The Skinny on Penn Plastic Surgery Chief Resident's Clinic

Are you close to your ideal weight and size?

Are you ready to get your body back?

Are you in need of a little assistance in that area?


Penn Plastic Surgery Chief Resident's Clinic offers quality service at reduced rates.

It all happens at Perelman Center for Advanced Medicine, a part of University of Pennsylvania Hospital (HUP).

Three Resident Plastic Surgeons chosen from a large group of 250 applicants, are there to help you with your cosmetic needs.

Every July, a new trifecta joins the program as the former three move on to other reputable positions.

The Resident's Clinic has hours every third Tuesday of the month. However, your surgeon may be willing to work with your personal schedule once you establish a relationship.

Your surgeon's assistant will stay in touch with you via email and phone.

You may be able to contact your surgeon in the same manner.

Step One:

Call to schedule your consultation appointment with one of the three Resident Surgeons.

Step Two:

Attend your appointment with a prepared list of all your questions and concerns. Know what you want, and listen to what your potential surgeon suggests.

Step Three:

Assuming you are comfortable with making this new person your plastic surgeon, schedule another appointment with him or her.

You will sign a procedural consent and have before pictures taken of the soon to be former you.

You will also discuss when you want your procedure to take place. The time frame is tentative but will be set once a Board Certified Attending agrees to participate.

Step Four:

You will receive a written Surgical Quote, which itemizes the Procedural/Physician's Fee, Hospital/OR Fee and the Anesthesia Fee. Both the OR and Anesthesia Fees are based on the number of hours your procedure will take.

I.e., 3 Hours for OR = $2750 and 3 Hours of Anesthesia = $850

Step Five:

Pay a deposit towards your Physician's Fee to secure the date of your procedure.

Pay the remaining balance of the Physician's Fee and all other fees as indicated on your Surgical Quote. The payments are slightly staggered. However, since they are separately by a few weeks, it is best that you have the total saved up in advance.
(According to the postings on Realself.com, abdominoplasty with muscle repair and flank liposuction performed through the clinic have ranged from $4400-$5450.)

Penn Plastic Surgery Chief Resident's Clinic Location and Appointments:

Perelman Center
for Advanced Medicine
1st Floor South Pavilion
3400 Civic Center Blvd
Philadelphia, PA 19104
Telephone: 215-662-7300

Lost During the Journey: A poem about restoration by Robin L. Jessie-Green

Lost During the Journey.

This is my body, yet I cannot seem to find myself amongst all the wrinkled folds of flesh and deeply grooved battle scars etched in my skin from pregnancy after pregnancy after pregnancy.

This is not how I began, so it will not be how I end.

I am woman.

It doesn’t affect my love for you. This is about me and my truth.

It does pose challenges for self-love and acceptance, though.

Questions how anyone else can love this and accept that, as is, when I can’t?

I don’t resent you.

I resent me for not having those good genes of mutant women who bounce right back.  Those select few who end up coming out without a scratch.

Life is a beautiful gift, but sometimes at the risk of disfigurement at the center where it all begins.

Why do I have to live with the sacrifice of my outer self?

Only mothers can empathize with how it changes one inside and out.

This is my body, yet I no longer recognize myself because I’ve created yours.

What’s more—as I continue to nourish you, I continue to change outwardly.

So much so that I can’t remember how I used to be.

I barely recollect the body, which was lusted over ultimately resulting in how you came to be.

So when I chose you, it was over me.  Unknowingly.

But I would not change your existence.  Simply the evidence of it left on me.

 

Causing me to live with what I wanted no one else to ever see.

I lost freedom of self.  Estimably, confidently, romantically, intimately…

Couldn’t comfortably share myself with anyone else without hiding what lay underneath.

Preventing me from being my truest self.  Not living up to my highest potential. Being all who I could be.

Hiding behind sizing up.  Some things you can’t work off in the gym.

The Curse of Eve was not simply labor and delivery, but marked flesh, loose skin, sagging breasts and loss of ones dignity.

