Sarah’s Story
by Sarah
October Contest Winner

My body never developed much breast tissue. I was maybe a 34 AA. I remember how hurtful kids were to me as a teenager. I was always very shy and had a low self-esteem, so I never stood up for myself and internalized all of the nasty remarks. It took me until about age 20 to really feel comfortable in my body. I credit that comfort to exercise and feeling ownership of myself. At that age I was 5'8" and 116 pounds with very little body fat and quite muscular. My breasts, however, stayed miniscule and I always thought about having a "boob job". This was right about the time that all of the silicone controversy erupted. I resigned myself to living with padded bras and accentuated my other features.

I married and had a son by the time I was 21. He nursed quite easily for 9 months or so. I even had nice full breasts-for a while. Boy, did I miss that fullness when he stopped nursing! I longed to get it back. My husband said he didn't lust after big boobs, but if I wanted to get some he wouldn't object ;). In 1995 I inherited some money and decided to go for it. By this time saline implants were getting positive reviews and we had moved to Texas, where it seemed that everyone had them! I bought a book on implants and with that, I pretty much decided that round, textured implants placed under the muscle via a crease incision were the way to go. I visited with two surgeons and chose the second doctor, because I felt comfortable with him. He was Board Certified and had quite good credentials and nice before and after pictures. I asked about 25 questions and felt ready to go. He did seem to prefer smooth implants with massage, but I was really nervous about capsular contraction and he said that he had used textured with nice results. He was comfortable with any incision and felt that I would get the best results putting the implants under the Muscle, but left the decision up to me. I brought in several pictures of what look I desired and he used those in the surgery to determine size. I never tried on sizers in his office or even knew what cc's were until I found this website.

The surgery was in November of 1995. I was put under general anesthesia with a Nurse Anesthetist. The surgery lasted about 2 hours. I woke up just fine, but in definite pain. I remember telling my husband they looked too small (they weren't), the ride home was bumpy and very uncomfortable. The next three days were a blur. I think the night of the surgery I woke up with terrible chest muscle pain, like the Charlie horse cramps I used to get in my legs during pregnancy. The nurse gave me Valium for the cramping and that worked a miracle. I watched movies at home and within 4 days went to the Zoo with my son (3 at the time) and my Mom. I returned to work at about 1 ½ weeks post surgery. At the time I was very concerned that everyone would notice at work. I was a Social Worker for the State and worked with very conservative people. About two months prior to surgery I began to wear padded bras and loose clothing. After the surgery, I only had one comment from anyone at work, which was a complement, saying that I looked very healthy and had I gained some weight? I had, in fact, gained about a pound and a half of water ;).

In the first year after surgery my breasts stayed the same. They were a full 34C, very round on the top. I was now at 5'8" and 125 pounds. It was hard to find any bras that fit well, but my clothes had never looked better and I still wore the same size-just filled everything out better. I did talk to my surgeon at about 2 years post BA about the fullness on top and wanting to be full on the bottom as well. I looked like I had a push up bra on, even while naked. He said that since I have such a small ribcage and chest area, any implant would be rounder on me than the look that I desired. He did agree that they were too high and also felt that the right side was slightly encapsulated he offered to redo the surgery to lower the implant. I would, however, have to pay anesthesia and OR fees. He also suggested that an anatomical implant, now available, might look more natural. My husband and I had decided to add to our family and my doctor urged me to wait until I was done having babies and nursing. He told me that hormonal changes, weight gain and nursing could stretch out my skin and alter the implant appearance. I agreed. I revisited my before and after photos and was reminded that although my breasts were not perfect, they really looked quite good in comparison. I even hoped that pregnancy/nursing might make them look more natural.

Well, after having two more beautiful children (girls) and nursing them for a total of 3 years 8 months, my breasts were a mess. They still were very high and round and firm; the right implant was now encapsulated pretty badly. It looked like my real breasts were sliding off of the implants, which looked like stuck-on tennis balls. I didn't even want to hug people since the implants felt downright hard. I hated to wear a bathing suit, I felt awful in any shirt that was more than an inch below my collarbone as my cleavage was ever present. As soon as I had ceased nursing for three months I started visiting plastic surgeons. I had three consultations and ended up going with my original surgeon. He managed to get part of my surgery covered by insurance since I had progressive pain and discomfort, as well as distortion of both breasts due to bilateral contractures. I decided to replace the implants with smooth silicone implants immediately after the removal. Silicone was available to me if I enrolled in the FDA/McGhan study. I still had to pay almost $4000 for implants, surgeon and other costs. My doctor put me on Singulair starting two weeks before surgery and to continue for as much as 6 months post surgery to help with the risk of another capsular contracture.

By the way--I chose to replace with a smooth-shelled implant because my research showed that, overall, textured implants tend to look stuck-on. The textured shell was created so that it would discourage contracting of the scar capsule. Unfortunately, the textured implant also "sticks" in place and doesn't drop into the pocket (I discovered that the my original implants were McGhan, round, textured 330 cc's overfilled to 360 cc's.) In my case, I think that the original placement of the implant was too high and/or the pocket should have been made lower. My PS wouldn't come out and say this, but he did wave a lot of his fees for someone 7 years post-BA. One of the PS's that I consulted with advised me that he would revise the pocket and place my original implants lower. He thought that I could get nice results with less out of pocket expense. He stated that he never uses textured implants unless he is working with a reconstruction and wants the implant to stick in place. I decided that if I was going to pay to have a redo that I wanted to have new implants. The general consensus is that silicone feels more natural (according to many surgeons and silicone-implanted women) than saline.

