Repost of a wonderful article by a Mommy Makeover patient!

Posted by admin on Tuesday, December 28, 2010

This is a WONDERFUL article written by a woman who has had a "Mommy Makeover" surgery.  

Although I wish I could boast about this being MY patient, it is not.  She is an excellent writer and I feel she sums up her experience in a lighthearted and sincere manner. 

However, I truly believe that anyone considering this type of surgery could benefit from reading this in order to help prepare for their experience!

Karen M. Horton, M.D., M.Sc., F.R.C.S.C.

10 Things I wish I'd known before a Mommy Makeover

10 Things I wish I'd  known before a Mommy Makeover After getting a mommy makeover, I came up with a top 10 list of things I wish I knew ahead of time!

1. Guilty as charged.

As most moms do, I tend to put everyone else first. A lot of times that is why women tend to feel like they have lost their identities. It’s hard to spend that much money on yourself, especially for aesthetic reasons. It seems okay to spend it on a car or a trip, but for some reason the thought of spending that money on your body is frowned upon. To some that may seem vain or boastful. For me it was about a self confidence that I had yet to achieve, a love of self that I have longed for my entire life. When I look in the mirror I like what I see now. When I feel good about myself…inside and out…I am a better woman, a better wife, and a better mom. It is absolutely normal to feel guilty about spending money on a mommy makeover and it is okay to finally put yourself first. It is the best money I have ever spent…just ask my family.

2. What to tell the kids.

This was a big one for me. I am a mom of two young girls (5 and 2). I grew up with a horrible body image and the last thing I wanted was to implement that to my daughters. I was concerned about what to tell the oldest, the two-year-old really didn’t understand. I thought about saying, “Well, you and your sister ruined my body while I was pregnant with you both.” But then I thought maybe that was too harsh. (Note the sarcasm). I have tried really hard not to down myself in front of them, calling myself too fat, or commenting on my huge belly. They see me exercise and make healthy choices, but I didn’t want them to know that I didn’t like my body. So I tried to keep it simple. The day before surgery I told my oldest daughter that I was going to have an operation to fix my tummy (I didn’t go into the whole booby thing). She of coursed asked why, I told her because the doctor said so. I was prepared for more questions but she seemed satisfied with that. I was informed by the ladies on this site that the best thing to do with boys, if they are older, is tell them you are having female surgery. They will shut right up and have no more questions. Nothing is more embarrassing than talking female issues with your mom.

3. I’m a big girl now.

Most mommy makeovers include lipo and a tummy tuck. Which probably means you will be lucky enough to wear a skin-tight crotchless compression garment. I, as most women, chose to wear panties over this outfit so I didn’t feel as it all my “stuff” was being squished out. (Think of baboons….ewww, or don’t.) Now, the tricky part here is the first couple of days after surgery. You will spend quite a bit of time on the toilet the first time you try to pee, similar to what it is like after giving birth. After a couple tries, it gets better. However, when you are taking pain medication and muscle relaxers on a regular basis, your mind may be fuzzy a bit. I had the great luck of forgetting I had those panties on and peeing straight through them…twice. Yes, not once, but twice. I was starting to think I might have to revert back to diapers but I graduated and learned how to use the potty like a big girl. Also, you will probably not poop for several days at first, so expect a good 3-5 days worth of poop on your first time. With that being said, consider pulling your garment down for that endeavor. The back to front wiping thing can be tricky in that thing. I’m just saying, not that it happened or anything…..I’m just saying…okay…next subject please.

4. Hello Dolly!

If you decide to get implants please remember that objects may appear larger than they actually are. When I first took a glance at my new girls, I thought “Holy Mary Mother of God, what have I done?!” I looked like Dolly Parton, or for younger ones, Beth from Dog the Bounty Hunter. This is NOT your final look. Please don’t freak out. The swelling takes a while to go down and for the implants to “drop” into place. After about a week your PS will probably give you the go ahead to start massaging them. Massaging the implants will help them soften up and find their final resting place. Your significant other with love this, and surprisingly, so will you. I was shocked to find how much I actually liked touching my own breasts. It sounds perverted, I know, but if you are used to your “ladies” hanging out down by your belly, then you will see how nice it is to hold them, let go, and be fascinated that they no longer fall down so low anymore. I can now understand why men are always holding onto their own “boys”. They are proud of them. I have caught myself with one hand on the remote and the other on one of my breasts. So relax, and let the boobs fall where they may.

5. Phantom of the itch.

I knew going into the tummy tuck part of the mommy makeover that my belly would be numb. It is a freaky and strange feeling. It is almost like you are rubbing on someone else’s tummy. I had heard before about people who have had an arm or leg amputated and still felt the feeling of it being there, the phantom limb syndrome. I was not prepared for that with my belly. Every now and then, I will get an itch, go to scratch it, and realize it is where my belly is numb. Scratching a numb belly doesn’t relieve the itch. Simple right? Well I have a masters degree and it took several times scratching before I got that one.