It is a fact of Life.

All I ever wanted was to make it right.

Adopting a realistic desire of restoration.

Wanting to no longer be distracted by my own malformations.

Welts on my lower back, dips in my hips, and flames rising to the tops of my rib cage will remain.

But erasing some of this part of me that has no rightful place is not vain.

It is what allows my happiness to be regained.

I am realistic.  I knew there were to be sacrifices. 

But I do not agree that the life of you had to mean the death of me.

I do not agree with my body having to be altered permanently and my beauty lost unnecessarily.

This is my body, and I am forever changed.  I shook the hand of the man who had a hand in having unearthed its hidden beauty awaiting its moment to be reclaimed.

Finally, revealing who I’ve always been.  Freeing me, once again. 

“I’d like to proudly introduce myself, I am woman.”

This does not detract from being mommy.  It rectifies what was lost during the journey.

Using Heat for Healing After Tummy Tuck Can Hurt You!

Heat is soothing to me. For nearly every ache, I opt for heat over ice.  I have a "Bed Buddy" that I pop in the microwave and drape around any sore muscle on my body.  I own a hot water bottle and a heating pad.

Heat is said to improve blood flow and can help in the wound healing process. However, you should be cautious when using heat to heal after a tummy tuck.

You are numb for a while after an abdominoplasty.  This is potentially harmful when mixed with a heating pad and sleep!  Unfortunately, I had to learn the hard way that I could actually burn myself with a heating pad and not realize it because I couldn't feel my skin burning.

Luckily, I got a hold of some silvadene for my burn.

If you feel you need some heat, try the lowest setting and stay alert!

Don't create an unnecessary set back with your healing.

Reconstructive and Restorative: Tummy Tuck with Muscle Repair

Abdominoplasty, more commonly referred to as a tummy tuck, can involve more than revealing a pretty belly. 

The core underneath can be repaired when the muscles of the abdominal wall have separated due to the trauma of multiple pregnancies or previous abdominal surgery.

"Front Butt" Before Pic

This such muscle separation is known as diastasis recti and can be repaired through plication or folding of the abdominal muscles and sewing them together.

Because of my previous laparotomies and five full term pregnancies, muscles were shot and required repair.

They were brought closer together and then secured with sutures.

Day 21

Undergoing muscle repair, allows you to strengthen your core. This has benefits, such alleviating back pain and providing help with balance and stability.  Of course, it ultimately allows you to reveal muscle tone as you resume abdominal exercises.

Who says beauty is only skin deep? Sometimes, you have to go in a bit deeper to restore much more than the mere surface. A tummy tuck with muscle repair does more than make your belly pretty, it strengthens you to your very core.

Sources: 

July 2015, Dr. Jonas Allan Nelson, Penn Plastic Surgery Chief Resident's Clinic.

2012, January 24.  Harvard Health Publications. Harvard Medical School. The real-world benefits of strengthening your core.

Wanna See My Before and After Pics?

You can view my before and after pics at the link below.  I'm not ashamed of the front butt because it no longer exists.

My doc still has to send me pics of the actual tissue he excised.  Those will not be for folks with weak stomachs! Stay tuned for those pics...

Click Here to See My Before and After Pics!

Drain Removal is a Big Step toward Healing After Tummy Tuck

DRAIN REMOVAL

I skirted over the drain removal a bit. Let's get real.  The first one Doc removed had been irritating me for a couple of days because I snagged it coming out of my compression garment.  I assumed it would smart when he removed it and I was instructed to breathe deeply.

So, I'm lying on the table, fists clenched, holding my breath.  I feel a strange sensation as the tube is traveling through my body and out my side but No pain!  This gave me a false sense of security.  I assumed that my entire experience would be pain-free.

Okay, so he gets to the other side, which had been the problematic side for me from the very beginning. Constant irritation with or without snags up until the left side decided to take its place just days prior to removal.  I thought I was in the clear because it hadn't been the thorn in my side for a couple of days. That was an incorrect assessment on my part.

