Plastic Surgery

Nov 19, 2009

I had my breast lift w/ implants and tummy tuck w/ muscle tightening and lipsuction today (technically yesterday since it's after 3 am.)  I am home and awake @ 3:10 because I have slept most of the day & afternoon (which isn't really condusive to a good night's sleep - especially when you're not comfortable).  So I figured I'd take a break from overnight tv (which is SOOOOO entertaining by the way) to get on and update y'all. 

Yesterday afternoon I got a call that they had moved my plastic surgery up to 6:45 am as opposed to the previously scheduled 8 am.  (They had to cancel or reschedule the small procedure that they had scheduled before me.)  That was fine by me so I said okay. 

PRE-OP

My mom drove me and we got there at 6:45, then got called back about 5 minutes later. 

First I met with the anesthesiologist (I'm sure I'm butchering that spelling - but you guys get that I mean the dude that puts you to sleep.) who went over basic questions and explained what he'd be doing (putting me to sleep and giving me stuff for pain through the IV). 

Then the surgeon and nurse came in and he made marks with black marker all over me.  He asked me again how big I wanted my breasts to be.  I told him that my mom's Cs looked good to me (Cs are the most common natural size in the US now) but that I wanted to be a tad bit bigger than her (because I have ALWAYS had large breasts and it just won't feel like me without them.  SOOOO I asked for a sort of inbetween size - larger C to big D.  I also had less actual breast tissue left under my skin than my mom did.  (I knew this because my OBGYN actually had them mammogrammed because he thought the walnut-sized masses in each breast may be tumors.  Turns out that was just the only breast tissue I had left.) 

He made marks on my hips and stomach where they were going to cut and liposuction.  I had asked to be liposuctioned to get out those extra fat pockets that I can't seem to lose no matter how small I am.  Who wants to be a pot-belly after going through all this to lose weight?  I wanted NO fat left in my stomach and the skin as tight as possible without risking skin necrosis (the skin can actually die if you get pulled too tight - so I wanted to be as tight as he could possibly make me without that happening).  He also made circles with the marker where he was going to liposuction a little off the sides of my upper hips which was a happy surprise to me.  I think he did that so that when he did the tummy tuck there wouldn't be places pooching out on each side?

We went to the operating room.  The anesthiologist started the IV (he missed once, then hit a vein the second time).  I guess I should have warned him that I had rolling veins before he stuck me the first time.  But I never know whether or not that will HELP the person sticking me or make them nervous and HURT the person sticking me. 

Then he left to eat breakfast while I stripped out of my gown so that I was naked on a blue tarp thing so the nurse could wash me down.  The nurse scrubbed me down from armpits to knees with a scrub brush with some special sterile soap stuff on it.  They I climbed on the bed and the nurse put on the leg compression devices and I got my socks back.  (THANK GOD FOR SMALL FAVORS.  OMG IT WAS COLD IN THAT ROOM.  THIS WAS HONESTLY THE WORST PART PRE-OP - BEING SCRUBBED DOWN NAKED IN A FREEZING COLD ROOM.) 

So after my socks and leg devices were back on the anesthisiologist came back in and gave me the stuff to go to sleep.  I told them, "Let's get this show on the road."  That's the last thing I said before being put out for my RNY too.  The next thing I remember is waking up in recovery. 

IN SURGERY

They ended up putting in 480 cc in my right and 440 in my left.  (I wrote that question down and gave it to my mom so she would ask after surgery when I would be too out of it to remember to ask.)  I guess my breasts were a little bit different sized to begin with?

They removed 2 - 2.5 pounds of skin from my stomach.  (That was the only other question I had written down for my mom to ask.)

They liposuctioned about 600 ccs out.  The surgeon and nurse both mentioned after the fact that I didn't hardly have any fat TO liposuction out.  (I guess the pot belly I have always had was either just weak muscle which could TOTALLY be the case or gravity working on my organs?) 

POST-OP

I don't really know what anything looks like yet because I am bandaged from my armpits to my public bone.  But the nurse said I looked fabulous. 

Underneath my breasts are sore when the incisions are - but otherwise they just feel swollen (because they are) and somewhat numb?  My lower stomach is really sore where that incision is.  The incision up the center of my stomach (and behind it where my muscles were stitched together really isn't sore at all right this minute. 

TROUBLE

They finished with my surgery about 1:20.  I went to the recovery room where most patients stay for 30 minutes up to 4 hours.  I was there until between 6 & 7 pm.  

