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Skin Removal after Weight Loss

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Poo Pee Your Genitals and Reconstructive Plastic Surgery

Being a WLS Reconstructive Plastic Surgery Patient myself, there are a few things that I have learned in the last 17 months that I REALLY wish people had told me and taught me about before hand. Let me just say, this isn’t the sort of information that I could have found on the internet, it isn’t for the faint of heart, and if my talking about body functions, defecation, or the change in location of genitalia is something that would bother you… do us both a favor and stop here and spare me the rude comments later. There are several people who will thank me some day for the fact that this article exists.

33819573First let’s talk about poo: Why not?  We talk about it post bariatric surgery all the time.  How often, what color, the consistency, the smell, yadda yadda…its like we are all first time parents talking about our children! (My BFF/Sister has had two kids now, I have seen this stage of Parenthood from the sidelines.)  Well let me just say first and foremost, when they tell you to start taking stool softeners after surgery, don’t screw around about it. Take the stool softeners whether you think you will need them or not. I promise you will be glad you did.

So let me tell you what happened to me…  Remember this is MY story, it might not happen to everyone.

My doctors tend to put me on oxycodone and valium post operative reconstructive plastic surgery because I am a baby and a wimp when it comes to pain. I also tend to have a lot of swelling issues and my body likes to hang on to fluid, so I almost always end up taking a diuretic to help with that, some sort of water pill. Water pills tend to make you shed water and often times you can end up dehydrated if you aren’t drinking enough. Do you know where this leads you my dear Slender Seekers? It leads you to sitting on the toilet, praying to the porcelain god that you could just push that big rock you feel inside you out.  I’m not sure anyone that hasn’t had abdominal surgery will quite understand the gravity of this (I’ve been reassured by my BFF/Sister that very pregnant women understand), but really try it while you are sitting there and you don’t have to go sometime. Just push like you do, see what muscles you use. Then imagine having an incision that goes all the way around your bikini line, a Fleur de Lis incision like mine that goes from hip to hip across your bikini line and up the middle of your stomach, or any sort of abdominal incision at all… really can you say ouch? I sure as heck did, many, many, many, times. Never in my wildest dreams did I think that the ability to take a poop would be such a painfully traumatic experience.  Oh but it was!

Now fast forward a few days, you’ve had this problem for a good solid 4-5 days now. And let me tell you that good and solid are not words I use lightly here because guess what folks that is exactly what it felt like inside me. It was this abundant feeling of “Holy crap, if I could just get some out of there and break the seal I’d be okay and I think the rest would just do it’s thing.” – by this point, I’m taking stool softeners, drinking Milk of Magnesia, heck I’ve started taking a “Gentle Laxative” – So let me say right now, being full of shit hurts. You can quote me on this one. It’s not a fun or pleasant experience. At a certain point you just realize how bad the situation is and it occurs to you that one of two things has to happen… either you have to find a way to go or you have to go to the doctor so that they can help you go. Do yourself a favor, Google “Impacted Bowels” and see that the usual treatment is if you go to the hospital for this problem. When I tell you that you want to have someone who you know loves you and that you are comfortable with taking care of you after reconstructive plastic surgery after WLS –  I am NOT kidding.

There have been times that I have needed help getting dressed, feeding myself, drinking, taking medicine, getting up and down, going potty, when we did my arms… which I did twice by the way. There were times I had to sit there on the potty and shout “All done,” and wait for someone to come wipe my bum like I was my three-year old nephew being potty trained. My arms just hurt too bad to move that way.

But there was a moment… where despite the pain, when I realized that I literally had so much poop stuck inside me that it wasn’t coming out on its own no matter what I took or did and that my possible options where to go to a doctor and get their help getting it out, the words that came out of my mouth when I looked at the person so lovingly taking care of me was “I need a rubber glove, a ziplock bag, and I need you to get the hell out of this bathroom until I call you back in.”  – I won’t go into specifics that will gross you out. There is no need to. I am sure you all understand first and foremost how painful it must be to move your body in that manner after having abdominal surgery and a brachioplasty at the same time… which I have done not once, but twice now. I don’t recommend that combination if you are wondering. I also highly recommend you ask the doctor about starting stool softeners pre-op rather than post op as a little bit of a preventative maintenance thing so that hopefully you don’t end up quite as traumatized as I did.

