You need to be aware that prednisone can cause significant weight gain no matter your diet or activity level and that prednisone is one of the best ways to control lupus despite all the side effects. So if at any point you end up needing prednisone there is a very good chance you will gain weight no matter what you do to avoid it. It will all depend on the dosage and how long you need it. Also know that no matter how good the surgery is you will not have perfect results. I went into my surgery knowing the end result would not be a prefect set of breasts- actually I asked her to avoid trying for perfection because I did not want my breasts to look obviously 'done'. I was very pleased with the end result because I had a realistic idea of how things would look in the end. Actually I ended up with better than I ever hoped for results.
A psychiatric consultation is generally required by really good surgeons. I would suggest that you get a quick consult anyway so that you have somewhere to go if something drastically wrong happens from the surgery. I met a woman who got a very rare infection post surgery despite having the best care possible. It left her with severe scarring but she was able to handle it better because she had someone to talk with thanks to the initial psych consult. When I met her she was getting ready for a scar revision to help minimize the scarring but was otherwise pleased with her surgery results.
I am glad your doctor plans on a hospital stay, it is very necessary to be carefully monitored. Also the anistesiologist needs to be informed of your lupus and if you have taken prednisone in the last year. I will say that when they removed my gallbladder I ended up very weak. It may have been from how bad things got or may have been a combination of the surgery and how bad it had gotten. It was over a year before I began to regain my strength. So be prepared for the worst case senario.
BTW I was told it was all in my head from my early teens until a few months before my 29th birthday. I suggest finding a rheumy who treats younger patients. I will admit if I have a c-section I will eventually have a tummy tuck- but my stomach muscles are very seperated which causes serious back issues and have been since my first pregnancy. The only way to have them stitched back together again is a tummy tuck. If I had the money I would have it with or without the c-section because my back is actually more painful than any of my other conditions. None of my doctors know exactly what is wrong with my spine, they just know I have old fractures, disks going bad, inflammation, and a congenital deformity. The amount of pain I live with on a daily basis has been significantly reduced by enbrel but the truth is that there are still days when sitting up, standing, and/or walking cause so much pain I wish I were a horse because then they would shoot me. I don't really want to die, it is just that the pain gets so bad that nothing touches it- not even diladed. I know that strengthening my stomach muscles would help my back as much as if not more than the breast reduction did. I am not one to advocate surgery just for the sake of one's looks, but if doing this will improve your self esteem and make you a happier person better able to cope with your limitations I am all for it. I just really want you to come at this knowing what could go wrong because if you don't and something does happen then you may end up in a serious depression. Depression is our enemy. We need to avoid it because it saps our will to fight.
Dx:fibromyalgia 2002, systematic lupus 2005- definate CNS involvement dxed late 2005, psoriasis 2006, rheumatoid arthritis 2006, PTSD 2007, multiple allergies 2005, migraine, compression fractures T11 & T12, Sjögren's, damaged periphrial nerves 2007, pregnant due May 2008
Tx: plaquenil, Enbrel, Darvocet, Singulair, Flexeril, Baby Asprin, Imuran, Procardia, Prilosec