On June 4, 2011, I broke my silence about what a nightmare my plastic surgery had become. People often stereotype plastic surgery with being vain, but 9 times out of 10 for patients whom have undergone weight loss surgery (WLS), that’s not the case. When a person loses 100 pounds or more and has the skin leftover to show for it, it’s no longer an issue of vanity. It’s a painful daily reminder of a life hopefully long gone. I LOVE when I hear people say, “can’t you just go to a gym and exercise it off or tighten it up?” No! No, I cannot just go to a gym and work out until it falls off or snaps back. Trust me, I tried, but I’ll get to that.
For a time after posting my original story, I was quiet about what happened. Not because my issues had fixed themselves (and in fact, they have become much much worse, but again, I’ll get to that), but because my plastic surgeon had his attorney contact my husband (who is also an attorney) to suggest that I be quiet. The surgeon (or whomever he has following obesityhelp.com) complained and stomped his foot in the sand until they removed my post because it clearly showed him in a less than favorable light. Here’s the thing, nothing I said wasn’t the truth and I’m not going to sit silent for one more second. Life is not always sunshine and rainbows. If one person reads my blog and spares themself the horror that I am currently living, it’s worth it. On Thursday morning I will travel to The Cleveland Clinic for treatment. For over a year, I have lived with problem after problem and they all started conveniently shortly after plastics.
I am going to post my original story and then fill in some blanks because things have changed dramatically since I originally posted my story and not for the better.
I would like to give you all a warning about having plastics and if it helps even just one person to not go through what I am currently going through, then my job is done. I’m not saying that WLS patients should not have plastics, I’m saying there are certain things that need to be considered before going under the knife. Let me start my story from the beginning.
10 years ago I had gastric bypass surgery; the duodenal switch to be exact. I’m not going to sit here and tell you that I have been a by-the-book patient from day one because that would be a lie. I have maintained my weight loss and I have had to work damn hard to do so. I had 3 children (my twins are 2 1/2 and my youngest daughter is 17 months old) and figured since I was done having children, it would be the right time to finally consider plastic surgery. Before even considering plastics though (and even before my children came along), I joined a gym, got a personal trainer, and tried to literally work my ass off. Over the years, I have had 4 additional open abdominal surgeries all stemming from complications from my GB, so the last thing I wanted to do was have another surgery just to have one. So again, I exhausted all options to try and tighten up my loose skin, but as we all know, it’s just does not happen when you lose that much weight. However, I wanted to be in damn good shape before any plastic surgery and I was.
I started at 263 and was down to about 132 before having plastics. When I was researching plastic surgeons, I chose my plastic surgeon not only by word-of-mouth reputation, but based on the fact that he specialized in post-op GB patients. I figured he knew what he was doing. I did my due diligence by having him checked out by my husband (who happens to be an attorney) and my friend (who was working for one of the top med mal firms in MI) to make sure he had never been sued. He hadn’t.
In Aug 2010, I had my initial consultation with Vincent DiNick. He seemed like a no nonsense kind of guy. Personable, slightly cocky, but I felt comfortable with him. Most importantly, he assured me that he would make me even more beautiful. I was contemplating two procedures: Abdominoplasty for excess skin with double hernia repair after the twins and my youngest were all delivered vaginally, and breast lift and augmentation. My insurance would be covering the abdominoplasty since I had lost over 100 pounds and I also needed a double hernia repair. I had to pay an out of pocket cost of $1000 for the extra vertical cut and skin removal which I was fine with. At that time, Dr. DiNick and I discussed the lift and augmentation with implants. While I would have LOVED to have complete body skin removal (thighs and arms) I just couldn’t afford it and I wasn’t ready to go through all that surgery.
So I booked the dates for the TT and breast aug. It saved me $2000 to split the surgeries up so that’s what I did. I was to have the TT first and 3 weeks later I would be having the breast aug.
At my initial consult, Dr. DiNick said to me that he could tell I was anemic just by looking at me. This would also be confirmed by the pre-op blood work, which it was. I got a phone call a week before surgery to tell me that I was anemic and to just double up on my iron. Ok, this is where the first problem began. Double up on my iron. Hmmmm, being a GB patient I already have absorption issues, but being a DS patient I am the most malabsorptive patient out there. So telling me to just double up on my iron a week before a surgery, yeah, that’s not going to do a damn thing. An iron infusion should have been ordered. But it wasn’t. I probably should have insisted that one be given, but I didn’t. I figured that my surgeon knew what he was doing.
So on 10/22/10, I had my abdominoplasty. It went off without a hitch, or so I was told. Recovery was fairly simple, but extra slow. Looking back on it, I now know why, I was SUPER anemic. On 11/15/10, I went in for the breast augmentation. What was to be a simple 3-4 hour max procedure, turned into an 11 hour, yes you read that right, an 11 hour marathon surgery. To this day, I haven’t been told why. The only explanation I have ever received from Dr. DiNick was that I had terrible breasts and he had to “force” the implants in. I was so “in-shape” that it was very difficult for him to get them under the muscle. Now, here is where my second issue begins. I was told BEFORE surgery number 1, that I was anemic. Dr. DiNick did not see fit to draw labs between surgery number 1 and surgery number 2. So, I went into surgery number 2 very anemic. Dr. DiNick did not see fit to draw labs after an 11 hour surgery either. Regardless if blood loss was minimal (so I was told) for either surgery, there was blood loss. LABS SHOULD HAVE BEEN DRAWN!!! This is a surgeon who does nothing but post-GB patients and he never saw fit to draw simple labs? Why?
