I have had a lot of time to learn how to live in my unattractive body till I was forty. Of course that I have gone through many different stages of weight reduction and diets. However, even in my skinniest period my drooping and big breasts were everything else than decoration. I have tried for several times to start with exercising. It would not have a positive effect on my breasts but on my feeling. As usual, it stopped after few trials. Yes, I was missing a will. It is hard to mobilize it when you don’t see any results for a long time. I envied beautiful and skinny women but also those, who were able to set their handicap as a privilege and wear it with proud. Unfortunately, I haven’t put up with my appearance. I was sure that there is no way out. Until I have had the chance in the project of complete change, which included also plastic surgeries.
| Before change|
| After change|
The first breast surgery
My first appointment was with the plastic surgeon Roman Kufa. I went there with a slight distrust that it would be possible to do something reasonable with my proportions. He didn’t find anything unrealistic on my expectations that I was almost scared to tell him. I realized that I was not an exception and I listened surprisingly to what he wants to change on me.
Large and drooping breasts and sagging extra tissue on the tummy are insensible to all reduction diets and exercises. The effect would never be as satisfactory as after the surgeries. The right diet program and enough movement will take turn after we relieve the body. It will be Laděna’s interest to keep her new proportions. Laděna needed not to only reduce the size of her breasts but also to model them to gain nice shape and push them up. In the second phase it was necessary to remove extra fat and skin from the tummy, hips, thighs and above tummy. The scars remain on the lower part of breasts and abdomen after both procedures, nevertheless the effect is absolutely unique.
A big role plays naturally the psychical state in similar indicated cases. Almost in all cases it is possible to substantially elevate the self-confidence and relieve the patient form dragging suffering.
Before we use scalpel, an injection agent is inserted into the breast that restricts bleeding. After that the breast areola is cut off and stepwise other areas according to drawn lines. After removal of a part of mammary gland and skin, we get to breast modeling. The residual laps of the chosen breast are folded around the areola, they are shaped and sewed together. Because absorbable sutures are used, it is not necessary to take them out. The scars are plastered and they can be showered after two weeks. A drain is put into the wound, to which flows the rest of the blood. It stays in the body until the bleeding stops and its removal the second or third day is painless, only a small pinch.
We have removed 340 g of tissue in the right and 640 g of tissue in the left Laděna’s breast. It helped to balance the original asymmetry. The size reduction of almost three numbers is big. The scars remain in the inframammary fold and upright toward areola. However, those are places that can be normally hidden in the bra. It is possible to evaluate the effect of the surgery after three months, when the scars loosen, the breast droop and become round.
Nothing is in absence or excess. This was the feeling I had after I woke up. I went back to my normal life very quickly. No pain, no complications, I couldn’t carry only heavy things for a while.
Even thanks to that Laděna was very well motivated, had courage and very positive mood, no complications occurred during the procedure and the effect is more than satisfactory. According to smooth process after the procedure a relative soon date for other stages of esthetic procedures were possible.
| Breast reduction surgery|
|Breast reduction surgery|
Second Abdominoplasty and Liposuction
The large excess of tissue in the abdomen can be cut off and even a liposuction of inner thighs can be performed at the same time. It is not an exception although we can expect pain for several days after such larger procedure. The patient can carefully stand up and walk even the next day, although it is nothing comfortable. The pain fades away fast and the patient can usually return to work after two weeks.
Like in the case of breasts I could never imagine that I can get rid of my kangaroo’s pocket on the tummy. Flat tummy was only in my dreams.
In case of the combined procedure we begin with the liposuction along in advance drawn areas directly on the body. During tumescent liposuction a solution is at first injected into hypodermis that helps to loosening of fat cells and the contained adrenaline stops the bleeding. Then small three to four centimeters wide holes in the skin are cut with a scalpel, where a vibrating cannula is inserted. The cannula vibrates and smoothly sucks at the same time. The sucked fat is really clean and without larger blood addition.
In case of Laděna one and a half liters of mixture of fat and residual solution was sucked within few minutes from both sides of hips and inner thighs. It was necessary to remove fat the same way even from the area of upper tummy to correct the effect of abdominoplasty. Only a flat upper part of tummy can smoothly lead to lower part, which is cut off to remove the large excess.
During the surgery the first and also the last is a navel. It is cut off to be later inserted into a new hole. When the whole abdominal wall is elevated, hidden rectus abdominis muscles appear. In case of Laděna there was a gap of almost two fingers between the muscles. That is not desirable according to expected effect. It was possible to remove more than a kilogram of extra tissue only after the suture of the muscles. After that the upper part of the abdomen is pulled close to the lower part and sewed.
The abdominoplasty is not a watchmaker’s job, it is much rougher. Nevertheless it is very effective. The belly looks very flat almost immediately after the procedure. Sucking drains are inserted into the wound for two days to remove residual blood. They are taken out in a second with one fast movement.
| Abdominoplasty - tummy tucks|
I really didn’t feel well after almost four hours at the surgical room. The first night was the worst. I woke up on the bed in a forming compress pants from the navel to the knees. My legs were pillowed to reduce the pull from the abdomen. Although I was under anesthetics I could feel every brisker movement. I also remember the journey home in the car, when I had to set my teeth during shakes. After that everything was better every day. I felt no other limitation except the compress underwear that is not very comfortable in the hot days.
A diet program is very essential after liposuction or abdominoplasty for each patient. No reduction diet is necessary, rather healthy life style. It is more or less useless investment to perform these procedures and not to plan subsequent discipline in food and exercise. Surgically formed area resist some time their fat deformation, but this is not valid for the rest of the body. If the patient thinks that the plastic surgery has solved everything for him/her, he/she can loose its self-control. This might evoke the elimination of the effect or even unaesthetic body disproportion. Both effects are undesirable.
