Plastic Surgery

Video Q+A with Dr. Ruff

Last week I had my 6 week post-op check up with Dr. Ruff of Ruff Plastic Surgery, and he sat down with me and answered a list of questions that I compiled from you guys! I knew most of the answers to these questions but it was really fun to talk to him (in regular clothes and not a surgical gown, to boot).

Here’s a look at the video:

And here is the list of questions that I asked him:
  1. What are some of the most common procedures that people who have undergone massive weight loss consider?
  2. How many areas would you recommend operating on at one time?
  3. At what point in a weight loss journey is it recommended to look into a body contouring surgery like this?
  4. Do you have any recommendations while people are undergoing the weight loss itself to reduce the need for surgery like this?
  5. How old is “too old” for someone to consider a procedure like this?
  6. How would this surgery impact future pregnancies? How would getting pregnant affect the results?
  7. Can you talk a little bit about the nerve pain – why it happens and how long it lasts?
  8. How long after a procedure like this do you see the final outcome?
  9. Even though it varies from individual to individual, can you talk a little bit about the cost of a surgery like this? Will insurance ever cover it?
  10. What are the most important things to look into when you are selecting a plastic surgeon?

Hope you guys enjoyed the video and my awkwardness!

He did say if any other questions come up he’d be more than happy to address them, so let me know if you think of anything else!

6 Weeks Post Op

Holy crap! Where has the time gone? I know I’ve started every single update this way, but I cannot believe it was six weeks ago today that I headed to Ruff Plastic Surgery to get my procedure done. They say 6 weeks marks the end of the first stage of recovery, and I made it! I could not be happier with the results and though it sucked pretty bad for the first several days after surgery, and then emotionally for quite a bit longer than that, I am so happy with the results that I’d do it again in a heartbeat.

Since my last update at 4 weeks post op, quite a few things have changed. Here are the highlights:

  • At 4 weeks I was given clearance to start running slowly, and I was really scared to think about what it was going to feel like to run again and how many steps back my body would have taken with the break from working out. The first time I went, I walked briskly for 15 minutes, then jogged very slowly for 20 minutes, then walked for another 10 to cool down. I didn’t wear my compression garment when running because I didn’t want to get it sweaty (plus at that point I was allowed to wear it just 12 hours/day), and it felt… awesome! My body was so much firmer than before and it felt so great to be running. The only part that felt kind of weird was the outside of my butt on either side, which seems random. The next day I was a little sore in the quads, but more from a haven’t-run-in-a-month way, rather than a just-had-major-surgery way. Since then, I’ve worked up to running 30-35 minutes straight, and have still been going pretty slowly for me. I’m averaging about 10-11 minute miles, and for a while there I was around the 8-9min mile mark pre-surgery. Still a ways to go, but I am so happy that it was such an easy transition back. As of today, all activity bans are lifted, so I can resume all activity with no restrictions.
  • At the 4 week mark, I was also given clearance to wear the garment for 12 hours a day instead of 24, though I wore it almost 24/7 until a few days ago. I was nervous I would have a lot of swelling and feel weird without it on, but I didn’t have any ill effects and love the freedom of not having to dress based on the cut of the garment!
  • Speaking of dressing, I went through my closet over the last couple weeks, and almost none of my clothes fit. Before surgery, I was a 10/12, and I wasn’t sure if my size would be effected or if my clothes would just fit better after surgery, but my size was cut almost in half. I got rid of everything in my closet than doesn’t fit, and was down to a pathetic amount of clothes, so I’ve done a bunch of shopping over the last couple of weeks. And, I got several skirts and a few pairs of pants, everything in a size… wait for it… 4 or 6! It is insane. When I went into the dressing room, I originally brought in size 6, 8, and 10 with me of most things because I had no idea what size to wear, and the 6s were too big for several of the items, which is crazy. All my tops are down to a small or x-small, depending on the cut, and I am so thrilled to be able to wear fitted clothing and not worry about extra stuff going on in the mid section. Woohoo!
  • I also started using a silicone gel sheet to treat the scar from NewGel+. They provided me with a strip complimentarily, and this is the one that I got (which is standard for tummy tucks). They are pretty pricey ($83.50 each unless you buy multiples), but I feel like this stage of the game is NOT the one to skimp on, so I am going to use my own money to buy additional strips. They last for 3-4 weeks depending on how well you take care of them, and it’s recommended you use them for 3-6 months for the best results. If you look at the before/after pictures on the site, the results are pretty incredible. The strip itself is VERY sticky, and you wear it for several hours at a time, the more the better, but its important to clean the area 2x a day to make sure you don’t have a bad skin reaction. I made the mistake of ignoring that suggestion and wore it for 24 hours straight when I was traveling to Woodstock. Once I realized I had overdone it, I took the strip off and looked to see that I had a minor irritation where the strip was, and ended up leaving it off for a few days and just using the BioCorneum, and it totally went away. I’m now back to wearing the strip almost all the time and haven’t had any adverse reactions. I am excited to see the scar fade and go down, but it’s honestly looking pretty awesome right now for this point during recovery (photos below). I’ll keep you guys posted on the progress as I continue to use the strip/gel.
  • Physically, I feel amazing. The only lasting effects I feel at this point (besides the whole body-cut-in-half scar) is sometimes a little tight in the stomach area, and my belly button is still healing. I have had almost zero swelling since the surgery, which I think is largely because Dr. Ruff is such an amazing surgeon. My primary care doctor had told me that I wouldn’t have a lot of swelling if I picked a talented surgeon, and I didn’t believe her because I had read so many horror stories about the swelling, but I think she may have been right. I feel very lucky! I do have a bit of swelling in my back that will continue to go down over time, but my stomach is, and has been, very flat since the surgery and has gotten better with time.