Let me also say, this wasn’t a one time experience in my post reconstructive plastic journey, but it is an experience that I seriously freaking hope I never have to go through again, so if I can spare you a little humiliation, embarrassment and discomfort by sharing it with you… I’ve done my good deed for the day.

images-2Now let’s talk about genital relocation: (I may just need this shirt from Zazzle.com featured to the left after writing this article.) This is not something I experienced after my first three surgeries to be quite honest. The only thing I really noticed in regard to my genitals after my first three surgeries was that I could see the pubic area of my body a bit and it seemed to change things for me sexually, like I had some issues with things not feeling quite the same as before. ( We’ll talk about that another day ) – Never before did it seem like my entire vagina had been moved and suddenly worked differently. Oh but this last surgery was different!

Let me say that my AMAZING surgeon, took great care to make sure that even though it wasn’t on my to do list, he made sure the excess skin I had in my mons area was addressed during this surgery. He took great care to measure from the very tippy top of the opening of my vaginal lips all the way to my belly button and make sure that the distance there was anatomically correct and that there was no more loose skin in that area of my body when we were done. This was something he did for me on his own to help make sure that I got the sort of body I was looking for post surgery and one of the few reasons that Dr. Yaker is so damn amazing at what he does.

Let me say first off, that I am three weeks out right now and my mons area is still one of the most tender areas of my body currently, probably coming in third with my arms and breasts being the top two. If you were at the WLSFA Event in May and you got to hear Carnie Wilson speak about her experience after reconstructive plastic surgery, you’ll get a good laugh at this. As I sat there and listened to her tell a story very similar to this I thought to myself “What is she talking about that didn’t happen to me at all.” – Oh boy did it happen to me this time.

I never knew that is where my va-jay-jay was supposed to be! And when you put it there it changed my pee stream by a lot! I can pee standing up in the shower now and have it propel forward and not dribble down the insides of my legs. The other day, I was sitting on the toilet going potty, and had the most unfortunate experience of coughing. ( Thank you to my niece and nephew for being little germ monkeys and giving me a cold during my recovery. ) As I coughed, the stream that was already hitting the front part of the toilet bowl more than normal, shot upward, went through the crack of the toilet and the toilet seat, and landed in a puddle on the floor in front of me. I sort of tilted my head to the side, looked at it in wonderment and then thought “wow, that’s a bit different.”

Trust me when I google “Genitalia Post Reconstructive Plastic Surgery after Massive Weight Loss” or “Your Genitalia and you Post Excess Skin Removal” I don’t come up with anything that would have helped me prepare myself for this strange moment. Mainly I find a list of Surgeons doing Skin Removal surgery – and talk about what different surgical options are out there and which ones address the genital area. But nothing that is like “Hey guess what things change down under when you lift them up and over!” Just sayin’.

We’ve talked about the pain with excess skin removal surgery. We’ve talked about the emotions involved in reconstructive plastics surgery and we’ve talked about poop, pee and genital relocation. What’s next? Well moving your genitals around and having them re-arranged doesn’t just change how you pee it changes a few other things too. But that my dear Slender Seekers is a topic for another day.

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Emotions Post Reconstructive Plastic Surgery After WLS

I’m behind on blogs and there are so many I need to write. Since this is the most prevalent in my mind, it will get written first.

