Treatment Provider

Marc J. Salzman, MD, FACS
Board Certified Plastic Surgeon
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Fat transfer today!

I just got back from my fat transfer procedure a few hours ago. Fat was liposuctioned from my abdomen, processed, and injected into the area on my right breast where I was missing breast tissue which covers the implant and provides a smooth transition from my natural breast to my implant.

Let me just say...never get lipo unless you REALLY need it. It was not particularly painful (although I felt some sharp jabs at one point and they had to give me more of the numbing agent) but it's just violent and barbaric. And I got the gentlest form of lipo. It was a very odd feeling, my surgeon grasping my flesh while this metal rod he had rammed into my tummy flesh. It just felt barbaric.

That being said, I did not have much abdomen fat to begin with, but the little pooch I did have is now totally gone. I was surprised by that because they only took about 30cc of fat. I do have some fluid retention in the area that needs to go down, but overall, my abdomen is likely to come out of this looking better.

My right boob will have improved, I'm sure. To what extent, I'm not sure yet because the fat has to have time to "take" and not all of it will survive. So my result depends on how much fat takes and thrives in the area. Already it looks much better, albeit probably not perfect. I am trying not to look at the boob at all right now because I want to reserve judgment until things have settled more. But I have my fingers crossed.

I've got to do the whole antibiotic/pain pill regimen again, which feels deja vu. I have been instructed to wear a spanx like garment to compress my abdomen, which will encourage the fluid retention to subside. I am also supposed to leave my right boob completely alone - I'm not going to touch it, put it in a bra, lay on it, nothing. I want as much fat to survive as possible.

So...we'll see! I'll update with before and after pics once I have a better idea of my final result.

3 month boobiversary & micro fat grafting procedure scheduled April 1

It's three months to the day since my surgery. I would say that in the last month the implants have settled and dropped a bit more and I am really happy with my nipple placement now. I have not had any pain in quite some time, except for a few days two weeks ago I had some sharp pains near my areola incisions - they must still be healing. I have been sleeping however I like and exercising however I like, except I try not to do much with my pecs because it feels weird. No pain, but I just don't like the feeling.

I still am not happy with the lack of tissue where my natural breast meets my implant on the right side, so I am going to have the fat micro grafting procedure on April 1. Before that I will have a consultation (I want to be able to manage my expectations) and a pre-op. The procedure will involve taking fat from my abdomen and filling in the area on my right breast with that fat. It's a procedure that will be done in-office under local anesthesia and valium. $1,200 fee from the surgeon who did my augmentation - I think it's regularly $500 more but he gave me a discount. I very much hope it fixes the issue. I am turning 30 at the end of April and I would like to enter my 3rd decade of life feeling confident about my breasts.

Last month I went on vacation and had fun with bathing suits. I bought a strapless one piece and a bikini that showed lots of cleavage. I really liked wearing both because I have never been able to wear anything strapless or show any cleavage so it was a new experience to be sure. I am going on vacation again at the end of June and look forward to wearing them again.

Hope everyone is doing well!

2 month update & spending entire tax refund on fat grafting :(

Well, I'm at 8 1/2 weeks right now. My implants continue to drop and I think they've dropped a lot the past two weeks. They are looking much more natural, the dropping makes them appear to have the natural heft that real breasts of my size would. I would say my upper pole to lower pole volume ratio is at 1:1 so I'm hoping that by the end of the third month I will have the ratio I'm looking for, 45% volume above, 55% below.

My issue with my right breast has only gotten worse. The more I analyze it, the more I can see that the problem is my natural misshapen right breast which is sitting on top of the implant. My original right breast had basically no lower pole volume. There was some breast tissue on the top and outside, but the lower part of my breast almost formed a straight line from the bottom of my areola to my ribcage. Whenever I raise my right arm or lie down, my native right breast tissue becomes apparent. There is the rounded implant, and then the straight portion where there is no breast tissue. When I am standing up, the implant pushes the tissueless area out, so it's not as noticeable. But as the implant drops it is becoming more noticeable because my lower poles are filling out, but not in that particular area.

So it's become clear that I need to fix this. I'll do the fat grafting - taking fat from my abdomen to make the flat area where I have no tissue rounded, like my left breast. I really hate spending $1200 to do this, but I really have no choice. If I leave it as is, I'm back at square one, feeling ashamed of my breast(s). I've read up on the procedure and apparently it is relatively new and cutting edge but quite successful. Surgeons use it a lot with breast reconstruction (cancer) patients who have no native breast tissue due to mastectomy. I also can't say I won't be pleased to have some fat disappear from my abdomen.

I need to call and inquire about my surgeon's schedule, but if there is room, I'd like to have the procedure at the end of the month. We were going to wait until 3 months to schedule, but I can already see this is a huge issue, so no point in putting it off. I SO HOPE that this minor procedure will fix my issue. I also hope it will fix my issue in one go - if the fat doesn't take as expected, you can undergo the procedure again, but then that's another $1,200 or more. But I have a lot of faith in my surgeon's surgical prowess. He has a terrible bedside manner but he knows what he is doing, so I trust him.

Besides that, my breasts are doing well. I do not have cleavage without a push up bra or pushing them together with my arms (they are about a finger's width apart), but with a bra or arms my breasts come together quite willingly. Wearing a VS pushup, I get some killer cleavage. They are very soft and move naturally now, like I can feel them bounce slightly when I walk.

I try to massage them as much as I can but I don't do it as regularly as I used to. I also try to apply the scar gel as regularly as possible but don't do that as much either. I don't even know how much it is helping, and it is sticky and dries to a gross, unsightly crust which I do not like. Hopefully without much intervention the incisions will be invisible at one year as planned.

I wear no bra or Nippies almost all of the time. I don't even notice wearing the Nippies, which can be dangerous - during a recent sexual encounter (and, ok, I was a little tipsy) I forgot to remove them. Those of you who own Nippies know the appearance of the breast with Nippies is a little weird; because they are flesh colored, it looks like you have no nipples. When my boyfriend pointed them out I looked down and felt repulsed. I peeled them off and threw them on the ground, disgusted. Fortunately we were both kind of drunk so we carried on without further ado.

Provider Review

Board Certified Plastic Surgeon
4702 Chamberlain Ln., Louisville, Kentucky
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Several people recommended Dr. Salzman to me. I had two additional pre-ops in Philadelphia and one of the best surgeons in the city (who charged $10,000 for a BA and whom I couldn't really afford) recommended the same thing as Dr. Salzman, so I figured two experienced surgeons probably weren't wrong. Dr. Salzman seemed really invested in giving me the natural look I wanted, and was pretty honest with me about what was and was not possible. I think Dr. Salzman has great surgical skills, but do be warned that his bedside manner is terrible. He rushes you and isn't very empathetic. He's a surgeon, not my therapist, but it would have been nice to have someone who was less brisk and who acted like he cared about me a bit more. He relies on his staff very heavily - they will be the ones you interact with most, with him basically just giving quick opinions and doing the surgery. He did call me the day after surgery and let me text pictures about a concern I had, which was nice.