So before I show you the pictures, I want to share a funny story that definitely borders on inappropriate to tell the world but I’m going to anyway. I think I had mentioned this, but before surgery, there was one particular style of underwear I would almost exclusively wear, because it was cute and kept everything contained better than anything else. These underwear were size XL from Target and I had literally 15 pairs. I continued to wear these after surgery because they were all I had, and I wanted to wait to see more final results before purchasing too many items. Right after surgery, when I was still wearing those it was actually OK because I had the foam pads in and the compression garment, so they worked. Well, lately, not so much. I noticed they were pretty loose and knew I needed to buy some new undies, but I kept putting it off.

But then one day last week, I went to CVS to pick up a prescription after work, and I had been wearing my compression garment, said underwear, and then a skirt over everything. As I was walking to the back of the store, I felt something weird around my foot, and I looked down, and my underwear had literally fallen down AROUND MY ANKLES. I was mortified! I didn’t even look back because I didn’t (slash don’t) want to know if anyone saw, and I just pulled them up haphazardly and scurried back to the prescription counter and tried to pretend it didn’t happen. The next day I went to Target and bought new underwear in a size small. Guess we all need an “a-ha moment” on occasion.

SO, without further ado, here are some pictures from yesterday in a bikini bottom.

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Despite the stretch marks that remain, I am absolutely thrilled with the results.

Here’s a look at the scar from 6 weeks post op, which I think actually looks worse in the pictures than it does in real life.


Kind of crazy to look at, but it is hidden under even the lowest cut items, so no one sees it unless I want them to.

And here are some side by sides of the progress

1 v 2 v 3 v 4 v 6 weeks

This Wednesday, I have my 6 week follow up with Dr. Ruff, and we are going to make a little Q&A video so he can address some of your questions. Do you have any burning questions you are wondering about that you’d want a plastic surgeon to answer?

Four Weeks Post Op

Somehow today marks four weeks since the surgery, and I honestly often forget that I had major surgery just a short time ago. It feels like it was ages ago, and the time has seriously gone so fast, especially after those first couple days post op.

The most exciting thing I have to report from the past week (which you’d already know if you follow me on facebook) is that, for the first time in my ENTIRE life, I laid out by the pool yesterday in a BIKINI. Me! In a bikini in public! Who would’ve thought!?

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It was also my first time at a DC public pool, and the day was absolutely gorgeous and perfect. It’s funny because I realized that yesterday was the first time in my 29 years that my stomach has ever gotten a glimpse of the sun. Thank god for strong SPF because somehow I barely got any color – I’m thinking my stomach just didn’t know how to respond. And just in case you’re worried, I cleared it with my surgeon, Dr. Ruff.

Since today marks 4 weeks, here are some other changes:

  • I’m now able to switch from 24/7 in the compression garment to 12 hours in it, and 12 hours in a tight Spanx garment. I am honestly going to try to wear the compression garment as much as possible and basically just wear the spanx during the day at work and then switch to compression immediately when I get home because I know the more I wear it, the better.
  • I am cleared to use the treadmill starting today. My instructions are to take it slow and listen to my body, and slowly work up from a walk to a jog to a run over the next two weeks depending on how I feel. I think it’s going to be hard for me to go slow because I feel so great, but that may change quickly when I got on the ‘mill. I’ve been really good about following my surgeon’s instructions to a T and don’t plan to stop here. Two weeks from today all activity restrictions are lifted – I have never been so excited to exercise. I’ll let you know how it goes!
  • The scabbing is completely gone from my incision, though it’s still pretty nasty. I’ve been using BioCorneum as instructed (thin layer over the entire incision twice a day after washing with antibacterial soap), and I’m just waiting for my silicone scar strip to arrive so I can start using that too. I’m noticing that the scar is starting to lighten, flatten, and fade a bit, but it’s still pretty enormous and gives me a minor panic attack every time I see it. That’s part of why I’ve been able to stay so committed to my compression garment.
  • I feel really awesome physically. Yesterday I was able to lay on my stomach for the first time since surgery (at the pool). That’s been the only position I haven’t been able to get in because my stomach is still feeling quite tight, but yesterday it wasn’t uncomfortable at all. I still can’t pull my chest off the ground while I’m on my stomach (I have to lay flat) because that stretches it too much, but that was an exciting change. Sleeping on my stomach again may be in my near future. Fingers crossed.
  • I also realized that I definitely underestimated the emotional impact this surgery would have on me. I did so much research, read soooo many people’s stories, knew that the “blue” feeling would inevitably come, but the mental stuff still has been catching me quite off guard. It’s hard to explain exactly, but I’ve just felt vulnerable and overwhelmed a lot even though I know I’m healing wonderfully and am already so happy with the results. It’s been one of the less fun parts of recovery for sure.

And now, for some updated pictures. These are from yesterday, 27 days post op.

