In October of 1980, my husband and I became the proud parents of a little girl. I weighed 120 lbs. pre-pregnancy and put on 32 lbs. for this 40-week pregnancy. It was an easy pregnancy, as they go, with a 22-hour labour. When I conceived our dizygotic (fraternal) girls, I was 124 lbs. and added 58 lbs. in this 40 weeks + one day gestation. After 5-3/4 hours of labour from first contraction to vaginal birth of second twin, two healthy girls were born 17 minutes apart weighing 6lbs. 10 ozs (one ounce more than our singleton) and 5lbs. 9 ozs. Our first daughter was 22 months old at the time.

I am just shy of 5 foot 4 inches tall and the gestational length plus the fact that I put on 58 lbs. was a wonderful beginning for our daughters. They both came home from the hospital with me.

Over the ensuing years, it became apparent that my abdominal muscles would not respond to exercise. Sit-ups, roller blading, swimming and my very active lifestyle meant nothing. I became more and more hindered by the ‘tire’ that was around my waist. In my early 40s, I went to see a plastic surgeon for a consultation. I left his office, “not a happy camper” as the saying goes. He examined me and said dismissively throwing a picture in front of me of a woman with an extremely large ‘apron’ of weight around her belly, “Now there’s a woman with a problem. Go home and lose 10 lbs.!”

I was very discouraged because now at 153lbs. and unable to improve my body shape, the “tire” around my waist interfered more and more in my life. Gardening (which I love) was a huge deal as it requires long periods crouched down. My “tire” would be compressed by my knees and pushed up into my chest compressing my lungs. I found myself panting and mouth breathing and could not stay crouched for longer than a few minutes at a time. Upon straghtening up it would take several minutes to recover from the strain. I hated how I felt and its limitations.

I took to wearing loose fitting and flowing outfits as nothing fitted was comfortable. I pretended it didn’t bother me that fitted outfits were beyond my reach and remained so as the years passed.

At age 54 with discussion and support from my husband, I made an appointment with another plastic surgeon for another assessment. I was also asking for an opinion on a breast reduction (one breast was very large, with stretch marks due to breastfeeding). He agreed this breast could use some reduction. Upon examing my belly he said, “your abdominal muscles are ‘finished’. You could do sit-ups 24 hours a day and it won’t make any difference.” This was very affirming to hear because I was worried that I had not exercised properly or consistently enough to make a difference. His next question: “Are you doing this for vanity reasons?” What a loaded one! I responded it would be difficult not to answer yes in part, however, I had become more and more uncomfortable with the ‘tire’ and was hoping for some improvement in my physical well-being and my current limitations.

Surgerywas set for 4 th April, 2000. I would go in early in the morning, he would repair the breasts and make them closer to the same size (“anything but “perky” I said, “Perky is for 14-year olds!”). He would also repair my belly and expected that I would be in the operating room for about 4 hours. As they would be doing both procedures at the same time, I would be kept in over night for observation (for most women, a stomach repair alone is day surgery).

In preparation for and at least 6 weeks prior to the operation, I was to cease all hormone supplements and as well as Vitamin E and glucosamine (helps with my arthritis but interferes with healing). I could continue with my Calcium supplements.

In the hospital I met the Anesthesiologist and he explained what his job would be. In the operating room, everything was once again explained to me and the equipment involved. The surgeon had me stand up while he drew on my breasts and belly where he would make the incisions (how many times have we told the kids not to write on themselves?). The last thing I remember was being told that they were giving me oxygen in order to assist the anesthetic travel quicker through my system.

I woke up to a nurse advising me the surgery was over and that I was in the recovery room. She encouraged me to sip a little water. I was very drugged and firmly bandaged from just below my neck to the top of my legs. The top bandage was a large padded square to soak up any blood and the lower Velcro belt I would wear for the next 4-5 weeks. It provided support for the healing muscles and helped them heal in place. Over the next few hours, I was monitored for blood oxygen levels, temperature, bloodpressure and had blood drawn on a couple of occasions. At one point I felt very ill and was sick. At the end of the day I was up and used a portable potty. Doctors came and went as did my husband and I could hear lots of mumblings. I was told they were keeping me an extra night. Fine, I thought, just let me sleep and I did.

My husband spent the day after the operation with me, reading magazines and giving me water when I woke up and encouraging me to sleep. The pain killers were making me hallucinate and Beanie Babies fell from the ceiling vent all over my bed (I was going to be rich), the faucets and taps of the sink in the room took flight and I asked the nurse to turn off the running water as it was being wasted just pouring down the sink. She softly advised the faucet wasn’t on. When the hallucinations began to turn nasty (dark voices threatening me), I stopped taking the pain killers.

