Question:
Have you had a lower body lift as an outpatient? haw was the experience?

I am scheduled for a LBL & brachioplasy in Sept, as an outpatient, I am nervous about going home the same day. Especially the pain control. I am highly motivated , but am a little chicken. Have you done this, how did it work out and would you do it again?    — **willow** (posted on August 18, 2004)


August 18, 2004
How do you define outpatient? Most places keep you overnight for a body lift. I had one done in July but had some bleeding and had to stay longer. I have a moderate to high pain tolerance. I only used 8-10 prescription pain pills total. I started taking Tylenol Eight Hour every 8 hours during the day and just took prescription pain meds at bedtime. Good luck. You willbe SOOOOO happy with the results.
   — dianne E.

August 18, 2004
I cannot believe there is a surgeon around that would send someone home the same day as having a LBL. MIne ended up being 10.5 hours of surgery and therefore it was after 6pm before I was ever out of the OR and about 7pm before I was back in my room. I had my surgery on Monday and went home late Thursday night. There is no way I could have gone home sooner. However, my recovery was slowed by the fact that I lost almost 5 units of blood. So the first 24 hours I felt like crap, till I got 2 more units of blood transfused. If I would have had to I could have probably gone home on Wed, but never the same day or the next. I certainly hope your experience is better than mine. The bottom line is if you are having any trouble they won't send you home. But assuming there are no complications and you go home, I guess it's possible but it will be difficult. You will definitely need someone with you 24/7 for the first 2 days or so. Because you are getting your arms done at the same time it will make it difficult to get out of bed or chairs etc. I know I used my arms a lot to move. My biggest pain issue after the LBL was from the skin being very tight. It burned very bad. You may want to talk to the surgeon about some sort of anti-inflammatory also. I know we should not take them but you will likely need something to help reduce the swelling so you can move. My doc had me on torodol shots in my IV, which was for pain but it also has anti-inflammatory properties. I found that about 30 minutes after I got a shot is when I could get out of bed and walk with the least amount of pain/difficulty. It knocked the swelling down just a little, which really helped. It's not something I could have in the first 24 hrs, due to bleeding concerns but after that I could. We did the same thing after my 2nd PS. I'm having my legs (extensive medial thigh lift) done in Nov. and I will be in the hospital one night. Yes it adds some cost but that's the way it is. I cannot imagine going home right away. This will likely be an 8 hr surgery again as I want him to revise a few small things at the same time. The legs themselves he anticipates 6.5 hours. I would just make sure that there is a backup plan as to where you can go should it be necessary to stay overnight. My legs will be done at a surgery center and I will be staying overnight at a hospital that's next door.
   — zoedogcbr

August 18, 2004
I didn't have a lower body lift but I did have a tummy tuck, breast lift with augmentation and brachioplasty last month and came home that night. To be honest, I didn't care where I was, I was so out of it. I came home after only 1.5 hours in recovery, slept the whole way home, stumbled into my apartment and slept for the next 24 hours pretty much straight through. Just be sure that they give you a nice dose of pain meds before you leave. I got a dose of morphine and was totally fine. Oh and I was sent home with a cathetar in which I was VERY glad of. I didn't have to remove it until 2 days post and that was no big deal. Check with your surgeon to see if he is sending you home with that. If I would have had to get up to go to the bathroom every time I had to go, I would have been in bad shape. Good luck to you!!!
   — SMG I.

August 19, 2004
I cannot imagine being sent home the same day as that extensive a surgery. I had an extended abdominoplasty, brachioplasty, hernia repair and removal of the skin on my sides that flapped over the bra five weeks ago. I had surgery on Thursday (7.5 hours worth), and he removed 15 pounds of skin and fat. The insurance company approved for me to stay as an inpatient until the following Monday. I actuallly went home on Sunday because I felt that I was able to, but there is no way on Earth I could have gone home sooner. And, even though I had a lot done, I'm having a very easy recovery. I had virtually no pain (not so much as a Tylenol since the day after surgery), was able to stand up straight by Sunday, and walk a mile at a stretch by Tuesday. But, I wasn't able to get out of bed by myself until Saturday afternoon, and had a catheter until that time. I was still on IV fluids, and they were carefully monitoring all my vitals. I would have had to have someone living with me to help if I had gone home any sooner. It might be easier that you're not having the arms and abdomen compromised at the same time, but I can't imagine going home so soon after a circumferential procedure. Best wishes, but I think it's worth asking to stay a day or two--especially if there's a chance insurance will cover it.
   — Vespa R.

August 19, 2004
I've had an LBL and breast lift, but stayed two nights in the hospital in order for them to monitor the swelling and blood levels. I'm surprised they even offer this as an outpatient procedure. It's extensive surgery. It takes awhile too, so will there be enough time to make sure you're stabilized before you have to leave? I didn't get back to my room until early evening. I don't think pain would be the issue. They'll send you home w/ good meds.
   — mom2jtx3

August 19, 2004
I define outpatient as in a plastic surgery center, surgery in the am and home by bedtime that night. I am seeing him next week and am going to have to have an extensive discussion about this.
   — **willow**

August 19, 2004
In November I will be having a lower body lift without the tummy tuck (basically a buttock and thigh lift, both inner and outer thigh) done as an outpatient at the surgical facility, going home the same day. I am also a little leary about this, but the surgeon does all his surgeries as outpatient.
   — Hackett

