Qs and more Qs...

[Googler 31]

Just like lots of others, I have tons of questions about plastic surgery. Specifically the Abdominoplasty and Brachioplasty. Some quarries are a bit more personal than others, but here goes...

-Recovery time experiences for these procedures? I realize everyone is different, just trying to get a general idea of what to expect if things go forward. I've been reading through the forum and it seems people return to work in 4-8 weeks, with continued recovery for excessive swelling, etc. Someone mentioned 9 months to return to normal?!?

-Did you go down in pant size quickly? Shirts can be worn loose forever, but for pants, how long before you saw a change. This isn't a vanity question--I've read that compression garments are recommended. Do you buy something that fits you at the time of the surgery? a size smaller? How do you know what smaller size? You'll have swelling, etc.

-What are some good compression garments? How do you put them on (and off) without harming stitches and such? Plus, just pulling some of those things off and on to use the restroom, isn't that a lot of straining and pulling when your bits are tender?

-Being a girl of a hefty size, my pubic area is pretty puffy. It's just soft and fluffy. I don't wish to end up with a pooch bigger there than my stomach. I'm not sure if I'm explaining this properly, but while the idea is to get rid of the stomach--I don't wish to look like I'm 'packing'. Is there anyone who has had the procedure who knows what I'm talking about and who can give me some insight?

-How long before you can do normal things--bending, walking, grocery shopping, sleeping on your side, belly laughs without pain, sex?

-Are these procedures really done on an outpatient basis? Seems like a lot of cutting/chopping going on for them to send you on your way.

About me: Started at 361 lbs, currently at 213 lbs, pear shaped.

Sleeved in 2012 converted to bypass in 2015. Not a glowing example of success, but thankful for what I've lost.

Looking to have an upper abdomen incisional hernia repaired and surgeon has suggested this be done during an abdominoplasty. I'm to be photographed next week for submission to insurance. I've asked that they submit photos of my arms too, hoping insurance will consider those too. Would be great (timing) to get both done at once, but no idea if insurance or the surgeon would go for that.

I have a large apron--large and squared-ish at the bottom. It doesn't cover my entire pubic area, but it is cumbersome. The surgeon said it would rate a #3 on the 'Pittsbrugh scale', so he believes it will be covered by insurance.

I currently live in Europe, so language can be an issue with medical terms, even though I'm ok with normal conversations.

I appreciate all the information here and any help you guys can give.

[JamieLogical 8,708]

I think I am the one you are referring to when you say 9 months to return to normal. But you need to understand, I had a complication. That is not a common outcome for people. I had soft tissue swelling in my lower back that made it painful to sit up in a chair for more than a couple of hours at a time and caused massive Fluid retention with physical activity after my extended Tummy Tuck. It did improve over time, but took a full 9 months to be completely resolved. Complications are a risk with ANY surgery, but they are by no means the norm.

Were it not for that specific complication, I would have been back to work full time at 4 weeks post op. Though I would recommend 6 weeks off if you can get it.

For the first 2-3 days, I couldn't care for myself, due to the severe abdominal pain and restricted movement. I needed help getting up and down out of bed, using the restroom, showering, etc. It was about 12 days before I could stand and walk fully upright. I would say it was a good 3 weeks before I could laugh, cough, and sneeze without soreness. My incisions were closed and I was able to shower immediately post-op, but it was a good 6 weeks probably before they were "healed". It was about 2 years before they were faded to the lightest they ever got. I experienced extreme amounts of phantom pain and itching for the first year and it took about three years for that to fully subside. I think all of that is pretty normal and had nothing to do with my complication.

For compression garments, you should be able to get your stage one garments through your surgeon. These will be the most restrictive and you will need to probably wear them for the first 3-4 weeks post-op. Stage 2 garments you may get on your own and they are less restrictive. You will wear these for a few more weeks. And then stage three garments are just normal compression-wear like you would by in a department store. Spanx is a major brand here in the US.

As for clothing sizes, it's really hard to predict. It depends on how much skin you have, how it's distributed, and how much swelling you have. It will be a good 3 months before the swelling is completely gone and you see your true results. But if you have a lot of skin removed, you could drop in clothing sizes immediately, despite the swelling.

I think it is INSANE that they do this as an outpatient procedure in the US. As I mentioned before, I was useless as a newborn for the first three days or so and had a very hard time getting up and moving around for a good while after that. I had my surgery in Mexico and stayed at a recovery house for two full weeks post-op. I am SO grateful to have done it that way. I had nurses to tend to me 24/7 that whole time instead of relying on family members or friends to do truly humiliating personal hygiene tasks for me.

[Djmohr 6,965]

So I can speak to the Brachioplasty as I had mine done 7 weeks ago but I will also answer your question about puffy pubic area because my surgeon and I talked about this specifically.

When she examined me for my Abdominalplasty she actually molds your body to show you how things will look. One of the things I was worried about was that puffy loose skin there. It will be pulled tight and flat just like the rest of my tummy.

