The Diving Bell and the Butterfly

I know I'm overdue for an update, but it could not have been typed any sooner, and even today is a bit of a stretch.

I would love to describe what I've seen of Costa Rica, but typing is still physically very demanding so I will save that for a later time. Forgive me for this dry, chronological account of my first few days. I promise that my usual wit and wisdom shall return as I shed the (hundreds of) stitches.

The pre-op consultation with Dr. Rashi went very well. He's a smart, charismatic man. We discussed my various procedures, and I was pleased to discover that his artistic sense of beauty seemed to naturally line up with mine. This was most important for the breast augmentation because that's where plastic surgeons get to "express themselves," for lack of a better expression. I had brought him some pictures, and we talked about size, slope shape and angle, nipple size and position. It was a bit disconcerting to be customizing my breasts, as if I were in a build-a-boob workshop, but it gave me great confidence in Dr. Rashi to see how well we got along.

Next, they drew some blood, and most people would not feel the need to mention this obvious, quite mundane step, but for those who know me well, you know it is worthy of mention in my case. I have always dreaded needles, and I knew this was only the first of many to come. The nurse seemed very competent, and I would qualify my experience as "very unpleasant," which I deem to be high praise considering the fright gauge needle was pointing to "sheer terror" as she approached me.

I know I have listed my procedures to be done in this trip in my first post, but here they are again in greater detail:

A lower body lift (LBL) which is the combination of an abdominoplasty (tummy tuck), a buttocks lift, and some liposuction on the outer thighs. The incision for this procedure is a full circle around my body, positioned to be covered by a reasonable bikini bottom (meaning thongs excluded).

A thigh lift. The incision for this one is L-shaped, starting inside the knee, running straight up to the groin, bending and following the groin line for a bit.

A breast lift with augmentation. Initially, I had decided to do only a lift but after squeezing the extra skin with my hands to predict the outcome, I feared I would be left with very little. Doing the augmentation at a later time would mean a lot more money than doing it at this stage, combining it with the lift. During a consultation with Dr. Jay Pensler in Chicago, I learned about the "next-gen" breast implants: cohesive silicon gel implants. Firmer than saline, they hold up (pun intended) better over time, and cannot leak, unlike their liquid silicon predecessors. There are some drawbacks that could turn off potential patients. Cost, for one, as they are significantly more expensive than any other kind. Shape could be another, for women who prefer the half-grapefruit breasts, as these only come in anatomically correct shapes (teardrop). Lastly, and most significantly for women only looking for an augmentation without a lift, is the incision type. Due to their more solid nature, these implants require a wider incision than others. Armpit insertion is very difficult, therefore yielding inconsistent results. Areola insertion is not possible at all. The only reliable incision type for this, is under the breast, about 5 cm wide for average implants.

These beauties are only accessible to selected patients of selected surgeons in the USA as part of an ongoing study. When I asked the Rosenstock-Lieberman clinic which implants they used, I was shocked by their response: "We have been exclusively using cohesive gel implants for years, as has most of Europe. They are only reaching the US now, but some countries have been using them for over 10 years." That is what swayed me. I would have my own pair of gummy bear implants, as they are affectionately nicknamed. Gummy bear implants in my build-a-boob workshop. How's that for humor?

Arm lift. The incision for a brachioplasty usually starts inside the elbow, and ends in the curve of the armpit.

There is one more procedure that I wanted to get done. Originally, I meant to keep this one a secret from the public. I now believe that I must disclose it for this account the be honest and accurate. I thought it would be such a meaningless little procedure in the grand scheme of things, but since I turned out to be dead wrong about that, I will talk about it here. I am talking about a labiaplasty. I am not going to describe what it is, just saying it is embarrassing enough. Go google it if you must.

The morning of surgery, Dr. Rashi took plenty of "before" pictures. He then drew some incision lines for the LBL. The plan for that surgery was to start with the LBL, and move on to the arms if all went well. He drew incision lines on my arms. Then, "just in case," as he winked at me, he drew incision lines for my breasts. One injection, and an IV insertion later, I was taken to the operation room and set up on the table. The anesthesia, which I was dreading more than anything else, was every bit as unpleasant as in my unmercifully sharp yet 26 years old memory, but blessedly short.

I woke up hours later, feeling a sort of hot, body-wide, mild pain mixed with numbness. Actually, this is not exactly true. My first memory, before being fully conscious, is certain hypothermia. I remember feeling my limbs shaking wildly and my teeth chattering loudly. I do not know at what temperature they keep surgery rooms, but I know I was freezing before I was even put to sleep, so imagine after.

Two surgeons working together for 7.5 hours of surgery yielded me a massive surprise: they had done everything but the thigh lift. This was excellent news considering that it would give me that much more time to recover before I flew back to Chicago, but you all see me coming with the downside: all-over pain. Breasts, arms, butt, stomach, and that other delicate zone. Ensued the longest night of my life.

I was not mentally prepared for such utter helplessness. From the groin up, I could only turn my head. My legs, left untouched by surgery, were encased in huge, electrically-controlled, inflatable leggings which compressed my calves periodically to maintain normal blood circulation. At that moment, I glimpsed the hell that Jean-Dominique Bauby (The Diving Bell and the Butterfly) must have lived, his healthy mind locked inside a non-responsive human shell. The pain was increasing by the hour, and despite being weak and sleepy, the discomfort of my position combined with the inability to reposition myself never allowed me to doze off for more than a few minutes at a time. I remember waking up once to find all the day staff gone, the place deserted except for an unfamiliar nurse. She greeted me: "Hola! I'm the night nurse!" My heart soared. "It must be midnight! Almost halfway til morning!" I asked what time it was. 7:30. A whole hour and a half after my mom had left. Oh. My. God.

The nurse slept in my room. I woke up and dozed off several more times until I could no longer fall asleep at all because of the pain. I told myself it must have been close to 5 am by then, and maybe I could just tough it out. 5 minutes later, the nurse woke up to check on me. I was constantly moving my legs, desperate to hang on to the shred of control I still had over my body, and the swishing noise of the leggings must have woken her up. I asked her what time it was. 11:20. I started crying, and begged her for a pain pill. She gave me one, and offered me a sleeping pill as well. The rest of the night went well, as from that point on, I was only waking up hmm, 4, 5 times per hour?

Well, it took me several hours to type this up, with frequent rests, and I'm not even to the halfway point of my story. I will have to stop here for tonight, and hope that I can finish tomorrow. Hasta luego!