6. Sit. Stay. Good girl.

Once again, most mommy makeovers include a tummy tuck. This is a huge procedure and as most of you have surely read, it is a good idea to take off as much time as possible from your job. I was fortunate enough to take 2 weeks off from my PAID position. I capitalize paid, because as all moms know, the mom position is considered a “non for profit” position. Rarely do we moms put in a request for vacation from that position, so therefore we tend to work every day of the year, even if we are taking a vacation from our “paid jobs”. As most moms, I am an expert at multitasking. It was killing me to sit there and not do anything. The first 3 days or so you have no choice, your body will not allow it. I will admit that I probably did more than I should have. Looking back, I wish I would have taken more advantage of the quiet time and rested and relaxed. I was convinced that if I didn’t do it, it wouldn’t get done, and it wouldn’t get done right. I was wrong. Trust your loved ones. My husband was amazing. He became Mr. Mom and was pretty darn good at it. I have never given him enough credit in that department. Granted, it may have not been done the way I do it, but he stepped up and took charge. And if you don’t have someone doing those household chores….so what. Just take this time for yourself and give your body a chance to heal.

7. All aboard...the Bi-Polar Express.

This is a BIG one. Having your body cut upon, stitched up, and hung up to dry is traumatic. Throw a few pain meds into the mix and you will turn into an emotional tornado. I was known to go from ecstatic to tears in 6.9 seconds flat. Top that!! Be aware that this will be an issue, and emotions will be crazy. Explain this to your loved ones and the people caring for you so they don’t call the men in white coats with the strait jackets. When I felt teary, I would cry. It’s ok, you have a permit to go crazy, take advantage of it. When I was feeling really down and out, I typically would go to bed and nap it off. Use this site. Realself.com is full of women who are going through the same thing. Use them to lean on and talk to. The ladies I have met on here have been A HUGE support to me and I couldn’t have gotten through this without them. Well, I would have, but I would have probably been divorced and sitting in a mental institution. Thanks Ladies!!!

8. Let's get physical.

Most people who are looking into plastic surgery are doing so because exercise has not been effective on certain areas of the body. There are only so many chest flies one can do before you realize they won’t make your boobies stand up and say hello. However, there are some who think this is the alternative to diet and exercise. If that is you….you are wrong. I truly believe my fitness level aided in my recovery time. And I know that I will have to work twice as hard to keep my new body looking tip top. The more active and healthy you are before surgery, the better your recovery will be. You will heal faster, feel better sooner, and be back to the gym before you know it. As you heal, stay away from processed and salty foods, soda, and fried foods. You will swell like the Stay Puff Marshmallow Man and be so uncomfortable. When your doctor says its okay, get back into exercising and let your body lead the way. It will tell you what is too much and when to quit.

9. Don't be naive: do the research.

When I decide to do something I go full speed, head first. In this case, you need to know what you are getting into. When I began this journey, I had no idea that there was a difference between a Board Certified Plastic Surgeon and a Board Certified Cosmetic Surgeon. Now, I will not step into the argument of who is more qualified; just know who you are dealing with. Ask around; find people who have used him/her. The doctor will give you referrals, but let’s face it; they are not stupid enough to give you someone who is unhappy with their work. If you know anyone who has had plastic surgery get as much info from them as possible. There will always be someone who is unhappy with a certain PS or procedure they have had done. But there is a HUGE difference between a “well, I just didn’t like his/her bedside manner” or “I just didn’t see a huge difference in my lipo” and the “he completely disfigured me”. Be wary of the flashy salesman. Go with your gut and ask LOTS of questions. The good ones will sit with you and take as much time as needed.

10. Avoid the Debbie Downers.

We all know one….the Debbie Downers, the buzz kill. And most of us will have to deal with a few after surgery. It is really hard when you feel that you don’t have the support from your loved ones. The choice to have a mommy makeover is strictly yours and hopefully you are doing this for you and only you. I have had a few family members of mine that I surprisingly haven’t received support from. It is hurtful, especially since they saw me struggle with my weight and self esteem issues for years. A lot of people will see it as a “waste of money”. I started feeling the need to explain my reasoning for having the surgery. I wanted them to know that it was not out of vanity, or selfishness. But remember the old saying “Those convinced against their will, are of the same opinion still.” It really doesn’t matter. As much as I wanted them to hear me out and understand my reasoning, they won’t. If they love you, they will keep their negative comments to themselves and support you no matter what. But you may have those who love you yet still feel the need to give their opinion even when not asked. My response to those people would be a nod and a smile. (Believe me, I know it’s hard) If you want, throw in a “please keep your negative comments to yourself” or a “if you don’t have anything nice to say…”. But my advice is to steer clear of the “screw you” sort of comment. It is just not worth it. As long as you know why you are doing this that is all you need. For me, being able to look in the mirror, smile and for the first time in my life, love what I see…well that is priceless to me. And for those who can’t see past the money or their opinions, they are missing out on watching someone they love transforming into the person they have always dreamed of being.

