OldDogNewTits












Let’s recap. I had five Round One breast augmentation doctor consultations and brought girlfriends with me to all of them.  After meeting with them and reporting everything I learned back to you here, we took a vote to determine which doctors would advance to Round Two.  You selected Doctors 4 & 5. I have no problem with that.  They were both great doctors who seemed very capable of taking excellent care of me.

Note: Doctor 1 is still in the back of my mind, too.  I like that she is a she. I like that I told her about my blog.  I like that she was willing to digest everything I learned from all of the other doctors with me.  I had actually made a follow-up appointment with her as well but had to cancel due to a family illness.  She’s still floating around in my brain somewhere. 

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It was a regular weekday morning around here, except that it was cold. Fall is finally creeping into our Southern part of the world. My husband and I managed to drag ourselves and the kids out of bed and get everyone to school on time.  And then it was time to drag him to his first Boob Doctor meeting.

This morning, we paid a second visit to Doctor 5. He’s the doctor that suggested a lift somewhere between a mini and a full and silicone implants (280 to 300cc).  His practice specializes in breast reconstruction after breast cancer.  My friend, Melissa, came with me last time.  Remember?

When we walked into the building, my husband had the same reaction I did. He said he felt a little out of place seeking cosmetic surgery in a facility that specializes in the treatment of often very sick women.  We sat down and flipped through the pink albums on the tables in waiting area together. I got a better look at some of these testimonials this time around.  I saw smiling faces hailing from Mississippi, Indiana, Missouri, Arizona, Minnesota and California – to name only a few places.  The one word used over and over again in the letters from these women and their families was “hero.”  They clearly had amazing results and relationships with these doctors.

Oh, and did I mention there were cookies? Delicious and pretty pink ribbon almond cookies for Breast Cancer Awareness Month. Yes, of course, I had one.  And then they called us back.

My husband and I got situated in the examination room and I found myself tutoring him, whether he liked it or not, about everything I’d learned so far. I spent the most time revisiting everything I learned from Doctor 5 during my first visit. I wanted my husband to be able to speak as knowledgeably as I now could and maybe even help him formulate some questions.

Then, the doctor came in.  He’s a very easygoing, down-to-earth person who I think quickly made my husband feel as comfortable upon first meeting as he did with me last time.  The three of us discussed the median lift that Doctor 5 proposed, with an L-shaped incision, and then talked a bit about the implants themselves.  At my first visit, Doctor 5 talked mostly about silicone and I knew they were his preference.  Still, with all I’ve learned to date, I might just be leaning to saline and wanted to be sure that was also an option with him.  It, of course, was.  He said that if I have any reservations about silicone then I should go with saline … because I need to feel comfortable with everything.

He reiterated his earlier points about not going too big and not going wider than what I’m starting to perceive as my freakishly narrow chest base.  He also explained and emphasized the lengths he takes to prevent infection during surgery.  We basically talked about everything we discussed in my first visit to get my husband up to speed with everything.  It was good having him there.  I think he feels at ease with this doctor and much more part of the process now. He even made a joke about making sure I’m not hooked up to the garden hose to fill up the saline implants.

Do people tend to make jokes when they’re more relaxed or more nervous?  I actually think both are true for my spouse.

One of the doctor’s assistants brought in a few silicone implants for us to handle.  I think it was my husband’s first time feeling them. (At least, I hope it was.)  I could see the scientist in him at work.  And, before he could say it, I jokingly blurted out, “Do you think we could feel a side by side comparison of silicone and saline within the patient?”  Doctor 5 politely laughed my sad, nervous joke, one that he’s probably heard every day since he entered the practice.

Then, we each had questions about insurance.  My husband wanted to know if any complications that arose in surgery would be covered by our insurance.  I wanted to know if he offered any products that came with an insurance policy such as Doctor 4.

And he basically answered our questions together.  The short answer is no … to both. Complications arising from surgery are not necessarily covered and his facility offers no contractual insurance for its work.  However, he added that, to date, he has not had any issues arise either from surgical complications or implant defects. And, while he didn’t discount these possibilities completely, he emphasized that they are very rare.

As far as surgical complications, he said the number one issue is infection.  And he takes such great pains to avoid it that it has never manifested itself in any of his patients.  As far as implant defects, he said he personally guarantees all of his work as well as the products he uses. Thus, if an issue such as a leak arises with one of his surgeries, he corrects it … immediately and at no charge.  It does nothing for him to have a very dissatisfied patient out in the world.

And, after taking up about an hour of this doctor’s time with my extreme thoroughness, we each shook his hand and thanked him for yet another very informative visit.  Then, we gathered our things and headed out.  My husband whispered that it was hard not to look at the boobs of every woman in the office to determine if they’d joined the club.

And we walked out through the waiting room together … but not before I could grab another cookie.

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It’s Breast Cancer Awareness Month.

Did you know that? Well, of course, you did.

Even my kids have noticed the ‘pinking’ of their worlds lately. I like that. I like that they’re so aware as children and don’t giggle at all when discussing something this important. Maybe it’s the fact that we’re all saying ‘breast’ and not ‘boob.’ (Yeah, that would likely send them both over the edge.)