27 Days PO

And here are some comparison pics of weeks 1, 2, 3, and 4 post op.

1 v 2 v 3 v 4 weeks

The changes are pretty subtle, but the swelling is going down and my waist is getting more defined as the weeks go by. You can see I still have plenty of stretch marks, but those will never go away and are physical reminders of how far I’ve come. And don’t worry, the pics from yesterday were taken BEFORE sun exposure, so I may be slightly less pasty now. Maybe.

Three Weeks Post Op

Today marks three weeks after surgery, which means I’m at the half way point of the main phase of healing! Exciting stuff.

Honestly, I feel pretty much 95% at this point. I’m still limited in what I can do and have been taking it way easier than I normally do, but I’m definitely at the point of forgetting that I just had major surgery a few weeks ago. I had a follow up appointment this week with Ruff Plastic Surgery, and I got a Medsculpt Massage, saw Dr. Ruff for a follow up, and met with Sharonda to discuss scar treatment. Dr. Ruff is incredibly impressed with my progress and is so pleased with the results thus far, which made me happy. He was impressed with how well I’m healing and reminded me that my shape is only going to get better as all the swelling goes away – which I can’t even fathom.

Dr. Ruff said at four weeks post op (one week from today) I can get on a treadmill and work up gradually from walking to running. For now, exercise is limited to walking (not on a treadmill), but by 6 weeks I can resume all activity, including running, yoga, and weights. So I’m halfway there! I have also really lucked out with swelling and bruising – both have been pretty minimal. As you saw right after surgery, I was pretty bruised on my back, but it went away before the two week mark and so I feel lucky (and also like I picked a really talented surgeon). Unless I run into a problem, I don’t go back for another follow up until the 6 week mark, which is when I’ll get my official post-op pictures and weight as well as meet with Dr. Ruff again.

As far as changes from the past week:

  • I am barely sore at all anymore, except for here and there. Sometimes I am a little sore at the end of the day if I’ve had a particularly active day, but I haven’t been taking any Tylenol for well over a week, and I wake up feeling a lot better in the mornings than I was. I have been sleeping on my side since a couple days after surgery (with the OK from Dr. Ruff), but I am naturally a stomach sleeper. I still can’t lay or sleep on my stomach because it still feels too tight and uncomfortable, but that’s pretty much my only limitation at this point (besides the exercise thing).
  • I went back to work at the office this past week and it felt good! I was worried I’d tire easily, but honestly it felt really good to get back to my normal routine and I had plenty of energy throughout the day.
  • I have really enjoyed not wearing the foam pads, which I said goodbye to one week ago today.
  • I started treating my incision with Biocorneum – a topical silicone scar treatment. John, the Biocorneum rep for Dr. Ruff’s office, saw my post last week and offered me a complimentary bottle, so I feel lucky to have gotten it for free (though with the investment of the surgery, treating the scar is not something I would skimp on regardless). I’ve been using it twice a day and have been taking pictures, so hopefully I’ll start to notice improvements soon. Once all the scabs are gone (which should be within the week), I am also going to start using a silicone strip over the incision which is supposed to help fade and flatten the scar greatly as well.
  • I went shopping yesterday because a looooot of my clothes don’t fit that well anymore, (AND I no longer have to fear form-fitting clothes!) and for the first time in my life, I bought a size 6 black skirt! Granted, it’s pretty snug right now, and I’m pretty sure the store I bought it from runs big, but still! I also bought a couple size small shirts, which was almost as exciting.
  • They say not to step on the scale for the first 6-8 weeks post surgery, but I have been because I’m not letting it bother me, I’m just curious. I stayed about the same weight as before surgery for the first week or so after surgery, and since then my weight has gradually been going down as the swelling goes down. I haven’t been weighing myself daily, but the last time I weighed myself I was down 14 pounds from before surgery – which means I’ve lost some weight on top of what they removed during surgery. My official pre-op weight was 178 pounds, and the last time I stepped on the scale it said 164 (which coincidentally was my official Weight Watchers goal weight way back when). Apparently this number is going to keep going down as I get rid of the rest of the swelling (which is barely detectable at this point to me).
  • I’ve noticed my bras have been fitting really poorly. I think I wasn’t in the right size before surgery, and then with the flank lipo during surgery, my band size may have been affected. I went to Target yesterday to try on a few different sizes, and I was off by one cup size and two band sizes from what I was wearing before yesterday. Whoops! What a difference it makes to be wearing a more appropriate size.

And now, for the progress pics! I’m definitely noticing looking flatter and having a more defined waist this week, though it’s a subtle difference.

These are from yesterday, which is 20 days post op:

3 weeks PO

That line up my side is an indent from the compression garment, which I’m still wearing 24/7 for another 1-3 weeks. Starting at 4 weeks, I can wear the compression garment for 12 hours and a spanx-like garment for the other 12, though I’m told the more I wear the compression garment the better, so I may just do that.

And here is a side by side of 1 week v. 2 weeks v. 3 weeks post op.

1 week v 2 weeks v 3 weeks

Overall, I am super pleased with my progress, and excited to see where I am 3 weeks from now when I hit the 6 week mark. I imagine the changes will be more and more subtle at the weeks go on, but I am already so happy with the results that I would do it again in a heartbeat.

