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Debra's Breast Augmentation Journal

Stats:
· Height: 5’3”
· Weight: 94 lbs.
· pre-op size: 32A
· Post-op size: 32C+/D-
· Unders
· Trans auxiliary
· Mentor HP 290-350. filled to 340cc’s
· surgeon: Dr. Vigen Darian
· Detroit, Michigan

Why I Wanted Breast Augmentation:
I have always gotten a lot of grief for being “under developed.” For a long time I was really uncomfortable with my body because I was so thin. Now – as a young adult, I get complements on my figure and I have come to appreciate my slender figure. However, I have never been happy with my bust line.

Despite the positive feedback I get about my figure I feel so unfeminine. I have a very boyish figure no hips, butt, boobs, etc. and I don’t find myself sexy or “women like” at all. From early on I’ve always linked femininity with having large breasts. Maybe it is because my mom is very well endowed naturally, obviously not genetically inherited. I’m not sure, but breasts have just always been something I notice about another women’s figure. So now that I have the money to actually change my breast size to something that would make me feel for comfortable, I have decided to do it.

Of course, I have a great boyfriend, who is completely petrified for me to have the surgery and loves my breast “just they way they are,” I continually remind him that this decision is not for him but for me. Whenever I tell people I’m getting the surgery they are like, “but why your breasts are small because you are small.” I haven’t kept my surgery a secret from my close friends and family so I get the typical WHY question all the time. My response, “no one ever gives a breast cancer survival grief over getting reconstructive surgery do they? I’m doing this because it will help me to feel more like a woman. It’s for me and no one else.” I don’t have to make others understand my reason as long as I am clear about my reason and content with my choice, but if I can provide an example or use questions around “why” as a teachable moment then I will. I think it helps others see my decision from a different perspective one that isn’t superficial or self-centered. It’s not about any of that it’s much deeper.

How I went about researching the procedure and finding my surgeon:
I talked to others that I knew that had received a BA and I searched the web. I went to 4 consultations one of which I had to pay for but I saved that one for last. I wanted to make sure that if I was paying to see someone that I was ready with any and all possible questions I might have. Though you can search the web for “what to ask” sorts of stuff there are other things that come up that you might not have thought of until you are actually in a consultation.

One Doctor I found on the web and he was advertised on a radio station. My initial reaction was, “I really liked this guy but he only does periareolar incision and I didn’t know if that was the incision type I wanted to go with.
The second doctor I saw was someone a friend had used and I was turned off from the moment I walked in the door. He was sort of like, “I’ll give you what ever incision you want and we can do what ever size of implants you want.” Plus he only used textured and no high profile, so I was less then interested.

The third doctor just really didn’t impress me, either. He was a lot similar to the second doctor and nothing about his style really captured me. Meanwhile I had a month wait to see my fourth doctor which is the one I ended up choosing. In that months’ time I had ruled out Doctor two and three because they just didn’t seem like a good fit. Additionally, I ended up ruling out the first doctor even though I was interested in him the most him so far because I later found out he was not board certified, which was extremely important to me.

Finally, I went and visited my fourth doctor who I found because he is a plastic surgeon for the same health care organization I work for. He caught my attention instantly. I was like, “yep! He’s the one.” I liked his style, confident but not too cocky and I really felt like him and I were on the same page. I trusted that he would do a good job and I trusted he would make a good decision on my behalf about ultimate size once in the OR when I could not speak for myself.

How my consultations went
Oddly, the doctor I ultimately chose was unconventional to what you might expect for a first consultation. If you want to hear about the three I didn’t go with email me and I will fill you in but for sake of time I am just going to cover the doctor I actually chose.

I met him at the hospital rather than the clinic where the procedure is usually preformed. He came in and instantly wanted to know what I already knew. Since I had been a lot of research of the most current literature I gave him what he asked for. I knew I wanted sub muscular placement and HP implants because of my narrow frame and that I wanted something in the neighborhood of a high B low C end result and I was open to incision type. He did an evaluation of my breasts and he concluded I would not be happy with anything less then 300cc’s and he agreed HP would be best and was fine with sub muscular placement.

Lastly he informed me that he only does the trans auxiliary incision. I was like, “perfect” I sat and asked him more questions and joked with him that I wanted to get all my questions answered since I was paying 150.00 to see him. He sat back in his chair and assured me I had his undivided attention for as long as I needed.

Finally, he left and his nurse came in with sizers for me to try out. I liked the way 300cc’s looked. He ordered Mentor HP implants 290 - 350. As a bonus the nurse that was helping me recently had a breast Augmentation by Dr. Darian and she let me see her scars which were hardly visible at 1 month post op and feel her breasts. I was pleased and felt even more confident with my decision to pick him as my surgeon.

Meanwhile, I left without confirming anything. I was given an estimate of 6000.00 dollars and encouraged to call in with any additional questions. After I left I got to thinking he never showed me any pictures I called in and talked to his assistant who told me he doesn’t have a portfolio that he shares because he doesn’t feel like anything would represent my individual case.

This seemed atypical to me but I also felt like it was sort of odd when I did get shown pictures by other doctors because it was like 10 girls or so and I thought, “wow – if this guy does this procedure so often how come he doesn’t have books and books of pictures to show me.” So the fact that Dr. Darian didn’t have photos for me to view didn’t bother me.

