My surgery and recovery

Kim Pekin
on 6/21/12 12:44 pm, edited 6/21/12 1:05 pm
Hi Everyone:

I had an extended abdominoplasty with an anchor incision, as well as a breast reduction/lift on April 25, 2012.  I'm pretty pleased with the results, but my recovery has been complicated and difficult so far.  I'm starting to see the light at the end of the tunnel, but I still have a ways to go.

The surgery itself went very well, as did my initial recovery.  Everything was good, until about 2-3 weeks postop.  My body did not like the vicryl sutures, and it kept pushing sutures out along the incision lines.  This meant that I had large areas of incision that stayed open.  Once one area would heal, another area would pop open.  I felt like I was chasing my tail with it!  Just in the last week, I've finally healed most of the lower and upper abdominal incisions (except the big problem, explained below).  I still have a couple of spots around the belly button that haven't healed yet.

I have some areas under my breasts that are still open and leaking a small amount of blood/serous fluid, so I have to wear gauze under my breasts even now.  So much for a 2 week recovery time for the breast reduction.  I'm still having to wear sports bras, and am longing to be able to wear something pretty.  My breasts look pretty good, but they are nothing like I thought they would be.  I went from squeezing myself into a 42DDD to what I think is a C/D.  I told my surgeon that I wanted to be a D, and that he should err on the side of too big, but he said that you can't guarantee a particular size with a breast reduction like you can with augmentation, and that he wouldn't know what I'd end up being, but that he'd try to have me be a D.  Not sure if he hit the mark there.  They're much smaller than I had hoped, but I am adjusting. In clothes, they look great.  I think maybe I just need time to adjust mentally to the new breasts.

With my tummy tuck, I had an area where all of the planes came together, just above the pubic bone, that developed a seroma and opened up.  It started as a silver dollar sized opening that was open all the way down to the abdominal wall.  It is healing by secondary intention.  I've had to pack it with soaked gauze twice a day since mid-May.  I've had weekly follow up with my surgeon, and things are finally starting to improve.  In the last couple of weeks, the opening has shrunk considerably, now about the size of a quarter, and is not as deep as it was originally.

To top it all off, the pain meds gave me horrible constipation, which caused significant hemorrhoidal bleeding.  I won't go into the gory details, but it was pretty horrible.  I became terribly anemic, and ended up having to have a transfusion of 2 units of blood about 3 weeks ago. I've been taking huge amounts of iron since then, and my H&H has returned to the normal range.  When I got the transfusion, my hemoglobin was 7.2.  Now, I'm almost 11.  Now that my anemia is under control, my healing has accelerated.

I knew there were risks with this surgery, but just like everyone else, I never imagined I would be the one who would have problems.  I've had other surgeries before and never had any complications at all.  I've always returned to work ahead of my estimates.  With this surgery, I anticipated a 3-4 week recovery.  It has been 8 weeks, and I'm just now starting to try to come back part time.  My work can be very physically and emotionally exhausting, and I'm not up for it yet.  With the open wound (my "hole" as I call it), I can't do a lot of what I need to do at births.  Considering I have open wounds under my breasts, as well as the hole in my tummy, I can't do water births and risk bacteria getting into those wounds.  Fortunately, I have student midwives who can do all of the baby catching, but since I never know when I'll have to jump in and take over, I can't feel comfortable attending births until those wounds have all closed.  Plus, my energy level has not returned to normal, and emotionally, I'm still a bit of a wreck.  All of the difficulty I've had recovering has led to a real struggle with depression and anxiety.

Would I do it again?  Yes, absolutely.  Would I choose the same surgeon again?  Yes, absolutely.  I got a great result, and I have had excellent care with his practice.  My issues, I believe were largely due to the anemia that developed late May.  The suture issue is something that I know many people struggle with, so that's not my surgeon's fault.  I'm still planning to do my brachioplasty with him in November, and he plans to use different suture material for that surgery for me.