I would definately ask your surgeon that specific question but I made it clear that I want that to go away.

As for the arms. I had mine done 7 weeks ago and they are absolutely fabulous. My Brachioplasty took a lot longer than she initially thought but she took her time and made sure they were well contoured using a laser liposuction before removing just the skin. Some doctors will just cut off the fat and skin and sew you up. Personally doing the Lipo first seems to be the better procedure. Because she does this, I had no arm drains whatsoever.

Then I was put in a compression garment that looked like a bolero jacket. That was miserable because it was too small. So they ordered just sleeves for me and I got them about 3 days later, I wore those for the first 4 weeks and noticed they were rubbing on the underarm incisions. So, I went to my local health equipment supply store to see if I could find just individual sleeves so I did not worry about them being connected. I purchased a pair of compression sleeves that are used for women who have their lymph nodes removed following breast cancer surgery. They are expensive. 75.00 each but the best money I spent!

My doc believes the longer you wear compression the better outcome for the arms because they do swell for along time. I am 7 weeks post op and mine are still swelling everyday. I wear the compression daily for most of the day and then will take them off for a little while.

I honestly don't mind wearing these sleeves and they have better compression than the sleeves that were ordered for my via my plastic surgeon. I have noticed my incisions are healing better and there is less pain in the incisions because swelling is being kept to a minimum which is why they have you wear them in the first place.

In terms of recovery for the arms. I did have a complication, it turned out I was allergic to the surgical adhesive so for the first 3 weeks I was in a lot of pain due to burning and itching. It felt like I had laid both arms on top of the stove and left them there. It about drove me insane with itching as well but there really was nothing we could do about it because the adhesive was holding everything together. I took prescription Benadryl for 3 weeks straight every 6 hours and packed my arms in ice, literally to help with the burning. I slept with ice packs on. To say the least the first 3 weeks were rough but as soon as the mesh covering with all the surgical glue on it was removed, the itching and burning stopped within hours.

I was so happy! Not if they itch its mild and because they are healing.

I definately underestimated the pain involved but have a feeling from talking to others most of my pain was the burning from the allergy.

Next is my tummy and breasts and Like you, have no idea what I will do about clothing because I have to believe the swelling will go on a long while. I guess it will be yoga pants for me.....plus I am having a breast lift and adding a small implant to give me my fullness back. so my tops will definately fit differently. LOL. I guess I will cross that bridge when I come to it.

[Googler 31]

Thanks for the replies, JamieLogical and Djmohr

I'm not sure yet how they do things here with this. I don't know anyone here who has had any of these types of procedures. The surgeon said after the photos are submitted, that they should hear from insurance in about a month, so I guess 5-6 weeks to hear something. If approved, then I'll have a more detailed visit with the surgeon. I'll continue looking into things and have my list of questions ready. Truth is, if insurance doesn't give the ok, then it won't happen. The hernia repair, maybe, but the extra won't. I was surprised the surgeon suggested it. I figured they'd lecture me about not having lost more weight before any reconstruction attempts. Could be that's what insurance will say, so we'll see. I so wish I'd talked to them about my arms. They're just soooo large and flappy and while I'm not small at all, finding shirts that fit them is horrible. I was just so surprised by the suggestion of the abdominoplasty that I was a bit dumbstruck. I went hoping for some answers about the hernia. All my questions could be for naught, it's all just gotten me to thinking about what-if's.

I've never seen compression garments like that over here, but I've never had reason to either..lol. Actually, I have seen compression stockings for circulation at a specialty shop. I don't recall them having anything for above the knee (shoes/insole/stockings), but who knows.

Thanks especially for addressing the pubic area question. When the surgeon described the procedure, he said they'll pull up and pull down and meet in the middle, retain my own belly button and remove the excess skin and some fat. I can't imagine it coming together smoothly. Like trying to wrap a gift with excess wrapping paper. Even if you cut it off evenly, there's going to be more on the bottom than the top (from the square-ish part of my apron belly). So when I got home and tugged and pulled in front of the mirror, it just seemed to accentuate the puffy pubic area. That's when I got worried. Though again, I can't imagine being flat--there's just still too much of me. And well, I just can't see it. I've never had a flat belly. I'd quite settle for slightly rounded.

Being off work isn't a problem as I'm a stay-at-homer. My husband could take off a few days, if necessary. I have no other family that lives close, so I'd be on my own when my husband is at work. We're planning on a trip home to the U.S. for vacation in the spring. So if the procedures are going to happen, I hope I'll have enough time to heal and be fit for travel.

I've been looking at photos online and trying to find specifically those that resemble my current size/bulk. Many of the before/after photos are amazing. I plan to show them to the surgeon to have him tell me which could most resemble where I'd end up. I want to have a genuine idea of what to expect. Some of the photos look incredible, others are less so. I just want to have a realistic outlook. Actually, I'm hoping he'll have some photos to share of his work. Especially on someone of my size-ish.

Thanks again for your replies.

