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Excess Skin Removal

The Pain of Reconstructive Plastic Surgery

I know that a lot of people have questions about the reconstructive Plastic Surgery aspect of the weight loss journey. With that in mind, as I write about my experience with Reconstructive Plastic Surgery over the next few blogs, I want you all to know that I will do a final wrap up blog where I will answer any questions that you all send in. So if you have any questions about the Reconstructive Plastic Surgery aspect of the weight loss journey that I can answer from a patient prospective, please send them to me at pandora@desperatelyseekingslender.com or leave them in the comment section on my posts.

I’m currently three days out of my most recent surgery, a thigh lift, and as I wrote yesterday, it is by far the most painful of all the surgeries that I’ve done. Today, is better than yesterday. Each day is a little better, today I can walk without having to hold on to someone else and I’m not hunched over in that way that makes you look like a 80-year-old woman with osteoporosis. This is quite an accomplishment for me. I feel like I have made great strides since in three days I’ve gone from “HOLY CRAP THAT HURTS MORE THAN I CAN TAKE IT, SIT ME DOWN, SIT ME DOWN, SIT ME DOWN,” too, “Alright, this hurts, but I can take it and by the end of this year I will be running a half marathon wearing shorts in public. That’s my newest goal. Though I am working on a few.

So to give you guys an overview of my Reconstructive Plastic Surgery Journey, I’m going to give you an overall outline of the process over the last year.

  • 07/2011 – First Consult with Plastic Surgeon
  • 11/2011 – Second Consult with Plastic Surgeon
  • 12/2011 – Consulted with Second Plastic Surgeon
  • 02/2012 – 1st Reconstructive Surgery:
– 8hrs of Surgery, Two days in hospital
– 360 Body Lift
– Butt Lift
– Brachioplasty ( Arm Lift )
– Liposuction on Outer Thigh
– Outer Thigh Lift
– Removed 12lb. of skin
– This surgery had the most complications and was extremely painful.
– My Insurance covered this surgery at 80% with no denial or appeal process needed.
  • 08/2012 – 2nd Reconstructive Surgery:
– 6hrs of Surgery, One day in the hospital.
– Side Gather Abdominoplasty ( Tummy Tuck )
– Breast Lift
– Removed 3lb. of skin
– This surgery had the least amount of complications and was a rather easy recovery.
– My insurance covered this surgery at 100% because I had reached my out-of-pocket max for 2012.
– The insurance denied this surgery when we first submitted because they did not have enough documentation on rashes and skin irritations being treated by this particular surgery. There were also originally a breast augmentation (Implants) in addition to the breast lift. My insurance denied the augmentation but approved the rest once the implants were subtracted.
– We didn’t have to submit an appeal, the insurance company requested a letter from my Surgeon confirming that we were treating area’s that had a history of skin rashes, sores and legions due to skin on skin contact. As soon as they had a letter from the Surgeon stating the surgery was a medical necessity, we received the approval.
  • 11/2012 – 3rd Reconstructive Surgery:
– 3hrs of Surgery, Outpatient Recovery no hospital stay.
– Thigh Lift
– Removed just over 3lb. of skin.
– This surgery was the most painful, and the hardest to get comfortable after, but once you do get comfortable the pain is almost non-existent and VERY manageable.
– My insurance covered this surgery at 100% because I had reached my out-of-pocket max for 2012. There was no denial or appeal process necessary.

Alright, I know that A LOT of people want to know how we got my insurance to approve my Excess Skin Removal. I’ll be doing an entire blog post on just this subject later and will come back and link to it here for those that want to read it. I just feel like that is such an important issue that it should be addressed separately.

Now, I’ve posted blogs after each of these surgeries, or close to it. And I think each of them shows a pretty good example of my emotional mindset during each of these surgeries. When I posted about my first Reconstructive Surgery back in March, the focus of my post was sort of “What can go wrong will go wrong.” and there was a lot of Woe is Me and a lot of feeling sorry for myself. There was also A LOT of complications during that recovery. I had so much swelling that I ended up back in the hospital about 3.5 weeks post op on IV diuretics to try to get rid of all that water weight I had taken on in swelling that wasn’t going down.