For 6 weeks after my breast aug, I vomited daily. I wasn’t able to keep a thing down, so I ate and drank what I could keep down. Broth, rice, and pop. Yes, I drank pop. OOooooooohhhhh, lol. I have since stopped drinking pop, but like I said, I was trying to keep myself hydrated. I called Dr. DiNick and advised him of my issue and he called me in a script for anti nausea meds. Didn’t help. On Dec 29, 2010, I saw Dr. DiNick for a follow up appointment. At that time he told me I looked like “death” and one of his staff members (the staff nutritionist) also told me that I look like “death”. Yet he STILL saw fit to not have my labs drawn and sent me on my merry way. Do you want to know why I looked like death (and I mean I was gray in color)? It’s because I was on the verge of death.
On New Years Day, I was taken to the ER by my husband because my legs had swollen up to the point of I couldn’t even make out that I had ankles or toes. I had over 10 pounds of fluid weight on me. My body was shutting down from low protein and lack of iron. One of the many Dr’s I saw at the hospital told me that I was in high output heart failure. What? High output heart failure? I’m 33(32 at the time), how the hell did this happen?
Well, I was so malnourished and so anemic (which would have been found out if he had drawn simple labs….how many times have I stressed this now? Not enough!) that I was dying. I was admitted to the hospital where I was given blood transfusions, iron infusions, and I wore compression stockings for the entire time I was there. Problems over right? WRONG! This was just the beginning of my current nightmare.
I noticed that something was not right with my left breast and my stomach early on. My stomach was distended to the point of me looking 6 months pregnant at all times and my nipple placement along with my scar placement on my left breast was off. My nipple was (well is) sitting under my armpit. After consulting with my regular Dr (who sent me through the ringer with tests because she felt a mass in my abdomen, still yet to be diagnosed as to what the hell she felt) and an endocrinologist (who would diagnose me with a laundry list of issues I did not have before having plastics…..secondary hyperparathyroidism, RICKETS!!!!!!!, low vitamin everything, anemia, etc.) I saw Dr. DiNick for what would be the last time in March 2011. Had he looked at my breasts he would have noticed a problem, but he only looked at my distended abdomen to which his response was, “there is something very wrong, maybe you have ascites.” Oh, and he also said, “You ruined my work!” I ruined his work? How?
Maybe somebody can answer that question for me some day. Yet nothing was done about it. I consulted with a gastric bypass surgeon who also said, something was wrong, but he didn’t know what. He referred me to a gastroenterologist. I haven’t been able to see him yet. The earliest appointment I could get was June 20th. So I have been sitting for months and months with a very painful, very distended stomach. And yet the problems just keep on coming.
Let’s go back to the left breast. A little over a month ago, I felt something pop (even more than it had) and I couldn’t catch my breath. I knew something was terribly wrong. So off I went to the ER again. I was told that my pectoralis had torn completely open which allowed the breast implant to pop on through. It’s pretty much free floating around. The implant bottomed out and I can now feel the right implant beginning to do the same. Bottoming out is something that happens in maybe 8-10% of normal patients. Patients with malnutrition/malabsorption issues (uh, GB patients, ding ding ding) have an increased risk to 20%. This was NEVER told to me. Also, this could have possibly been prevented had Dr. DiNick used the proper type of implant, which he did not and a mesh anchor, again, which he did not. I did not even know an anchor was an option. The fact that I was a gym rat (and Dr. DiNick knew this) meant that I was all muscle in the breasts. He knew from the start that I would have a hell of a time. I like to say that he gave me the Kia of implants. He used a smooth round saline implant when he should have used a textured implant and a mesh anchor to hold the implants in place. When you are all muscle, it puts pressure on the implants. Um, I would have thought that a plastic surgeon (who does nothing but GB patients) would have realized my increased risk and would have realized (by me being a gym rat and being in, according to him, the best physical shape he has ever seen any of his patients be in) that I the very least would need a mesh anchor due to increased pressure that I would no doubt have on my implants. And by the way, none of this still explains why my surgery went 11 hours long and while he offered for me to stay the night, he allowed me to be sent on my merry way.
