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Revision surgery scheduled for 11/12/15.  Stay tuned.

Let's see...how does that saying go?  "Bitterness is like cancer.  It eats upon the host."

Bitter is the best word to describe how I felt after my thigh lift on Aug 11, 2013.  My surgeon simply did not pull my legs tight enough, and my result is more cellulite on the back of my thighs, much skin laxity on the inside of my thighs, and dimpled appearance.  Translation:  my legs look worse than before the surgery.  Let's just say it was an expensive lesson learned at a cost of thirteen thousand dollars Yep, you read that correctly...and the needle DID just go across the record...

what happened to me emotionally after surgery was not easy.  I was mad.  I was bitter.  I was majorly depressed that I had an invasive procedure that took me away from exercising for 6 weeks...all for worse-than-original results.  I prayed for acceptance of the situation and wow, it was difficult.  It took me a good 3 months to get over it and turn a corner.  But not without dealing with a few slips.  I started falling into bad eating habits because I was mad (anger is an eating trigger for me).  After being so moody and irritable, I slowly began to realize that eating poorly was not the answer.  And I knew that deep down inside.

I usually give 2 talks a month about success habits after bariatric surgery.  And magically one day I got a call to do more of then after being on hiatus from surgery.  It was just the jumpstart I needed to get back on track.  I also started doing hot powerful flow yoga and dealing with my negative emotions on the mat.  What a powerful experience for me.  I held myself accountable by getting back on the scale and getting my body fat retested.  I promised to view it as a new starting point and not beat myself up over it.  I had gained 8 lbs since surgery and gained 2% points of body fat.  I was bummed...but more motivated than bummed.  And whammo...2 weeks after getting back on track I broke my big toe.  3 months in a boot forced me to do non-running activities.  I believe God has a sense of humor and he wanted to test me...he knows I cannot stand gym equipment...but I worked with my trainer to devise creative workouts.  And I am stronger than ever right now.

So...the point is...yes I experienced a setback.  But I caught myself.  And I emerged an even stronger person because of it.  Keep things in perspective and be patient with yourself and your life situations.  It's okay to be disappointed but set a time limit on the disappointment and channel the disappointment into motivation and become a better version of yourself than you were yesterday!  

 

My Objective:     eliminate saggy and wrinkly skin on inside of thighs AND eliminate cellulite on back of thighs.  Eliminate  lumpiness in pair of skinny jeans and capris.     My Questions:   I want  to make sure my expectations aren't too high for this surgery.  Don't want to go through such an invasive surgery to realize modest improvement.  What do you define as modest improvement?     What type of thigh lift will help me to achieve the best results?  medial?  Outer?  Inner?     How tight will my thighs realistically be pulled?   Can the scar line be strategically placed on the inside of the thigh so it cannot be seen from the front or the back head when looking at me head-on?   Will the groin scar definitely be along the leg crease or is there a chance it could be below the leg crease?  what determines that?  Where would this scar be in relation to LBL scar?   Will you need to reshape my butt in order to get ideal contour or "seamless integration" of new thighs with my butt?   Will the incision and tightening along the groin create a misshapen mons area?   Are you planning on doing Lipo at the same time?   What would be the length and shape of inner thigh scar...straight line down inside of thigh or angled across front of thigh?  How far down inside of leg would the scar go? Is it reasonable to assume that if the scar goes all the way down the inside of my leg to the inside of my knee that even my "knee skin" will be tightened, or is there a limited area that can only be tightened with a scar that long?   How many Drains will I have?  When will they be removed?    Are you planning to use Surgical glue again?     When will my Post-op Follow up appointments be?     Do you recommend I wear a compression garment?  If yes,  when should I start wearing it and how long should I wear one?   When can I shower or bathe?  Get in a pool?   What is the waiting period before exercising again? Any chance I can start upper body weights sooner?  Need clarification on types of exercise I can do.  Running, weight lifting, yoga, etc.  What about heavy weight lifting...squatting, lunges, etc.   Release form for Shannon to start personal training again    What will I need to do to prevent the incision from splitting open?   How long do I need to avoid putting tension on my inner legs?  What is the best "posture and form" to minimize tension to the area?  I.e. shuffle walking?  Are shorts or pants better?  Minimize rubbing legs together?   Will I need to keep my legs elevated or reduce the amount of sitting time?  How frequently should I get up and walk around?   Is it reasonable to assume that if I healed well with my LBL scar that I will heal equally as well with an inner thigh scar?   Bathroom strategies with gauze in place          

This list is pretty similar to my LBL Recovery Checklist with a few differences:

 

PREP FOR SURGERY

pre-sort vitamins for the first 5 days to make it easy

Arnica Montana and Bromelain supplements.  I took them the 10 days leading up to surgery

good nutrition and exercise!  Being healthy definitely makes recovery easier!  Increase your protein intake, too.  

