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"The Journal of A Mommy Make Over Patient"Posted Monday, January 21, 2008 to PATIENT STORIES > Body Posted by Kenrick Spence, MD. http://www.spencemd.com/journal/journal-1b.cfm
This is the journal of 42-year-old mother of 2, married for 20 years, and a certified public accountant and business manager. This patient has captured her experience almost daily, sharing her highs and lows, doubts and convictions, and her final emergence after having had her plastic surgery procedures: a breast augmentation/mastopexy with a full abdominoplasty and umbilicalplasty.
My decision for surgery
Now that I have done it, I realized this journey began over 10 years ago. To ask a mom what has been the best gift of her life, you would probably get the same answer from most, which would be that her children have been that gift. She would never return them...she couldn't.... and would never contemplate life without them. But, and this I am happy to say, "was", the big "but". I needed to see the return of a part of the old me. The part that did not return with near desperate dieting, the part that eluded me even with my compulsive exercising, the part I prayed to see. For a short time, Victoria’s Secret held my secret. But she did not do this well enough, because I still saw the truth at every bath time, during every swimsuit season, and yes.... during some of my most intimate moments.
Which surgery, who would be my Doctor, where would it be performed, when would be the right time?
Finally I mustered up the courage, I was going to meet with a plastic surgeon and at least learn about the procedures available to help me recapture my beauty (I already had my youth...I only needed to bring them together). My search began by talking with others who had the procedures; I needed to know about the pain.... I am deathly afraid of pain, I am even afraid of combing my hair. The poor, lucky surgeon I chose would have to virtually walk on water.
I knew that the plastic surgeon I chose had to be surrounded by a team that understood customer service ...
Everyone I spoke with had a different story to tell, but I listened because one of these stories could be mine. I learned of poor experiences, frightening events, unmet expectations, and poor results. With these conversations, I knew that the plastic surgeon I chose had to be surrounded by a team that understood customer service, would value my emotions during the journey, had been patients themselves so that they too had been in touch with the jitters, and more than anything, were properly trained and certified to assist in my journey.
The facility selected needed to be "accredited". For most of moms, "accreditation" means a school to enroll our children in that would assure their success for life. But as I educated myself, I learned that the place one selects for surgery must have the met the qualifications of a governing body that subjects it to reviews, reporting, testing, and evaluation criteria all designed to assure the patient's safety. For example, I learned that an in-office suite must have doorways and floor plans that permit emergency personnel and vehicles to service a patient during a crisis, heaven forbid this ever happens you don't want to be that patient that could not get out in time. Finally, the most important was the answers I needed to get about my prospective surgeon. I did not need to know his age, sex, or race. I did not need to know who his other patients were or how popular he was. I needed to know that he was board certified by the appropriate and relevant board, had an excellent reputation in the community, and knew what he was doing.
I met with my doctor and his nurse and we talked about all the changes I wanted to make. Before going in to meet with him, I already knew that my breasts were what really concerned me the most. Even before pregnancy I wanted to enhance the volume and positioning and now after pregnancy, I did even more so.
I became overwhelmed with the amount of information to digest. It also dawned on me... that this was in fact major surgery. I began to wonder if I was being frivolous ...
During my consultation with Dr. Spence and Kathleen, his nurse, I became overwhelmed with the amount of information to digest. It also dawned on me, with alarming intensity, that this was in fact major surgery. I began to wonder if I was being frivolous, were there more important things I should have been focusing on and was this in fact necessary? I was an accomplished, confident woman. The answer came back with a resounding, unequivocal commitment to the transformation. I had waited too long and would wait not longer. I deserved this, had worked hard for it, and as a matter of fact now that I could see how beautiful my breasts were going to be, my eyes traveled down to my stomach. "What about here, Dr. Spence, what can we do here.... I cannot have a tummy of a 75 year old with breasts of a 25 year old. No can do! Fix it once and for all!" Dr. Spence smiled and began to explain the options, risks, and benefits.
I learned that what I needed to achieve the youthful look of fullness and positioning was a breast augmentation with a mastopexy (breast lift). The implant size I chose was 400 cc silicone, high profile. I agreed with Dr. Spence that placing the implant sub muscular and making the incision around the areolas would make the results appear as if "I was born with it." Ladies, there is no simple, straightforward breast augmentation. There truly is a lot to consider. Dr. Spence had me try on a number of actual implants in the appropriate bras so that I could begin to visualize the change. I did not want to be big I constantly remarked to him. He constantly replied that I would not be. Then we turned our attention to my abdomen. Growing up I had always thought I had the most perfect belly button. Not so anymore. My last pregnancy forced my belly button out making it appear as if I had a lemon seated on my tummy. Dr. Spence never presumed he knew what I wanted to address; instead, he asked in an unrushed manner what he could do for me. I held up my Victoria’s Secret Magazine and pointed to a bellybutton I had been dreaming of. He drafted the technique he would use to create the look I needed and showed me numerous before and after pictures. Then I pulled my drooping skin below my pubis firmly and told him "I want to look like this".
At first I did not understand why 1 ½ hours were needed for my consultation. Was I special or that complicated? But as the visit drew to a conclusion I realized that having plastic surgery was a major decision requiring my medical history, having a mammogram, proper medication, safe and helpful preoperative and postoperative habits, receiving and absorbing a wealth of information, and making important decisions. After all discussions had taken place Dr. Spence, with the most serious expression I had ever seen, looked me straight in the eye and explained the recovery process. I needed 10 days of pure rest. I assured him I would take the required time off (my fingers were crossed behind my back). At first I did not understand the importance and ramifications of taking the time to recover. But later, about 2 weeks after my surgery, it turned out that Dr. Spence and Kathleen had to literally force me into a state of rest.
Mommies do not know how to rest.
The day before surgery
On the night before surgery, I began to "nest". For most moms, you will know this feeling. You begin to fixate on getting everything in order. Everything! I cleaned the house, double and triple checked homework, filled the house with food, and had my son and daughter practice their musical instruments over and over and over again. Just when I was about to go completely nuts with excitement and fear, Kathleen's cool and calming voice reached me over the phone. It was as if she knew I was a ball of emotions. She reassured me that this was a completely elective procedure and I needed to take the pressure off of myself and focus only on getting a good nights rest. She walked through what would take place the next day and reminded me that I was in extraordinarily skilled and caring hands. With this I read to my kids and went off to bed.
My surgery day
My dear sweet sister arrived to take care of everything at home so that I could go off to get beautiful without a worry. What she did not know was that she was about to become my nurse. My surgery seemed effortless. Dr. Spence and Kathleen made it seem as if the world had stopped for me. Dr. Ondra, a board certified anesthesiologist, was warm and reassuring. The point of the day that stood out the most in my mind was when Dr. Spence marked me for surgery. He stood in front of me with a marker and began sketching like an artist consumed with birthing a beauty he saw within. The room and everyone in it stood perfectly still during this process. At the completion of his drawings, his nurse confirmed the instrumentation she sensed he needed to create the masterpiece.
Dr. Spence and Kathleen made it seem as if the world had stopped for me ...
Four hours later I woke up thinking, "Who rammed a truck into me, backed it up, and did it all over again?" I was not in pain, I just felt as if I could not move as fast as my mind was. I had looked at the clock on the wall and knew that my son had a football game he needed to attend in 2 hours and my daughter had a birthday party she was looking forward to attending. I told my nurse I needed to get up, she looked at me and simply smiled. Then she softly stroked my arm. This small action served to calm me into a much-needed sleep.
After the surgery
Four hours later I woke up thinking, "Who rammed a truck into me, backed it up, and did it all over again?" ...
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