On the second day post-op, I was moved to a ward. Blood tests and monitoring for blood oxygen levels continued at regularly set intervals. I was given a nasal prong for pure oxygen. Still the doctors came and went; some new faces whom I did not recognize. The evening of the third day I had 3 doctors appear at the bedside. They grilled me with all kinds of questions about my state and only in retospect did I realize that I made a fool of myself. They wanted answers and I was too sick to make any sense at all. The first doctor said, “’This’ is potentially lethal and I want you to know that we will do everything we can to save you”. “Thanks.” I responded sleepily and they left. I drifted back to sleep not even sure about what had just happened.

In the middle of the third night I was asked if I could sit in the chair in the room and portable X-ray equipment was used to take chest X-rays. Next I was asked if I felt strong enough to get on a gurney and proceed to the X-ray department where they would take further X-rays of my lungs and ultrasound of my legs. I was given a portable oxygen tank and whisked down the halls. The porter should have been given a driving test as he overlapped a couple of hallway doors by at least 25% each time and the resulting jarring was very hard on my incisions.

In the X-ray department, I was given radiation/oxygen combination to breath in and pictures were taken. Next I was injected with radiation and the pictures repeated. The injection serum was handled with heavy gloves and for safety reasons, not brought into the room until it was actually to be injected. Charming, I thought, maybe I’ll end up as “glow in the dark”.

In the “Vein Department” I had a routine ultrasound done on the back of my legs and was told by the technician that my veins were “Clear but you have this beautiful vein and I know that Dr. So and So (who remembers names at this point) would love to have a photo of it for his conference talk next week. Would it be OK if I get him?” Sure – why not? So, for anyone looking at vein scans, one of them is probably mine! My 15 minutes of fame had at last arrived!

My husband was awaken later that night by a phone call (I learned later) and he was told that I had had a pulmonary embolism and 30% of one lung was blocked.

Meanwhile I continued doing a lot of sleeping and didn’t even notice the week pass by. A friend came to visit me and to this day, I don’t remember her visit. On the sixth day I was allowed to go home. With the diagnosis of the embolism, I began a series of coumadin injections which directly into muscles. In very short order, you are covered in large bruises. To give the muscles a break, different muscles are used for each shot. My husband was taught how to give the injections, which would continue at home. Who knew this was to be part of the “better or worse” vow? Injections are given initially so that your blood can be quickly thinned – they work quicker than pills. When the desired blood density is reached (i.e. thin and watery), the patient can then switch to pills and boy are the muscles pleased! I now had thin blood and still heavy thighs. Where’s the justice?

Coumadin, for those not aware, is a blood thinner (rat poison, to be exact) and its purpose is to thin the blood so that blot clots do not form and the blood can flow freely through the veins. Although blood clots usually come from the back of the legs, my resulted directly from the abdominal surgery. A clot(s) tends to come to rest in one of three major organs: the brain, the heart or the lungs. I was ‘lucky’ and mine chose to lodge in my lung. 30% of one lung was affected. How it is decided what the amount of coumadin you must take necessitates a blood test every few days and, depending on the scores from the resulting tests (they are personal and each person would have their own evaluation – mine needed to register between 2 and 3 out of 10), then I would have to take one, one and a half or two pills each day until the next blood test.

As there is pooling of water and blood in the abdomen after a repair surgery, two small incisions were made one on each of my sides and drains with tubes were inserted at the end of the surgery. Twice daily the drains were pumped and the excess fluid drawn off. These were left in until about 4 days after surgery.

For the next several weeks, I was closely followed by the Thrombosis Unit. I couldn’t have had better treatment. They took another set of X-rays and radiation pictures and confirmed there had been a clot. It was explained to me that I will now spend the rest of my life at risk of further clots and need to advise my doctors of the risk if I have any further operations during my lifetime.

After 3 months on Coumadin and a clean bill of health, I was allowed back on my Vitamin E and glucosamine. I have been rollerblading and gardening with none of the previous difficulties. I can stay crouched down for long periods of time and physically feel very well.

It has been a long haul and I feel that both my husband and I went into the venture rather naively. Either one of these operations (breast reduction or abdominal repair) would have been a major ordeal on its own and here I had two done at the same time. Silly me!