Stock fridge with lots of fresh veggies, fruit, high quality protein and the occasional "cheat" food :)

"Preparing for Surgery" guided meditation CD

Fill all prescriptions

Emend anti-nausea pill.  A wonder drug that prevents nausea after anesthesia.  Prescription only.

 

TAKE TO HOSPITAL

lip balm

glasses and case

toothbrush and toothpaste

driver's license 

eye drops

long tank dress (loose fitting) and flip flops to wear home

pillow and pillowcase (for under-leg support on way home)

 

RECOVERY AT HOME

Wheelchair transport company to get home from hospital

lift recliner with multiple positions.  I personally had to elevate my legs the first few days.  This felt the best to me.

small table next to recliner with basket to hold TV remote, lip balm, magazines, pain meds, IPad, cell phone and charger

pillows for placing underneath knees and calves

Comfy blankie to snuggle with

elevated toilet seat with handles.  Eases tension put on incisions.

compression garment.  Even if surgeon does not mandate it, wear it anyway.  Keeps pain and swelling down.

feminine wipes

Tres Semme dry shampoo.  Removes the greasies beautifully and removes odor.  Awesome stuff.

Assurance pads to sit and lay on.  My incision lines oozed the first 2 days and the pads absorbed them all.

Dial soap.  When I was cleared to shower (1 week after surgery...ugh) I stuck with an antibacterial soap to be on the safe side.

benadryl!  When the incisions start healing they will itch like crazy!  ARGH!

pineapple.  It contains Bromelain which speeds healing

arnica Montana.  I kept taking it with Bromelain to assist with healing.  

 

CLOTHES, ETC.

i stuck with a loose-fitting tank top and no underwear the first 5 days.  My legs were wrapped in gauze and ace bandages, and the drains prevented me from wearing underwear.  Once the drains were removed I switched into loose-fitting lounge pants and tank tops.  Because the incisions on the inside of the thighs are raised and almost rope-like, the sensation of the incision lines rubbing together between my legs drove me NUTS.  Wearing pants that put material in between them helped vs. wearing a nightgown.

CAREGIVER

find a very patient person.  The first 2 days following surgery are the most frustrating because your mobility is limited.  I dropped so many things on the floor and Mom had to pick them all up.  

Pre-sort your vitamins.  Makes it a lot easier.

 

 

Well, Dr. Krieger worked his magic for 4 hours in the OR for lipo on the outside and inside of my thighs and for excision of loose skin on inside of my thighs.  He ended up doing very, very light lipo on the back of my thighs because he explained the danger of overdoing it..overdoing lipo in the back will cause the buttocks crease to droop.  Well, I wanted no part of that so I agreed to trade off leaving a bit of cellulite on the back of my thighs to avoid dragging a droopy ass around Cleveland.  Easy choice!  Ha ha

Much of this experience is the same with the LBL...the burning, tight pain sensation is the worst.  I woke up shivering  in the recovery room with my legs wrapped in gauze and ace bandages and taped up with a drain in each leg.  The Dilaudid (hydromorphone) PCA in the hospital (Inova Fair Oaks in Fairfax,VA) made me pain free but also completely stupid like last time.  in a crazy way I love it.  I could not finish sentences.  I forgot what I was saying.  And reading the dining menu was way beyond my comprehension.  I think I tried to read it 4 times before my Mom grabbed it and started laughing and offered to read it to me.  And I itched like crazy (common side effect).  My Mom says I even asked her to tell me a story when I was trying to pee for the first time after the catheter was removed.  But hey, the Dilaudid managed my pain so I will not complain.  I elected to stay overnight in the hospital. And I would encourage everyone to do the same. It is easier on you and your caretaker and it ensures you get the best care immediately following the procedure. Plus, you can order hospital chocolate pudding with whipped cream and cherry Popsicles!  

