Realistic expectations?

Hey y'all!

I am down 100 pounds from my highest weight, and my weight has been stable now for about 12-18 months.  I don't feel like I'm likely to lose any more weight, and I'm feeling like I'm ready to start down the path towards "finishing the job I started."  I'm not at my goal weight, but I'm at peace with that.  I'm way better than I was at 320 pounds!  I'm never going to be skinny, and that's fine, but I would like to feel more comfortable with the weight I am.  I've been working out with a personal trainer for about a year, and have seen no visible results.  I feel healthier and I have more stamina, but the exercise has done nothing to change what I'm seeing physically.

In particular, after giving birth 5 times and also losing 100 pounds, I am carrying around a large grade 2 panniculus and a fair bit of abdominal fat.  My belly button is just above my pubic bone :(  I'd love for that all to disappear, and no amount of exercise is going to make that happen.  I don't really care so much about the cellulite on my butt and thighs.  The floppy arms are a little depressing, but I can hide those most of the time, and it isn't that big of a deal.  I'd love to get my breasts lifted and possibly get a reduction, but a good-fitting bra can do wonders, and while I'm not thrilled with how the girls look when I'm naked, I think I like them better than I would if they had scars.  So, I'm on the fence about doing anything other than the tummy.

I am a midwife, and I am a partner in a very busy practice.  We just opened a birth center last summer, and my life is very full.  I have 5 children and 2 stepchildren.  The youngest is 5 and the oldest is 22.  I have good support at home, and my husband loves me no matter what my body is like.  So, the surgery is all about helping me feel better.  I'm not doing it for anyone else.

As a midwife, my work can be very physical.  Doing prenatal and postpartum visits can be pretty laid back, and I have students who can do a lot of the getting up and down during appointments.  I could pretty much sit on the couch and chit chat with people during appointments.  My clinic days can be long, sometimes 12 hours straight with nothing more than a 15 minute break here or there.  I could probably get longer break times if I were to rely more heavily on my students, though. 

But, at a birth, I would be bending over and leaning into a birth pool, or helping a mom in and out of the pool or bed, or putting some muscle into helping a stuck baby get out.  In an emergency, the work can be very physically demanding, and there is no way to know when there will be an emergency.  So, I can't rely on my students in those types of situations.

My biggest concern for this surgery is the recovery time.  For those who have had a tummy tuck/panniculectomy, how long do you think I'd have to wait to get back to doing appointments?  How long until I would feel OK to be at a birth?

Also, any recommendations for surgeons?  I am OK with going to Mexico, Brazil, Argentina, etc., as well as staying locally in the DC area.

Thanks in advance for your help!

Kim

 Congratulations on your weight loss and on your decision to start the PS journey.  

I completely understand your reasonings and think you have an excellent attitude for PS.  Sometimes folks expect themselves to look like 20 year Sports Illustrated Models and are very disappointed.  I felt deformed with my stomach hanging down so low and was uncomfortable shoving all that skin and tissue into jeans (the shoving was ok, it was later if I tried to eat while sitting that was a big problem).  

I had a LBL and BL on Nov 8, 2011  and was thrilled to see a normal person staring back at me from the mirror.

As far as recovery time goes, everyone is different. I know this answer will frustrate you but unfortunately it is true.  Many (maybe even most) of the posters here seem to do exceptionally well.  They feel pretty good and are back at work in 2 to 3 weeks. They report being easily fatigued. I don't think many of those posts are working as many hours as you do in day.  Some of us take alot longer.

I am 2 months out and have had open incision complications and seromas.  I still can't really bend too much or lift anything more than 10lbs while trying to get these incisions to close.  In the last week my energy level has improved and I can stay awake all day. Before that it was falling asleep in the chair for an unplanned nap and bedtime by 8pm.

My diet and lab work looked excellent pre-op and I followed all the rules post-op and had an amazing surgeon in Houston.  I should have healed well and had no issues. But instead I am in slow heal land.

Most likely, you will heal well and be able to get back to a restricted work schedule quickly.  I read about people here who attended formal dances, weddings, even a marathon within 2-6 weeks.  But things might go wrong and it could go slowly. Just go into the PS informed and mentally prepared.

If you are wondering, I would do the surgery again.  This recovery is slow but the results will be there to enjoy for the rest of my life.