Two Weeks Post Op

It’s crazy to me that exactly two weeks ago today, I was on my way to Ruff Plastic Surgery to go under the knife (and by choice!). It feels like it was just yesterday in some ways, but then it also feels like ages ago. I think when things are really tough (like they were the first few days post op) each hour feels like a day and the time goes so slowly because you just want to press fast forward, but because you’re just focusing on getting through each obstacle that presents itself one at a time, overall the time passes pretty quickly. I’m not sure if that makes any sense to anyone outside my own head, but hey.

So overall, recovery is going REALLY well. I notice improvements almost each day, and this weekend marked the first time I was completely off painkillers of any form. I switched from narcotics to Tylenol after the first several days, but was taking Tylenol pretty religiously, with an occasional Vicodin here and there as needed since. Saturday, I woke up feeling pretty good, and decided to try to go without anything that day. I was a little sore, but nothing major, and I feel like allowing myself to be a little sore is actually a good thing because it reminds me I am still healing and need to take it easy. Sunday I felt a little more sore than Saturday randomly, but still managed not to take anything and am going to try to stay off going forward unless I really need them.

In terms of other changes from this past week:

  • The steristrips are now completely off the incision, so it’s no longer covered by anything. It is still pretty gnarly and scabby, so I will spare you photos until it’s less scary to look at.
  • I am walking completely upright now, which means my lower back is no longer in pain from walking hunched over – thank GOD. That sucked.
  • I am definitely feeling more energetic and less fatigued, which is another welcome change.
  • I am going back to work at the office today for the first time since surgery, though I did manage to work quite a bit from home last week.
  • Today is the first day I no longer have to wear the foam pads under my compression garment – another VERY welcome change. Those things were really hard to put in, but also made me feel really hot and stuffed like a sausage into the garment.

Speaking of the compression garment, I’ve gotten a lot of questions, so I had Matt take a picture of me in it yesterday so you can see what it looks like.

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It goes all the way from just above my knees, over my torso, and up over my shoulders. It has at least two layers of material, and is designed to be very tight – think Spanx gone wild. The straps over my shoulders have eyelet hooks (like the back of a bra), and then the main closure is up the side (under my left arm) with eyelet hooks covered by a zipper. This garment used to be extremely tight (in fact, even a little hard to breathe in), but it’s actually loosened up quite a bit now, which I think is a combination of the swelling going down and it stretching out from me being in it. It’s actually not that bad, but it does make it challenging to get dressed in normal clothes (especially summer ones) because of both the top part going over my shoulders with the neckline, and it being down to my knees. I found a solution this weekend, where I unhooked the straps and tucked them into the garment just under my bra so that I could wear a maxi dress. You couldn’t even tell I had something on under it!

photo 1 (1)

I went out for lunch and a movie with my friend Erika on Saturday wearing that, and then after the movie (The Spectacular Now, which was AWESOME), I looked down and saw there was something on my dress.

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It took me a while, but then I realized it was the Neosporin I put in my belly button leaking through the compression garment and onto my dress! How nasty! Luckily, it happened during the latter half of our outing so I could go home and change (and stay in for the rest of the night as to not overdo it). I treated the stain last night and really hope it comes out because this is one of those dresses I loved but could never wear before because of how it clung to my body. Argh!

Here are some new progress pictures, which were taken yesterday (day 13 post op). (You can look at this post for before pics and earlier progress photos).

The front:

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The back:

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You’ll notice the bruising is almost completely gone on my back, which is a big change from last week. That weird triangular dent from my underwear up my back to the left of the middle is from where the foam pads were laying, and that vertical line to the right of it is the scar from my back surgery in 2006. It’s kind of hard to tell from the pictures, but the swelling is worse in my back than in my front.

Here’s a side by side of one week post op v. two weeks post op.

1 week v 2 week

Not sure you can tell too much of a difference between these photos (and I realize I definitely need to be more consistent about lightening/angle/undergarments), but my belly button is definitely healing, and I’m very glad to have a belly button that you can actually see!

I have a two week follow up appointment this morning where I will discuss scar treatment and get my first Medsculpt Massage, which is a lymphatic drainage massage that I am pretty sure is not going to be nearly as luxurious as it sounds. I’m going to ask questions about what limitations I have at this point, when I can start scar treatment (which I’m pretty sure is not until all the scabs along the incision are gone), and whether I need to get a new compression garment since this one feels on the loose side now.

I’m planning to do a Q&A Post soon to address the many questions I’ve received, so please let me know if there’s anything about the surgery you’re wondering. Nothing (respectful) is off limits, though if it’s too personal I may just email you the response rather than the post it on the blog.

Ending the Week on a High Note

I wanted to end the week on a good note, so let me share with you two exciting things.

1.) The bruising on my back has made incredible progress. Check it.

Bruising Progress

Isn’t that a crazy difference in just 5 days (from PO Day 6 to PO Day 11)? It’s practically gone! I’ve been using arnica gel on it a few times a day, as well as been taking Arnica supplements since 1 week before surgery, which is a homeopathic drug that helps with bruising and muscle soreness. Seems like it’s working!

2.) Yesterday, I bought my first ever bikini!