Doctor Jonas Nelson proceeded to snip my sutures and begin to extract my right drain and it Sizzled like rubbing alcohol being poured into an open wound without someone to blow on it.  It burned like acid the entire time he pulled and it seemed like it took 3 times as long to come out. Along with the tube came drainage that oozed out of my side.  He had to do some extra cleaning and padding.

I wanted to tell him to "Blow! Blow on it!" But instead, I made that air sucking between your teeth sound when something burns like that. I'm surprised I didn't cuss.  It was over in a couple of minutes.

After the removal, I could immediately stand up straighter.  I had more pep in my step. Although, I experienced cramping and tenderness in areas I had previously had none, it was a big step towards healing.

What I Experienced with my Tummy Tuck with Muscle Repair and Liposuction of Flanks Days 11-15

CHANNEL YOUR INNER MACGYVER.

Days 11-15 have been all about getting comfortable.

The drains came out on Day 12. My drainage was 30 ml followed by 22 ml.
Swelling has subsided some, but there are still a few months to go in that area.

What I've done to make the healing process easier has much to do with some of my pre surgical purchases.

I picked up a pharmacy store brand 30 Piece Wound Care Kit for $19.99 and have found many uses for its contents. I also found cotton rounds especially useful.  Not all cotton rounds are created equal, so use those that are stitched around the edge because they are less likely to fray and stick to your wound.

Initially, I used the medical tape and long gauze pads to cover my incision while suited up in my armor aka compression garment.

I also padded my inner thighs where the compression garment seams seemed to be irritating me. And I cushioned my cooch because after the pre surgical shave, my growing pubes even seemed to hurt.

The drain tubes were pressing into my skin under my compression garment.  So, I cut cotton rounds in half and with medical tape affixed one half under both sides of my drain tubes. This created cushion under the tube and gauze pads where then placed over the tubes.

After my drains were removed and bandaged, I used transparent dressing covers to waterproof the ones the doc applied.

What I Experienced with my Tummy Tuck with Muscle Repair and Liposuction of Flanks Days 6-10

DRAINS, SWELL HELL & COMPRESSION GARMENTS

By day six, I had already had my first follow up with my plastic surgeon two days prior. He said I was extremely swollen but coming along nicely.  It was time for me to come out of the two hospital issued abdominal binders I was wearing and for me to get into the compression garment I'd purchased prior to surgery.

After the trauma of an abdominoplasty with or without liposuction, your body begins to develop fluid or seroma that needs to be eliminated.  Drains and compression garments aid in the process.

I was given a drainage goal of 30 ml or less for a minimum of two consecutive days in order for my drains to be removed.  My drains were sutured at both ends of my incision, as not to create additional holes.

They were secure; however, they still hurt if snagged or slightly shifted. It is difficult to avoid while dressing and undressing. It is especially challenging when applying or removing a tight ass compression garment.

You must "strip" your drains to prevent clogging.  With one hand, you grip the drains close to where they are sutured.  With the other hand, you squeeze and slide your fingers down the length of the tube to where the fluid collects into a bulb at the end.

After stripping your drains, you empty them into fluid collection cups and record on a log the ml indicated on the cups.

Once emptied, remember to squeeze the air out of the bulbs so the suction process will be most effective as your fluid continues to drain.

DID I MENTION COMPRESSION GARMENTS?

I ordered something online from Leonisa in a Large, which seemed to fit comfortably until I slept in it. About 1:00 a.m. it felt like it was cutting the circulation off to my labia and inner thighs.

My best friend took me to Latin Fashion where I got a Stage 2 post surgical compression garment that seemed to provide instant relief. It became uncomfortable at 3:00 a.m. too.

It's as if my thighs swell at night.

I tried a corset I bought from Latin Fashion last August to sleep the rest of the night in.  I decided to wear the full piece compression garment during the day.