As with my LowerBody Lift, I arranged for a wheelchair transport company to take me from the hospital to my Mom's house.  This included picking me up in a wheelchair in my hospital room and getting me into my Mom's place safely.  The major difference with the thigh lift vs. LBL was that I could sit with my legs dangling down at a 45 degree angle after the LBL but NOT after the thigh lift.  My legs had to be propped up in front of me.  The burning pain was too great to handle.   So the wheelchair guys elevated my legs in front of me.  Thank god.  When they got me home they carried me up a flight of steps in the wheelchair.  I closed my eyes.  I rented another lift chair recliner.  Thank god I did because of the needed elevation for my legs.  I lined the chair with an Assurance pad to catch leaks and got nestled in with pillows to prop up my legs above my heart.  That position was most comfortable for me and it kept the swelling way down in my legs.  But, it "transferred" the swelling to my lower back which was kinda funny.  I had a mini hunchback.  I catnapped and took my pain meds every 4 hours(liquid hydrocodone 7.5 is my preferred painkiller).  So, what am I wearing?  Ha, glad you asked.  A tank top that is two sizes too big with nothing on the bottom because I cannot fit a pair of pants or shorts over the drains, gauze, tape etc.  Yep, going commando people.  I wear a long nightgown once in awhile.  

Mobility is a challenge.  I am shuffling around at a very slow place and I am walking like I just finished riding a horse.  A really rough horse.  I get up every few hours to shuffle around to keep the blood circulating and to change position.  Oh, and the raised toilet seat came in handy again.  It eases the tension put on the inside of the legs for sure!  

I always say the pain level on a scale of 1-10 for the LBL was a 12.   No joke.  That sucked and it made me cry a few times.  I remember immediately after surgery looking at my Mom and saying, "What the f did I do?"  A thigh lift with lipo is a 7 in my book.  There are different mobility challenges between the two procedures but at least I can use my core and arm strength with the thigh lift. Incidentally I, would NEVER do my arms and legs at the same time.  Even if someone told me it was less expensive to combine them you will be seriously incapacitated.  Don't do it.  The big takeaway in all this is I have not found the pain level with the thighs to exceed that of a LBL.  Many people shy away from the thighs because of this common belief.  Glad I chose to test the theory and find out for myself!  

5 days after surgery and my drains came out!  They were only outputting 16cc of drainage per day and my surgeon felt comfortable removing them.  My legs are still wrapped in gauze.  But damn, it was **great** to look down at my legs and not see loose, puckery skin!  I do not have to wear a compression garment with the thigh lift.  The upside of this is I don't have to wear an itchy garment..  The downside is because there is no tight compression there is more swelling.  I noticed when he removed the bandages my legs hurt a bit more because he reduced the compression.  No worries... Pain meds to the rescue!  The occasional rubbing together of the raised incision line is driving me crazy!  I mean stir crazy.  Weird sensation.  So I switched to wearing cropped, loose fitting yoga pants.  Much better.  Ad I may have to wear mittens to bed because the incisions are starting to itch and I am starting to scratch the areas around them.  

As for what I am eating...I truly believe that food heals.  I follow a pretty strict Paleo diet everyday with the occasional vices of self serve frozen yogurt and spicy potato chips.  I have been taking Bromelain and Arnica Montana supplements and /or eating pineapple in addition to consuming 100g of quality, clean protein, 70g of fat and 70g of low glycemic load carbs.  That is my standard consumption even outside of surgery.  I did lower my caloric intake by 200 calories per day because I am not as active.  I also drink at least 80oz. Of water a day.  It is killing me to lay around and do nothing.  Ugh!  But I have to be patient and heal.

7 days out and I have rounded the corner.  I may be able to stop taking pain meds today.  Woot.  I am still swollen around the hips and buttocks(weird) but I am rocking a pair of shorts today for my brief shopping outing with Mom.  I finally showered for the fist time yesterday (God bless clean running water).  After using all that dry shampoo in my hair it took a while to produce a lather with regular shampoo.  Kinda funny.  It was nice to finally be officially clean instead of taking sponge baths or using wipes all the time.

11 days out and I started wearing a compression garment.  I forgot how much of a difference it makes.  Damn, I wish I would have worn one as soon as possible after surgery.  The pain is not as great with it on.  it is actually just a pair of Spamx.  i did not feel like busting out the old school, industrial compression garment I wore after my LBL.  When wearing it I have wider range of motion.  And it keeps the swelling down.  I have a trouble spot on the inside of my right thigh (puffy) that I am hoping resolves itself.  Surgeon told me to be patient with it.  

