Three days for surgery

[allbah]

Ok...This is my third surgery. First two in UK and this one in egypt!
First op they took too much from the middle and left too much around it. second one implants inserted to fill the depression.
This one should be the last. I told the surgeon to be as aggressive as he wants but just get these boobs tight. he is more than happy to do so.
Just finished my oncall duty. preparing my bag for my flight tomorrow midday. I ll be alone so I took all what I need and I intend to come back only with a breif case.
Once its over and I am back, I ll post pre and post op photos.

[allbah]

ok guys I am back.
went to cairo in 21/5/05. stayed in Marriott.
It was pretty tense there, there is some sort of election going on and the police and secret service every where.
First 24 hours went very slow. went for a walk then watched tv and finally fell a sleep.

22/5/05: went to see the surgeon in his practice office. he is a gentleman who looks like omar al sherif. there are so many certificates on the wall.
Had a long chat with him, we both understand that my case is very difficult. non of us could decide what is the best thing to do as the breast implants making things obscure. but the general agreement was to open up, remove implants, remove excess skin and do liposuction around the concave centre to smoothen it.
I decided to sleep in hotel and get to hospital around 6 am to have surgery. he starts at 7.

23/5/05: Arrived to Al Salam international hospital at 6:30 am. he was already in thaetre as one egyptian actor was attacked at his flat by a man with a knife. This actors face was damaged good style!
seen the anesthetist and went to theatrearound 8 am.
received my general anesthetic and everything went bye bye.
Woke up in the room. feeling generally well, with lots of bandages on my chest. I could vagely remember the surgeon saying..."I did a flap for you...no liposuction...you had vey bad capsules forming around the implants......I am very happy with the result" then went to sleep again.
Woke up again in the afternoon to answer phone calls from family at home.
every thing went ok during the next 16 hours, I received some IV antibiotics and oral analgesia.
I found a bag next to me containing the implants, the tissue capsules that the body formed around them and some skin!!!!

24/5/05: having sore throat from tracheal intubation.
I tiped the domestics and got them to clean the balcony for me and put a chair and a table there. I sat looking at river nile and breathing the early morning fresh air. couple of hours later things changed....noise...cars...beebs...smoky weather...
had to get in.
Surgeon arrived midday....he was very happy...took the bandages off.....ofcource the first scenery was not pleasnt.
Big bruises, big scar, fluid accumulating under the skin. but  the depressed concavity had disappeaered. Great.
He reassured me that he removed the old scars and that new scars will disappear almost completely in few months.
he said that instead of liposuction he boroughed fat tissue from the surrounding fat and flipped it over to fill the gap.
I was discharged.
Booked a flight back home for the next day. went for a meal in the evening.

25/5/05: arrived back home in Kuwait. everything is great except some diarrhoea.

26/5/05: worst day in my life....severe dysentery..watery diarrhoea every 10 minutes...severe abdominal cramps..fever with rigors....I sent my brother to get me Ciprofloxacin, metronidazole, buscopan and imodium. drinking lots of fluids and lying dizzy in bed all day screaming with pain.

[allbah]

I forgot to tell you that he refused to take any fees from me. I only paid for the hospital. He said that my case was interesting and he would benifit from publishing it. He took my permission to publish the photos and I had no objection.

I also am taking photos now almost daily when I remove the bandages to clean the area and email them to him.

27/5/05: better, no fever, mild diarrhoea only. went and bought compression vest as the elastic adhesive bandages
is very painful to remove.
chest looking better every day. little fluid under the skin only. Still brused. will be back to work tomorrow!!!

[allbah]

28/5/05: things are stable. dysentery resolved and I celebrated with a massive meal.
taking a shower is a long nightmare to avoid water coming on the wound.
no pain but still fluid accumulating under the skin. scar is clean. severe skin rash despite using hypoallergic dressings.
bruises still there but starting to fade away.
not comfortable with vest as the pressure on the chest irritate my stomach!!
more photos taken.

[allbah]

29/5/05: Not very good start. I felt fluid shifting under the skin of the left breast as I woke up and slightly more swelling.
went to hospital and got 50 mls of bloody fluid aspirated out from the left side. nothing on the right.
this happened after my first surgery, so nothing new to me.
things now are stable again and it doesnt seem that any fluid is building up again up to now.
more photos taken including the aspirate.

[Blitz]

Your story is very interesting.  Please post some pics.  Why did you fly to Cairo to get the surgery?  Money?  Better Doctor? Or does Kuwait have no doctors that specialize in this sort of operation?  

[allbah]

you could say its a combination of all what you said. But really
flying for long distances to have surgery in countries I am not familiar with was not appealing for me. Egypt I know inside out.
I will post some photos when I feel more confident about it, but surely I will. you can not imagine how my chest looked before, it was beyond anything I have seen before. anything would be better.

[allbah]

lots of things happenening. since arrival I had allergic skin rxn to the surgical ealstic band to the extent that I had to find other way. I am currently using a compression vest.
swelling is a problem due to fluid collection. I have aspirated fluis 3 times upto date, mostly from the left side. fluid was a blood stained transudate. no evidence of infection. first time 60 mls then 50 mls and last but not least 40 mls. colour is becoming clearer every time. there is also some subcutaneus oedema. I occasionally take brufen to help.
the right side is healing faster. unfortunately although much better than ever, there is now some concavity appearing at the centre. the left side still swollen so its difficult to say how it will look.
Still there is bruising  scatterd here and there.
I took the stiches off this morning....this was tricky. I think I removed everything. Scar is healing nicely.
I think this operation is a great success, but I also think that it is probably inevitable that I will need some Liposuction done in the future around the flap to make the chest look more regular.
It is early to say.

