37 Yrs Old, 2 Kids, Very Fit and Petite - Breast Augmentation with Inverted Nipple Repair. Houston, TX

I have always had inverted nipples. Pre-kids, one...

I have always had inverted nipples. Pre-kids, one was flat, the other inverted. Despite common folklore, I was able to breastfeed both of my boys for almost 2 years apiece. Post nursing, my nipples were extremely inverted, and resembled chewed up pieces of leather :( My breasts however, were in decent shape. Pre kids I was a 34B/32C. Post kids, I was sized a 32D, although the size is deceiving - it simply meant I had enough breast tissue to properly fill the cup, it by no means meant a perky 32D!

About 18 months ago, I decided to get back in shape. I trained and ran two half marathons, then completed Beachbody's Insanity and Asylum programs. I was in the best shape of my life, however my breasts lost what little fat they had and shrunk down to probably a 32B. I decided it was time to get the upgrade and fix my inverted nipples. My goal was to simply be a true 32D, as I liked the proportion with my frame.

I chose Dr. Ciaravino based on recommendations from a few fit friends in the area. He is known for being an artist and keeping things proportional.

During our consultation, he measured me and discussed how small my frame is and originally suggested 250-275 cc silicone. I knew nothing about the sizing, but felt that was small. He said we could discuss further at the pre-op. They also did 3D imaging, which gave me an idea of what projection would like like with 275cc. He mentioned that he usually determines whether to go over or under the muscle during surgery when he gets an idea of the anatomy.

I was initially scheduled for surgery on July 18, but due to a conflict with house issues (we are in the middle of trying to move across town) - I had to reschedule for August 28. During the interim, I made rice implant sizers in 275cc and 300cc. I liked the look of the 275cc.

During my pre-op, I mentioned this to Dr. Ciaravino and he agreed that the 300cc silicone Mentor would give me the look I was going for, since you do lose volume during the procedure. He also discussed in detail his plan for repairing the inverted nipple. Basically he would make two small incisions at the base of the nipple, cut whatever was tethering the nipple, evert the tissue and bolster with sutures. He also planned on using a wire type suture with a piece of plastic to hold the nipple up post surgery and discussed possibly using a cap to protect the area.

DAYS up to surgery

I am a researcher and have been lurking on this site and others for months. I also grilled several of my friends how have had breast augmentation on things the recommended. One thing I made sure to do pre-surgery in my fitness regimen was build up my entire core - abs, back, glutes and my shoulders to help support the new girls. I also built up my flexibility as much as possible, and for my own fun, started working on inversions. I eat fairly clean, but for the weeks before the surgery I completely cut out sugars, breads and any inflammatory foods. I hydrated like crazy the days before surgery. The night before, I roasted a chicken with veggies and had a lovely snack around 10 PM, since they said to eat no later than 11:30 PM

AUG 28 2014 - surgery day
I was told to arrive at the surgery center between 6:15 and 6:30. My husband dropped me off first, then dropped our kids off. Thanks to Houston traffic, he wasn't able to make it back to see me before going in for surgery. The nurses were great - they ask you about 5 different times "Who is your doctor? What procedure are you having done?" They took a urine sample and had me undress down to my underwear. I was given a hospital gown, surgical socks and a hair cap to wear. I brought the surgical bra I was given at pre-op and they tucked it under the pillow.

For me the IV stick is always the worst part of any surgery. After sitting with the IV for 45 mins or so, the anesthesiologist came in and hooked up the happy juice. I remember being wheeled over the surgery area and scooted from my gurney to the surgical table (I think?).

Afterward, I remember feeling compression on my calves and a blood pressure monitor. The nurse woke me around 12:30 and dressed me. She fed me some ice chips and called my husband in. I was groggy, but not nauseous. I already had the surgical bra with some gauze padded to protect the nipple area. I was not wrapped in any kind of compression bands. The nurse helped me get dressed and made sure I wasn't nauseous. She wheeled me to the front door where my husband picked me up.

I slept most of the way home. Once we got home I was starving. I know they say to take it easy with food, but I was craving the roasted chicken and veggies. My husband fed me a small meal with lots of water and gave me my first set of meds consisting of pain meds, antibiotic and muscle relaxers. I napped on and off the entire day and remember peeing a lot. I felt incredibly sore and tight, as if I had chest pressed 300 pounds 100 times and my milk was coming in at the same time. I ate lots of fruit, mainly papaya and pineapple and continued drinking a lot of water.

