What am I getting myself into???

I'm new to this part of the forum, but not to OH.   I had RNY in Sept of 2010 and hit my goal weight in Sept of this year and have been pretty stable since. I just met with a PS on Thursday and we're discussing lower body lift, boobs and tummy tuck.  He said I'm mostly just excess skin, not a lot of muscle work (held up his fingers about 3-4" apart and said that was all he'd have to tackle on my lower abs).    Since it was my initial consult, I really didn't know what questions to ask.   I plan to go back one more time with my hubby and would like to have the surgery done in late Feb after we return from a dream/bucket list trip.

I went into the RNY very well informed which really put my hubby at ease. This surgery is completely elective, there's no medical necessity for this - just plain old vanity to be completely honest. I've been working out with a personal trainer for about 4 months now and plan to step it up to 3x a week (up from 2x currently) in January to really prepare for the surgery.

I've been trying to delve into the various current threads and am wondering how long does the swelling tend to last?   How long from surgery until you felt you looked "normal" again?  Any regrets?  What questions should I be asking?   What was the one thing you wish you knew then that you know now?

Any help will be greatly appreciated.   Thanks for your time!!!

 I wish I were more assertive with my surgeon. I think a lot of people here can say the same. Some plastic surgeons have a real god-complex and will do what they want to do regardless. They are busy or don't like aftercare or I don't know, but there have been times when I (and others) have known that there was something wrong, but was ignored by the surgeon who said "jus****ch and wait, things seem fine" and then things were NOT fine. It's hard to be assertive with doctors for some people. You know your body, if you think something isn't right, insist on being seen and getting investigated. 

One thing that has been helpful for me has been taking pictures of myself every 3 days or so. When I feel discouraged about how slowly I'm healing, I can compare the pictures and it reassures me of my progress. Also it ended up being important because I had bleeds in my breasts at 2, 3, and 5 weeks post-op. We were able to figure out exactly when I got my hematomas based on comparing the pictures (I didn't notice it myself at the time) and we readjusted the timing of my TT accordingly. It can help you spot changes in your body that might signal complications, like extra swelling or redness or bruising, stuff you might not notice as different otherwise.  

There are others here to have had LBL so they can tell you about their individual experiences but even so, it's such a person to person thing. Some people bounce right back, others (like me) have very slow and arduous recoveries. I don't think it's necessarily directly correlated to physical fitness because I've been a competitive cyclist and my recoveries have been horrendous despite being in racing shape going into it. Some people are just better at handling surgeries I guess. It also doesn't predict complications. Unless you're extremely lucky you can expect to have some sort of complication, whether it's something small like a tiny section of open incision, or something bigger like seromas, hematomas, bleeding, or god forbid, blood clots (I'm looking at you, Bubba!). It's good to hope for smooth sailing but realistic to expect something. That way you aren't totally shattered and devastated when that something does happen, and you're prepared to deal with whatever comes up. And it is worth it, in the end. I think most everyone here would say even with the complications their surgeries were worth it and they'd do it again.

For my breast lift/augmentation I felt about 85% at 2 weeks post-op. For my TT I now feel completely back to normal (except I do get tired more easily) and I'm 5 weeks out, but can't exercise for another week. I was extremely swollen for 2 weeks, and now I'm swollen to a much lesser degree towards the end of the day but I look pretty normal. How long it lasts varies, some people say 4-6 months others say up to a year. Regardless, it's totally worth it. 

When you're looking for a surgeon I think it's really wise to ask them specifically how many WLS patients they've worked on. Because we have unique challenges and there are different considerations. Our skin is much less elastic. There is typically a lot more cutting because we have so much more extra skin. The surgeries are longer. We need different medications. Our nausea has to be much more tightly regulated. We typically require extra drains. Sometimes our drains are in for much longer than normal. The risk of complicaitons is higher. So it's important that you find a surgeon who is sensitive to all of these issues. 

I didn't, I went with a mainstream (but still very skilled) plastic surgeon and when things started going south, he was caught off guard and didn't know what the heck to do with me because he so rarely had the types of complications I was having. If I had to do it over again I'd go with someone who had more experience with WLS patients. I still love my result but I think I suffered more than necessary. 

Also get a list (in writing!) of fees for revisions and complication treatments. Things such as draining seromas (some offices charge for it, others don't), re-inserting a drain, revising your scar, etc. Get an itemized list of charges, so you have a picture of what you'll be paying for. Anesthesia, OR charges, surgeon's fee, etc. 