Well, let’s be real. I bought three. When I say first ever, I mean it. I have always been too chubby and more so too self conscious to ever even consider wearing a two piece suit. I remember going through a tankini phase but I would always make sure to buy the ones that overlapped with the bottoms, and even then, it caused that same intense fear of it coming up when I jumped in the pool or moved the wrong way. Not that there’s anything wrong with a one piece, and I’m sure I’ll continue to wear some, but as you know I was feeling a little blue, so I decided to do something to make myself feel better. I headed to Target just to try a few on and see if the incision would be covered slash if I would feel comfortable enough to wear it, and I ended up almost freaking out in the dressing room because not only did they fit and cover the incision, but they actually looked ok!

Bikini 1:


Bikini 2


Bottom from Bikini 2:

bikini bottom

The scar is TOTALLY covered. (That redness just above the bikini on the left side is irritation from the steri strips that were covering the incision – not the incision itself – so that will go away.

And yes, I still have a lot of stretch marks, and yes, my body is definitely not perfect. But you know what? I am TOTALLY going to rock these bikinis anyway!

Happy Friday!


So it can’t be all sunshine and roses, right?

Yesterday, even though physically I am doing incredibly well for 9 days post op (well now, 10 days), I had the toughest day mentally. I knew that I would experience a rollercoaster of emotions after surgery, but knowing that it was coming didn’t make it any easier to deal with.

I took my first shower without the shower stool and was feeling great. Then, I looked down and noticed that some of the steristrips were coming off part of the incision. I was told this was fine, that some of them would start coming off naturally over the next several days, and then come Monday I’ll have to make them come off if they haven’t already. So after getting out of the shower, I snipped part of the tape that was loose away and got a look at about 2” of my incision over the hip. I started crying immediately.

I mean, logically, I KNOW that I had my body practically cut in half, but seeing that incision is really something else. Until yesterday, the whole thing was covered so I couldn’t actually see the cut mark itself, and while it is beautifully done, it was still very disturbing and strange to see it on my own body. That set me into an emotional whirlwind, and for the rest of the day I was on the verge of tears. I think I cried 9 or 10 different times yesterday, and I am so not a crier.

I think at this point in the journey, my mind is totally there and my body, is just, well, not. I am so frustrated to be so helpless and I just want to be back to my normal life.

My top complaints at the moment are:

    1. The damn compression garment. I have to wear the compression garment 24/7 for 6 weeks. So, 4.5 more weeks. It goes from just above my knees to over my shoulders with a v-neck covering my chest. It doesn’t go well under any other clothes, and the side has eyelet hooks underneath and then is zipped up over them. It’s really hard to get on by myself, and I am just sick of it.
    2. The foam pads under the compression garment. I am wearing medical grade foam sheets – 3 of them – around my midsection under the compression garment. I’ve been wearing them since right after surgery, so parts of them are covered in dried blood and disgusting. They make me feel even more stuffed into the compression garment than I already do, and are really difficult to put in the compression garment without assistance, though it’s getting easier. Luckily I can say goodbye to these on Monday.
    3. Waking up very sore and stiff every single morning and having to take Tylenol before I can get out of bed. Not much more to say here, but I feel like a 90 year old woman first thing every day. I usually wake up the first time and pop a few tylenol and stay laying down for a little longer before getting up, and then it’s not so bad.
    4. Getting exhausted from things like putting on the compression garment. Or taking a shower. The compression garment is pretty hard to put on without assistance, but I did so yesterday after taking a shower and it took me a really long time. I had to pull it up over my hips, put in the three foam sheets, make sure they stayed in place while I pulled it the rest of the way up, and then close the eyelet hooks on the side and zipper it up. It felt like what I’d imagine it’d feel like if I had just run a marathon.
    5. My lower back aching when I’m on my feet for too long. That’s been one of the surprising things about this surgery. My back is what hurts more than anything else! I was expecting my abs/stomach to hurt (which they did for several days), but now, it’s my back that aches like crazy. If I’m up and walking for any amount of time (which ranges from 15 minutes to an hour depending on the time of day) I have to sit down immediately and can’t finish what I was doing.
    6. Feeling scared to be alone because of the “what if’s”. Not really much to say here, but I live alone and being there by myself makes me extremely nervous. I’m staying at my boyfriends this week but it makes me feel like such a burden because I can’t do much and I am just always here. Ugh!

I wanted this to be as honest an account of what going through this procedure is like as possible, so you are welcome. Smile

The Procedures, The Concerns and The Photos

So here we are about a week and a half past surgery, and I am feeling amazing. If you didn’t know I just had major surgery, you probably wouldn’t guess it because I am getting around well, albeit a little slower than normal, and standing mostly upright at this point. I still have a lot of soreness and stiffness when I first wake up in the morning, but it’s getting less each and every day. I am still quite tired and things that seem like they shouldn’t require much energy completely wipe me out, like taking a shower. I did that on Monday (my first unassisted one!) and passed out for almost 3 hours afterwards. But besides the fatigue and soreness, plus some random itchiness and twinges from nerve regeneration, I am feeling pretty amazing and thankful that my body is healing so well.

The Procedures:

I’ve gotten a few questions about exactly what I had done, so I thought I’d spell it out here. I had my surgery with Dr. Paul Ruff of Ruff Plastic Surgery on July 29, 2013. Here is a breakdown of the procedures:

1.) Extended Abdominoplasty – it was “extended” because the incision starts right in the middle of my hip on either side, basically straight down from the center of my armpit. The reason is because I had a lot of excess skin to get rid of, and they have to cut longer than the skin they are removing. I had full muscle repair as part of the procedure as well, which feels like you did two million sit-ups in one sitting at first, but has gotten less sore with time.

