This surgery was not in the doctor's office, as my first two had been, but in the Health Resource Centre, a former hospital which was closed due to budget cuts and became a private surgical facility for uninsured medical services (mostly cosmetic surgery and surgery paid for by the Worker's Compensation Board). I arrived there by cab at 8:10AM, about 20 minutes ahead of schedule. I was a little peckish and very thirsty since I hadn't been allowed to eat or drink since midnight.

They had me change and put me on an IV of Ringer's lactate (saline with some other stuff thrown in ) and I was laying there in bed waiting by 8:40AM. About 10AM or a little before the anaesthetist came in and gave me an option between a general and a spinal anaesthetic. I chose the latter. With a spinal they insert a needle deep into the lower back. It not only freezes you from the rib cage down, it also paralyzes you temporarily. Choosing the spinal meant they would have to freeze my lips separately.

I was taken into the operating room about 10:15 AM. The doctor came in and marked off the areas where he was going to work and told me that small incisions would be made at the base of the back on both sides, and on the lower front of the abdomen on both sides as well. Then I sat on the operating table and bent over to curl my spine forwards so they could give me the spinal.

They started off with the liposuction by having me lay down on my stomach. I remember feeling something like a light touch running up and down my lower back. I wasn't even sure at the time whether it was inside the skin or on the surface at the time. I don't remember much after that until they were strapping me into the support garment (after liposuction you have to wear an elastic garment for 12 weeks. For the first six you have to wear it 24 hours a day except when showering. After that you can take it off at night.)

Then he started to work on my lips. He have me several needles (the only part that really hurt in the whole process) in various spots in my upper and lower lips. Then I remember seeing him with a syringe of yellow fat inserting it into my lips in various spots. This time it didn't hurt since the freezing had taken effect.

By 12:30PM I was conscious and in the recovery room. The nurse told me a couple of things about the surgery and I asked how much fat he had taken out. She said 850cc. I was shocked, as that's only about two pounds (less than a kilo). I had thought it would be more like 10 pounds, and possibly more. The nurse offered me various painkillers, but I declined. As it turned out, I didn't take any pain medication at all after leaving the operating room. I noticed while talking to her that my lips were very swollen. I couldn't see them, but I could hardly talk.

Anyway, after 20 minutes or so they put me back in the main ward where I had been prepped. As expected, I was paralyzed. By 1:30PM I could just barely move my legs enough to see my toes move a fraction of an inch under the covers. By 2:30PM I could move them quite a bit. I tried to stand with three nurses spotting me, but I was a little too shaky. At 3PM I tried again with one spotter and was able to stand briefly, but not walk. Within an hour I was able to walk by leaning on the IV pole and was taken to the washroom. I protested that I didn't have to go, but they said I probably did and just couldn't feel it due to the residual effects of the anaesthetic, and that the rule was I had to go before I could be discharged. To my surprise, they had no sooner closed the door than I began one of the longest urinations I had ever done. When I came out they said they expected this because they had given me three litres of IV solution.

Around 4:30PM my friend and photographer Alexis came and took me home. By that time I could walk and the swelling in my lips had gone down considerably. I was home by 4:45PM.

I took some immediate "after" photos, and checked myself out in the mirror. My lips were quite swollen, but far less than I had expected. To my surprise, though, my body measurements were just the same as before (albeit with the support garment on now), and my weight was actually five pounds heavier! Before surgery I had managed to gain enough to weigh 195 pounds and have a 34 inch waist and 36 inch love handles (both about four inches more than normal, which is also about what I put on my hips). Now I weighed 200 pounds, which I hadn't weighed in about eight years!

I did some quick math and 195 minus two pounds of fat plus seven pounds of IV solution is 200 pounds. That's when it really hit me that he had only taken out two pounds! I was devastated, as the whole reason I had gained weight was so that he could take out ten pounds and leave me with the waist I had when I weigh 175 and the hips I have when I weigh 195. The worst part was not that I had to go on a diet now to get rid of that weight; I lose weight fairly easily, so that did not concern me that much (though it was certainly not a pleasant prospect). What really bothered me was that when I lost the weight I would lose not only my hips, but also the ancillary benefits: fuller face, smoother arms and hands with less visible tendons, muscles and veins. etc. I had gone to all that effort and expense and now would have to wear this stupid restrictive garment for three months all for two pounds and no real progress towards the whole reason I had done it.

I was completely devastated and burst into tears. I cried inconsolably for over 45 minutes, often so hard I could barely breathe. I just kept saying, "how could he do this to me?" and "what was he thinking of?" and sobbing till my face was so swollen my eyes were barely visible.

My best friend was away on a business trip, so I called my electrologist, who is also a nurse, and whom I have come to share many intimate secrets in the many hours she has spent working on me. She tried to console me and said she would check into how things went. I was so upset I burst into tears again just as we hung up and she called me again later.

When I saw my electrologist on Friday, I expressed my surprise that only 850cc had been taken out. One of the other nurses came in and she tried to explain that for someone of my build, 850cc from the midsection alone is actually quite a lot, and should make a very noticeable difference in my shape once the swelling goes down. I must say, though, that I didn't find her explanation very convincing due to some lapses in logic (though it still might be right).

So, now the suspense begins. Was I overreacting? Was there some reason why 850cc was all he could take out? Were my expectations unrealistic? (I had explained my desires to him three or four times, including just before he started.)

I saw him for a check up when I went in for my next appointment with my electrologist on Monday, June 14, 1999. He explained that the figure of 850cc was only the amount that had settled out of the fluids they had taken out of me. Because some of the fat stays in suspension in the other fluids, you have to increase that to about 1200cc. While that still didn't sound like much, he assured me that he had been very aggressive in removing fat through the entire midsection, and especially the love handles, and that more would die and be flushed from my system over time. He said he was surprised I wasn't even more swollen than I was. In liposuction, they reach in with a small spoon-like thing and scoop out fat which has been loosened with the injection of a large amount of fluid. At the end, he used ultrasonic liposuction, whichuses a small head on the tool that vibrates at high frequency to loosen more fat cells. Because of the heat this technique generates, it can only be used for a limited time in any area, and he said he used it to the maximum limit in the love handle area. The heat causes one of the layers of the skin to swell greatly, so he had actually expected more swelling. In summary, he said that he had in fact done as I had thought he was going to do and removed every possible bit of fat in that area, but that it would takes a few months for the swelling to go down so this would become noticeable.

I felt very reassured by this, and am no longer upset. My surgeon has this very strong air of confidence that just calms me down and makes me feel everything will be OK. I hope that when I find a companion he also has this quality.

As for my recovery from the liposuction, I was not nearly as incapacitated as I thought. The evening I got home I went out for a 20 minute walk and went in to work (albeit hobbling a bit) the next morning for a meeting. The worst part of it was itching under the support garment and having the bandages cut into me in the areas where I was most swollen and the garment applied the most pressure. By the Saturday, June 12 I was OK to mow the lawn, and had been going for my usual 1-2 hour walks for a couple of days. By that time I was back to my pre-surgery weight. The itching had mostly gone, though I still found the support garments tended to dig into me.

Now I just need to get some clothes that will fit until the swelling goes down!

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