One last thing that reassured me that Dr. Darian what the right pick was that he also does reconstructive surgery for breast cancer patients who have had mastectomies. For right or wrong my perception was that he was a “good” doctor and that he had more value to me over doctors who strictly do cosmetic surgery for cosmetic sake.

Preparing for surgery:
I didn’t have to do a lot. I even could wear make-up but they recommend I have nothing in my hair and that I wash with an antibacterial soap the night before and the morning of. I was also told to dress comfortable with a shirt that could be buttoned or sipped in the front as my arms would not be able to go above my head given my incision type. I bought me a fleece zip top and a pair of jogging pants fleece lined and wore tennis shoes. I removed all of my jewelry the night before and ate a light dinner around 7pm and nothing else afterwards.
I laid out clothes I could be changed into over the next couple of days so that my care giver would know where they were and I wouldn’t have to go searching for them, incase I didn’t feel up to it.

Oh, and I went shopping the week of surgery to get ice packs, pudding, jello, yogurt, chicken noodle soup, and crackers to have on hand incase I wasn’t feeling good afterwards.

Surgery day:
I got up early and took a shower and put on my attire. I had two care givers my mom and my boyfriend, which accompanied me to the surgery. We left the house early so that I wouldn’t be late. The procedure was being done 45 minutes away from my home and I wasn’t sure what traffic would be like. I arrived early but they took me back anyway and got me set up for surgery and then allowed my mom and boyfriend to come back and keep me company until the OR and Dr. Darian were ready.

I was asked to take everything off except for my socks and change into a gown and robe. I was then put in a bed where the nurse took my vitals and hooked me up to an IV. Shortly there after the Doctor came by to take some pictures and draw on my chest and on my armpits where the incision would be made.

Next I was given some long socks to put on to help prevent any blood clots and I was given some sort of relaxant. Finally, the Dr. was ready and I said good-bye to and was wheeled into the OR. The nurse warned me the OR would be very cold and it was, I jokingly asked how they could work with it so cold and if anyone wore turtle necks in the OR.

Next I was transferred to the OR table and straps where attached around my lower legs. I know this sounds scary but it was some how normalized and I wasn’t nervous at all. I did see other straps by the head area but they weren’t attached while I was conscious, anyway. Finally, the Anesthesiologist came in and put a breathing mask over my nose and mouth, he said he was going to be giving me oxygen and asked me take a couple of deep breaths. That was the last thing I remember before I came to in the recovery room.

Recovery
Surgery was scheduled for 8:00 and I was in the recovery room by 11:00. It took three hours, I don’t know if that is really long or not. I was informed early on that the procedure would take awhile. One woman stated that Dr. Darian would have nurses in the OR with him insuring my breast came out beautiful and that it could take awhile. I’m not sure if I received a catheter or not I didn’t get it while I was conscious if I did.

I was in and out of consciousness for about an hour. I remember coming to with blankets on me and some warm air blowing over me under the covers. My first thought was, “wow I feel ok and I don’t feel sick” I was petrified that I would be throwing up sick from the general but I wasn’t. The Anesthesiologist had given me anti-nausea meds pre and post surgery via my IV and they must have worked.

Next thing I knew my mom and boyfriend were by my side and we were talking. My mouth was really dry. A nurse came over and asked me to eat some crackers and drink some juice so that they could give me more medication orally before I left the clinic. It sucked, my mouth felt like a desert and I had to take a drink of juice with every bit of cracker just to get it down but I did it and next thing I knew my mom was helping me to get dressed and we were off.

FYI: Even though I felt fine, I didn’t look great. My boyfriend revealed to me later that he almost turned around in tears after he saw me because I looked so white but my mom assured him it was the general that made me look so fair and that I was fine. I guess they had made a pack before they saw me to tell me I look great even when I didn’t. I remember them telling me I looked great and I was shocked that they thought so but thought, “Wow! well that’s cool.” What a great team……

Advice for pre-ops, tips, etc.

Eat light the night before. It is generally recommended that you stop consumption of anything by midnight but if you stop sooner it will only be of help.

Eat a light dinner. My doctor recommended I stay away from heavy or greasy foods the night before as they are a sure trigger for nausea post-op.

Do not even chew gum, suck on lifesavers, or drink water, etc after midnight the night before and sooner if you can help it. All can contribute to nausea post-op.

Take your prescribed medications as prescribed. I was feeling so great the first night that I made the mistake of falling behind on my pain medicine and I found myself in a lot of pain early the second morning which took nearly all day to get back under control.

Gel Ice packs are great for your chest post-op.

Have a heating pad for your back it can get sore and stiff.

Have GasX or other anti-bloating medication on hand. I felt like Santa Claus post -op and it took a few days for the bloating to go down.

Have some form of laxative on hand. The pain medication can leave you irregular, no since in adding to your discomfort.

Ask for Dyflocan or another yeast infection fighting agent if you are prone to them with antibiotic use. I asked for them but I didn’t use them. I wanted to make sure I had all my bases covered.

Have a lot of pillows so that you can be propped up in bed. I strongly recommend a neck pillow if you don’t have one already. It does an awesome job at stabilizing your head and neck while your other pillows might not completely do the trick.

Have clothes laid out for a few days post –op so that your caretaker can find a change of clothes for you easily and you won’t have to get up and go looking yourself.

Most of all – relax! The pain is manageable but it can be awkward not being able to do stuff for yourself but soon you will up and moving around in no time.

Good Luck!

~Debra
Feel free to contact me with questions: dkolk@umich.edu