Day 1 - post op

I had a difficult time sleeping in our bed. We have a Tempur-pedic which is difficult to slide around on as it has no bounce. I kept trying to use my arms to adjust myself, but quickly learned it was easier and less painful to use my abs and legs to adjust myself. I slept with several pillows propped up but kept sliding down and would wake up from the pain of leaning on my arms. I finally moved upstairs to our theater seating, where the recliner is operated via remote. So much easier!

I have stayed on top of my meds and find it easier to move as the day goes on. I've walked down the street to check the mail and move around the house, up and down the stairs as much as possible. I take small naps here and there and move around when I can to prevent soreness. I have burning sensations around my right nipple.

I also took a peek today. I have gauze attached to the nipples so I don't have a full view. Again, they look like they did when my milk came in with my first child - high and tight with corners. I called the doctor's office today and they confirmed he ended up inserting the implant under the muscle. I was surprised given my fitness level, however I am small framed and have less tissue in my upper pole, so this makes more sense so the implant does not look obvious.

Post-op day 2

Last night around midnight I felt itchy all over. It started with little itches on my nose, then head, then belly. Luckily I have some nurse and pharm D friends and they suggested it was either the anesthesia or Vicodin. I took some children's Benedryl and knocked out until 4:30 am. Took the muscle relaxer and Vicodin and fell back asleep until 9:30 am.

I felt much better this morning. I took extra strength Tylenol instead of the Vicodin this morning.

Post-op day 4

My birthday and post-op appt are tomorrow. I felt really great today. Well rested, have better range of motion with my arms. I did a few loads of laundry, went to lunch and the grocery store with the family. Three things that are excruciating - sneezing, laughing, and shivering. Sneezing feels like my incisions at the nipple and crease have burst (I seriously had to check down my bra to make sure they didn't open up!). Laughing and shivering send a strange sensation starting at my nipple and radiating through my breast.

I changed my surgical bra today to an older front zip sports bra I had. It is a bit more snug than the surgical bra. The girls are still sitting high and tight. Not much change so I won't bore anyone with update pictures!

As far as meds go, I've continued taking the Arnica for muscle soreness and bruising. I feel good during the day when I am moving around, but at night is when I can feel everything tightening up. I plan on skipping the pain pills tonight and just taking the muscle relaxer so I don't wake up so tight. I still sleep in the recliner, as it is easier to get up. Tomorrow is my last day of antibiotics.

I am curious about what my nipples look like since they still have the original dressing on them. I will find out tomorrow what they look like! Anything will be better than what I had!

I've been reflecting on things I am glad I did before surgery.

#1 - At the beginning of summer, I started using an epilator on my legs and underarms. I took care of things the day before surgery, and everything is still baby smooth.

#2 - Completed all loads of laundry and set aside any top that buttons or zips. I am still not at the point where I am comfortable pulling anything over my head, so luckily, I have several cotton tops that button up and I wear my zip hoodies at night.

#3 - Got in kick ass shape. Seriously, just having flexibility in the hips and legs to squat down for things so I don't have to reach them and having the strength in my core to lift myself up from a reclined position have helped protect my chest area tremendously.

I did not expect to tire so easily this many days after surgery. I find that after a long conversation, I am winded. I absolutely do not have the lung power to yell at my kids (like calling them to come downstairs :) ). My husband and I love karaoke with friends, and I can't sing at all at this point. I am making an effort to do deep breathing. At least once an hour, I will stop and take 5 deep breaths. This seems to help keep my energy up and it just feels good, kind of like an internal stretch of my ribcage.

Post-Op Day 5 - I have nipples!

This is the best birthday present. Ever.

This morning started rough. I was up early to get my kids ready for school and drove for the first time since surgery. Ouch. Those left turns were painful! It got easier as the day went on and everything loosened up.

Went to my post-op visit. I watched a video on breast massage. Dr. C removed the dressing and suture from both nipples. I am still pretty numb on the underside of my breasts, but I did feel a pinch, like a needle prick. There was a little bleeding from the right side. But for the first time in my life, both nipples are out without assistance!

He demonstrated the compressions massage to encourage my implants to drop more. I have really tight chest muscles. In hindsight I wouldn't have worked them so hard the months prior to surgery! But it feels so good to massage them. I still get tingling sensations around my nipples. They also feel very raw. I am wearing my surgical bra with lots of gauze to bolster around the nipple so they aren't rubbing on the fabric.

Dr. C still recommended showering with my back to the water, no scrubbing the girls. At the two week mark, he said I can remove the steri-strip and start applying the scar fade gel they provided.