The post after my second surgery, which really had no complications other than a little hiccup with my drain site, was much more upbeat and much more “I got this, what’s next?” – that was quite a change in my emotional state of mind. But something that I think is really important to note here is that it was this Reconstructive Surgery in August that really allowed me to look in the mirror and start seeing the real me again. I think that my being able to do that was a pivotal moment in my emotional weight loss journey. For the very first time, after this surgery I started to see the “skinny” and “thin” girl in the mirror when I looked in it that my friends and chosen family all assured me they saw.

This was a huge moment in my emotional journey. It was the first time that my mind raced forward and tried to catch up with my body. I love to run, I get something out of it spiritually and emotionally that it’s hard for me to explain. But when I run, my feet just go, they don’t need my mind working with them, it’s the one time during the day that I can honestly say my OCD mind actually slows down. I get to think, really think about things. What I want to write about, how I feel about something going on in my life. Just as an example, as I sit here today writing this blog from the recliner I am resting in after surgery, I look around me and my first several thoughts are…

I really need to find a way to make that cat box being in this room more discrete. I wonder how soon I can get back to work. I need to not be nodding off constantly first which means I need to ween my way off the Oxy very quickly. I’m really glad that we ended up buying the TV for this room when Heather moved here, it’s been great having it in here after my surgeries. I wish I was making more money at work though, then maybe it would be paid off by now. Oh I bet the no interest on it is almost up, I should look into that and think about moving the balance to another card that will offer me lower interest rates. I think Discover is doing that right now. I should tell Siri to remind me to look into that next week. Where is my phone? Ah there it is. Man I really need to clean my phone. Oh I should clean the MacBook at the same time. And I need to reorganize that laptop bag so it’s easier to find things in. And shoot I still need to send last month’s giveaway present to Joy because I didn’t get around to doing it before my surgery. Maybe I can have Heather do that for me next week. Oh we need some things from the store today, I should make a list so that nobody forgets things, and it’s getting close to the time that we said we’d try to give me my first post operative shower…

I have an entire new “To Do List” to make and it took less than 3 minutes of me sitting here silently. That’s just how my brain works. But when I run, it’s different, I can actually stop thinking about all those things and focus on something like, “I’m angry about this, how should I deal with it.” or “I need to think of some ideas for my next blog post,” or better yet, “I need to find the inspiration for this book I want to write.” When I run, its like my head is clear and I can see clearly without anything getting in the way. The second reconstructive plastic surgery that we did in August, it was a very similar experience for me. The skin that was removed from my body after that surgery let me clearly see what was left behind from the hip up when I looked in the mirror. I could see the skinny me for the first time. I could see the thin girl that I always told people I believed was hiding inside me. It was the same clarity I feel when I run, only I wasn’t moving, so I figure my mind was running, and it needed to, my mind needed to run and catch up with my body and start allowing us both to be on the same page again. It was a breakthrough moment for me.

This surgery, I find myself in a completely different place emotionally. I’m not in a big hurry to look at my incisions like I was before. I’m not in a big hurry to inspect them and scrutinize them, I realize that 9 months from now, let alone a year from now they are going to look completely different. I’ve also decided that I am going to spend 6 months concentrating on body toning to the areas I am unhappy with before I commit to a 4th round of plastic surgery that will be entirely on my dime because my insurance isn’t going to cover anything else from here on out and I’m 100% sure of that. (I’ll discuss this more when I do the piece on insurance aspects of these surgeries, I promise.) I find myself much more positive and patient during this recovery and once again I can only say that my time in Dallas at the OAC Convention and my time in California afterward, changed me. It put me on a whole different path and right now I find myself more focused on healing so that I can get moving on this new career and start working on all the things I want to do to help others with their weight loss journeys.

My emotional journey has been amazing this year. It really has, and I think that journey has been very evident in my healing and recovery after each surgery.

From a pain perspective, I really have to stop and consider which surgery I think was the most painful. For the last three days I have insisted that this one was the worst. But honestly I think that is incorrect. I think that for the last three days I’ve been in pretty excruciating pain, it’s not fun, but each day has been notably better than the day before, and I have been more mobile each day. I hardly have any swelling, maybe a little in my feet, and I couldn’t say any of those things three days after being home from the hospital after my first surgery. I was miserable, swollen so bad I could hardly move.

I have a picture that I sent my mother a few days after the first surgery and the look on my face screamed “I’m in so much pain my eyes are rolling into the back of my head and I’m blinking repeatedly to keep from crying and screaming.” Then I look at a picture of myself yesterday and I can clearly see that I’m not in any pain, I was in a very comfortable position. Now when I move, the pain at first made me cry and made my knees buckle. I guess the most honest thing I can say is this. When comparing the first three days of pain after all three of my surgeries I would say that the Thigh Lift is by far the most painful. I think however that in comparing my pain levels here to the pain levels during the recovery of my first surgery I would have to say the first was more painful.