As usual, I will be sharing the full experience of this fourth bout of reconstructive plastic surgery with you once I am fully healed and can write about it from bringing to end. What I want to talk about today is the emotional and mental aspect of this part of the weight loss journey.

dd7222daa7986c2ad775cc3885e20b34Rarely a day passes without someone somewhere in the weight loss community talking about loose skin, how much they hate it, how ugly it makes them feel, and how much they wish they could get rid of it. I won’t lie and say I wasn’t one of them, in fact, I think I was one of the worst. I honestly think there was a point where I was dangerously close to this place where no matter how much I cut off my body it would never be good enough [ See: My Body Issues vs My Support System Them Zero Us One ] and I would never achieve the vision I had in my head of what I wanted to see in the mirror.

Thankfully, I found an amazing surgeon who has been able to do for me exactly what I needed him to do. Even before the swelling goes down, I can tell looking in the mirror that this time things are different and that this time around, my body looks more like the body I feel I have put the last 2 years and 9 months into creating. – ( This is how I feel most of the time – until the irrational emotions kick in. )

I’ve been very honest and open about my journey, my mindset, and how I put myself in a very unhealthy place when I started to associate cutting the skin off of my body with cutting my abusers out of my life.

I’ve been open and forthright when it comes to telling you that there is a big difference between reconstructive plastic surgery and cosmetic plastic surgery and that having realistic expectations of what your body is going to be like after these surgeries is of the utmost importance. This is also an area where I had to learn from mistakes, because the over-compulsive-virgo-perfectionst in me, struggles to realize that I will never have a perfect body, that I will never look like a Barbie doll and that my body will always have some part of it that remembers it once weighed 420 lb..

Reconstructive Plastic Surgery is by far the hardest thing I have ever put my body through both physically and mentally. It is NOT easy. It is the single most painful experience I have ever had in my life. I can still honestly say that I have no buyers remorse, though there were a few times in the first few days following this last surgery when the pain levels were so high that I am pretty sure the sentiments “I wish I hadn’t done this.” and “Why did I do this to myself?” were expressed multiple times.

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Me trying to put on a very big smile despite the pain and discomfort.

The answer was clear for me though, I did it because it was what I needed to do for me mentally. It was what I needed to do for me emotionally. I had to get my body to a place that when I looked in the mirror I saw the woman I had worked so hard to become and not a remnant of the abuse that I had endured through my life that had pushed me into unhealthy addictions, relationships with food, destroying my body and committing suicide with a fork and spoon. The problem here, is that even going into this last surgery, I thought the surgery would change this for me somehow. When the reality is, whatever remnants of abuse I see when I look in the mirror, are in my head; I am the only person that sees my body now as some sort of taunting of my past. Nobody else looks at me and goes “Oh look at Pandora, her left arm is bigger than her right arm and she would never look like that if she hadn’t weighed 420 lb. and she would never have weighed 420 lb. if she had not been a horribly abused little girl.” – Nope nobody would say that if they looked at me today, only I negatively empower myself with those automatic negative thoughts when I look in the mirror. This my dear friends and fellow Slender Seekers is a break though moment for me. Because it really is one of the first times that I have been able to separate my negative thoughts about my body image from my body and say; “This is something that is wrong in my head,” verses “This is something that is wrong with my body.”

c022d749a8f8154307dd8875189def22I cannot honestly say that I believe reconstructive plastic surgery is the right answer for everyone. I think a lot of factors have to be considered. How close to your goal weight are you? Because the further away from it you are, the less likely you are to be happy with your results in the end and the more likely you are to have to have more surgeries. I also think you have to ask yourself why you want it, what it is going to change for you, and if you want it enough to endure the massive amount of pain that it puts you through.

I can honestly say, that I wish Reconstructive Plastic Surgeons asked you to see a mental health specialist before having reconstructive plastic surgery. It is something that I personally would highly suggest, because I think that when it comes to reconstructive plastics we start to reach into a whole new emotional part of the weight loss journey.

I remember my first few days post-op gastric bypass. I remember the emotional roller coaster that I endured in that first 12 months of my honeymoon phase. I remember all the emotional set backs I battled. My father having a stroke, me going back to smoking cigarettes and struggling to quit again, my Father passing away, the intense relationship changes I was going through in my marriage, being on crutches for 8 weeks after learning I was an extreme dumper. It was like life suddenly said “Oh look Pandora is doing something to try to get her life back, let’s see what we can throw in her way.”

