This topic is about someone considering a permanent colostomy and proctectomy, often referred to as a "Barbie-butt" surgery. This decision comes after dealing with multiple failed surgeries and ongoing issues with fecal incontinence. The person is seeking realistic information on what to expect in terms of recovery, daily life, and mental adjustment to living with a permanent ostomy.

Here are some helpful insights and advice:

1. Surgical Approach and Recovery Timelines
- Robotic or laparoscopic proctectomy can lead to a quicker recovery compared to open surgery.
- Hospital stays typically range from 7 to 14 days, with staples and drains often removed by the sixth week.
- Incision site pain usually subsides within 3 weeks, but the perineal wound may remain tender for up to 6 weeks and cause occasional discomfort for several months.
- Returning to demanding work can take 3 to 6 months, with some individuals resuming activities like firefighting or running within this timeframe.
- Driving can often be resumed around 3 weeks post-surgery, with long car rides being manageable using reclining seats and plenty of cushions.

2. Comfort Aids for Butt-Wound Healing
- Daily Epsom-salt baths or using a portable sitz-bath can aid in healing.
- A waffle-style seat cushion is recommended for comfort, while donut cushions should be avoided.
- Use reclining seats and extra pillows for added comfort during car rides or while sitting at home.

3. Ostomy Management After Surgery
- If much of the colon is retained, discuss colostomy irrigation with your surgeon to help manage bowel control.
- Keeping abdominal fat down and avoiding constipation can reduce the risk of a parastomal hernia.
- To prevent night-time pouch leaks, place a towel under you and use a side-lying pillow for support.
- Colostomy output may require more frequent pouch changes, so be proactive in emptying it.

4. Products, Procedures, and Therapies
- Solesta® injections can reduce fecal incontinence by about 50% if any rectal segment is retained; discuss this option with your surgeon.
- Consider using a waffle cushion, portable sitz bath, and Epsom salts for comfort and healing.

5. Mental and Lifestyle Perspectives
- Many find relief in not having to worry about leakage and continue to lead active lives, including driving and engaging in physical activities.
- Fatigue and limited stamina are common for several weeks post-surgery, so rest as needed.
- Maintaining a positive outlook, asking questions before surgery, and seeking support can greatly aid in long-term adjustment.

6. Typical Unpleasant but Temporary Issues
- The Foley catheter and surgical drains are often the most uncomfortable aspects of early recovery.
- Sensations of tearing or tightness in the perineal scar, random skin tags, and minor twinges can persist for months but usually improve over time.