For the first surgery my pain level for the first few days was around a 7 I think, before pain meds kicked in or if I went too long without them I’d be sobbing and hyperventilating in pain. I had incisions all the way around my body which made it hard to get comfortable no matter what position you laid in you were always laying on some part of the incision. The pain tapered off during days 4-7 but when complications kicked in at about day 15, it was hell, pure hell and I spent a good week coming back from that and fighting a pain level that was a constant 7 again.

The second surgery was a walk in the park, the incisions on the side and under my breasts made it very easy to get comfortable and very easy to stay off the incisions. For the first few days I’d say my pain level was a 6 or so but it dropped off quickly in days 4-7 to like a 4 or so and then within another week it was more like a 3 during the bad times. In the last couple of weeks I’d put it at a one or two though and it was pretty much an easy 6-week recovery.

This last surgery, when you are experiencing pain, it is the most excruciating. It’s a pain level that is like twice as painful as everything else that I’ve been though.  The good news is that you don’t have to be in pain too often. You can avoid the pain a good 60% of the time. By not moving.

At the time of I’m now, 5-days post operative reconstructive thigh surgery I’m still limiting most of my movement to getting up every 2 hours or so and walking to the bathroom. Yesterday I did the whole sponge bath while standing at the sink thing even though I am released for a shower, I know my thighs are not ready for that yet and that my legs needed a couple more days to commit to the promise of holding me up in there. So that’s what I decided to do. I’ve made two big commitments during this recovery; that I would listen to my body and that I wouldn’t freak out over weight gain. I’m doing really good with the first part of that. But my body issues are heavily at play today. I wish I could figure out what is wrong with me, why my head works the way it does, but today I’ve been obsessing for hours about the loose skin that is leftover after the skin relaxation of the first surgery. I also did my first walk de la apartment, that’s my little official lap from the guest room door down the hallway into the living room so I can see all the Christmas decorations we have up and then back. It’s not far at all, maybe 100 ft. total. But it’s my first walk, and it was an accomplishment for me. Now I’m back in my “recovery recliner” admiring the pretty little Christmas Tree that Heather took the time to put up for me to make sure I got to enjoy the holiday season while I’m stuck in here recovering.

Tomorrow I plan to do 2x the laps I do today, so probably 3-4 tomorrow. Plus tomorrow is going to be a full on shower. Then I have my follow-up with Dr. O’Brien on Wednesday the 5th. Tonight, I’ll be watching TV, focusing on pain relief and enjoying Authentic Lebanese Food from one of my all time favorite Portland restaurants, Nicholas. If you are in Portland and do not eat at this restaurant, you’ve committed a crime. From their Lentil soup to their, whole wheat pita bread to their lamb pizza, EVERYTHING is delicious. Man, with as much as I mention all the companies I love you’d think some of them would start to love me back. LOL, fat chance.

Post Reconstructive Thigh Lift

Okay folks, I’m doped up on Oxycodone as I sit here with my legs strategically positioned to cause me the least amount of pain possible trying to recover from yesterday’s Thigh Lift.

Okay so I’ve always said that when I got to the end of these plastic surgeries that I would discuss it all honestly and bluntly, so that’s what I’m going to do…

So first let’s talk about pain. But to do that we need to establish my pain threshold. I’m a whinny little twit when it comes to pain, if it hurts in the slightest I’m going to let you know about it, in great detail, repeatedly. That said I also have a pretty high pain tolerance. I’ve done a lot of painful things in my life. Had my appendix taken out, had a hysterectomy, had my tonsils removed, wisdom teeth pulled. I’ve broken fingers, broken ankles, broken feet.

I used to have menstrual cycles pre hysterectomy from endometriosis that would literally drop me to my knees bent over on the floor in pain. I used to have back pain so debilitating it would make me have to sit down and rest in the middle of cooking dinner.

My Gastric Bypass in 2010, was a walk in the park, I was up and walking the hospital floor three hours after surgery and had no problem moving around and within a week or two I was in the gym killing it again.

But Excess Skin removal surgery – by far the most painful thing I have ever experienced in my life.

Each Excess skin removal surgery that I have done, had its pros and cons. So far each one has had different complications and issues.

