he was done (no anesthetic) The incision was gaping open and really gross looking now it's packed and closed up a little. When I got home I was soaked so had to replace all padding and removed internal gauze (not fun at all)
2/3/2001 Today the Nurse that comes twice a day for a week she said & starts acid wash saline and vinegar (God help me) if this hurts I'm loosing it Don't think I can take much more pain. I'm so hypersensitive.. Ok to answer your question no this is not common (it happens) yes, can happen in any surgery. I knew once the jackson Pratt drains rejected I was in deep do do.. Not having to go into surgeon every other day I think will help the nurse can do everything right here and I won't be applying stress on the incision. She reports to him daily. I'm hanging in there yes, I have my weeping days ..yesterday was one cry cry cry all day.. you know the why me thing.. Why not me it happens it's a complication we all know about and another thing that makes my fight to not be obese a milestone soon this will be a memory I know and I'll be back to my old self (got to keep telling myself that one)
02/03 01:10 PM Update: The home health nurse is now coming twice a day and is packing the open part of the incision with gauze soaked in saline and vinegar mixed (not much vinegar I guess). the packing is to keep it from healing on top.. The top was healing before the inside (not a good thing) so the surgeon while I was in his office yesterday cut away all new top growth and drained out the accumulated fluid build up then packed the open incision (yeah I had to be peeled off the ceiling) . The incision has to heal from bottom up. Today the nurse stuck a long q-tip in about 8" so it's pretty darn deep tunnel.. scared the heck out of me.. I asked nurse how long she though this would take to heal. She said hard to tell, 2 months minimum.. So needless to say I have been crying all afternoon. Right now I'm just so scared it will open more and praying that it won't..
2/4/2001 Update: Nurses in and out all weekend dressing change getting easier for me to handle still bites and stings but all part of healing I guess. My daily routine. Wash hands with antibacterial soap, then I assemble the things I need like, gauze pads, normal saline and saline mixed with vinegar, tape & pads and special q-tips (long sticks) also 8” roll padding.. I have durapads on my sides for the tape to stick too which saves my hide from being ripped off at each dressing change.. I remove padding and top gauze then slowly remove the gauze packing from the open incision, all this material goes into a plastic biohazard bag. After all is removed. I clean the whole area with normal saline then pat dry. The then process starts of repacking the open crevice with gauze soaked in normal saline and vinegar solution. I have to use the long q-tip sticks to help pack the wound when all the cavity is packed I lay dampened gauze across the incision to keep it moist on the edges. We don’t want the edges to harden. Then once all this done it is covered with dry roll pad this pad is thick and adds cushion. Then my binder goes back on. The binder helps support my whole tummy area and hopefully prevent anymore opening of the incision.
2/7/2001: Nurse just left and brought more supplies. Friday they measure the depth of wound to see how fast or slow the healing in taking place.. My BP was 104/64 today that's an improvement.. The fingers on my left hand have been burning like on fire and the pain has been sever slowly getting worse for two days.. not sure why nurse called surgeon I called my PCP.
2/9/2001 BP was 98/62 today...believe it or not fingers much better still to tender to type but no PAIN.. My PCP called me back said he heard of a phenomena post surgery where the capillaries get inflamed in the nerve endings such as fingers and toes what I discribed to him fit exactly he said. Cortizone helps but time best medicine usually resolves itself in few days.. He said it may never occur again just one of those phenomena.. You would know on top of every thing else I lucked out and got the draw on this one LOL He mentioned other possibilities but this was the most likely..
2/12/2001: Nurse says looking so much redder and tissue starting to form and she said I should be much better in 4-6 weeks time.. :-) My second belly button is starting to close from bottom up about 1/2" deep now... Big opening about 7” wide ...
2/14/2001: measurement day.. The tunnel on the right is about 1/2 what it was two weeks ago.. The debt is about 1/2 what it was.. Now the bad news a tunnel has opened up under the rest of the right side horizontal incision ;( more packing I will have to have some sort of narrow long packing that will pull out easily daily.. This does not sound good. I’m not running a fever and still on antibiotics so this may have been a fluid canal hopefully the incision will not open all the way.. Nurse has to order this type of packing all I had here was 4x4.. this will need to be much smaller.
2/17 Some leakage this morning woke up soaked, soaked all pads, gauze, bedding and my night shirt, with fluid and bright red blood. Hope this is another pocket that decided to empty.. Incision site looks like it’s closing up some harder to pack..Hope this is a good sign..