I had my weight loss surgeries in Mexico, and felt really comfortable with that choice. But, after what I went through with the plastics, I can't imagine what I would have done if those things had happened and my surgeon was in Mexico.  That would have been an absolute nightmare.  I'm so happy I chose to have my surgery done close to home.  If you're considering doing your plastics abroad, please think long and hard about how you will manage complications, if they happen.  I'm not trying to be all doom and gloom, but my recovery was nothing like I expected, and having to deal with that with my surgeon being in another country would have been extremely difficult.  I had absolutely no health issues, am only 46 years old, and have had uncomplicated surgeries with quick recoveries in the past.  There is no way I could have anticipated the troubles I've had.

Anyway, one of these days, I'll post pics.  The transformation is pretty amazing!  I love my new body.  I just want to be done with the recovery already!!!

One question I have that I keep forgetting to ask my surgeon... is it normal to have lower abdominal pain from hip to hip this long after surgery?  It hurts every time I go from sitting/lying to standing. The pain is low and runs across my pubic bone.  Anyone else have that?


  
Banded 8/20/05, Lost 80 #, Regained 40#, De-Banded & VSG 8/13/09
PBJ
on 6/21/12 1:49 pm
I am so sorry to hear all of the struggles that you have had to go through but the fact that you would still do it all over  again says alot!  And so glad that you can now see the light at the end!

Enjoy that new body of yours...you have certainly earned it!

Patty
My weight loss journey                                                    
PluggingAlong
on 6/21/12 3:04 pm
 I hope you don't feel like I'm hijacking your post but I just wanted to say that your post really spoke to me - especially the part about not expecting complications. Like you, I have bounced back from multiple surgeries (laparoscopic oophetectomy, 2 c-sections, hernia repair with mesh [failed], VSG) faster than expected with little pain and easy recoveries. I had abdominal wall reconstruction/abdominoplasty and removal of the mesh and adhesions on April 27. Everything went better than expected and because I had lost so much weight the surgeon was able to pull the flaps of my abdominal muscles over themselves with no tension and he didn't even have to use mesh (if you don't know about this it is an incredible outcome!). They told me I'd be in the hospital 7-10 days and I was out in 3. Felt great and was healing well - or so it seemed.    After a week or so I had a wound (I also called it my hole) at the intersection of my incisions and I was getting fevers over 101. Both my drains simultaneously lost suction becsuse I was draining so badly from my hole. I was on bed rest for 2 weeks and packing it and more antibiotics and no improvement. Finally my surgeon said he needed to operate again and debride the infected tissue. He said he thought it would be about an hour surgery. Once in surgery they realized they would have to completely open both incisions and three and a half hours later I woke up with a wound vac and on bed rest in the hospital for a week. Turns out I had gotten a rare bacteria (probably hospital borne) and so they were finally able to give me the right antibiotic. Once home I was on bed rest again for a little under 2 weeks. Now 4 weeks out from the second surgery (which was much more painful than the first) I am cleared for normal activity with periods of rest and all of my issues (still have special dressings on parts of my horizontal incision) are superficial and I'm hoping to be cleared for swimming and exercising on my next visit. I ended up not working for 6 weeks and my job has me at the computer from home so I was really down for the count! I am still recovering from being on bed rest. A few hours of regular activity wipes me out and I am still very swollen.    That all being said, tonight is the first night I am actually optimistic that I'm going to love my new tummy and not having the abdominal issues (I had complete loss of abdominal domain) and pain and lack of activity and many near misses with incarcerations. Before the surgery I had a laundry list of plastic surgeries I wanted to have done when I reached goal and after this experience and up until tonight I had decided I would never have another elective surgery. The NP at my surgeons office promised me on Wednesday that I would get over what happened and be truly happy. Just 2 days ago I doubted that! Tonight I am starting to think she may be right. Even with this awful experience I will get over it and move on. Sounds like you will too! The same heart and strength that always served us well in the past is still working for us. We will recover and love our new bodies (I can SO relate to the feeling of being SO over "recovering")!    Keep healing and feeling great! We have been through so much - it makes us stronger!
    