For more information or to ask questions directly about Mommy Makeover surgery, visit my website!  
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Nipple-Sparing Mastectomy: The Ultimate Aesthetic in Breast Reconstruction

Posted by admin on Friday, November 26, 2010

Over the last 10 years, there has been an increasing awareness among General/Breast Surgeons that in many cases, it is not necessary to remove the breast skin along the breast tissue. This is called NIPPLE-SPARING MASTECTOMY (NSM):

Advantages of the NSM and immediate reconstruction technique:
  1. It is a single-stage technique with only one general anesthetic in the majority of cases
  2. There are no visible scars on the breast, unless later mastopexy ("breast lift") is desired or needed
  3. It is performed using an adjustable permanent implant, not a tissue expander, OR a flap reconstruction
  4. The implant or flap is placed over the muscle to avoid animation ("motion") deformities when the pectoralis major muscle flexes
  5. The recovery is shorter and involves significantly less pain than traditional two-stage expander-implant breast reconstruction
  6. This is an oncologically safe, unique mastectomy technique which cores out the nipple on the involved side for additional Pathological tissue analysis
  7. In some cases, it is possible to perform a nipple lift (mastopexy) at the same time as the mastectomy and reconstruction
  8. This technique is the simplest, quickest, most aesthetically pleasing technique for women who are considering prophylactic mastectomy for genetic risk.
  9. There is no delay of radiation or chemotherapy due to a speedy recovery and extremely few wound healing problems


The NSM technique has taken years to refine, but we believe it is the simplest and most aesthetic single-stage implant reconstruction. It is also being used in our practice with the DIEP flap and other microsurgical flaps such as the inner thigh (TUG) flap.
 
NSM is ideal for women who are carriers of the BRCA-1 or BRCA-2 gene and other women with a strong family history of breast cancer who are seeking prophylactic mastectomy and breast reconstruction. It is also appropriate for women with DCIS and invasive cancer that is at least 2 cm away from the nipple.

For those women who have tumors which are very large, very aggressive, or involving the nipple, single stage reconstruction removing the nipple is still available. This is also done over the muscle in our practice.
 
NSM is performed through an incision hidden under the breast, in the breast fold ("inframammary fold"), limiting the scar.  Following mastectomy, in the same operation, reconstruction is performed using either an implant or a flap. 

Read about my patient Desdemonia's experience with this procedure!

If an implant is placed, it is located in the exact same space that the breast was, on top of the pectoralis major muscle.  A permanent, adjustable implant is used.  It is inflated approximately 60%-80% of the way at the time of surgery; only one or two additional inflations are required in the office in the 1-2 week period following surgery.  No "expansion" of the breast skin is needed, as the implant is not used to stretch the skin but is used to "fill out the space".  The great thing about these types of implant is that the woman undergoing the procedure is empowered to make the final decision about her desired implant size, not the surgeon!

A flap placed for reconstruction provides the ultimate soft, warm, living tissue reconstruction that has none of the risks and potential complications of implants.  


Please visit our website for more information.
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Upcoming Presentation: RECONSTRUCTION OPTIONS FOR YOUNG WOMEN AFFECTED BY BREAST CANCER

Posted by admin on Saturday, October 9, 2010

I have been asked to speak at a free seminar for young women (age 40 or younger at their diagnosis) affected by breast cancer.

I will be discussing the latest in breast reconstruction option, including single-stage breast reconstruction and microsurgical techniques such as the DIEP flap, the SIEA flap and the TUG (inner thigh) flap: 


A few of my patients will be invited to also be there to share their personal stories about their reconstruction experience.

To RSVP, contact yscnorcal@youngsurvivalcoalition.org and visit http://womensplasticsurgery.com/about_horton.html#571 for more information on my practice.

Hope to see you there!
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Mommy Makover surgery requires at least 6 weeks for a full physical recovery

Posted by admin on Monday, August 23, 2010

After any major surgery such as a Mommy Makeover, you need to give yourself the time needed for complete physical recovery.


In most instances, a Mommy Makover includes a breast lift/implants (or breast reduction), a tummy tuck and/or liposuction.


For each of these surgeries individually, I counsel my patients to take 6 weeks off aggressive physical activity such as exercise, and to take at least 2-3 weeks off work, longer if they can!  For combined procedures, the effects can be cumulative and recovery can take a little longer. 

Becoming too active immediately after surgery can increase the risk of complications such as hematoma (bleeding), wound healing problems, increased bruising and pain!  You may also have drains, that require special care and attention until they are removed.  


When at home, rest as much as possible and have friends and family members assist you with your activities of daily living - like making meals, cleaning, child care, and transportation. 

If you need to work from home early on after surgery or at you desk at work, be sure to get up and move around at least each hour to encourage circulation in your legs and lungs, and be able to delegate any lifting more than 5 pounds to others in the workplace or your family for the first 4 weeks.

You are planning to invest a great deal of time, effort, energy and money into your surgery - be sure to also invest the appropriate effort in your recovery!
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