[Julie norton 2,850]

I can only speak to tummy tucks. Yes I was very sore and could not get up or down for a few days without pain. Also, pain pills were a must for the first week for me.

My doctor pulls your mons ( pubic area) up when doing his TT ... And also does liposuction there and on my love handles. It really helped! It took about 6 months for all my swelling and itching to go away... The scar has faded a lot in the 18 months post op.

Best of luck.

Ask a lot of questions is my advice!

[WLSResources/ClothingExch 3,444]

I currently live in Europe, so language can be an issue with medical terms, even though I'm ok with normal conversations.

I have no information on reconstructive procedures to share, but I'd like to recommend that you have a good interpreter with you at some if not all appointments. The service may turn out to be unnecessary, but I wouldn't want to leave room for misunderstanding.

Everyone I've talked with who has had reconstruction (these are indeed reconstructive undertakings, not plastic surgery, which sounds cute by comparison) stresses the importance of having surgeons who've done lots of the work we're talking about.

[LisaMergs 2,854]

Thank you all for discussing the puffy pubic area. Good to know it can be stretched back tight!

Sent from my iPhone using the BariatricPal App

And as an aside- why is it men don't worry about these things?. Lol.

Sent from my iPhone using the BariatricPal App

[Jane1979 270]

@@LisaMergs men actually do worry about these things. My hubby just weighed in and lost 70lbs (diet and walking everyday for 4 months) and he is insecure about the skin starting to drop down there. He's afraid it will cover and hide the goods.

Sent from my iPhone using the BariatricPal App

[Googler 31]

Thanks to everyone for the advice.

I received some information from the hospital and it talks about a 'tubigrip' that they recommend be worn for 4-6 weeks after the abdominal surgery. That's a compression band. So at least the first one will be supplied at that hospital. So that's one answer.

My husband isn't too keen on the whole thing. Major surgery and all scares him. Plus, after the hernia debacle from the previous surgeries, he just doesn't trust they'll get it right. More that I'm giving them yet another opportunity to jack things up.

Photos are tomorrow and then waiting to see if insurance will pay. I just feel that if insurance is willing (big IF), that I'd be foolish to not take advantage of the possibility. This in addition to truly wanting the hernia issue fixed and to be rid of that pain.

Again, thanks to you all.

[TheRealMeIsHere! 863]

@@Googler I looked up Tubigrip, hopefully it provides more support than it looks like it does. I, personally, preferred VERY firm compression. It just felt better on my healing muscles and my surgeon told me that the longer I wear compression, the better. Since this was my one and only shot, I wore compression for 6 months.

The hospital gave me this: http://www.staples.com/Medline-Premium-Tri-Panel-Abdominal-Binders-Small-Medium/product_521329/

Once the drains were out I bought this: https://www.amazon.com/gp/product/B0007QMK2S/ref=oh_aui_detailpage_o02_s00?ie=UTF8&psc=1/

and this: http://www.walmart.com/ip/Cupid-Extra-Firm-Control-Bodybriefer-Style-5908/20931991

That was just my preference, You will find what suits you best.

Edited September 7, 2016 by TheRealMeIsHere!

[Googler 31]

Thank you, @TheRealMeIsHere! , for the links.

That's part of why I was asking. In case there's something that I want to order and have someone send it to me over here beforehand.

I actually have one of these (different brand) http://tinyurl.com/jzkyzjc
and when I spoke about being able to get it off and on for the restroom, I thought the compression would be more along the lines of this (i bought them as a set a while back) http://tinyurl.com/gu6k28p
I figured the underwear type because that's where the scar/sutures are, but I guess if they sew/tighten the muscles, they're all up and down there.

Did you wear the compressions for 6 months 24/7 (sleeping too)?
My FIL wears Rx compression stockings for circulation and they were explicit about him absolutely not wearing them at night/while laying down.

[Googler 31]

I just checked the brand. It's 'heavenly shapewear' I have a set of 1x and 3x

[BayougirlMrsS 3,934]

@@Googler my experience with TT.... it's all ive had done. I had no complications, stayed over night at the surgery center with a pain pump. Went home the next day. i slept in my recliner the first week. It's where i felt most comfortable. I was up walking the day i went home. I equate the pain with my 2 c-sections. Which was not bad at all. The compression garment it key.. my doc put mine on in the op room. it snapped at the bottom and zipped on each side. i only took off to shower. Wore it for 6-8 weeks.

i also had a puffy kitty.... now she is trim and purrrrrrtttttyyyyyy. lol

You can pm me with any questions.....

I also have some pics on my profile...

http://www.bariatricpal.com/gallery/album/23717-post-tummy-tuck/

[Djmohr 6,965]

@TheRealMeIsHere!

I agree with the firm compression statement. Trust me, your body feels horrible when it swells. Those compression garments are both your best friend and your nemesis all at the same time.

[JamieLogical 8,708]

@@bayougirlmrsc Did you have muscle repair? I'd be surprised that you were up and walking around the day after surgery if you did. That's impressive!