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En Bloc, Liposuction, and Fat Transfer to Breasts

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Today I’m sharing my experience getting an en bloc, liposuction of flanks, abdomen, and thighs, and fat transfer to my breasts. Many of you are reading this and considering having at least one of these procedures. I hope to answer as many of your questions as possible.

– This post contains affiliate links to the products I used.

Preparing for Breast Implant Removal Surgery

Deciding to have my implants removed was a no-brainer after learning about breast implant illness. Using the Facebook group, I found a qualified surgeon near me.

Dr. Stanwix is on the list of the recommended explant surgeons in my area. He also has a Facebook group dedicated to his practice. The Dr. Stanwix Facebook Group was more helpful than the large group because it was specific to our surgeon. I learned more about Dr. Stanwix, his techniques, and how the ladies prepared and recovered. It is important to have a group where you can ask questions and view real-life results from the doctor your choose.

I called Dr. Stanwix’s office in December or January 2019 and made an appointment for a pre-op consult in June 2020. He is a busy surgeon.

Tip: I strength train regularly, and I can honestly say having strong leg and ab muscles was a game-changer during my recovery. You will need to utilize these muscles to prevent using your chest muscles, so be prepared by strengthening your core and quads/hamstrings before your surgery.

Choosing my procedures

Before my pre-op appointment, I researched which procedures I wanted to include with my breast explant. I debated between leaving the surgery with new breasts or waiting to see what my old boobs looked like without any additional tissue.

My husband pushed for a fat transfer because it was cheaper to undergo one surgery, there would be less downtime, and he believed I would be depressed if I didn’t like the results.

After seeing the beautiful fat transfer photos in the Stanwix group, I was excited to talk to the doctor about my options. My only fear was that getting a fat transfer would interfere with mammogram readings.

I have the BRCA gene mutation, so I need to consider future breast cancer complications in everything I do. I researched having a full mastectomy instead of en bloc but decided against it. My insurance covers mastectomies but that’s not what I want.

Just for your information, the large group generally discourages fat transfer to the breast. There are some pretty scary stories on there, along with lots of lackluster results. That is not the case with Dr. Stanwix’s patients. You need to make sure you research your selected surgeons’ fat transfer retention before choosing to have the procedure.

Day Before Surgery

My parents came down from Maine to help me recover, and my husband and I decided to get a room near VPFW since I had the first surgery of the day.

We booked the Residence Inn by Marriott Richmond West/Midlothian because someone in the group recommended it. The hotel opened in June, which means they have never been open pre-mask. The hotel was within walking distance to the surgery center.

I packed everything from my Explant pre-op shopping list that I thought I might need the morning of and on the way home.

We ordered Pad Thai for my last meal before surgery and didn’t wat or drink after midnight. I went to sleep around 11 pm but tossed and turned most of the night.

En bloc, Lipo, and Fat Transfer Surgery (Monday 9/21)

Waiting Room

My surgery progressed as follows:

  • 5 am woke up and took medication prescribed for nausea with a sip of water.
  • 6:45 arrive at the Virginia Physicians for Women surgery center
  • I registered and went to the waiting area (maybe 15-minute wait)
  • The nurse got me changed into a gown and was I given medications (honestly do not recall what I was given), and my anti-nausea patch was placed. I answered a lot of questions, then met the anesthesiologist and answered his questions. He informed me of how the anesthesia would work.
  • Dr. Stanwix came in and marked out the areas for surgery and talked to me about what I wanted and how great everything would go. Everyone was super peppy (not me, I was scared).
  • The nurse took me back to the OR, and I laid down on the table. I remember her telling me about the compression boots I would be wearing, and she asked me to stretch out my arms. That is the last thing I remember.
  • Based on the post-op report Dr. Stanwix prepped the area with Betadine and marked my breasts and liposuction site (7 total). He injected Tumescent under the skin in my flanks, base of the abdomen, and inner & outer thighs and proceed to make the small stab incisions. All but two of the incisions were located on my previous tummy tuck scar line.
  • Both left and right implants were removed with the capsules intact. Both were attached to my pectoralis major muscle and my chest wall. I was injected with a nerve block for pain.
  • Liposuction was done on all requested areas removing a total of 2050 mL. The fluid was strained and washed in Bacitracin and placed in syringes.
  • The fat was then injected into both left and right breasts until the desired look was achieved. I received 375 mL in the right breast and 360 mL on the left. My original implants were 330cc.
  • My window shaded pec muscle was repaired and placed back in its original position. I received stitches on my breasts, and as far as I know, the lipo sites were not sutured but possibly glued. My skin seemed shiny and glued, which later peeled off, but I’m not sure.
  • My implants were removed from their capsules, and the capsules were sent to pathology. I expect to get the report back in a few weeks.
  • I woke up in the recovery room and was given meds for the pain (wasn’t terrible, but I felt it) and was wheeled down to my husband, who had to wait in the hotel due to the virus procedures.
En block explant surgery
Anxiously waiting to go into surgery

