He asked me to lie on my back, and he pressed my stomach. He explained that abdominoplasty is physician-speak for tummy tuck. My stomach had not only stretched and deflated, leaving a heavy, crinkled pouch of skin and tissue, but the two halves of my abdominal muscles had been permanently wrenched apart, leaving a three-finger gap between muscles. It was painful to move, to exercise, to pick up my children or get out of bed in the morning. The doctor examined me for a moment and stood back.

“We can fix all this.”

I cried behind sunglasses as I walked to my car.

Never in my life would I have guessed I’d get plastic surgery.

I disdained women like that: insecure and shallow about their looks. And yet, after having two children, I found myself at 25 years old with the body of an old lady. My grandmother’s 82-year-old figure was more feminine. My body was like a rubber band that had been stretched one too many times, unable to snap back into its natural shape.

It’s hard to explain or describe how a woman feels about her body—it’s either her friend or her enemy. Mine was no friend. I didn’t want my daughters growing up thinking that a woman should be embarrassed about her body. I was also afraid they’d never have children, seeing what pregnancy did to me.

In 2010, more than 296,000 American women underwent breast augmentation; 116,000, tummy tucks. And I was one among them.

—

I got pregnant with my first at 22, before I was ready. I had morning sickness all day, every day. Rectal bleeding began and never stopped. I developed a mystery rash on the palms of my hands, and I could only stomach food if it was drenched in Ranch dressing. My ankles swelled and my fingers and toes looked like Red Smith pickled sausages. But the worst was the way I carried the baby—wedged right up under my ribs. I couldn’t see my feet.

In my fifth month of pregnancy, my male colleagues started saying stupid things, always with an incredulous, “how do you women do it?” shake of the head. “You must be so uncomfortable.” Yeah, no shit. “Aren’t you past due?” My boss made a joke to coworkers about me waddling down the halls of our offices.

I could sit in bed and balance a bowl of cereal perfectly on my bloated stomach, spoon—no joke—parallel to my chin.  I was thrilled, triumphant even, when the doctors found pregnancy-induced high blood pressure. Because of the preeclampsia, they broke my water three weeks early, and Madison Charlotte was born twenty-four hours later.

While my baby was being weighed and scrubbed, I grabbed my husband’s collar and I insisted that I did not want to be pregnant again—ever.

Over the next six months, my breasts swelled to two and a half times their normal size and then deflated like old wine skins, flaps with no tissue or density. I put cabbage leaves and ice packs in my bra, because the lactation aides told me it would help, but instead I just smelled like coleslaw. My stomach was a strangled, purple color with a brown line called the linea negra running from ribcage to pubic bone. I had stretch marks resembling a National Parks topographical map, with white crinkled tributaries that sprawled from east to west.

My parts were elongated—deformed and freakish. I didn’t want to see them. I didn’t want my husband, Nick, to see or touch them. He approached me after our dry spell with candles and comical suavity.

“Come on, baby. Let’s rekindle the love.”

“Really? That’s your line? I feel fat.” He tried to draw my body into his, his hands wandering to parts I hated. “Seriously. Please don’t touch me like that.” This was a conversation we would have many, many nights.

Even if Nick refused to admit it, I wasn’t the only one who noticed my body had not adapted well to pregnancy.

My gynecologist: “My goodness, honey! Was it like this before?”

“No, it wasn’t. But it should get better…right?”

My family doctor, asked me at my physical the next year, “Wow…is that from pregnancy?”

“Yep. Bummer, huh?”

My squirrely gastroenterologist chuckled for a full ten seconds, exclaiming, “Boy, pregnancy sure did a number on you!”

Maybe I’ll just join the circus.

I didn’t join the circus. I got pregnant—again. When Madison was barely 13 months old, I peed on a stick and waited, wanting to vomit with dread. I loved Madi; I just couldn’t function pregnant. Three minutes and two pink lines later, I found out Frances was on the way.

I knew misery while pregnant with Madison; I acted psychotic while pregnant with Frankie. Incapacitated by my ulcerative colitis, I stayed in bed for several months, doctor’s orders, watching “Law and Order: Special Victims Unit” until I had repeated nightmares of perverts and pedophiles. My doctor prescribed Prednisone to calm my diseased colon, but its major side effect—besides the bitchiness—was to balloon me to a distorted proportion. I looked like I ate myself. And Frankie, my sweet, chubby baby in utero, was enormous. She was already at viable birth weight at 32 weeks. By that time I was wrecked.

I waddled around cradling the bottom of my stomach, scared that if I let go, she’d simply rip from my body and fall to the floor. I could feel my skin and muscles tearing a little more each week. My mammoth baby and what she’d do to my birth canal scared the hell out of me.

While still pregnant, we scheduled Nick for a vasectomy consult.

Months after I gave birth to Frankie, I still looked pregnant. I puddled over the waist of my jeans, embarrassed to feel my stomach rub my upper thighs when I sat down. I wore sweat pants and baggy shirts. I’d lie on my back and my boobs would nestle into my armpits like snuggly bunnies. I only had sex in the otherworldly dark, and if my husband accidentally grazed my breasts or stomach, it’d be over. I was 25 and barely married.