So, after having a lower body lift and thigh lift with lipo, am I planning to do any more procedures?  Yep...removing the loose skin around my armpit and having a boob lift.  Years ago I gave my Mom a magnet with two elderly ladies on it.  it says, "When did a 36c become a 32 long?".  Hilarious and oh-so-fitting!  

August 2nd...it's on the books.  Hooray.  I am going back to the absolute most artistic Plastic Surgeon in the world, Dr. Krieger, for a thigh lift.  On the whole, my thighs aren't as bad as the average post-massive weight loss patient.  But to me, they bother me, and I am willing to deal with a scar on the inside of my legs in order to have loose, wrinkled skin removed from the inside of my legs and the cellulite removed from the back.

I have been joking that, since turning 40, I gotta be able to wear a pair of 2" inseam booty shorts.  ha ha  All kidding aside, I do wear skin tight capris to work out in, and I HATE the dimply/wrinkled skin on the top of the back of my legs.  I work out so much and nothing will ever fix it unless I have surgery.  I feel like once I have my thighs done my body will be proportionate.  Most people think I am crazy because they think my legs "don't look that bad."  But...what about, "hey, I think your legs look great!"  I want to be able to confidently wear a pair of shorts without my wrinkled skin hanging out.  I am slightly worried about how MUCH of an improvement it will be for all the pain and discomfort.  I will discuss this with my surgeon on July 30 during my final consult.

 

 

Each month I am blessed and fortunate to speak to pre-op patients at the Cleveland Clinic.  I enjoy meeting each and every one of them to share my knowledge and experience and answer their questions.  Sometimes I get emotional in front of the group.  On the outside I look lean and muscular...but underneath it all I still have my insecurities, and I still battle food issues. 

I think it's important for us WLS patients to share our experiences with each other.  We can always learn from each other.

The things I try and underscore and the most frequent questions I get are:

1.  Start practicing the post-op principles BEFORE surgery (like for 3 months).  These include not eating and drinking at the same time, getting in daily exercise, getting treatment for bingeing, and timing your meals so they last at least 15-20 minutes.  I truly believe this helped set me up for success, and it was one less thing I had to learn after surgery.

2.  The irony is...you WILL still think about food all the time.  This time, it's about managing your protein grams, water intake, and nutrition.  Whereas before you wondering whether to eat at Mc Donalds or Taco Bell, now it's about fueling your body and being kind to yourself.

3.  I'm often asked if I ever thought I would binge again or if I ever feared regaining weight.  The answer is NO.  When I think back to how bad my feet and back hurt, how swollen my ankles were from daily activity, how self-conscious I felt just walking around, how I was constantly sweating or hot, how I was moody and irritable from eating high sugar/high carb foods, how fearful I was about fitting into an airplane seat without an extender, there is ABSOLUTELY NOTHING IN THE WORLD I CAN PUT IN MY MOUTH TO MAKE ME WANT TO GAIN WEIGHT AND GO BACK TO "EXISTING" LIKE THAT.  Notice I used the word, "existing" and not "living."  

4.  Does having weight loss surgery mean you cannot eat your favorite foods?  Not at all.  BUT, I do have 2 rules.  The first is I will not order pizza to my house for delivery.  Can't eat it unsupervised.  I know no limitations with pizza.  The second is I cannot have macaroni and cheese in my house.  I still enjoy cake, cheesecake, jelly beans (my weakness) but only in a smaller quantity and less frequently.  Fortunately or unfortunately, I can eat sugar.

5.  Do I try and hide my past?  Not at all.  I accept the poor decisions I made health-wise.  It turned me into a completely different person.  However, through the process of being obese I learned a lot about myself--good and bad. 

So, after busting balls and getting into the best shape of my life, my thighs still suck.  It's so disappointing to know that, no matter how much Crossfit or running one does, nothing will ever tighten loose skin.  So therefore I am planning on getting a thigh lift at the end of August.  It's time to bid adieu to loose skin and cottage cheese thighs in favor of tighter skin.  And did I mention having the ability to whittle my middle and new shapely legs into 2" inseam booty shorts?  Kidding.  But geez that would be nice to wear short shorts and not have any junk hanging out of them...

About the eye lift...crow's feet.  Why didn't someone tell me in college--when I was jumping in a tanning bed 5 days a week--that I would get awful crow's feet around my eyes and crepey skin under my eyes?  Ugh!  It's outside the fixable realm of Botox so I am going to explore an eye lift.  But I don't want to look permanently surprised...I just want to get rid of the crepiness. 