Because I was still producing too much fluid, I couldn't have my drains removed.  I began using gauze from my wound care kit to pad myself for comfort.

I had spent over $300 in garments and was still struggling.

Luckily, as I continued wearing the compression garment the less swelling I had and the more comfortable it became.
last August to sleep the rest of the night in.last August to sleep the rest of the night in.last August to sleep the rest of the night in. I'll have to wear the full piece during the day.
I'm still producing too much fluid to have my drains removed. My drains are sewn in at the ends of my incision. This sometimes hurts with the garment on.
Stuffing gauze and padding to try to help.
Over $300 worth of garments and still just struggling.last August to sleep the rest of the night in. I'll have to wear the full piece during the day.
I'm still producing too much fluid to have my drains removed. My drains are sewn in at the ends of my incision. This sometimes hurts with the garment on.
Stuffing gauze and padding to try to help.
Over $300 worth of garments and still just struggling.last August to sleep the rest of the night in. I'll have to wear the full piece during the day.
I'm still producing too much fluid to have my drains removed. My drains are sewn in at the ends of my incision. This sometimes hurts with the garment on.
Stuffing gauze and padding to try to help.
Over $300 worth of garments and still just struggling.last August to sleep the rest of the night in. I'll have to wear the full piece during the day.
I'm still producing too much fluid to have my drains removed. My drains are sewn in at the ends of my incision. This sometimes hurts with the garment on.
Stuffing gauze and padding to try to help.
Over $300 worth of garments and still just struggling. Fashion last August to sleep the rest of the night in. I'll have to wear the full piece during the day.
I'm still producing too much fluid to have my drains removed. My drains are sewn in at the ends of my incision. This sometimes hurts with the garment on.
Stuffing gauze and padding to try to help.
Over $300 worth of garments and still just struggling.

What I Experienced with my Tummy Tuck with Muscle Repair and Liposuction of Flanks Days 1-5

PAIN.

Day one through three were the most painful days post op.  That should be no surprise.  However, everyone tolerates pain differently.  My pain was very difficult to manage.  In fact, when I was being transported to recovery, I supposedly came to and made it very clear of my extreme discomfort.

I was given Dilaudid aka Hydromorphone, which is an effective prescription narcotic. Except, it wasn't so effective for me.  So, I was given another and prescribed Valium as well.  By the time I made it home, I was fully alert and full of pain.

I took two 2mg Dilaudid pills every 3 hours and one Valium every 8 hours.  At no point did I experience complete relief.  I awoke every few hours and just dealt with the pain.

I have a few theories as to why this was such a challenge for me.

1. I have had 3 non birth related, non cosmetic, abdominal surgeries under general anesthesia.
2. I have given birth vaginally to 5 children with epidurals.
3. I've had a couple of gastrointestinal tests that also required general anesthesia.

For these aforementioned reasons, I believe I have had so much pain medicine that I require a higher dosage for comfort.

PRESSURE.

By day five, I was experiencing an altogether different type of discomfort. I hadn't had a bowel movement since the day before surgery.

The problem I was facing was that in order to prevent my pain from spiraling out of control, I had to eat something when I took my pain meds. By eating, I was becoming increasingly bloated and uncomfortable.

Plus, narcotics tend to curb my appetite so, I wasn't hungry, was constipated and in pain.

During the first few days, I vomited a total of 3 times because I hadn't had enough on my stomach with all the narcotics, antibiotics, and nausea meds. I had to force myself to eat to avoid vomiting.

I took Renu Herbs Colon Cleanse, Milk of Magnesia, stool softeners, drank Dieter's and Smooth Move teas, ate prunes and drank plenty of water. Nothing happened but more of the same discomfort.

Then, I started breaking down. I stopped eating, I stopped medicating and I began sobbing.

I finally sent my oldest son out for an emergency Walgreens run for some enemas.

I administered one on my own and found relief in a matter of minutes. Twice.

By the next morning, I had no need for any products for constipation and haven't since.