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Me trying to play “Super Pandora” with my nephew wrapped up in compression gear and trying not to let the emotional breakdown in my mind seep through in my face.

This journey with reconstructive plastic surgery has been no different. The last 17 months of my life have been just as much of an emotional roller coaster as the early post-operative part of my gastric bypass was and my body has changed just as drastically in those 17 months as it has in the first 16 where I was shedding 260 lb. at star speed. In those 17 months I’ve gone through even more relationship issues, cut myself off from my entire blood related family, watched my mother try to commit suicide and go in and out of mental health counseling, and then last October I got involved with the Weight Loss Surgery community online more intensely, and boy let me tell you, that alone is more of an emotional roller coaster than I am sometimes sure we even realize.  I’ve worked on a complete career change that has intimidated the heck out of me on levels that include being intimidated by “learning” for the first time in nearly 20 years, and for the last 7 months I’ve pretty much been home in my own environment for all of 7 days as I bounce from place to place dealing with the different crisis that life has handed me.

This is my 4th round of reconstructive plastic surgeries and I can think of a ton of other things I COULD do… another breast lift, an outer thigh lift to make them look better, butt implants so that I could actually have a butt instead of suffering from the “No Ass At All Syndrome” that my 360 Upper Body lift left me with, a face lift to get rid of the rooster chin I hate when I see from a certain angle… I could go on and on.

But the reality is, if I did, I would probably still always find something to be unhappy with when I look at my body in the mirror. People who love me ask me often, “Why can’t you see how amazing you look and how far you have come?” – I wish, I honestly do that I had the answer to that question. I think that I am working towards it. I am using the right tools, talking to the right people and getting a little bit of help from some mental health professionals when it comes to trying to address my body image issues.

What I can say, is that it isn’t that I don’t realize how good I look. I see the progress. I see how much better I look now than I did when I had all that skin hanging off me. But I see my flaws and my mind focuses on them more than it does the positive. I suffer from over compulsive disorder. For me personally it is very easy for me to look in the mirror and go “My right breast is larger than my left breast” and have it become something that consistently bothers me. It is very easy for me to look in the mirror and see my arms and say “My arms are asymmetrical,” and have it become something that I obsess over.  The next time I am standing in front of the mirror naked, instead of looking at the amazing flat stomach my surgeon gave me, or appreciating how there isn’t skin dangling from my forearms anymore, my eyes are instantly drawn to the flaws I see.

I can cover those flaws up and play the out of sight out of mine game. I can tell myself how great my breasts look in a bra and how the difference is hardly noticeable, I can wear clothes that highlight features I am happy with and draw attention away from ones I don’t like. How many times did you all see me add a shrug to a sleeveless dress to cover the arms I hated so much?

But covering my flaws wasn’t ever my goal. My goal was to be able to stand in front of the mirror buck ass naked, and not only like what I see, but have the confidence to know that if someone else was looking at me, they were going to like what they saw too. I mean we don’t talk about sex a lot in this community, but hey, let’s go there for a second…

I remember when I weighed 350 lb., hated the way my breasts sagged out of a bra and was so afraid of someone seeing me naked that I literally wore a t-shirt during sex. Sure you could touch me anywhere you wanted too, as long as it was covered up and the lights were out.  Then there was the me having sex after losing 260 lbs. Same thing, I wanted the lights out, I wanted to not be seen, and oh Gawd, I wanted the sound of skin to skin contact to be between me and my partner not me and my loose skin as I tried to move in a sexual rhythm to theirs.

So post reconstructive plastic surgery, what I wanted most, was a body that made me want to leave the lights on, that made me want to let someone look at me, that empowered me to feel sexy, to want to wear lingerie and feel confident in doing those things.