[allbah]

6/6/05: mixed outcome upto now (13 days post op).
the right side is settling down and healing well althought there is very mild central concavity. the scar is healing and starting to disappear.
the left side is giving me headache.almost every other day it is filling with fluis and I have aspirated it for 5 times now. the fluid is blood stained, less bloody now but still filling up rapidly. the is no pain or signs of infection there. there is also soft tissue swelling and some brusing partly from the aspiration needle.
I will consult the surgeon about this although I am almost certain that he will say wait, the surgery was extensive and this inflammation is part of the healing process.
from my previous experience in the last 2 surgeries I have to say I am not surprised or worried, I think I am in a hurry. I am sure that in two weeks from now I will have no fluid building up. I use the compression vest almost all the time, but I wonder if the pressure from it is affescting the circulation to the flap. I will try using it less often and with less pressure, I will also use ice packs and see.
I have started going for long walks now.
Although I am sure that its inevitable that I ll need some liposuction in the future, I don't think I can go through this again. I look much better now. surely I can go naked on the beach.

[allbah]

7/6/05:
things are still pretty dynamic. no problems with R side.
L side still bothering me. Very swollen today but no pain, fever or skin discolouration. I have to say the idea of flap failure or infection was in my head untill I stuck a needle again there and aspirated around 40 mls of blood stained clear non purulent fluid. this was followed by ice pack and compression vest (with less pressure) and long sleep.
I am deliberately using the vest less often now, I am worried that the pressure might compromise the blood supply to the graft.
I woke up and had a look and thank god, no bruises or swelling, no pain at all and the sweeling is minimal.
The scars are healing nicely, but better on the right.
I do still have a big chest but I have to say I am happy with my appearance now. the Pre op appearance when the implants were in was disgusting, now it looks/feels natural but slightly big.

[allbah]

9/6/05: further swelling on the left side only. initially I was determined not to stick a needle there but I took the aspiration kit home with me from work and I started a course of cloxacillin. Although I am sure there is no infection, sticking a needle every other day in my chest puts me at a high risk.

once home I saw the swelling and I could not resist aspiration. I stuck a needle there and surprisingly after several attemps I managed to get only little fluid out. it was serous and only slightly bloody. I could feel the needle this time penetrating tissue rather than a fluid filled space. I felt reassured that this is simply soft tissue swelling with some lymph. I used some ice, topical antiinflammatory creams, put my vest on, then took some brufen and paracetamol with the antibiotics and went to bed. woke up and rang the surgeon in cairo, he fully agreed with my judgement and suggested not to aspirate any more but use the vest more often and reassured me that in around 10 day max all this will go. I was convinced!

[allbah]

12/6/05: much better with the new compression vest. less pain and less swelling. general appearance is a bit funny. the left side is swollen. I could feel a big lump in the left breast. this is not free fluid as was the case initially but an edematous (swollen) tissue. the right side is the opposite although the flap is very hard when you feel it its actually slightly concave and the nipple with its surrounding are is puffy. believe it or not I am very happy with this up to now. at the end the worse that can happen is that I may need some liposuction from around the flaps to smoothen the appearance, although I am losing weight right now,and this might be all what is needed, I lost 12KG in the last 4 months.

[allbah]

13/6/05: pretty much the same. I continue to take antibiotics and waiting for the left breast to deflate. right side is same. I have started doing non resistance shoulder exercises. maybe abit early but it makes me feel better.
Although surgeons will say its too early to judge, I am convinced now that once the left side is deflated it will look like the right ( will have some central concavity) and I am convinced that some liposuction will inevitably be needed.

[allbah]

14/6/05: more action happening.
came back from work yesterday and the left breast was still very swollen with some discomfort. I rested then decided to face my worst nightmare scenario...this is an abscess or flap failure. I booked an urgent ultrasound scan........
Thank God...they found what is called SEROMA on the left. simply this is the accumulation of serous fluid inside the flap tissue...in bubles!...exactly like water in a sponge.
I was reassured that it will all resolve with time.
I had a read about it on the net and the suggestions were really all what I have been doing....try aspiration, Ice, compression and massage. I was over the moon.
I rang the surgeon in Cairo and informed him then asked him if he could after 3 months do some liposuction around the flap. Initially he said this was too early then he agreed.

[allbah]

15/6/05:
I woke up at around 02:00 am with alot of discomfort. took my vest off and the left breast is just the same....swollen.
I thought, the hell with that, I am aspirating this, I can't wait anymore.
got my aspiration kit ready and with sterile technique and a small needle and 10 ml syringe I stuck the needle in different areas and managed to aspirate total of 10 mls of serous fluid.
put some creams and dressing and went to bed.
After returning from work, I decided to sleep and see what happens. woke up and thigs still swollen. I aspirated again this time total of 10 mls. Man I have to say this makes feel realy good. I continue to take antibiotics as a precaution.