Now, since this is not considered medical malpractice (and let’s be clear, I feel in my heart of hearts that he is responsible for medical malpractice) and I cannot sue him (unless when the new surgeon opens me up and finds some really jacked up stuff) I am now forced to pay out of pocket to fix his mistake to the tune of $14,000. They deem this as cosmetic surgery which means insurance doesn’t cover it. To me, there is nothing cosmetic about this. What’s cosmetic about a torn open pectoral muscle and a nipple that’s sitting in my armpit? What’s cosmetic about an implant that has ripped through the muscle? I get that implants themselves wouldn’t be covered, but the surgery itself, anesthesia, the theatre, the hospital stay, etc. really should be covered. A tear is something medical, it’s not cosmetic. I’m sitting here looking like a monster with my nipple in my armpit, my implant floating around, a torn open damn chest muscle, a pregnant looking stomach (which hasn’t even been addressed yet, lord only knows what the hell this issue is), swollen legs which now require me to wear compression stockings for at least 6 months due to lipedema and the bonus is that I get to literally pay for it. It’s not enough that I am reminded of his mistakes every time I look in the mirror or when my son looks at my stomach and says, “what’s wrong with your belly?” Nope, I get to pay thousands upon thousands of dollars to fix this. What’s worse is that I am currently on a lift restriction and I am in severe pain. No surgeon deems this as a medical emergency which means I get to wait and really I get to wait even longer because I have to find the $14,000 money tree first to fix this. According to the new plastic surgeon, the longer I wait, the more difficult the repair becomes. Try to explain to 3 toddlers why I cannot lift them, hold them, play with them and simply be their mom. I chose to have plastics yes, I knew there would be risks, yes, but not these risks and not these problems that I am now living with. I was NEVER informed that any of this would be a possibility.
I don’t want another living soul to go through this. Do your research people. Be up front with your surgeons and most importantly ask questions. If you are splitting up your surgeries, DEMAND that iron levels be checked. If you are anemic before having surgery, get your iron levels up with infusions BEFORE going under the knife. If you are low on protein levels, get them up BEFORE you have surgery. Do your part, but also make sure that your Dr does his/her part and hold them accountable when he/she isn’t doing the right things by you. This is your life we are talking about.
That was my story. Since then I have had my implants repaired by a different plastic surgeon. When the new surgeon opened me up he found that on the left side, the pocket (or capsule as I guess they call it) had never formed. This is what allowed the implant to be able to move around and bottom out. While the right side was closed, it was nowhere near where it should have been for someone who was 7 months post-op from a breast augmentation. So, he sewed in the mesh anchor to my ribs and replaced my smooth round saline implants with a textured gel silicone implant instead. Couple that with my nutritional/vitamin issues and I never had a chance. The surgeon said that he had seen cancer patients with better tissue structure than me. *insert the sound of a record scratching here* What? Now, health wise, I wasn’t 100% percent going into the implant repair, but I was in a far better place than I was. So, I can only imagine what the condition of my tissue was when Dr. DiNick performed the original surgery. Wouldn’t he have noticed this immediately? My guess is yes and if that’s the case, he should have stopped the surgery right then and there. In my opinion, that was putting me at 100% failure rate if my tissue was in such a state. So in plain English, he put implants in my body with no means to cover them up, but closed me up anyway. Knock on wood, the new implants as far as I know, are still in their proper place. That’s the breasts, what about my stomach?
Well, since this original post, I have been operated on, again, by my original gastric bypass surgeon. Since nothing of substance was showing on any scans/xrays or any of the other bazillion tests I had, he had to open me up blind. He found only slight adhesions and two areas of the small intestine that he had to widen. It didn’t correct my stomach distention, bloat, or pain and the gastric bypass surgeon is fairly convinced that my issues, whatever they may be because he just doesn’t know, are too coincidental to be anything other than related to the abdominoplasty.
Upon receiving my operative report, I noticed a couple of things. One, a missing JP drain tube. I would hope that with the surgery and with the myriad of tests that I have had, if a JP drain tube was lodged inside me somewhere, it would have shown up. However, at this point, I wouldn’t put anything off the table as this story is crazy enough and that would be the icing on the cake. It would also explain a hell of a lot. So as you can imagine, I’m a bit concerned with regard to that. Also, Dr DiNick removed adhesions unbeknownst to me. I get that sometimes surgeons will remove adhesions in order to repair a hernia, but according to his own operative report, my hernias were not large so why root around in adhesion land given my past surgical history? At the very minimum, I should have been informed that he removed adhesions, yes? Again, this is one carnival ride I would really like to get the hell off of.
I have had consultations with a gastroenterologist here locally and a bacterial overgrowth was ruled out as well as Celiac disease. I have also been hospitalized again due to the swelling and stomach issues. I’ll spare you readers the details of what occurred at this most recent hospital stay, but let’s just say it wasn’t pretty and I tip my hat to all nurses of the world. You are all grossly underpaid if you have to do things like that on a daily basis. OMG! Anyway…
So off to The Cleveland Clinic I will go. No tests, no Dr’s, no nothing have been able to diagnose the issue or give me any sort of relief. The one general constant in all of this is that there is a problem, a very real and visible problem. I am getting worse by the second and had I not been able to get this appointment when I did, I would probably still be in the hospital. AND THAT’S THE TRUTH!!!
I wasn’t going to post these, but I feel that a picture is worth a thousand words.
This is my current state. The first pic was BEFORE plastics, the middle about 5 seconds after, and now. See my problem!