August 19, 2004
My abdominoplasty was scheduled as outpatient surgery, but I was there from Monday morning until Wednesday morning. The surgeon's office scheduled it with the hospital as outpatient, but the surgeon said they would find a reason to keep me there! I work for the insurance company, and I have no idea why the did that. The nurse that authorized my days in the hospital is a co-worker and we both knew I would be in for a couple of days. I, too was highly motivated to get moving, but there was no way I would have felt safe and comfortable at home. (I am a nurse, so the bloody drainage in my JP's didn't bother me, but probably would have caused more than one person in my house to pass out!) Also, the surgeon didn't want me moving a lot at first - and I was in bed with my head and legs elevated - hard to do at home! I really did need the nurses and patient care assistants checking on me and helping me out the first day or so, and I am one to try to do as much for myself as possible. Tlak to your surgeon about the possiblilty of being changed to an inpatient stay if that is necessary.
   — koogy

August 19, 2004
Your DR. has GOT to be kidding. I am 3 days post op abdominoplasty and hernia repair. There is no way in !@#$% that I could have left the same day. He told me my surgery was practically bloodless, but I could not stand up no less walk that night. I am not a nurse, and would have dealt with drains, but no way for a catheter at home. If I can't pee then I stay. As a matter of fact, I stayed a 2nd night due to low blood pressure from the demerol. That second night made all the difference in the world. My drains were empty and were removed, and so was my catheter. I am in extreme pain but with my husband's help am managing. I would have killed myself if I was alone. This pain, at least for me, is much worse than the RNY or the gall bladder removal. Please discuss the possibility of staying over with your Dr.. He may not be able to confirm your ability to stay as a pre-op due to the insurace company's policy, but he has the right to make a medical decision based on your condition at the time he sees you post op.
   — Fixnmyself

August 19, 2004
I am a nurse too, and am not in the least worried about drains or a catheter, they don't bother me at all, Actually the cath would be good, less getting up and down, LOL. MY real fear is the pain being out of control. My second other fear is a big hospital bill that may or may not be covered.
   — **willow**

August 19, 2004
I had n abdominoplasty w/ a vertical and horizontal incision plus a breast lift. In at 7A, out at 5. I stayed in a hotel across the street from the surgery center as I lived out of town. But the next morning I rode home (not driving) I am an RN and wasn't too worried.
   — Connie M.

August 19, 2004
I had an extended TT, with the insision 360 degrees around me, breast lift with agmentation. 5 hours of surgery, and went to a Motel afterwords due to living out of town. The first night was hard, but I would do it again after the results. I had 4 drains, that I kept for 10 days. I saw my PS the next morning, and rode home. The Brachioplasty, I just had 6 days ago, and I can't amagin having it with a TT. It is hard to use your arms. You have some movement, but team it with a TT and I think it would be hard. But determination plays a big roll. I was determined to get out of bed, and I did. Some think I pushed too much too soon, but with both surgerys I have had no problems. Pain is very manageable. I took most my pain meds only at night so that I wouldn't move........thus getting a goodnights rest. Good luck to you, you can do it.
   — Julie H.

August 20, 2004
A friend of mine came to Seattle area and had LBL, in a day surgery center. She stayed the night at surgery center, because the alternative was to have a nurse in hotel/motel. Must be attended first 24-48 hours. <p> BUt this is more common, and better, IMNHO . . . hospitals are hotbed for infections. Ones you can't get at home. <p> My friend did fine . . . I think she was more comfortable that would have been in hospital.
   — RWH G.

August 21, 2004
Hi Willow. I had an LBL on an outpatient basis on July 29 (just over three weeks ago) and went home the same day, without an overnight stay at the surgical center or hospital. I was also very nervous about making this choice because of my concerns with pain control. Fortunately, percocet alone did the trick for me once I got home, following whatever it was that they had numbed me up with during surgery. I understand your apprehension, I certainly felt unsure about my choice for quite a while, but fortunately it worked out for me. (And I am not particularly studly about pain; it's just that the percocet -- a double dose every four hours for the first 24 hours, I took no chances on that from the beginning.) We're all different, but the LBL was much less painful for me than the mediastonotomy I had last year (chest bones broken open to get at some thyroid cancer mets in my chest), so that's my own personal frame of reference for pain. I know I saw a post from somebody who said their LBL was *more* painful that a mediastonotomy they'd had, and that kinda freaked me out for awhile, but I'm glad I chose to come home for the LBL.
   — Suzy C.

August 22, 2004
Home the same day after an LBL or tummy tuck is a clear departure from the standard of care.
   — DrL

September 13, 2004
ORIGINAL POSTER HERE! I had my lower body lift / belt lipectomy and muscles tightened and brachioplasty on Saturday morning, Into OR at 8 am, 3 hours of surgery, another 4 hours in recovery and home by 4 pm. It all went great and I feel much better than I ever expected. My Dr. gave me a "pain pump" that continuously infuses a small amount of numbing medication into the incision site and much of it is numb and there are also some sore spots that the lortab elixer is helping alot. I am up and around and have been outside taking walks twice already today. I am glad I did not stay in the hospital as my home is quieter , no roommate except my beloved husband who I can evict from the bedroom if he is noisy, and my very own comfotable bed. thanks for all the input from every body!
   — **willow**

September 13, 2004
Congrats, Willow! I'm glad to hear it went so well. I think it's pretty studly that you're walking around already. I'm surprised to see Dr. LoMonaco's view that going home the same day after a TT or LBL is a departure from the standard of care. Zowee. That's a strong statement. All I can add is that I had consults with three board-certified plastic surgeons, two of whom specifically predicted I'd be going home the same day (one of whom was also a medical school professor who's operated on me on other occasions ffor melanoma). I didn't discuss this particular issue with the third, so I don't know what his position would've been. Certainly I can imagine that it might be a wildly inappropriate choice to send a patient home the same day in some instances, but by the same token, I can't imagine it would *always* be a deviation from the standard of care to send someone home the same day.
   — Suzy C.




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