Consult Weight-323 / SW- 312 / CW-173/ GW-155
Starting BMI: 65.2 Current BMI: 34.9
 
godzilla
on 6/21/12 3:27 pm - Israel
I too can relate on much of what you wrote!
My worst surgery pain-wise (c-section, 2ankle surgeries; SRVG,VBG-both WLS and incisional hernia repair before RnY: my TT and then gangrene and dehiscence -my debridement of such a small area was by far the most painful of all! And I am still waiting in reschedule if my Breast Lift and scar Revisions surgery!
Swelling comes and goes but hip-to-hip pain - my surgery was last August and the debridement was mid-September to which I still at times have pain but not all across the incision, just little patches. I do, however still have numbing on my left thigh and it can itch and I can scratch it but I don't necessarily feel relief from said itch.
Check with your OS too about the lingering/continuous pain.
Mikimi in Israel
LoriD70
on 6/21/12 10:29 pm - Fort Lee, NJ
Thank you for sharing your story.  I'm so sorry you went through all that and I'm so glad you're finally seeing the light at the end of the tunnel.  Despite all you've been through you have a great attitude which I'm sure played a big part in you getting you to a better place!
Tess145
on 6/22/12 12:04 am - Senatobia, MS
I am so sorry for all that you have gone through but that you would do it again is remarkable.  I hope the light at the end of the tunnel is very bright and that you will start getting the full enjoyment of what you set out to accomplish for yourself.  This is the very reason that I decided to have my surgery close by, just in case there was that chance that something could go wrong.  I am five weeks out and so far no major complications.  I hope you continue to get better each day on your journey.

 Tess

Starting Wt 306; Losing Wt 155; Goal Wt 145: Regain Wt 225; Current Wt 157
PS:  FDL Tummy Tuck, Hernia Repair 5/17/12, TT Revision, Butt and Thigh Lift 4/18/13
      

JustLookingToo
on 6/22/12 4:28 am - AL
Wow...sorry about all that you have been and are still going through. I know it will all eventually become a distant memory, but I hate that all of this has happened to you. I need to quit complaining about the two drains that I have, and appreciate that my surgery has so far been free of complications. 

I wanted to say that you are very on point with your advice that others should think very carefully about going out of country, or even to a U.S. surgeon who is far away from their home. I had a full face lift in Costa Rica in March, and everything went perfectly. Before I went, I was well aware of possible complications, and of the fact that a facelift has very few complications that would occur after the 14 day period that I was to be in Costa Rica.

I had a tummy tuck on June 7th, and decided to have it in the U.S. with a local surgeon. I was well aware of the fact that a tummy tuck carries the risk of complications that, like with you, can come on several weeks after surgery and can persist for many weeks or months. For complications like those, a person needs to be close to their surgeon. 

For people who do want to go out of country for surgeries, travel medical insurance is available at a reasonable cost. Looking at those cost charts will also give you a good idea of which surgeries carry the most risk, because the risker the surgery (complication wise), the higher the price for insurance. 

If I ever need any more facial work, or less risky body work, I would return to see Dr. Lev in Costa Rica. However, for surgeries that carry a high complication rate, I would stay close to home.

You made a great point! Feel better soon.
    
bamabelle16
on 6/22/12 11:31 pm
I am so glad that all you ladies spoke about your complications, because the things I read always sounded as if everyone had easy recoveries. My surgeries are in Aug and my eyes have definitely been opened to what could but hopefully will not happen.
Kim Pekin
on 6/23/12 11:36 am
Thanks, everyone for your supportive words!  It has been a really rough journey, but I am so very happy I did this!  I wish my recovery had not ended up being as lengthy and difficult as it has been, but every day is an improvement.  Just today, the incision under my right breast finally healed to the point I can say it is finished!  I haven't seen any fluid on the gauze for 2 days, and everything looks closed there, so I'm saying it is done.  Now, if that left breast and the hole would finally heal...

Once everything has healed, I'll have my husband take some pics that I can post here.  I have the before pics my surgeon took, and I don't even recognize my old body now.

Thanks again for all of your support!  It really helps!

  
Banded 8/20/05, Lost 80 #, Regained 40#, De-Banded & VSG 8/13/09
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