I had the second surgery on February 3, 2003 in a hospital affiliated surgery center. My husband brought me to the facility at 8:45 am; I was immediately whisked back to a cubby where there was a rolling hospital bed and a chair for my husband. We talked with my PS; I reminded him that I wanted a natural look and MUCH LESS cleavage. He said that he had ordered implants in my current 360 cc size and ones slightly larger, in case the capsule had created more volume in addition to the implant. I had already given him several before and after pictures from a website that were "the look" I was aiming for. He drew with a marker on my chest and said he'd see me in the OR. The anesthesiologist also visited with me and reassured me that all would be fine. Next I got my IV (like a quick bee sting) and my nurses wheeled me back to the OR. I started to get nervous and quite cold. The nurses put a toasty, warm blanket on me and the doctor put something in my IV to relax me.

Suddenly I was awake in the recovery room. My throat HURT and I was thirsty, but not in any real pain. The nurse gave me ice chips and got my husband. We peeked at my braless breasts-wow! They looked so real, they fell to the side as I was on my back and there wasn't cleavage like before, best of all so soft like the real thing. The nurse gave me a card from McGhan with the implant info; smooth, round, silicone 360 cc's on both sides. My husband had to run over to the PS's office to get me a surgical bra. Once he got back with it I had downed the best, most thirst quenching Pepsi of my life and was ready to go. He helped me to the bathroom and to get dressed, the nurse wheeled me down to our car and we drove home. I was really quite pain-free. I did take the anti-nausea medication, just in case, and I took Darvocet. The next morning my husband got all three of the kids up and to school and me to the PS for a look.

I was at this point in a bit of pain and the swelling and bruising was getting ugly. The left breast was awesome, other than the deep bruises, but the right one was very swollen and high. The doctor said that the left breast had not been too terribly encapsulated, in fact he ended up releasing the capsule, lowering the pocket and putting the new implant in there. The right, however, was pretty bad and took a bunch of pulling/scraping or whatever they do, to get it removed. He felt that the swelling was in response to the trauma and he was unconcerned. He did ask if I had taken Advil or aspirin in the last two weeks, as my bruising was bad. I hadn't, I do tend to bruise easily since I am fair skinned, so he seemed fine with the bruising too. He asked me to return the next day and again two days later so he could closely watch the swelling/bruising. He was concerned about a hematoma forming and doesn't like to use drains unless the swelling gets to be too much. His nurse did take some pictures for comparison over the next week. I asked for and was given stronger pain meds (Percocet), which did help a bunch.

At one week I returned to get my stitches out. He asked me to continue wearing the surgical bra to help decrease the swelling and to come back at three weeks post op. No underwires until further notice. He felt the swelling was the same, but optimistic that it was fine. I learned how to move my implants to keep the pocket open. He did not instruct me to do any kind of massage. The day after I got the stitches out I returned to work (I only work 2 days a week in a preschool), I had to go home early and take pain medication. I just fell apart and called the PS's nurse, I cried and cried. She told me that I was ok, suggested that I begin to take 800 mgs of Advil every 8 hours along with the Darvocet at night. She was sweet and patient, she told me that I probably did too much and to rest and take it slower tomorrow. Well the next day I started having panicky feelings that I had made this huge mistake, my breasts were so high and felt firm again, I cried for an hour and then called the nurse again.

She was again sweet and reassuring. She said that some people get depressed after the surgery; sometimes general anesthesia will do that to a person. She asked if I thought the implants were still moving ok and if the swelling was any worse. I said I thought they were the same. That night my husband came home to a sobbing woman fixing dinner. He reassured me that all was ok and that they were 100 times better than before. I took Percocet and calmed down. The next day I worked again. I came home and the nurse called to see how I was. She listened to me and was again just a good shoulder. I asked if I could get the strap thing to push down my breasts and she asked me to come in the next day to visit with the doctor.

I could see that he was busy. He felt that everything was progressing fine. He did not feel it was necessary to use the push down, especially because it would increase my swelling. He asked me to be patient and wait for the swelling to go down. He said that at three weeks we could better tell where I was He also said that if he needed to go back in and lower the pocket he would, but he really thought that it would settle in time. He also gently suggested that I was experiencing post surgery depression and maybe my family doctor could prescribe some anti-depressants to help me through the next couple of months. He said that I was probably expecting to be back to normal and that wasn't realistic with kids. Ideally he advises patients to take 3 weeks to do as little as possible-impossible for most normal moms of preschoolers!

I felt better after this visit, but still pretty down. I did not take offense to his anti-depressant suggestion as I had successfully stopped taking them two months prior to my surgery. It is now one week after I last visited with my PS. I am feeling better emotionally. I stopped taking pain meds yesterday, including the Advil. I did not start anti-depressants again, deciding to wait and see. I have been looking at before and after photos online and this makes me feel better. Almost all of the post pictures seem really high until 3 months, sometimes even until one year. I am trying to rest and my house is a pigsty since I have three kids (2,4 and 10). I also looked at my own pre and post pictures again and see that even with the black bruises and swollen right side, they are not so high and my "real" breast isn't visible or sliding off of the implant anymore. My left side is nice and soft and moves easily and is only a bit tender. My right side is rounder, firm and higher, it feels very tender when I move it and I can't tell if the pocket is staying open. Also, my cleavage has come back, but it is lower and less obvious than before. When I lie on my back, my left breast falls to the side more than the right, but they actually move now!

If you are thinking about having this surgery, make sure to get a good PS that you can talk to and feel very comfortable with. I hope that my lengthy story doesn't come across as negative. I want to share with people that it can be a difficult surgery, especially if you have to redo. I went into my BA knowing that I would probably have to have another surgery at some point down the road. I definitely would do all of it again, even with all of the trouble. Thanks for reading my story.

Sarah