2.) Flank Liposuction – this was actually something I wasn’t expecting before my consultation, but apparently it goes along with many tummy tucks. Dr. Ruff explained that when they remove the skin/fat on the front of you, the flank liposuction helps contour your body and slim your waist so that you have a more hourglass shaped figure.

The Concerns:

When I wrote the post the night before surgery, I had some big concerns going in. They were:

  • That something will go wrong during the procedure. it didn’t.
  • That coming out of anesthesia will be rough. it wasn’t.
  • The pain during recovery. that proved true and was not fun, but thankfully I’m over the hump.
  • The scar I’ll be left with from hip to hip. I still haven’t seen the incision itself because it’s covered in steristrips (clear tape), but that comes off Monday and then I’ll get a good look. It’s pretty enormous, but I would take the scar (I think) over what I had going on before any day.
  • Having to deal with the surgical drains during recovery. these were not nearly as bad as I expected. Annoying, yes. Painful, no. I actually liked seeing the progress in the drainage as it went down over the days after surgery and turned from red to lighter in color. I also liked that the fluid came out of me instead of staying in there. I got one drain removed at 5 days post op (PO) and the second one at 7 PO.
  • Not being able to do things for myself. This is something I struggled with a lot, and still do to some degree. It’s hard to be slower than I normally am and I have to make a conscious effort to remind myself that I am recovering. I need rest so my body can keep working on healing me. Having to be given a shower was probably the hardest part for me.
  • The fatigue and run down feeling I know I’ll be dealing with for weeks. Yup. Dealing with it. But it’s manageable. It’ll be a lot harder when I go back into the office full time.
  • Swelling. I am about 10 lbs swollen right now. I know this because my weight is still the same as it was pre-op, and they removed 10 lbs of skin/fat from me during surgery. I am definitely feeling a little swelling/bloated, but it hasn’t hit me yet. I’m told it gets worse in the coming weeks, so stay tuned.
  • Not recognizing myself in the mirror. Sort of, but this is actually a good thing. I still can’t believe how slim my waist is. And this is with medical foam padding under my compression garment AND 10 lbs of swell.
  • That I’ll be unhappy with the results. So far, I am ecstatic with the results of the surgery. I still have a long ways to go as far as healing goes, but the progress I’ve made in the first week is amazing. Our bodies are incredible.

The Photos

So what you’ve all been waiting for! The pics. Just a few things of note. First, I am healing VERY well. My doctors have been impressed with how great I look for this soon after surgery. Also, I am dealing with about 10 pounds of swell right now, so my stomach is going to be even flatter over the next several months as my body fully heals. Also, I still have a lot of stretch marks. If all the stretch marks are below the belly button, they will all generally get removed in surgery, but mine were all over the place, so they did not. The stretch marks will be come less prominent as the swelling goes down, though, and most of them are now below my new belly button. I also have not seen the actual incision yet since it’s covered in steristrips. Those come off on Monday, so I will show you guys the scar itself once I see it for myself and how it progresses with scar treatment therapy. Ok, enough with the disclaimers.

I literally get sick to my stomach with the thought of posting these “before” photos of my stomach. Ironic, isn’t it? I hid it quite well in clothes and always felt like I was hiding something because, well, I was. But, this is not my body anymore and I know a lot of people who undergo massive weight loss deal with issues of loose skin and flab around their midsection, too. So I’m going to take one for the team here and show you what I looked like until last Monday. For comparative purposes, my stats are: 5’8”, ~175lbs, size 10 pants/medium top. Here we go. Gulp.

Before Tummy Tuck Surgery

Before TT

The one on the far left is with everything “tucked in” and the one on the far right is with it… not. The scar above my belly button is from the time I decided piercing my own belly button with a sewing needle would be a good idea at age 16 (and shockingly it got infected) and the rest is just from being obese for so many years.

And here are some photos from the after; the now.

Post Op, Day 3

PO Day 3

Post Op, Day 5

PO Day 5

Post Op, Day 6

PO Day 6

Post Op, Day 7

PO Day 7

This was the day they removed the gauze/tape from my belly button, as well as my last drain.

Day 3 – Day 5 – Day 7 Comparison

Day 357

Before and One Week PO

before after

I am terrified to press publish. Please be kind.

The Flat Side: The Next Few Days

So let’s see, I left off with me being in extreme pain in the middle of the night within the first 24 hours of surgery. I didn’t intend to leave such a cliffhanger, it just felt like a good stopping point at the time until I re-read it and realized why so many people said ending there was torture. Sorry ‘bout that!

I ended up taking 3 more Vicodin and a Xanax and drifting back to sleep for a few hours. I woke up and took more pain meds, and then my mom drove me back to Ruff Plastic Surgery. I was greeted at the car by a nurse, Sharonda, and she helped me walk into the building. I had actually called and requested a wheelchair, but when Sharonda came down to the car (without a wheelchair), she said Dr. Ruff really wanted me to walk on my own because the more I did, the quicker I’d heal. The visit there was a blur – literally. I was brought into an exam room immediately and there were three people there – Sharonda, Lori, and Michelle – and they all helped remove my garment (which was still unhooked from the night before, but I was still busting out of it).