Hello! Like Raven said above me, recovery is different for everyone. I too had a hiccup in my recovery- fat necrosis that developed after about a week (not common). The first few days after surgery I was in a lot of pain and very swollen (the necrosis slowed my healing) but by the middle of my second week I could get up easily and walk around, didn't have my drains and felt more self sufficient. At 3 weeks I was still very tired and it was really hard for me to be active for a long period of time so I still needed help. I am currently 2 months post lower body lift and feel SO much better than I did before- my energy is back (well... most of it), my incision and necrosis are healed and I no longer have any pain. I probably feel well enough to deliver a baby... minus the fact that I don't how. I hate trying to guess on healing time for someone else but I think it would be ideal to take at least 2, maybe 3 weeks completely off work if that's possible. There is no way I would have been able to return to such an important job such as yours within 2 weeks of my surgery- I was too sleepy, too uncomfortable, too swollen and too groggy from being on pain meds and being fatigued... not to mention I spent the first 4 days not being able to stand without help. Sitting on a couch after 2 or 3 weeks without a lot of labor would probably be doable (just try to get up and move around whenever you get a break to help with swelling) but as far as when you could return to delivering babies I think a few more weeks. 

As far as surgeons, I only have experience with my surgeon, who I absolutely love and would literally trust to take me completely apart and put my back together again. I was put in touch with him through my weight loss surgeon because he specializes in post wls reconstruction and he is honestly one of the best and then some. His name is Robert Jetter and you can read my review for him on his OH page and you can see my results thus far on my profile. The reason I'm telling you about him is because you're in DC and even though New York City is not exactly local, it's a lot closer than another country. 

If I could do this all over again, I wouldn't change anything.... except perhaps buy a recliner chair for my recovery (which others swear by). I went into my surgery understanding there were risks and that I'd be in pain but none of it was actually terrible enough for me to have wished I could undo it.. My necrosis wasn't my surgeon's fault, just how my body reacted to trying to heal after such a big operation and loosing a lot of fat.... so I really can't blame anyone or change anything. 

Anyhoo, happy holidays and congratulations on your success. I hope this was helpful. Good luck with everything!!! 

First I'd like to congratulate on the weight loss, I know how much better life is without the excess weight being there. Having lost 285 pounds I know how you feel about being healthier and increased stamina.

They others were right in saying it seems like most people do heal fairly well and seem to get back to some sort of activity, work, excercise even a few weeks out. I had some stitiches open up on me in a couple spots and almost ripped my newly replaced nipple off as well, and I developed blood clots 15 days out and got a Pulmonary Embolism in my Lungs. I spent 8 days in the hospital on blood thinners and still have to take them for a few more months. Need less to say none of this was in my plans at all, I had walked a 1/2 mile the day before and was feeling pretty good to that point.

It sounds like work really hard in a day probably harder than I do. But know one can predict how you will recover from something like this. I had a Extended TT, Hernia repair & Gynecomastia and had 15 pounds removed in the procedure. Granted this was a lot but certainly not underheard at all on this board. The thinking being the more surgery you have done at once with one recovery is very valid cause it's cheaper and less to do later. I wish I would have had my arms done or a LBL done since I spent all this money looking back but just happy to be alive. If your only concern is the TT then the less you have done, the cheaper it is, the quicker the recovery, less chance for complications that's the thinking anyways.

I don't own my own business but my 2 cents is if you have this done plan for the worst hope for the best. I was lucky I got off work 6 weeks for the hernia repair, never would have gotten 6 weeks to make myself look pretty. So I had just enough time to recover and go back to work and my boss put no expectations on me when I came back so I was lucky. There are a few people who had plastics done and they talk about it being 2-4 months to get their mogo back before they are in full swing again, it took me about 3 months myself.

I would talk to your PS for more info but only you can decide what all you want done. 

I wish you luck,

Bubba 

I had an LBL, BL, arms and medial thigh lift, then 4 days later a full neck & face lift.  I took 8 weeks off and it still took another month to get back a little of my energy.  I don't have a taxing job, mosting sitting in front of a computer screen. 

I went to Dr Sauceda in Monterrey Mexico and will go back in Jan '13 for an upper body lift.  I don't have a model body, but I had realistic goals to have the panni removed and the bewbies up where they belong.  I'm very happy with the results.  The scars on my breasts don't bother me as much as putting a smile on my face when I see my nipples up where they belong.  Dr S did do a reduction on my left as it bigger than the right and now they look normal and the same size.

I will say that weigh loss bumped up my self-confidence, but PS shot it over the top.  I'm so glad that I got everything done at once.  I didn't think I'd want the UBL, but Dr S had told me that it would help.  I couldn't see my back so... But, after trying to wear cute little tops and having them roll from the loose skin...

I do love my new body.