Saturday, 21 April 2012

Surgery day, finally!

At my consultation I was given prescriptions for Augmentin antibiotics to start the day before surgery and Lorazepam to calm my nerves the night before. To manage any pain after I returned home I got Co-codamol pain killers. As I was heading out the door on Wednesday the surgery called to tell me they were having equipment difficulties and needed to postpone till the following Monday. As annoying (and a bit troubling!) as this was it did give me the extra weekend to get a bit ahead at work (helping me feel less guilty about taking three days off), as well as buying in some new black towels and waterproof sheets in case I'd leak a lot of fluid. I cleaned the house, did all the laundry, shopped for easy cook meals and placed everything I thought I'd need in the first few days at waist level so I wouldn't have to bend or reach too much. Happy about feeling a bit more organized pre-op I was further cheered up by receiving lovely flowers from the clinic, apologizing for the inconvenience in moving my appointment!

While having a cup of tea in the surgery on Monday I got an explanation on the equipment issue they'd experienced. Turns out there was a special fat collection canister that Dr. Gupta refused to operate without, and the one belonging to the surgery had not been returned from the specialist cleaning/sterilization facility in time for my original appointment. Instead of opting for a less closed loop solution he felt was inferior from a hygiene perspective, he decided to postpone. In fact, that very morning I had to wait 30 minutes while the canister was rushed directly from the place where they had the correct autoclave to sterilize it properly. It just re-confirmed my assurance that I'd chosen the right clinic and doctor for this. All along the way they've been honest, straightforward, helpful, friendly and free of judgement. They've made me feel like they've had nothing but my best interest in mind and been unwilling to compromise on what they do best, even when I've been asking if I can do several things in one surgery or wanted to fit the procedures in across a fairly short time span.

As we waited we went over all last minute questions and concerns and I signed the consent forms. A nurse then gave me a few pills to help relax me. I hadn't taken the prescribed Lorazepam the night before as recommended, since I prefer to be alert even if it means I'll be more uncomfortable, but then and there I did what the nurse said thinking it wouldn't hurt. Oddly it didn't have any effect whatsoever, I was still fully awake and aware as I changed into my less than flattering paper garments and I was still just happy and looking forward to getting underway with the surgery.

The surgery room was nice and bright, warm and comfortable, and in addition to my doctor there were lovely nurses Claire and Charlotte who were going to be around to assist. Dr. Gupta took pictures of the areas to be treated, then got his sharpie out and drew outlines on my saddlebags and love handles of where he was going to focus the liposuction. He was thorough, turning me around and checking all angles, drawing and re-drawing his lines as he built the bigger picture of my final look. For my breasts he drew lines to guide him in the injections, ensuring he'd get as much symmetry and natural shape as possible. I'd been very clear about what shape I wanted and what I didn't want, and I trusted he'd get it right!

Once in place on the bed I was given some local anesthetic to numb the sites where he'd later go in with a cannula to fill my tissue with saline and more painkiller. I could hardly feel the tiny needle at all, and I had to almost laugh at Dr. Gupta constantly having a glance at my face to see if I was in any discomfort. Once this local kicked in he proceeded with a larger needle to inject the saline mix which would pressurize the layers of fat causing the cells to loosen and become easy to suction out. My skin felt very tight to the touch but I felt no pain at all through any of it, and I continued chatting and joking around with the nurses as the equipment for fat removal was installed and prepared. They kept me warm and covered with towels, and I was glad I'd worn thick socks under the non-slip ones they'd provided, as my feet always get cold even in room temperature.

Having made little round holes in my skin that would accommodate the cannula removing the fat, we started on my right thigh, moved to my right hip, flipped me over on my side and did the left. I was fascinated to watch it all and kept asking questions, and I think the staff were a bit surprised that I was so awake and relaxed about it all, even excited! But the thing is, I'm not too squeamish about this sort of thing in the first place, and this procedure is something I've wanted for so long. The fact that I finally got to a place where I could do it just made me happy to be there.

As the fat collected in the special canister the clinic medical director, Dr. Comins, came in and commented on how great my fat looked (hilarious, but thanks!) and hung around for a while to watch Dr Gupta working his technique. He is one of the if not the best in the UK at this. We talked and laughed about favourite and least favourite parts of our jobs, and as the syringes for injecting the fat back into my breast were prepared; equipment envy between plastic surgeons. (Boys and their toys...) The vibe in the room was just so nice and the nurses and I bopped along to the music coming off the music player. Still, focus was fast and clear on the job at hand, and we drew out what looked to me like about 1200 ml of fat, which was more than I think we all expected and more than we'd realistically be able to fit in the breasts, so we were all pleased we'd have optimal results all round.

After making sure my breasts were also fully numb Dr. Gupta went through my tissue with a cannula to loosen the fibrous structure, making room for the fat to be injected. This was probably the strangest feeling of the whole surgery- it didn't hurt it just vibrated and sounded a bit like gently running a stick down a washboard! I thought my breasts would just be a soft, loose pillow inside, but there was a definite grid of fibers that we were breaking aside a bit to accommodate the fat. He made 10 little adits surrounding each breast, and with a gently curved needle he proceeded to inject syringe after syringe into my breast, moving around the injection sites and distributing everything in the shape we wanted. It was great fun watching them grow before my very eyes, and  was able to suggest filling a little more here or there depending on what my birds eye view was telling me.

Once all the fat had been taken out and put back in (or redistributed or recycled as I've fondly come to think of it) I was patched up with band-aids over the adits on my breasts, and lots of padding and a pressure garment on my lower body. The whole process had taken about 4 hours, but it felt a lot quicker! I looked a bit like when I was a kid during winter, so bundled up in woolly underwear and snowsuits that I could only waddle around, but otherwise I felt great! I couldn't bend down from the wrapping so I needed help with my shoes and socks, then I just slipped a loose flowy dress on that covered all the bundling nicely. I was given a bag of bandages and absorbent pads to help soak up the slightly blood stained saline that was going to be leaking back out of me, and I was already all set with pre-prescribed antibiotics and pain killers to take over the next few days. I hopped in a taxi and set off home, giddy and happy and glad the local anesthetic was still keeping me comfortable as the driver navigated the busy London traffic.

Morning after surgery, fetching, I know!

When I got home I felt really good, not dizzy, nauseous or in pain, just a bit stiff and immobile in my wrapping. A friend came over and we cooked dinner, watched a movie and went to sleep, me in my bed that was prepared with a waterproof mattress protector and black towels just in case of any seeping through the bandages. I slept fine other than waking up a bit with back pain, I think being as wrapped up as I was, my muscles didn't approve of being immobilized. Other than that I thought the surgery day had been a breeze! I wish I'd taken pictures throughout the surgery, perhaps I will ask permission next time! The plan now is to heal up a bit from this, then do my inner thighs and knees in 10 days, and later on do front of thighs and abdomen, with potentially a repeat on the fat transfer to the breasts.

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