Lastly, spend *at least* the first night in the hospital. Suck it up, pay for a room. It's worth it. These are big surgeries, and a lot of plastic surgeons these days have their own surgical suites where they do outpatient surgeries. Maybe average people would be ok having a TT as an outpatient procedure but we generally aren't. The first 24 hours is the diciest because you've got anesthesia in your system, you are trying to figure out how to keep your pain under control, and you've been gutted like a fish. I should have been in the hospital, they would have caught my hemorrhage that first night. Oh well, you live you learn. 

p.s. stool softeners. Can't stress that one enough. they are your new best friend. 

I remember valium.  They claim it can interfere with your memory but I still remember it...go figure.  Haven't been able to get anything for pain or to relax since my pain problems began after a gone wrong buttock lift 10 1/2 years ago ,that no one (except me) seemed to admit went horribly and  painfully wrong.  Recently though a neurologist prescribes for me 10 as needed hydrocodone pills at a time.  I try somehow to make them last at least 2 months.  I live in the Midwest and my experience is doctors are terribly reluctant to give meds for pain here.  Anyway that's why I don't post on here any more. When I used to get  overwhelmed with a screaming pelvic nerve endings  pain bout I would vent on here as a distraction mostly.  Everbody got and is still sick of me.  I guess you could say I made there crotch crawl because that what I ened up having after plastic surgery "crawling crotch"  My hydrocodone has cured me from posting on here. Yep stuff can go wrong  Murphy's Law can and does rule a lot these days and one needs to take pause and consider and  "beware of witty inventions" more than ever. Just ask Bernie Madoff's former clients. Steve Martin's movie "the Jerk" contains a good lesson on why not to wear the  anti-slip eye glass braces.  He wrote a good short story too called " The Cruel Shoes" that I wish I would have read before I had plastic surgery.  If it ain't broke why fix it?  should have been my motto but it wasn't at the time. Dang it!

Thanks for the tips, especially the one about taking photos every couple of days.   I'm a big fan of before & after photos in general just because sometimes you need to look back to see how far you've truly come.

I'm a big fan already of stool softeners.   With all the calcium I have to take post RNY, they're a part of my daily regimen. 

The doctor I'm looking at has worked "with" my RNY surgeon for about 20 years and does a lot of bariatric patients.  In fact, the photos he should me were the results of other bariatric patients.  So I feel good about that.  Also, my friend the operating room (OR) nurse has worked with him in countless surgeries and said his work is exquisite.    The woman I go to for bioidential hormones is a former breast surgeon (cancer patients) and I learned they've worked together extensively over the years.  I'll see her tomorrow and get her opinion as well.    While I was waiting for my appointment, another patient offered how thrilled she is with is work, although she had a breast reduction.   She said she checked out 6 other PSs locally as well as in Cincy & Columbus and said Dr Rigano was the best pick for her.

He also spoke at our WLS support group a few months ago and showed a lot of photos of his work.   He admitted that PS used to be really notoroious for doing what they thought was best instead of what the patient wanted.   "Want to be a C cup - nah, you can handle a D"  type stuff used to be the norm, but he said they've learned a lot.

So I'm not sure I'll check out other surgeons given the ringing endorsements people I know and trust have about this one.  But I just don't know what I don't know so I'm thrilled with any tips & tidbits you guys can offer.    I've always had an easy time with surgery - I go in with a great attitude of everything working out perfectly and that's pretty much what I get.  I don't have problems with anesthesia or pain meds either.   So I'm not fearful of this surgery, just want to be equipped with all the knowledge possible ahead of time so I can prepare accordingly!

For me, I felt almost normal once the drains came out. I healed very quickly. Even my plastic surgeon was shocked at how well I healed. Even on blood thinners because of a lot of blood clots in my leg. I have very minimal swelling but I just had a panniculectomy. I have a great surgeon tho and he did tighten the lower stomach muscles and even lipo'd and lifted the mons area. He took of eight pounds of skin, but I had a lot. From losing over two hundred and sixty pounds.

Make sure you keep your protein levels up so you can heal as quickly as possible.

My panniculectomy was october thirteenth. So not quite two months out and I feel great. I look great too, well my lower stomach does anyway...lol. He did a great job and I look better than I ever have in my whole life. I now weight less than I did in high school.