This picture was taken on 3 weeks post op when the incision opened up.. Yes, very scary..
This was taken at 4th week post-op just a few small changes in appearance.. The small belly button looking thing you see is NOT my real belly button this is small hole that opened in the verticle incision.. looks like I have two belly buttons though.. This one is not real deep so should heal faster.
This picture taken at 5 weeks post-op as you can see there are some subtle changes in the way it is pulling together and the bright red color. Also the white and yellowish stuff on the top of the incision is less this is a good thing the nurse says..
I'll update as often as I can.. Just wait until you see the totally healed PICS.. I'm sort of waiting to see those too!!!
3/1/2001 Update: I had to call my surgeon today, I noticed that when I removed the gauze from the small tunnel it looked a little tinged in green indicating infection.. I have an appt. with the surgeon at 2:30 pm to see what’s going on and see if I need back on antibiotics.. Ok here is the evening update... the tunnel was healing at either end fluid trapped in the center.. hence the infection.. He had to open the tunnel again.. (yep I was on the ceiling again) once he opened it up the fluid came out with a gush... (sigh) he took a culture of the infection to see which antibiotic is best to be on.. For tonight he gave me KEFTAB take 2 tonight 2 tomorrow then his office will call me with results and new antibiotic RX.. When he walked into the room he said "I heard you didn't want to come into the office to see me" I stammered and stuttered and said "Umm I thought you might just fix this over the phone with antibiotics" He chuckled as he brought out the roto rooter to open the tunnel.. Also he said once all healed (the best it is going to heal) then he would do a scar revision to correct all this ugly uneven healing..He said this would be minor surgery and will be done May or June.....
These last pic was taken later that same night (after the office visit) when I was removing his packing. Remember I mentioned the roto rooter :-0
3/2/2001: Update surgeon put me back on Levaquin (antibiotic)
3/6/2001: after culture results came back I was taken I was put on Ampicillian 500mg 4 times a day plus the Levaquin, that should kill anything..
3/9/2001: I had another office visit with the surgeon. he was very pleased with the looks of the wound now.. very minor tinge of green mucus left but very little compared to over the weekend. I go back the 23rd hopefully this wound will be ready to close then ..I hope!!
This PIC is taken at week 9 on March 11th.. The right side (my right left in the picture) is still very swollen, that is the same side that the incision opened. Packing is getting more difficult I can get in 1/4 of a 4x4 gauze on now.. So it's slowly but surely healing. I'm still on the antibiotics.. Next appointment is 3/23/2001..
3/22/2001 Update: I go to the surgeon tomorrow form check up I able to get less that 1/4 of a 4x4 gauze packing in now and I find what little packing I get it when I change the dressing it has worked it’s way out.. So I will discuss this with the surgeon.
3/23/2001: I went for my appointment today with my surgeon that did my abdominoplasty.. No infection & the incision is only open about 3" now (horizontal) and about 3/4" deep.. I pack in the best I can not much to get in there.. also it pushes back out.. I told surgeon that he said that's fine it's in there long enough to clean it ,,He said next two weeks should be healed and will stop all packing and wet dressing.
4/09/2001 Update Small crevice remains that will not close and now small crack along left side of hole. bright red blood today when changed bandages.
4/10/2001: Doctor says it has healed as much as it is going too time for the revision.. Scheduled for revision 5/22/2001 hip to hip to extend to around sides to revise incision wounds and scars.. He said he will roll me on my side incise& close and roll me to other side incise & close .. then do center and close. Approx 3-4 hours surgery time and 5 days in hospital. Pre-op one week before. Now I start pumping the protein again 120 grams a day.. and tons of water.. I’m going to Branson for the WLS reunion and forgetting all about this.... Well, try to anyhow!!!
5/8/01: Update on the open hole that remained on my incision...it is NOW healed up completely yea!! I can now take a bath I have missed that more than anything.. I have been stuck with taking showers since January.. I pre-op at the hospital & the doctors office on May 16th, then Surgery May 22 for the revision.. I pray all goes better this time I sure don‘t think I could handle another set back with another open incision or any other complications
5/25: Surgery date changed to 6/15.