My son and I recently got to spend a little one-on-one time together when he was home sick from school a few days. Strep throat. Poor kid missed playing in his football team’s playoff and championship games, which has got to really bite for him. So, what does a mom do to make it up to her boy? Well, once he was feeling well enough to leave home, we went straight for the fast food (greasy and delicious!) and then to a local sports store where, of course, I bought him a for-no-reason present. Love those kinds of days.

And, while we were in the store, my son couldn’t help but notice all of the pink jerseys, hats, gloves, cups, pens and other merchandise that touted the Breast Cancer Awareness message alongside the name of his favorite football team. (Duh, the New Orleans Saints)

I expected him to think all of the pink stuff in a Saints/Hornets/LSU store was oddly out of place. He always asks a lot of questions and I was ready to do some serious explaining. But instead, he just surprised me and said, “Look at all the pink jerseys. All the NFL teams are wearing them for Breast Cancer Month. And pink pants, gloves, socks, cleats, everything. You ought to put it on your blog, Mom.” And then he suggested that I take a few pictures.

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My blog??? My boy’s been paying attention enough to know about Breast Cancer Awareness Month and that his mom is writing a blog?? I just looked at him with my mouth open and decided to do exactly as I was instructed.

I don’t know that I’ve been giving him enough credit. His birthday is Sunday. I think I’ll go buy him an extra present.

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My fifth (and potentially last first round) appointment was Thursday morning. My friend, Melissa, had recommended the doctor and came along for the ride. And I want to point out immediately that this place as well as this experience was different from the others.

What better month to bring up this topic.

My friend, Melissa, has been battling breast cancer now for the last few years. And she’s been beating the hell out of it I might add. You know how when you’re watching some Sex and the City, Desperate Housewivesy-type show and one of the characters has cancer, but they manage to deal with it with levity and an amazing sense of calm and grace, you think to yourself ‘This woman does not exist. If it were me, I would not be able to face people every day and talk about it, let alone joke about it.’

Well, I’m here to tell you that this woman does exist and her name is Melissa.

I won’t delve too much into her personal story but, suffice it to say, she was given the sobering news twice. For the first occurrence three years ago, she opted to have a lumpectomy. After this procedure, she (like all patients) was carefully monitored for any signs of recurrence. Which is how they caught the second occurrence about a year and a half later. This time, she (like many women) opted for a much more aggressive treatment. This time, she would take on a double mastectomy so that she could live worry-free of this disease. For good.

So, the two of us spent the afternoon at the very specialized facility where she had her procedures done. And, as I mentioned above, it was a very different experience from my prior appointments. Rather than a small, private waiting room filled with others seeking cosmetic improvements of various natures, this office (really a small hospital) had a large, beautiful waiting area … a two-story, glass-ceilinged atrium that actually looked and felt more like a spa than a clinical space. There were no TVs or other distractions but rather just a setting to promote peace and comfort to all who entered. The center even offered a little refreshment area for its visitors. And on the table in front of me … where there were typically albums of before and after work … was a similar pink scrapbooking album filled not with breast photos but rather with heartwarming letters, family pictures and other amazing testimonials from women whose lives had been changed as a result of the services and treatment they received from the medical staff here.

Honestly, it was very humbling.

We were taken to a private examination room almost immediately, which is where I actually completed all of my paperwork. Melissa and I caught up a little bit while we waited and she confessed that she wore a boob-showcasing outfit to this appointment … in my honor, of course. (Coincidentally, this is the second time this week that a woman has selected her wardrobe based on its boob presentation for me. Is that weird?)

And, after waiting a little while, the doctor came in. Friendly right from the start. He gets points for that. Feeling a bit small for seeking cosmetic augmentation in a place that is largely medically restorative in nature, I nervously explained right off the bat that I was not here necessarily but more recreationally. He liked my use of the word ‘recreationally’ and said he’d be using it in the future. We talked just a few minutes about what I was looking for (you know the drill by now … nothing too big as I am a small person) and he seemed pretty in tune to everything I had to say.

He said that the biggest mistake women make is going too big or too wide.

He added that women should look to correct and improve the shape of their breasts and not just be worried about their volume. He actually said smaller breasts are “more elegant,” which I’m pretty sure makes me Audrey Hepburn. And finally, he emphasized that an implant should be used to enhance your natural breast, not become it.

In discussing my options, he said that he encourages his patients to get everything that they want done in one procedure. When I asked about the full lift and implants being done together, he said it was no problem. Remember Doctors 1, 3 and 4 all stating it should not be done? And they offered two different reasons.

  • Doctor 1 & Doctor 4 said it shouldn’t be done because the anchor incision involved in a full lift would be under too much pressure to heal if there was an implant stuffed beneath the skin. Doctor 5 said that the anchor incision he makes involves only a very superficial layer of skin and therefore healing and thus scarring is not an issue.
  • Doctor 3 said it shouldn’t be done because of complications that can occur with the patient’s blood flow and there is a possibility of losing the nipple. Doctor 5 said that blood flow concerns are only present in repeat implant patients and assured me that, while the risk is never zero with anything, I would not be a candidate for these types of problems.
  • Doctor 2 (in case anyone was wondering) was also pro-2-procedures-in-1-surgery but his only argument was that any accomplished surgeon can achieve the desired results with no problems.