Let’s talk about my most painful though; the Thigh Lift. My Surgeon, Dr. Shannon O’Brien from the Waldorf Center of Plastic Surgery, did a Y incision on me. That means the incision comes up the inside of both my thighs, and then comes up the inside fold of my thigh and my groin in both directions, forming the top of the Y. As far as I can tell, which is guessing because I’m only a day out and I haven’t gotten a really good look at the incision line just yet, but I’m guessing it goes along that inside crease of my groin and my thighs to about the middle of my labia.

I have two drains after this surgery. They are located pretty much right along the bikini line incision from my 360 Body Lift earlier this year. If you imagine the V of your pubic region as you are standing, the drain sites are at about mid-point up on the V.

So the positive parts of this surgery thus far:

1. I was able to do this surgery outpatient, didn’t have to stay at the hospital and made it home the same night as surgery.

2. While this surgery is by far the most painful, it is also the easiest to get comfortable from. That may sound a bit strange, but with the incisions where they are, moving is excruciatingly painful, but if I get into a comfortable position, which is easier with these incisions that it was with the others, then I’m in absolutely no pain.

Now the negative:

1. This is by far the most painful thing I have ever done. The incisions make it ridiculously hard to move. Thank goodness I have my arms to help. The incisions are very tender, they burn, a lot. And anytime I move they just burn more. Getting comfortable is very tricky, but as I mentioned in the positives, I think it is easier to get comfortable after this surgery than it has been after the others. So it’s the most painful and the least painful at the same time. That has both its good and bad points.

I find that the most comfortable position for me, at least at this point, is sitting or laying in a recliner with the feet up. We can adjust my back to the right angle to make sure there is no pressure on my hips or thighs. Then we take these squishy pillows and put them under my knees to get each one in just the right position. I find that I’m much more comfortable when my knee is swaddled by a pillow. But the most important thing I have found in making sure that I am as comfortable as possible is that my ankles need to be level with my knees.

2. The Pain, when you move, is unbearable. It really is, I have no other way to explain it. It’s so bad that I am listing it twice as a Negative aspect. The first time they stood me up after surgery in the hospital and wanted me to try to walk to the bathroom, but when the nurse saw the look on my face just trying to stand, the pain on my face was unmistakable, and we ended up bringing in a bed side commode. Now, I will say that as I have pain meds on board and I don’t try to tucker through without it and let the pain sneak up on me, it gets a little easier. But as of Day 2 getting up out of the chair I am in, walking to the bathroom, sitting down, getting back up, walking back to the chair, which is maybe 12 steps each way, and sitting back down in that chair is enough to make me nearly want to pass out in pain.

3. The Compression Garments make me want to pull my hair out. They are crotchless, but that hole is nowhere near where it needs to be for everything to come out right. So unless you are alright with soaking the pants you can’t take off for three days at the earliest to shower with urine, you might want to go ahead and take the route I did, unhook and unzip the sides, take them down, do your thing, then pull them back up. It makes the bathroom routine way longer and contributes to it being a miserable experience, but the alternative sucks too. I just have to remind myself that this too shall pass and what drives me nuts right now won’t even matter to me two weeks from now.

4. I need help doing EVERYTHING. Getting up out of the chair, walking, sitting down. I’ll let you put two and two together here, but let me just say, make sure whoever is taking care of you afterwards is someone who loves you; they are going to have to get very up close and personal with you. I’ve been very lucky in that I have like the best girlfriend in the world and have had the same person to take care of me through all of my surgeries.

It’s been really hard for me to even get this post written because I doze in and out constantly because of the pain medication I’m taking. I’m usually the person that doesn’t really like to take pain medication, but man this time I’m taking it on the clock when I’m due for it, just to try to keep the pain managed. I’m outside my own box here, but I think it’s a good thing.

The first day home from the hospital was horrendous. Every time I moved I wanted to cry. Today, day two has been a little bit better, it hurts a little less to move today than it did yesterday.

It’s a little easier to get comfortable today than it was yesterday. I just keep reminding myself that in a couple of months, none of this will be hurting like this, and I’ll be able to wear shorts this summer. I hope… I haven’t actually gotten to see my thighs yet, so we’ll see. I’ll let you know.

I need to have Heather proof read this before I post it and make sure I made sense through my pain medicated rambling. 🙂

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Author: Pandora Williams

Author of Desperately Seeking Slender

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