Update 6/20/01: I had my abdominoplaty revision surgery 6/15 The surgeon chose NOT to do the brachioplasty at this time as he wanted me to concentrate on a successful recovery with no complications. BOY, am I glad he didn't do my arms I don't think I could have stood the pain.. It has taken all I can muster to get through this one. I had a reaction to the morphine (hives, severe headaches, nauseau) so had to go to a pill form of pain medication.. I'm not a pain medication type of person but this time YEAH you betcha I am taking it... I have a incision that runs all the way around me like a belt 360% around me.. and a vertical incision that starts below by beast bone all the way to my pelvic area. So far so good no complications this was just a very painful procedure just no way to get comfortable with an incision that wraps your entire body. I can't wait to see the results in a few months.. The swelling will be great for at least that long I am wearing a binder and have 4 JP drains that I hope will remain in for at least 4 weeks ...or as long as needed.. I'll update with pics in August.. (let me recover first ) Thank you for all the well wishes, cards, letters, posts, and calls while I was in the hospital.. all was much appreciated.. Thank you Ava for being such a GREAT angel.
6/15: Surgery lasted 7 1/2 hours a total circumference incision like a belt around me and a vertical incision that went from pelvic area to breast bone.. whoooo nellie this was a whopper of a surgery.. would I do it again as of today HELL NO>>> right now I’m trying to find somehow and somewhere to get comfortable. Post more later :-/
6/23 Update: Hi all..I thought I would update on my abdominplasty revision surgery on 6/15.. I'm now 9 days post-op and so far so good..No complications.. The JP drains are still siphoning although the two on the left side are verily putting out now.. the ones on the right side are still pretty active.. At least their still in place and doing their job :) I go back to surgeon Tuesday for a check up..This same time last surgery my incision had already opened up big time.. so this is an improvement.. "God Willing" no complications this time..
I thought I would also update you on the type of procedure I had.. It was to correct the way the opened incision healed improper.. The surgeon did a complete circumference incision like a belt around me he was able to do a lower body lift 9" was lifted he told me.. Although I am still very swollen I can tell my butt now has a new home.. and my outer thighs no longer have wrinkles. He also had to re do the belly button and this one is doing great no infection and looks very natural.. I will admit trying to get comfortable being cut from all angles was difficult I stopped all pain medication two days ago so winging it solo now :) I have a high pain level so most other people would be still on pain medication I'm sure :-/ My weight is now 140 and holding.. I don't want to lose any more weight so I have increased my calorie intake to keep it stable and my nutrition level up to heal properly.
I'll update again next week after my doctor's appt.
6/26 update: Today I went for my 12 day post-op checkup... The drains on the left had quit draining last two days.. The ones on right had put out less than 68cc in 16 hours..The surgeon pulled all four drains out as one of the ones on the right was now seeping some drainage and he did not want infection setting in.. So now I'm JP drainless .. I have mixed feelings on this happy that their gone (they are a pain-in-da-a**) however, they do perform a very necessary job that is removing the internal fluid that develops to the outside... I looked back at my drainage charts from the last surgery and the drains were much more active when they rejected, actually last surgery the drains were more active the whole time maybe because I had three hernia repaired that surgery... so maybe this is good news that these drains had just about stopped draining and not because they rejected.. They seemed fine and intact this go around.. They just simply slowed down to almost nothing. So I'm going to think positive here and call this a good sign.. The incision looks good for what he uncovered which was all the front part he left the back steri-striped taped.. He said to leave that on another week. I feel good, strength coming back... Now I can wrap binger tighter to allow for less chance of fluid building up... This binder server many purposes keeps the incision pulled in and together during healing and supports the abdominal area and back.. I don't mind the binder at all now, it makes me feel more secure about this large incision..
7/1/01 update: I took the steri-stips off my back (they were coming loose anyhow) so far s good looks like good clean incision line.. no leaks or open areas.. ahhh this felt good getting these completely off tapes makes me so ichy..Taking it day by day so far everything is in place and no open incisions or holes or any leaking.. There is some fluid build up below where the binder compresses.. but maybe the body will absorb that.. I go back to surgeon Thursday.. My back steri-strips came off and looks good up under there itchy though guess that means it's healing. I cleaned it by dabbing 70% alcohol not bathing it just a dabble... All the JP drain holes are healing and look good..One has a few stitches poking out surgeon will take care of those when I go in.. What I have seen so far everything looks great.. I don't leave the binder off unless in shower,, Keeping the binder on and tight will prevent fluid build up the surgeon said.... so that puppy is stuck to me like glue.. :)
7/3/01 update: I called surgeon's office about the fluid build up on my pelvic region so far no stress on the incision line there.. He will see me thursday..I'm not sure if he will drain it or not..we'll see..