I had warned them ahead of time (in the pre-op appointments AND right before the surgery) that I have had trouble several times waking up from anesthetic.  My obstructive sleep apnea went away with the weight loss.  But I also have central sleep apnea which doesn't go away no matter what you do.  (For those of you that don't know, central sleep apnea is when the part of your brain that is supposed to regulate unconcious action in the body - such as blinking and breathing - "forgets" to tell the body to breath.  So the body doesn't get the signal it is supposed to get from that part of the brain, so it doesn't do that action - in this case, breathing.)  I TOLD THEM THIS SEVERAL TIMES. 

After surgery, they could not get me to start breathing again properly.  I kept stopping breathing and I couldn't cough up the junk in my lungs - it just kept getting stuck right in the back of my throat.  They had to stick a tube down my throat (while I was awake).  I gave them permission to try that because I could NOT get that stuff coughed up and I was getting frustrated.  Then they ran a smaller vacuum tube down through the larger tube to try to vaccuum the stuff out.  I motioned for them to pull the smaller tube out.  Then I pulled the larger tube out.  It was a very uncomfortable - not painful at all really - just very uncomfortable and unnatural feeling to have a tube down your throat.  I was in and out of conciousness.  When I'd fall asleep, my body would stop breathing and they'd wake me up again.  It was like being a soldier who was being tortured with sleep deprevation because I was so drugged that I needed to sleep. 

They tried everything.  They even gave me meds to counteract (nullify) the sleeping and pain meds to see if that would help.  The office closed and the surgeon let all his staff except for the operating room nurse go home at 5:45 pm when I was still not breathing properly.  Once I woke up and asked if I was seeing things or if it was really dark outside.  I wasn't.  It was just after 6 pm.  I knew I should have been done with surgery between 12 and 1 pm.  I knew I should have been in recovery for 30 minutes to 4 hours tops.  So then I started realizing that something was wrong.  They explained to me about my breathing.  I got up to pee and that woke me up a little more.  

The surgeon said that if they could keep my oxygen levels up to in the upper 90s, that they'd let me go home.  So I did my best to deep breath, etc because I was awake and wanted to go home then.  Let's get this show on the road, you know?  So they helped me into a wheelchair where I breathed even better.  Sitting up helped I think.  My O2 levels stayed in the upper 90s for a while and I wanted to go - so they let me go home around 6:30 - 6:45ish. 

The surgeon gave mom his cell phone number in case we needed him.  He also cautioned her about giving me pain meds because he worried that that would contribute to more breathing problems.  So I have only had 2 vicoden since I've been home - 1 before I went to sleep and 1 before I got on here typing this. 

NOW

I'm not in pain really.  I'm really achey, but not like I worried I would be.  I was expecting horrible pain as I had read that plastic surgery was the most painful procedure you could have next to orthopedic surgery.  I know I'm tough - but I just really don't find it to be THAT bad.  When it got uncomfortably painful, I took 1 vicoden and it was enough.

I am walking hunched over like I'm supposed to which is a pain.  I'm sure my back will be aching after a few days of this.  I also HATE the support garments I have.  I bought the smallest size they had which fit fine at JCPenney's when I tried them on.  They were snug - but not uncomfortably so and they are supposed to be snug.  So I thought surely they'd fit perfectly after some of me was gone underneath them.  I did not account for bandages. 

I also could not find any anywhere that had a straddle that unbuttons, so each time I go to the bathroom, I have to pull the tight things over my incisions which I hate.  If I had that to do over again, I'd have bought a medium instead of a small and I'd have gone to Little Rock if I had to to get one with a straddle that unbuttons to use the bathroom.

They want me back in the office tomorrow to take the bandages off my breasts.  So I will get to put on a regular bra tomorrow.  (They recommended a front opening, supportive bra.  I am going to use a cotton, front zippered sports bra that my mom bought that didn't fit her correctly.) 

Unfortunately, I have to wear the panties of torture for a few weeks.  They're supposed to help with swelling but I really wonder if this is worth it?  But I'll do it because he said to and that's why I gave him the big dollars.

In any event, that's the long story. 

The short story is: 
I'm alive and kicking.  
I don't know yet what it looks like or if I'm satisfied with it.
I don't know yet whether or not I'd do it again.
I wish I could walk totally upright because my back is NOT going to like this over the next few days.

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