I could hardly recognize myself one month after the surgeries. Ten kilos of weight was gone and the mood permanently great. I have surprised even myself how full of energy I was and the drive to fight anything I had. Back then and even now I say “Devil takes that little pain. You can stand it and the result is really worth it!”
I felt like regenerated and the regular training and rightly set menu were still ahead of me. I expected from that another ten kilos down. And the reality exceeded my expectations. Although I truly bathed in my own sweat, I felt good and another 13 kilos were gone.
Concerning my physical condition, there is always something to improve, but today I don’t perceive it as an unreachable problem. I see it as a challenge.
| Ladena`s training|
I have ceased my training scheme for a few days only because of another plastic surgery. I know that some people might see in me “the one that starts one day and doesn’t know when to stop.” I can only state with a clear conscience that it was not useless whim. The eyelid surgery and wrinkle smoothing on the forehead with botulinum toxin injections were recommended by the surgeon Kufa already at the beginning when we had discussed my possibilities of improvement within the big change.
Laděna needed the eyelid surgery so-called blepharoplasty on both upper and lower eyelids. The reason was a large drooping of the skin that restricts vision in the area of upper eyelids and that forms cosmetically unattractive wrinkles on the lower eyelids. The extra skin is to be surgically removed. Another argument for this procedure might be bags below eyes; they were not at all dramatic in case of Laděna. A human eye is locates in bony eye sockets in the scull and surrounded with fat cushion that moderates shakes. The protecting socket of these fat cushions loose their firmness so the fatty bags might be pushed out below the skin of the eyelid. Even these visible bags can be reduced by the surgery.
The blepharoplasty is performed either separately on the upper and lower eyelids or both at the same time. That was the case of Laděna.
The procedure is performed under local anesthesia, so the patient can normally communicate with the surgeon during the surgery and he/she can go home right after the procedure. It is called an outpatient procedure.
The procedure starts with the local anesthesia of upper lids that is injected into the skin. That is probably the only little bit uncomfortable moment of the surgery for the patient. The excessive skin is removed, the muscle is cut and the mentioned fatty bags are removed. A part of the bags is removed and the skin is then sutured with thin subcutaneous stitch. The same process is applied on the lower lids, it is more difficult for the surgeon because of the small area. It is crucial to remove only such amount of skin so that it is possible to close the eye again. Otherwise the lower eyelid might lift off. The eye would dry up then and it could cause damage of the cornea.
The wound on the lids is covered with sterile plaster for a week after the surgery. The wound is healed after seven days from the surgery and the sutures might be removed.
The eyelid surgery represented only a cosmetic improvement for me. Someone could feel as little bit uncomfortable to lie on the surgical table, perceive everything around although the eyes are closed and a half of the face is covered with drape. It is not a natural position but you get used to it after few minutes.
The following night was worse. I didn’t feel any pain but I had to sleep on the recommendation of the surgeon Kufa half seated. The horizontal position is not allowed. Moreover I had to ice the plastered eyes and their adjacency the whole night. I could not fully close the lids for the first two nights. So I didn’t enjoy too much of a sleep.
Noticeable swellings and bruises might persist even another ten days. The patient should stay in calm and should avoid physical strain. Common office work is possible after already three or four days.
| Eyelid surgery|
Wrinkle correction – Botox injections
I looked quit tortured because of the immediate bruises in my face and the botulinum toxin injections in the forehead and between the eyebrows to remove wrinkles were still on my plan before leaving the clinic.
Botulinum toxin causes temporary paralysis of muscles and the wrinkles that are caused by their contraction become smooth. Due to weakening of the facial mimic the injection should be applied reasonably only to parts of face where the mimic is not important. It is appropriate to smoothen wrinkles with botulinum toxin in the forehead, between eyebrows and also in the area of outer eye corner. Wrinkles in the lower part of face such as creases from the nose to lip corners or around eyes are better solved with another procedure – face lifting associated with lower eyelid surgery.
The effect of botulinum toxin lasts three to six months. Again it is very individual. The injection can be naturally applied again after its disfunction.
The application takes few seconds, no anesthesia is necessary and the patient goes home right after the procedure. The effect is visible in three to four days.
I perceived the botulinum toxin injections only as a little pinch into the skin, nothing else. The treated spot is a little bit swelled after the procedure, although it is just a matter of few hours. Like with the feeling of stretch and pull between the eyebrows that fades away also very fast.
I was happy to sacrifice frown look to smooth forehead and drooping eyelids to big eyes. There was no mark of bruises and swellings after three weeks and my face really changed for better. It simply rejuvenated without anybody recognizing what exactly was beneath it.
None of the plastic surgeries of my body and face was performed at the cost of natural look. And I am extremely grateful for that.
| Botox application - smooting out of the wrinkles|
At the end I have enjoyed a complete care Top Image in Bomton studio. Here, in the hands of hairdressers, manicurist, cosmetician and visage maker and stylist, a real woman’s change happened. Very pleasant surprise. My shame was away and I even liked to pose in front of the photographer. I liked the way I looked and even other people did. What to wish more?
Uniquely the biggest change was inside of me. I felt that my life and its perception will change because of such radical step. However, I did not expect that the found self-confidence can cause such wonders. Today I see the world different eyes, I smile much more, I am much more opened and I have enough power for everything. And I like myself.
| At the hairdresser|
| Before change|
| After change|
The plastic surgery and Botox application was performed by Roman Kufa, M.D., Perfect Clinic Prague