Post-Op Experience Journal with Photos

Monday 9/21 – Day 0:

I was pretty groggy when I left the surgery center. The drive home was about 1 hour and 35 minutes. After about 30 minutes, I was ready to use the bathroom and wanted a milkshake because my throat was sore. We stopped at Dunkin, and I used the restroom and walked the sidewalk for about 5 minutes with my husband’s help.

I was able to eat hashbrowns and drink the shake with no problem.

My husband said I didn’t talk much on the ride home. When I got home, my parents and kids were waiting for me. I stayed in the sunshine a bit and then headed inside. I laid around some and stood around a lot. It felt better to stand because the garment was tight and uncomfortable. I tried to make sure I walked every hour for five minutes.

bed set-up after liposuction
Bed set-up following surgery

I was told I would leak 1/2 cup per hour from the liposuction sites, but that was not the case. I leaked some but nothing like they said I would. I’m pretty sure that’s why my legs were HUGE after surgery and for the next three days. They were so swollen, and I stopped leaking after 24 hours.

Pre-Surgery Weight: 147lbs

Pain: Not horrible, but I was stiff and pretty out of it mentally.  The pain was okay, but my shoulder, back, and right armpit hurt consistently. The nurse called and told me to make sure I stayed ahead of the pain with meds and told me how the surgery went.

Tips: Use the urinal (on the shopping list) even if you feel fine sitting down. You don’t realize you’re peeing on the suit, but you are. Some people recommend cutting the crotch of the suit, but I think that’s a bad idea. The garments aren’t cheap, and ripping the seams makes the suit looser. I changed my bandages once a day because I wasn’t leaking. I used maxi pads cut into thirds and affixed them over my lipo sites with paper tape. I also used a pad under each breast for leaking (which I never had).

Tuesday 9/22 – Day 1:

Looking in the mirror when I woke up was a bad idea. My skin on my left breast looked bubbled like it had been branded with a hot iron. I panicked inside and worried that I had made a huge mistake. Thankfully when I looked again a few hours later, it was back to normal.

My surgery took four hours, so I ended up leaving the center at 12:00 pm. I based everything I did on full twenty-four-hour periods, so I decided not to shower until noon on day one.

Taking the garment off was such a relief, but not long after removing the bra, I was ready to put it back on. My boobs felt hard and heavy, so the compression bra, even though it was loose, helped relieve some of that weight.

Showering felt great, but I was warned not to use hot water, and I guess the water was hotter than I thought it was because my blood pressure dropped fast. The nurse warned me this might happen, but I thought I was using cool enough water. As soon as I stepped out of the shower, my mom mentioned that I looked pale. My lips were white, I couldn’t get enough to drink, and I felt like I was going to pass out.

Doctor Stanwix called Tuesday night to check-in. I told him I was super swollen, and he said that was totally normal and reminded me that I would feel more pain as the nerve block wore off. He informed me that I could take 2 pain pills if the pain got bad enough. Before going to bed, I did take two pills and slept much better. Unfortunately, the pills gave me a headache, which was something I just had to deal with.

Weight: 156lbs ( I haven’t been this swollen since I had my first child)

Pain: I woke up feeling better other than some right side pain in my shoulder, back, and armpit. The nerve block started wearing off, and I could feel that my boobs were tender.

Tips: Have someone with you for your first shower. Don’t worry too much about actually washing; enjoy the warmth and have a bar of soap ready because pumping any bottle is difficult. You can also ask someone to help you our the soap or have them put it on a loofah before getting into the shower. Hot water lowers your blood pressure (even if it doesn’t seem very hot) so please be careful with that first shower. 

Wednesday 9/23 – Day 2:

post implant explant surgery
My face had some color in it and my skin wasn’t as dry!

Sitting is so uncomfortable so I spent most of the day standing. I was also constipated and felt like my organs were being pushed up into my ribs in the garment. I was pretty miserable today.