7/5/01 update: The surgeon had to aspire fluid from my pelvic area via a needle and syringe he was able to remove three 8" by 3" round syringes full of fluid. So far so good on the rest of the incision. He said 10 more days with no complications and I should be out of the woods on the incision opening up.. I'm counting the days ..
All the above pics were taken at 21 days post-op don't be shocked by all the swelling, very visable scars, drain wounds, and brusing this is to be expected..I'll take more pics in August.
7/12 Update: Return doctor appt to surgeon was today and all looks great... swelling going down now ..no opened incisions, or infections.. I didn't have to be drained on the pelvic again so another good sign.. I'm very pleased with the results this time, no serious complications like last time. Even after all that I have been through NOW I can say this was all worth it.. . Sure it's natural immediately post-op to say "Why did I do this" although I would have to think twice before having it done again :) phew sure glad it's over with and I never have to do this again :) Now I can take the binder off during the day and wear an all in one type firm control garment (It keeps swelling to a minimum) & supports the incisions for another month or so.. although I like wearing these anyhow... I will still wear the binder at night in bed for another month.. It's my pal now I have got quite used to it.. :) The incision is still pinkish red some scabs still in place especially the drain areas and around the belly button & a few around the center of my back. These will fall off in time. Now, I can concentrate on shopping for my vacation trip to WV, DC, MD, and VA.. You know I used to hate to go clothes shopping. I never found anything big enough or looked good on me ended up ordering from Lane Bryant or Roamans and I purchased all black to make me look thinner (I wasn't fooling anyone but myself) Now, I love to try on clothes what a treat that is now to actually buy something NOT BLACK and a size small... .. I'll add more in August in my new clothes :)
Well, I'm at my goal weight of 140 pounds and holding firm.. I'm healing very nicely now, no "Grand Opening" on the incision and the incision lines are starting to fade... I still go in about every other week to have stitches removed that work their way up and out..This is normal..
The above pic taken Sept 5..the scars are fading and swelling has finally gone down.. It took a full two months..
I love my new body thank you Dr. Miller..It's so nice not having to wear my shirts out to cover my tummy.. I wear everything tucked in now, got to show off that flat tummy :) I still can't believe that image in the mirror is really me..
Update: I had a small opening in the incision line that runs around my waist on Jan 2, 2002... The culprit is adhesions attaching to my muscle wall and colon that caused a pulling on the incision line.. I'm scheduled for surgery to correct this problem March 11, 2002.... I'm also having my bat-wing deformity corrected due to the severe muscle spasms they cause in my arms, neck and shoulders..
Above is a pic of the adhesion right side of picture and below that is where the incision opened (dime side hole) after pics will follow in 6-8 weeks :)
Update: 3/15/02 Surgery went well 4 hours for both surgeries, released next day with no problems other than severe morphine allergy.. So had to go cold turkey no pain meds at all.. This surgery was no where near as bad as others said.. I guess pain is individual.. I thought this one was a breeze.. arm pits have been the only discomfort and that is the rubbing or stretching.
Update: 3/20/02 All JP drains out of arms and tummy.. all steri-strips removed.. So far so good :) although this compression garment makes me feel like sausage or like I have been shrink wrapped in one of those seal-a-meals things :)but it is supposed to keep swelling down.. Yeah right as IF it could possible swell this outfit sure does the job.. But I do love my skinny little arms :) just hope once the shrink wrap is off I don't explode...
Below are some after PICS taken April 2002.. Now I have to go hunt my before "arm" pics..(you won't believe the differance) :0 My under arms used to hung down to my sides in a big draping fashion, you could not see my armpits at all. As you can see the incisions are starting to fade. The adhesion puckering and pulling on my upper abdomen before surgery is now gone.. and that incision is also healing nicely.
My Favorite Web Sites
Gastric Bypass Information, Links & Recipes
Victoria's Recipes for Gastric Bypass Patients
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My Weight Loss PICS
Dr.http://www.plasticsurgery.org/lookup/refer_to.cfm?ID=4440">Miller- Cosmetic and Reconstructive Surgery of Tulsa