Around our house, framed pictures from our Caribbean honeymoon mocked me; the smiling, tan girl who wore string bikinis singsonged, “You’re ugly, you’re ugly” every time I passed by, baby on each hip. My mom, at 50, was an absolute knock-out. My sister, who had given birth at the same time as I did, was training for the Virginia 10 Miler. Every woman in my family was beautiful and busty; I saw myself as an androgynous blob.

I worked out like crazy. I hired a personal trainer to kick my ass into high gear. I dieted. I crunched until I wanted to vomit. I lost about 20 pounds, but in my mind, I was unacceptable. After one workout, I mustered sizable courage to pull up my sweat-soaked T-shirt and show my size-2 trainer my stomach. She stared, closed-mouthed, thinking hard for an acceptable response.

“Wow. Pearl, wow.”

“I know, right?”

“Seriously, they did that to you?”

“Yep. I had very big babies.”

“I have never seen one this bad.” She covered her mouth with her hand, embarrassed by her candor. “Oh, I’m sorry.”

“It’s OK. That’s why I wanted to show you, to see if doing crunches or whatever would ever make it look normal again.”

“I don’t think so, sweetie.” She reached out fingers to touch me. “No. See, all that’s just loose skin. It will only get looser the more muscle tone you get.”

I looked around for a moment at all the gym equipment in the room. Fuck. “That’s what I thought you’d say.”

“I’m sorry, kiddo.”

I drove home sweaty and sad. I’m a freak.

More than anything, I worried about how my husband had been robbed—committed to keep me, have sex with me—based on a reneged contract. He could never be attracted to me again. He was hiding repulsion when he looked at me. He said I was crazy and tried to demonstrate both his love and lust, but I couldn’t trust it. I asked him once what it was that initially attracted him to me.

He said, without pausing, “Your passion for life. And your boobs.”

Three years into marriage and I had lost both.

—-

I invited my mom to my second consultation. Linda called us into the back after ten minutes. I noticed immediately that her lips had gotten plumper since my last appointment.

“Okay, so today we’re going to choose the size, correct?”

“Yes. I brought my mom along to help me decide.”

“That’s great. Just take off your shirt and we’ll get started.”

I was amazed at how unembarrassed I was to be shirtless in front of two slim women. I had gotten so excited about the upcoming surgery—about finally having my body back—that I didn’t care how I looked to them.

“Now, what are you thinking as far as size?” Her lips pouted.

“Like I told the other doctor—I’m not interested in enhancements; I just want to have my normal breast size restored.”

“All right.” She headed over to the shelf with her clipboard. “We’ll start small and work our way up. Let’s go with silicone over saline.” She cupped a blob in her palm. “It’s firmer, very realistic. Plus, it’s less likely to rupture.” She plopped it into my hand. It felt like pudding in a balloon. I stuffed it into one side of my bra and held out my hand for lefty.

We shopped for fake breasts for about 45 minutes, finally choosing a size that felt right after the women stared at and squeezed my boobs repeatedly. Linda kept suggesting I go bigger.

“I’ve never met a woman who wished she had less after surgery. After the swelling goes down, you’ll be surprised at how it looks.”

“Um, I think this one’s a good size,” I said, picking up the second set I tried. “What do you think, Mom?”

“Those looked just about perfect,” she said. It was settled.

A nurse my age came in at one point. She’d had a tummy tuck and boob job after having her children. She showed me her scars, a thick, white line from hipbone to hipbone. Like me, she’d needed to have her abdominal wall sewn back together. We talked about the trauma of recovery. Mom asked a lot of questions. I would need full-time home care for about three weeks. It would be about ten weeks before I could resume normal activities.

The nurse pulled her scrub shirt tight so I could see her breast contour. “They’re completely realistic,” she said. Why does everyone keep saying ‘realistic’? They’re fake breasts. “Totally natural. Do you wanna feel?” And so I did.

I left the office, smiling and feeling like I’d never had a stranger day in my life. But I didn’t tell my husband about the implants. In fact, I went out of my way to lie to him, my mom’s idea.

“The breast lift alone will restore my former shape,” I told him after we put the kids to bed. “Isn’t that great, honey? No plastic!” I didn’t want him knowing his wife was made in Taiwan.

—–

On the day of the surgery I sat at the end of the bed, naked except for a gown, which I clutched fiercely between my breasts and thighs, trying not to swing my legs like a little girl. My pubic area had been totally shaved. It looked so bizarre.

“Mom, I’m scared,” I whispered.

She scooted her plastic chair across the floor and put her hand on my back, smoothing in figure-eight motions the same way she did with my labor contractions.

“Are you sure I’m doing the right thing?”

“You and Nick made this decision together, and I support you 100%.” She worried her neck skin between her thumb and forefinger.

The doctor knocked on the curtain, a most pathetic attempt at formality. It’s impossible to knock on a curtain; there’s no sound, just a pitiful poof poof and a shallow air current.

“Come in,” I said. His hand was already sliding the curtain, pulling metal rings across a metal bar.