And of course my surgeon of choice is Dr. Mitchel Krieger.  He was the miracle worker (actually artist) who performed by lower body lift and butt augmentation.  He is outstanding. 

I thought it would be helpful to assemble a list of things I found to be essential for preparing for plastic surgery (lower body lift) and for the first few days after surgery:

Emend anti-nausea pill taken 2 hours before surgery.  If you have a problem with nausea after anesthesia, this things works wonders.  Prescription only so ask your surgeon about it.  It works for 24-48 hours.
Fill all prescriptions ahead of time.  One of mine needed to be special ordered.
Know which painkillers work for you and request them from your surgeon.  I used Liquid Lortab which is what I took after WLS.
Full-time, patient and loving caregiver.  You really are incapacitated the first 48 hours after surgery and need full-time care.
Slip-on shoes or flip flops.
Pain pump in hospital that allows you to release pain killers into your system every 10 minutes.
On-Q pain pump for home use.  Sends lanacaine (I think) through body for additional pain relief.  Ask surgeon about it.
1-piece short or full-length zippered/snap nightgown.  This is what I wore home from hospital and around the house.
5" raised toilet seat with side handles.
Dial soap.  Great anti-bacterial soap.
3-way lift recliner.  Totally a lifesaver.  I rented it through a medical supply company.
TresSemme or Pssst! dry shampoo (found at CVS).  It absorbs oil (and odor) for those days you cannot wash your hair.
Arrange for medical transport (wheelchair transportation) from hospital to home.  Money well spent!!!
Move all groceries to bottom shelf of cabinets and top shelf of refrigerator.
Lightweight cotton blanket and fitted sheet for sleeping on lift recliner.
"Preparing for Surgery" guided imagery/meditation CD by Martin Rossman.  Really helped me relax and channel energy.
Assurance 24x36 underpads (found at Wal-Mart) to lay down and catch leaks on lift recliner or in bed.
Hoodie and yoga pants 2 sizes bigger.  With swelling, your normal clothes will not fit.
Multiple pillows for propping up and supporting legs/knees/head.
String/lanyard to wear around neck and pin drains to for showering.
Cotton/spandex stretchy tank tops (Target or Old Navy) to wear underneath binder once drains are removed.
Triple thick 3x3" gauze to change dressing.
Hydrocortisone cream and Benadryl allergy pills to help with itching.
Breakfast/TV tray for using laptop while sitting/laying on lift recliner.
Basket next ro recliner to hold remote controls, lip balm, cell charger, etc. so you won't drop anything on the floor. 
Antibacterial body wipes (found at CVS).  Great for freshening up.
Stool softeners.  I took them daily after surgery until I had a BM.
Bromelain (pineapple enzyme) chewable tablets.  Great for speeding healing.  Take 5 days before surgery and after.
Individual Ziploc bags containing the first 7 post-op days of vitamins and other meds.  It was so easy for my Mom this way.
Pillow for sitting on in the car to get to post-op appointment.
This did not happen to me but I couldn't imagine being on my period AND undergoing this surgery.  Make sure you schedule your period when Aunt Ruby isn't visiting :)

I hope this helps!  Here's wishing you a stress-free preparation period and speedy recovery,
Jen

 

For Plastics!  I am officially scheduled for a Lower Body Lift and Butt Augmentation on February 22 with Dr. Krieger in Fairfax, VA.  After receiving a consultation from Dr. Hurwitz in Pittsburgh and knowing unequivocally he was NOT the surgeon for me, I kept looking.  I couldn't find anyone at the Cleveland Clinic who impressed me...and then voila, I found Dr. Krieger.  After reading patient reviews and meeting with him twice, I knew he was the surgeon for me.  Terrific knowledge, sense of patience, and his willingness to let me ask as many quetions as I wanted all let me know he would be a solid choice.  I'm going to spend the entire recovery period down in Virginia at my Mom's house.  She is a saint for offering to take care of me.  I'm in prep mode now--packing up DVDs and books, comfy clothes, and a few protein shakes.  I am very excited to have this done but a little nervous about the pain level.  I tend to be someone who uses a hammer to kill an ant (if you know what I mean) so I'm fearful I will get extremely grouchy if my pain gets out of control.   All this aside, I'm listening to a positive affirmation CD specifically for pre-op patients and it's going well.  Having a positive attitude is more than half of it!  Onward and upward and here's to an improved body :)