I remember standing there and feeling like I was either going to pass out or throw up because the feeling was so intense when the garment came off and I’m pretty sure I did pass out a bit. They were putting those smelling salts under my nose and the three of them were holding me up while they put another (larger) compression garment on me. I remember being told to keep my eyes open and just being in SO MUCH PAIN I couldn’t even get my head around it. They put medical foam pads into the garment which help keep things smooth and contoured post surgery, and then I was sent on my way back home. I was bummed because that day was also when I was supposed to get to get a first glimpse at the results of my surgery, but because I was in such a haze during the whole switching the compression garment ordeal, I didn’t even get to see what I looked like underneath the compression garment.

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Clipping the drains to that chain ended up being clutch.

That said, I was given scripts for much stronger pain meds (OxyContin and Percoset), and was told to take the Oxy every 12 hours, and then the Percoset for breakthrough pain every 4-6 hours as needed. The new pain meds were like night and day. I basically slept on and off the entire day and only really woke up to take my antibiotics, more pain meds, and to use the bathroom (only to pee – more on that later). I also got lots of gorgeous flowers delivered, which was definitely the highlight of the day (from my close girlfriends, my office, and my old boss).

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And a balloon!

I was still in a good amount of pain even though it was much better managed, and I remember telling my mother more than once that if I knew how painful it would be, I wouldn’t have had the surgery. She told me it was too late. Ha. Truth.

So that was the first day post surgery. Not one of my better days.

The next day was Wednesday, and that was the day I was told that if I hadn’t had a bowel movement (BM), I had to start doing something to change that. When I woke up that day, the pain was much more manageable, but my stomach was in KNOTS. I felt bloated, uncomfortable, crampy – you name it. I barely even felt any pain from the surgery itself – all I could think about was how to empty my system. Warning – TMI ahead – so if you don’t like poop talk, I’ll see you tomorrow.

I had actually started taking Colace (a stool softener) on Saturday before surgery, because the anesthesia and the pain meds can really back you up. I was taking that once or twice a day, but come Wednesday, that proved not to be enough. Natalie (the OR nurse) called me in the morning to see how I was doing, and was relieved to hear the pain was much more under control. She asked about whether I’d had a BM, and told me that she would text me the recipe for a cocktail that there was a 95% chance would get things moving in 2 – 6 hours.

This is what I had to drink, I kid you not:

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4 oz. of a mineral oil enema (ie. one that is intended to go in the other end, but it was just mineral oil), 4 oz. of apple juice (for flavor?), and 1 shot of vodka (to help me forget I was drinking an enema?)


I drank it like a champ, choking down the cocktail while promising myself it would be worth it when it got my system moving. Well, guess who was part of that 5% that it didn’t work for? Awesome. So, not only did I drink an enema, but I also did not have a BM as a result.

I called the nurse back after the 6 hour window had passed because I was getting more uncomfortable by the minute, and I was told to try taking a laxative. That was at least intended for oral consumption, so it went down easier. I popped 2 Senokot and hoped for the best. Matt had come back that night (and was the lucky one to get to purchase said laxative), along with a few of my closest girlfriends, so it was nice to have the distraction and the cheer squad each time I got up to try to use the bathroom. Everyone left around 10 that evening, and I coaxed myself back to sleep with more pain meds and Xanax. I woke up once in the night for more pain meds, but overall it was pretty uneventful.

When I woke up Thursday, I literally felt like I was going to explode. My stomach was going crazy and I couldn’t think about anything else besides the gastrointestinal issues. I was doubled over in pain and switched myself from the narcotics to Tylenol so I had a chance at getting things moving (plus the surgery pain was feeling a lot more manageable that day). I spoke with Lori from RPS, the nurse practitioner, and she said that she had a lot of issues with constipation during her pregnancy and that I should try suppositories. So, my mom went out and bought me some from CVS, and after several hours of concerted effort (I will spare you the details here), FINALLY, finally, finally, I had a BM. And then probably 10 more in the next several hours because everything I was doing to get my system moving kicked in at once. But I’d take that over the previous situation any day.

PS: I’m really glad I just shared that story with the world.

I also took my first post-op shower that day (thank God I bought this shower stool – best purchase ever). And by “I took”, I mean “I was given” my first shower. By mom and good friend Kate, and to say it was a humbling experience would be an understatement. It actually wasn’t as painful as I was expecting (I’d read horror stories), but being a 29 year old female unable to bathe herself was a tough pill to swallow, even if it was temporary.

So then came Friday, 4 days post op, and it was the first day I woke up feeling pretty good. I was very sore and quite stiff when I first woke up, but after taking a few Tylenol and walking around a little bit, I loosened up, and actually ventured outside for the first time post-surgery, besides that fun compression garment switcheroo earlier in the week. My mom and I went out to lunch, and even though the restaurant was just 1.5 blocks from my apartment, it took me a good 20 minutes to get there because I was walking so slow (and so hunched over).

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That’s probably how I look while dancing, too.

I was pretty uncomfortable at the restaurant so it was a fairly quick lunch, and I couldn’t really eat much because my appetite was still all messed up from the meds.

But! I was walking. And I was outside my apartment. And I was feeling a bazillion times better than I was the days before.