I wasn’t prepared for the amount of muscle-spasming as the abdomen healed. When a spasm occurs, it catches your attention. I was encouraged to keep the incisions moist with vaseline and although it was messy, the vaseline did stop the itching as the incisions were healing.

How the Repair Works:

For the breasts, they are cut underneath side to side and up underneath to the nipple and areola. The nipple and areola is removed, the breast ‘gathered’ and excess fat, flesh, skin removed. The nipple and areola are sewn back into place. None of the scars are visible to the front view. It takes some time for the redness and swelling to go down and the incision areas are extremely itchy as they heal.

For the belly, a cut is made hip to hip much like a caesarian section but not through the muscle like the cesarean. The overstretched muscles are pulled downwards toward the incision and tacked in place on each side and the middle. These three “tacking points” are the last three places to heal. My tacking spots remained tender and oozed blood. One became infected and necessitated treatment with an ointment for about 9 weeks after the surgery. Apparently this is normal. No muscles were removed or cut. The muscles are, in a sense, pleated and gathered, much like curtains and then tacked at the bottom. As you can appreciate, your navel is drawn down because there is also excess skin (which is cut away). The one I have now is a fake. It is sewn into the appropriate place and resembles the one I had before.

The last step is liposuction. This is done from just below the breasts to the top of the navel because if only the lower muscles are tightened, you would be left with a ledge between the upper and lower abdomen. Liposuction allows the belly to run smoothly from under the breasts to the pubic area.

What they did not tell me ahead of time was that liposuctioned areas are numb due to the fact when fat is siphoned off, surface nerves are interrupted and must resettle and adjust themselves and this takes time. I was shocked to find that there initially was no feeling at all to this area and although very slowly the feelings have come back but not completely in the lower belly. It feels as if I have constant pins and needles. I am told feeling to this area will never completely return.

I have some hints for anyone considering having this type of repair done:

• REMEMBER THAT THIS IS SURGERY WITH A FULL ANESTHETIC. AS SUCH, THERE CAN BE PROBLEMS AND ANY SURGERY IS POTENTIALLY LIFE THREATENING. GO INTO IT HAVING DONE YOUR HOMEWORK AND UNDERSTANDING HOW IT WILL WORK, THE RESULTS YOU CAN EXPECT FOR YOUR PERSONAL SITUATION AND THE RISKS INVOLVED. YOU AND YOUR PARTNER NEED TO BE INFORMED SO THAT YOU CAN MAKE APPROPRIATE DECISIONS AS NEEDED.
  


• It is helpful to have the agreement of your husband/partner in making the decision.
  


• Get a couple of opinions and quotes for your particular situation. Also be sure and ask about follow-up care.
  


• You will need to wear a bra post op. Gravity is a problem on the repairing muscles and a bra alleviates some discomfort. As it will be impossible to tell what size you will be because you are so swollen, take a couple of your old bras and remove any wires.
  


• Cut your toenails BEFORE you have surgery as it is impossible to reach your feet until some time after the swelling goes down.
  


• Purchase several pairs of men’s boxer shorts to wear as underwear. These are loose fitting and do not put any pressure on the incision areas.
  


• Purchase some large pairs of jogging pants. These pull very nicely over the abdomen and, once again, do not put any pressure on the incisions.
  


• Make sure that you have someone in the house to assist you for at least one week following the surgery. My husband took one day off work because we thought this would be sufficient but we grossly underestimated my recovery time. My dear friend came from Toronto and moved into the house for 4 days and I don’t know what we would have done without her support.
  


• It is quite expensive and a belly repair from having multiples is not covered by health insurance in Ontario. In most areas of Canada it is viewed as elective surgery. It can cost up to $9,000.00 - $5,000 for the belly and $4,000 for the breasts. Some surgeons offer a discount for having both done at the same time. Full payment was due in advance of surgery. You may wish to get a couple of opinions and a couple of quotes. If you choose this route, i.e. breast and tummy done at the same time, realize that EACH SURGERY ON ITS OWN IS MAJOR SURGERY and it will take your body an extended perid of time to recover.

Lynda’s Extra Note: I was going to list some Tummy Tuck resources from the Web and when I looked at them all, I felt completely overwhelmed. Some really scared me, some were for women in worse shape than I was, some didn’t resonate with me at all. Please, make sure you do your homework for your own particular situation. I hope you are happy with whatever you decide to do.

Do you have questions or feedback regarding this article?
I would like to hear from you:

Please add your email address if you would like me to reply:

To prevent abuse of this form, please enter the 3 letter code you see below: