1st PS consult - TT vs LBL

I had my first PS consult today with Dr. Douglas Forman in MD. He was very pleasant and professional and made me comfortable even during the examination, which could be awkward. His evaluation was that I could use 1) an extended mastopexy (including removing lots of side skin that runs to the underarm), 2) an extended abdominoplasty with pubic lift and 3) a butt lift. He said that it is possible to do the last two as a circumferential body lift (LBL), but that he really suggests doing the front (mastopexy and abdominoplasty) together and then do the back later. He stated that if the front and back are done together that the surgery is longer (11 hr or so) and the recovery is more painful and difficult because both the front and back are pulling and hurting and it is difficult to get comfortable. One other issue is that he would do the front or the back as an out-patient but that to do both would require a hospital stay of one or two nights. That is certainly a reasonable factor for me since it will be strictly out of pocket.

I am curious about what others here on OH have heard from their surgeons about the pros and cons of doing the front and back together vs. separately.

Thanks for your thoughts.

I had an LBL plus mastopexy at the same time. It all looks great and recovery wasn't horrible.

Did you have any trouble resting when both your back and your front were cut? How long were you off work?

No, the incision was literally no big thing compared to the muscle repair. My butt hurt and my stomach hurt, but there wasn't any problem with sitting/laying that I feel would have been better going through it twice.

I took 2 weeks off and then worked from home for 2 weeks. I was mentally fine to work at 2 weeks, but I wouldn't have been able to sit at my desk for long periods at that point.

I rented a lift chair and slept in it week one. I was working from home week 2 and sleeping in my own bed. Week one was brutal, week two is manageable with no pain killers. Plan to go back to the office mid week, next week. (Week 3).

eveyone is different, I am a quick healer, have high pain tolerance. I recovered quicker than most from rny.

They all seem to have different ways they like to split up operations. Some do all bottom, then all top. Others mix top and bottom. Others won't do certain surgeries together that some will. And the one you saw likes front then back. Go with what sounds right to you and the surgeon you feel the best about!

I had a lower body lift and mastopexy at the same time and am glad I had it all done together. Get more consults and see how they all compare.

I would also ask to see before/after pictures of patients that looked like you in their before pictures.

Hi Janet - that is so exciting! I did a LBL and breast lift at one time, and then decided to go do my arms once the rest of my body looked good ha ha. I didn't have any pain along my incisions from my LBL or my breasts - it was the muscle tightening in my abdomen that was absurdly painful! I knew I would forget tons of stuff so I made a document and you can find it here.

You may know that a few of us on here (me, Erin, Cynthia) are super fans of Dr. Joseph Michaels in North Bethesda. His speciality is plastic surgery and body contouring after massive weight loss. He's beyond incredible. Perhaps look into a consult with him. I am still ecstatic with my results years later :) Here are my before and after from my plastics posts.

Plastics: http://www.obesityhelp.com/forums/plasticsurgery/5309071/X-p ost-Everything-I-wished-I-had-known-and-everything-I/

Two years post LBL:
http://www.obesityhelp.com/forums/plasticsurgery/6022374/Pic s-2-years-post-op-lower-body-lift-breast-lift-and-1-5/

I have an appointment with Dr. Michaels at the end of May. I look forward to hearing what he has to say.

I did the lbl, butt lift and mastoplexy at the same time, but I went to a clinic where 3 surgeons work simultaneously. Total surgery time was 4 hours. They do the back/butt first under a spinal, then they flip you and put you under a general anesthetic and do the boobs and tummy tuck.

12 HRs would be longer than I'd want. I'd be concerned about anesthetic for that long, as well as surgeon fatigue.