Better place to end this one, eh?

The Flat Side: The Day of Surgery

What a week it has been! I honestly barely even know where to start, so I think I’ll just start with one week ago today.

As I alluded to in my last post, I was feeling reaaaaally anxious and nervous on the day before my surgery, so when my alarm went off at 5:45am last Monday, I wasn’t quite sure what state I’d be in. But somehow, I was much more calm than expected and I woke up pretty easily. I took a quick shower with antibacterial soap, brushed my teeth, and sipped just enough water to take a Zofran (an anti nausea medication) before gathering up my things to head out the door. I was instructed to wear comfy pants and a top that zipped or buttoned up (nothing that went over my head), as well as my glasses rather than contacts.

Since my parents had stayed in town for the weekend, I got in the car and drove to their hotel for 6:15am, so we could head to Ruff Plastic Surgery. We got there a few minutes before 6:30am and since the building wasn’t quite open yet, we putzed around outside for a few minutes while I tried to teach my parents the wonders of the iPhone camera.

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Before too long, we were met by my OR nurse, Natalie, and taken into the office to get ready for surgery. I honestly could not believe how calm I felt! I was expecting to need to take a Xanax, but I felt calmer than I do on a normal day – weird. After going through the basic questions and a review of the medications, I changed into my hospital gown and compression stockings, took some pre-surgery meds, and then just hung out in the room where I’d be recovering.

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I am cool, I swear.

Before too long, Dr. Ruff came in to check on me and see how I was doing, before marking me up all over with three different colored markers. He said that they mark your natural anatomy/curves while standing because things shift when you lay down (for the surgery) which I hadn’t really thought about before. After he was done with the markings, he said he’d see me soon and left the room, and then the anesthesiologist came in. He went over my medical history with me, asked about any prior complications or family history of complications with anesthesia, and then hooked me up to an IV to start me on fluids.

At just a few minutes after 7:30am, I said goodbye to my parents, and then Natalie escorted me into the OR. Right away, they had me remove my gown, and my entire body was painted down with this betadine solution by two medical assistants with these rollers – almost like what you paint walls with. The solution smelled TERRIBLE and was so cold on my skin, but I needed to be completely sterilized prior to surgery (obviously). After that was done, I was walked over to the operating table where I laid down with my arms stretched out on either side, and then the anesthesiologist came back into the room. I remember him asking me some questions about my job, and making some small talk. I thought I would have a “here we go” moment where I would be aware that I was fading and come to terms with the fact that I was going under the knife, but it was not like that at all. I don’t remember even starting to drift off, I just remember waking up in recovery fully clothed.

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Totally doped up and happy post surgery.

The procedure itself took about 5 hours (just slightly longer than the 4.5 anticipated) and I came out of anesthesia quite well. I wasn’t nauseous at all, which I was really thankful for, and I just remember being way more “with it” than I was expecting. I have flashes of people (Dr. Ruff, the nurses, my friend Susy who works at Ruff Plastic Surgery) coming in and out of the room, and also of the machines they had me hooked up to beeping and my mom telling me to keep breathing. I also got my hands on my phone and texted a bunch of people back (with totally coherent, non-anesthesia sounding responses) and even updated my facebook page.

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Priorities, right?

It was kind of surreal.

The other time I had anesthesia was for my emergency back surgery was in 2006, and when I came out from being under that time I supposedly was swearing pretty loudly and persistently. This time, I was a bit paranoid about having the same reaction, because I asked the doctors three separate times if I came out swearing, though I only recall asking the third time, and don’t even remember the answer. I was asking very coherent questions, but don’t remember most of the answers. One question I did ask was “how much did you remove from me?” and I do remember the answer (though I’m told it wasn’t a one-time question) – 10 pounds! Holy crap.

After the fading in and out stopped and I was stabilized and mostly with it, I was wheeled out of recovery and the building, and got into my parents car. I got home, up to my apartment, and was totally alert. It was wild! I was expecting to be sleeping for the entire first few days post surgery, but I was totally awake. My boyfriend (good of a time as ever to make that “announcement”, eh?) came over and brought flowers and a get well package with magazines, an eye mask, smoothies and protein snacks. My mom made some chicken gyoza from Trader Joe’s and we all watched the season 6 finale of Dexter (I’m still catching up).

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In my compression garment, with the sexy drain tubes and compression socks. And lots of beverages.

I wasn’t in much pain at all and was getting up on my own to use the bathroom. It was wild!

But then around 8:30pm, my body woke up and realized what had just happened to it. I hit the wall, and hit it hard, and was overcome with pain, fatigue, and tears. Dr. Ruff called me to check in around that time from his cell phone and I had my mom talk to him because I couldn’t. He said I could take 3 Vicodin every 6 hours if the 2 every 4 wasn’t working, so I did that and coaxed myself to sleep with some Xanax. That worked for a couple hours, but then I was up in tears again around 2am, paralyzed from the pain. We called Dr. Ruff on his cell phone in the middle of the night and he recommended my mom try to open my compression garment to release some of the pressure, which she did and that helped a tiny bit. He said our options were to either go to the ER right then or wait until 6:45am to go back to the office to figure out next steps and how to get the pain under control. We went with the latter option because the last thing I wanted was to go to the ER at 3am…

To be continued…

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