I can hear what several of you are thinking already, I’ve heard it said to me more than once…

“If someone loves you, these things won’t matter to them.”

“You have to love yourself despite your flaws and learn to be happy with who you are.”

“Nobody is perfect.”

“Everyone has one breast that is different from the other, your breasts are sisters not twins.”

“Everyone has a little asymmetry to their body, one side of our body is not a perfect clone of the other.”

“Nobody notices these little things but you.”

And you know what… those statements are all probably 100% true and accurate. But that doesn’t mean my brain can rationally accept them, or rationally apply them to my situation.

We talk often about how it takes awhile for our minds to catch up with our bodies where the weight loss is concerned. So many of us lose weight so quickly after weight loss surgery and we look in the mirror and we still see ourselves as “big” or “fat”. We talk about how we have this misconception that we are a lot bigger than we are, we see ourselves different from others see us.

I don’t think reconstructive plastic surgery is any different. I’ve done four very large-scale surgeries in a 17 month time frame and they haven’t been spaced very far apart. My first was 02-12, next was 08-12, next was 11-12 and then 07-13 — and after each surgery, we were already planning the next one.

The weight loss journey as a whole is an extremely emotional one. Whether we are in the pre-op phase, early post-op phase, the honeymoon phase, or the maintenance phase, there are always big emotions involved. I haven’t even reached my three-year surgiversary yet and I have gone through them all.

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There are times when I feel like perhaps I rushed forward too quickly. I had just reached Onederland at my one year surgiversary and weighed 195 lb. when my surgeon said I could go ahead and consult with a plastic surgeon because my honeymoon phase was over and I had lost the weight I was going to lose. Just four months and another 20 lb. later I was having my first round of reconstructive plastic surgery. Then it was nothing but cut, heal, cut, heal, travel, cut, heal, travel, cut. So I spent 16 months losing my weight, and 17 months doing reconstructive plastic surgery immediately after doing so.

If you asked me “Pandora, if you had to pick the part of your journey that you saw the most changes in your body, was it the weight loss or the reconstructive plastics part?” My answer would be by far, the reconstructive plastics part and because of that, for me personally, this last 17 months has been one of the most emotional roller coasters of my life.

Someone asked me not too long ago “So when does the knife get put down for good?” – my response was “Hopefully after this surgery.” – My IM box was flooded by people in our community that were concerned about me when talks about transfer addictions to plastic surgery began to surface right around the time that I announced I was having my final surgery. Some of my dearest friends were concerned that I’d just always keep cutting on myself because nothing would ever be good enough.

78e5937ba1ef644bfe671872cf388409My feelings on these things change daily right now. I am through with reconstructive plastic surgery. I can honestly say, I won’t be doing any more big surgeries. There are some minor touch ups that need to be addressed after my body is done healing from this last surgery, that is completely normal. I will do those. But I am done enduring this sort of pain. I am done being out of commission from exercise; my major coping skill. I am done being cut in 3-4 directions or 8 different locations at a time and I am ready to close this chapter of my life and move on to the next one.

Since I haven’t begun but an outline of that chapter, I am not sure what all it entails just yet, but I do know for sure, that it doesn’t include any more rest and recovery days unless they come in the form of two days off of a marathon training program.

The next chapter of my life involves moving on with my new career and making that my primary focus. The next chapter of my life involves figuring out how to stop letting my past taunt me in the mirror and detaching my associating with my abusers with my body, because really, the Pandora that abused her body because everyone else always had is someone I left behind a long time ago, and now that I realize that is what I am doing to myself mentally each time I look in the mirror and search for my flaws I realize that emotionally I am letting them win again, and that is something I promised myself I would never do. The next chapter of my life includes some very serious and very deep cognitive work, which I can’t honestly promise I will be sharing and I will be talking more about this in the weeks and months to come.

We have a lot to talk about my friends, I have a lot of things to process with through with you now that I can sit and write comfortably so stay tuned lot’s more to come.

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Author: Pandora Williams

Author of Desperately Seeking Slender

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