As far as energy level, I feel good but tire easily. After taking the kids to gymnastics/karate, I was completely wiped out. Was supposed to meet hubby for birthday dinner, and I ended up falling asleep on the couch. Talking to some of the girls in the office, they reminded me to take things easy the first two weeks. I am continuing watching what I eat to make sure I don't gain weight, but making sure I am getting lots of protein, healthy fats, lots of fruit and tons of water.

Post-op day 5 pics

Day 8 - post op

I've been battling a cold for a few days and lost - woke up coughing and sneezing this morning with a slight temp. I also felt like my right side is more swollen and tender, so just to be safe, I called my PS office. They scheduled me in to talk to one of the girls. She told me what to look for for infection and said I am healing fine. She mentioned that there will always be one side that heals faster, although when she looked at them she pointed out the left is still more swollen along the top while the right is more swollen on the side.

Otherwise I feel really good today. I have full range of motion and momentarily forgot about the surgery and scooped up my 3 year old. I realized he is a big boy and enjoyed the snuggle, but will probably wait a few more weeks to do it again!

I am still putting gauze between my nipples and bras to prevent chafing. I did find a great bra at Target, it's a Playtex bra. It feels as supportive as the bra my surgeon gave me, but it's seamless, adjustable and feels so much better! It also has foam cups which cut down on the chafing. I will post a pic.

2 weeks post op

The day I posted my last review, I started using arnica cream and performing lymph drain massage on myself. Wouldn't you know, the next day both breasts felt the same size. They still have a long way to drop. I've mentioned I was very fit before, so I think it will take longer for the muscle to fully relax.

I've been feeling good. Taking it easy. I have full range of motion and more strength but taking it easy as far as workouts go bc next week we are moving across town so I am savoring my last few days of laziness! I have been massaging my breasts as instructed and I can finally stretch my chest.

I pulled the steri-strips off today. I made the mistake of watching a YouTube video of breast surgery, so i initially thought something was hanging out of the incision! Then I remembered the nurse saying it is lumpy bc he overlapped he skin to help ease the scar (or something). I immediately rubbed coconut oil on the incisions, cleaned them then applied the ScarFade gel my doc provided.

The nipples are healing nicely. My left was always inverted, while the right was more flat with slight inversion pre- breast feeding. I noticed the right nipple has better projection and shape and the left still has an inverted tip, but I love them so much more than their previous state that I don't care???? most of the dissolvable stitches have fallen off the nipples.

Overall, I am happy with the size. I hope the will drop more, as I've never had fullness in the upper pole so I am not used to it. They have at least lost the corners and look round. I look forward to seeing what changes come!

1 month post

It's funny, I spent so long obsessing about boobs, but the last week or so, I've been preoccupied with other things. I've gotten used to them and still love them :)
I recently went to Nordstrom Rack to buy new bras. I told my doc I wanted to look the way I did in my VS 32D bras (but obv without a bra!) and he did just that. They have settled down and I fit perfectly into my old, unlined 32D bras! However, I spill out of the padded 32Ds so I needed more unlined ones.

I fit into 32D in most brands. In Wacoal and Chantelle, I am closer to a 30DD. I also love the way I look on strapless dresses. My new favorite bras are the lacy ones, I feel my shape looks most natural on those.

As far as feeling, the pulling i had in my right boob has subsided. I've been massaging my breasts and scars and one day, I realized no pulling. Morning boob is getting better. I can sleep comfortably on my side. Yesterday I even got Thai massage. They use foam mattresses instead of the hard massage tables, and they gave me a pillow to put under my breasts when I was on my belly. I told her at the start I had breast augmentation, so she flipped me over after about 20 minutes.

I still have some numbness on the lower portion but it is fading. Some days I get the sandpaper feeling, but not often.

I still have not worked out yet, not bc I can't buy bc I have been busy with other things. The incisions feel fine. They are smoothing out. I do feel tightness underneath the breasts, about an inch below the incisions. I use ScarFade gel twice daily and slather the entire chest with cocoa butter every night to help smooth the skin.
Houston Plastic Surgeon

Dr. Ciaravino's staff is great. All of the girls are easy to talk to and were able to answer most of my questions. Dr. Ciaravino is very to the point. He didn't spend as much time with me as I thought he would, but he was very thorough in his measurements and explanation of what was realistic with my frame. The surgery center staff were very accommodating and friendly given the early check-in time. Both the surgery center and Dr. Ciaravino's office called me within the first day to check in and answer any questions I had.

5 out of 5 stars Overall rating
4 out of 5 stars Doctor's bedside manner
4 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
3 out of 5 stars Time spent with me
4 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
5 out of 5 stars Payment process
4 out of 5 stars Wait times
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