As you can see, the water weight is serious, and I’m trying to smile through the pain.

I took a shower again and managed to wash my hair, which was refreshing. It hurt to keep my arms above my head for too long, so I had to make it quick.

After showering, I was over wearing PJ’s, so I started wearing sweat pants, my husband’s basketball shorts, and anything else that felt more like real clothes.

Weight: 153lbs, so I dropped 3lbs, but I didn’t feel any better.

Pain: The pain was the worst I have felt so far. The nerve block was gone, and I found myself waiting to take my pain meds. I probably should have kept taking two at a time, but I didn’t.

Tips: The heating pad is your best friend. Use it often on your neck and back. It also feels great when you lightly massage your lipo areas.

Thursday 9/24 – Day 3:

Today was pretty much a repeat of yesterday.

Walking outside was a nice break from the house. It was hot with the garment, but I needed the fresh air. I spent a lot of time in bed, binge-watching Love Island

Today I ordered a new garment so I could wash/air dry my current garment. I ended up with a stage two garment that I couldn’t get into, so I just kept the dirty one on. 

Weight: 150lbs

Pain:  The pain in my flanks and abs feels like I did some seriously hard workouts and my muscles are tender to the touch. Getting in and out of the garment is quite a pain. 

Tips: As soon as you know what size your garment is, order one exactly like it and stage 2 if you’d like. Dr. Stanwix sent me home in this garment size M so I purchased this garment in a Medium as well.

This is the garment they sent me home in, and this is the one I ordered. I love them both, and I wear each of them during the day. I switch back and forth between the two depending on how I feel.ed of the way one feels.  

They have been on backorder, so get yours as quickly as possible. 

Friday 9/25 – Day 4:

I was dancing around the kitchen when I woke up. After the past two days, I felt so much better on day 4. I also took a morning walk and played a little Pokemon Go! 

Even though the pain was better, and I felt better mentally, I still spent most of the day in the bed today watching Love Island. Don’t judge! I told my parents they could leave before the two week mark. I later realized this was a mistake, and I should have kept them here for at least 8 days.

Weight: 147lbs 

Saturday 9/26 – Day 5:

At midnight I removed all of my foam. I ended up putting the foam back on my flanks off and on, but I couldn’t wait to get rid of it.

I drove for the first time today. My right side felt weak and stiff. I parked in spots that were straight ahead and avoided turning right. Using my left hand to shift and open the door was necessary. Surprisingly, I was able to shop for about 2 hours but stayed in the car when we went to the last store. I picked up some supplements and fruits and veggies to help with healing.

Weight: 147lbs 

Sunday 9/27 – Day 6:

Today’s pain was better and I went shopping at the mall for some work clothes and felt pretty good all day. I only used Tylenol 3-4 times.  I managed to sleep on my side for about 20 minutes while lying in the recliner with my pillow and body pillow. The recliner woke me up when it decided to put me back into a sitting position. 

I almost took my garment off after waking up in pain, but saw some ab definition and decided to keep it on. I didn’t go through all this to quit now. At least that’s what I keep telling myself. 

My parents left today, and I felt pretty depressed.

Weight: 145lbs 

Monday 9/28 – Day 7:

Today I woke up feeling amazing. I woke up at 4 am and took my garment off. Usually, I shower, but today, I decided to enjoy the 30-minute relief of taking it off fully. If I’m honest, I kept it off for about an hour.

Driving today was a breeze. I didn’t feel any pain or pulling. 

I dropped my husband off at work and took my Yorkie to the groomer, and now I’m back at home working and getting caught up on the things I’ve missed since last week. 

Tips: Prepare to feel exhausted after a day of feeling great. You will likely do way too much and end up needing some downtime. I still take Tylenol as needed every day.

Weight: 145lbs 

I hope you found my Week 1 En Bloc, Liposuction, and Fat Transfer to Breasts update helpful. Please let me know if you have any questions. Good luck on your journey.

Read my Breast Explant Surgery with Fat Transfer Week 2 Recovery here.

Liposuction, fat trasnfer to the breast, and en bloc

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Kimberly

Wednesday 24th of March 2021

Thank you for sharing your story!! Did you use lymphatic massage at all? Also did your dr suggest arnica? These are two things my dr is recommending and am curious.

Thank you again! I’d love to hear how you are doing now!

Sincerely,

Kimberly

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