The doctor was all smiles. “Good mornin’, good mornin’,” he said, a little like the host of “The Price is Right.” “And how are we this morning?”

I wanted to answer, “We are nervous as hell. We are afraid you’ll molest us in our incapacitated state. We are afraid you’ll laugh at our shaved private parts.” But I didn’t.

“I’m good. I’m ready,” I said with a forced smile.

His salt-and-pepper beard neatly covered his distinguished face. A lawyer friend once told me never to trust a man with a beard. The jurors will suspect a bearded man is hiding something every time. But the doctor stood before me clean and dapper, crisp white coat over stainless scrubs. He straddled a rolling stool and slid to the edge of my bed.

“Go on ahead and stand up for me.” He looked over at my mother. “Mom, you may want to step outside a moment.”

“It’s okay,” I said. “She’s seen me give birth. She can stay.” The three of us laughed while I tried to calm my panic.

I stared at the crack that separated one mauve curtain from another and lowered my gown to my hips. I held it tight around the top of my ass; sweat trickled down my ribcage and plopped with finality on my cinched gown.

The doctor lifted my left breast and marked my pectoral muscle with a black permanent marker. He drew X’s and dashes and numbers. I found a stain on the curtain and focused, breathing deeply and trying to suffocate my shame by sheer concentration. His hands felt indecent on my breasts. At one point, I looked down at the top of his head, his neck taut in concentration as he studied my body. There is a man, sitting on a stool, drawing on my breasts.

He stood back as an artist to his canvas, coming close again to adjust his markings. After my chest was redesigned to his satisfaction, he bent lower; I inched the gown downward. My mom watched his every move, forcing discomfort from her expression. She didn’t look me in the eyes. I returned to my stain in the curtain.

“You can put your gown back on your shoulders. I’m just gonna make some marks here on your abdomen.” I covered my breasts, feeling heat pulse up my neck to my ear lobes.

His head still low, low enough to bump my privates with his chin; he pressed a tape measure across the span of my belly, drawing a black line from hip to hip. I thought about the scalpel and felt faint.

“This here,” he drew a circle and slid back to examine it, “is going to be the placement of your new belly button. Have you given any thought to the shape you’d like?”

What the hell?

“Um, just regular, I think.”

“Most people like the inverted oval. You’ll find most supermodels have oval-shaped navels.”

“I did not know that,” I said. “Huh, that’s interesting.”

About an hour later, I was wheeled into surgery.  “Is it going to hurt?” I asked the nurse.

I knew it would. The doctor had said it would, Linda said it would (she’d had hers done before the facelift). My personal trainer said it would be a bitch. It was stupid to ask right then, but I was afraid of the sterile room and unfamiliar faces outfitting me with IV’s and a hairnet. The nurse, Katie, wore pastel purple scrubs; a mask covered her coral-stained mouth. I noticed a CD player, blinking red on the metal countertop, like it was impatient for someone to push play and get the party started. What does a doctor listen to while slicing off and then reattaching your nipples? I wondered. The anesthesiologist hovered behind my prostrate head like the angel of death.

“Yes, it will hurt,” Nurse Katie answered. I could see only brown eyes, feathered, blond bangs, and small lines of professional concern across her forehead. “You’ll be OK, honey. The first three days are ungodly, but then it’s not so bad.” She reached down and laid her hand over my clenched fist on the table, giving it a light squeeze.

“Now just take a deep breath and relax. You’ll be asleep in a minute.”

I closed my eyes and breathed in, trying not to be scared. I breathed out, imagining I was in Bermuda, lying on clean, pink sand. My mind felt thick and heavy; they told me I went out humming Bob Marley.

****

It’s been 18 months since the surgery, and I keep asking myself, Would I do it again? Should I have done this? Do I regret my decision?

I don’t know.

I do know this: I feel augmented. All this “reconstruction” and I still don’t feel like me. Just call me Humpty Dumpty Barbie, the permanent bra-stuffer. Pure and simple, I wanted bigger breasts to replace my small ones. I wanted a flat stomach that tucks nicely in my pants. Did I need a supermodel’s belly button? Hell no—but I did need to measure up to my own personal standard of sex appeal and femininity, something of a mixture between my beautiful mother, my often-preferred sister, and my fictitious perfect self. I still need that.

So I did it. I did the whole thing—three procedures, one afternoon. My abdominoplasty, breast augmentation, and mastopexy cost a whopping $14,459, out of pocket.

It cost me five days where I thought I’d like to die, new breasts and re-sewn abs and all. Five days that I didn’t sleep, didn’t eat, hated to breathe, while tubes drained vile, stringy liquid from my stomach into a pouch. Childbirth was nothing in comparison to the excruciating pain of invasive plastic surgery.

It cost my family three months without their wife and mommy to care for them, to hold them, to play with them. It’s costing me now, almost two years later, as I live with the constant discomfort of agitated scarring, a result of complications.

The list of things I’m willing to do to augment myself has gotten longer over time—makeup was my gateway drug. Dying my hair the many shades of autumn came next. I’m currently considering additions to my budding tat collection. When will it stop? When will I be enough? I wonder if I traded dignity for some cheap confidence.

And that’s pretty damn expensive.