The doctor also assured me that, if anything, he was a bit of a germophobe and he had never had any complications arise as a result of infection. He said he uses something called an implant funnel to insert the implant. He literally likened it to a pastry tube … only instead of sweet buttercreamy goodness, mine would be filled with silicone. Delicious.

When I asked about the texturized implant shells (that we learned about from Doctor 4), he said he feels they do nothing to prevent the possibility of scar tissue and hardening. Additionally, he said the texturized shells don’t slide down into place and settle as well after surgery.

When I asked about implant placement, he said he determines whether the implant should be placed above or below the muscle based on two things:

  1. The patient’s activity level – Triathletes, for example, are encouraged to seek over the muscle placement … as putting the implant beneath the pectoral muscle could become too physically restrictive for them.
  2. The patient’s quantity of tissue – Patients with a limited amount of breast tissue available are encouraged to seek under the muscle placement … as there often simply isn’t enough skin present to stretch and support the addition in the front.

And, incidentally, he added that under the muscle placement typically results in a more natural curvature and slope from the chest wall into the breast thus creating a more natural look overall.

When I asked about the silicone versus saline decision, he said much prefers … are you ready for this? … silicone. (The exact opposite of Doctor 4, remember?) He said he uses it almost exclusively in his practice explaining that silicone is lighter in weight than saline which is more comfortable for the patient. He added that silicone also doesn’t have the same problems with breast hardening or even possible visibility as the patient ages and her skin thins. That said, he highly recommends a new innovation in the implant world called cohesive silicone for various reasons:

  1. Unlike the silicone of old, cohesive silicone adheres only to itself, keeping it together where it should be on the chest wall rather than leaching into other areas of the body.
  2. The recommended MRI every 2 years for these implants has been lifted by the FDA.
  3. The same 3.5 centimeter incision made for the lift can be used to insert the silicone implant, thus any argument to opt for saline over silicone due to less cutting would be null and void.
  4. He’s seen many first generation silicone implants (from the 70s and 80s) come out … practically empty of their contents … with no harm done to the patient.

When I asked about the fat injection method rather than implants, he seemed to steer me away from that direction altogether. He explained that he felt the technique was best used in cancer patients who are seeking to match one post-surgical breast to another healthy one. Melissa and I were both pretty surprised. We expected this technique to be one he lingered on for a while. It was, after all, the method Melissa had chosen … though she did explain to me that, because she had undergone radiation during the course of her first treatment, she was not a candidate for implants. Her breast tissue would likely have rejected them.

When I asked about the effects that implants have on mammography, he said that so many women have implants these days that there are now named techniques for performing the test proficiently on these specialized patients. He also added that any mammogram, implants or not, can miss anomalies in the breast tissue. Apparently, nothing is foolproof. (Sigh.)

Then, he took lots of measurements of just about everything I’ve got above the waist. Which ain’t much. And he seemed very focused on the fact that I have a very narrow base width which basically means I have a narrow chest. 32 to be exact, A/B. (Lord, did I just put my bra size on the internet?) The doctor said that, for me personally, he would recommend somewhere between 280 and 300ccs of “assistance.” Which is just about exactly what Doctor 4 said. (Yay! Consistency!) He also said that he would recommend something between a full lift and a mini-lift. Rather than an anchor incision, I would need something more L-shaped, coming down from the center of the breast and turning outward on both sides. Best of both worlds, I suppose.

Oh, and they took pictures. Lots of ‘em. I was escorted to a special room, a studio if you will, with very high-tech cameras, computers, lighting, etc. There was even a little heater in the area where I was photographed so I wouldn’t get too chilly, being disrobed and all. I kind of felt like a supermodel. A naked supermodel. Which I guess would sort of make me something else, wouldn’t it?

A word of advice to all women out there who may pursue this avenue – Do not wear any identifiable jewelry, clothing or hairstyle in your headless photos. And God help you if you have a tattoo. Trust me. Your pictures WILL be recognizable. I’ve already identified an acquaintance in one of these photos with complete certainty.

With my photo session behind me, I returned to my exam room to find Melissa waiting for me. And while I dressed, she undressed and showed me the handiwork of her operations. And, I must say … Melissa, you are beautiful. Your boobs are far superior to anything I could hope for. Your doctors did an outstanding job and you deserve every ounce of it. Unbelievable. Boobs made from scratch … using only parts of your body. I am speechless.

We left the exam room and walked back out into the posh waiting area again … with me having learned (and I think grown) a lot from my visit … but not before stopping to snap an all-important picture. It’s one of the many t-shirts they sell in the lobby.

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Breast cancer patients are incredible, awe-inspiring. I bow at the feet of these women.

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et cetera
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