Implant Exchange (Downsize), Breast Lift and Capsulorrhaphy - Marietta, GA

In 2006 I had BA and went from small B/C range to...

In 2006 I had BA and went from small B/C range to full D/verge of DD. Doctor used 425cc round saline implants filled to 500. Over the years I felt this was too big for me and decided to go smaller. I am 5'8 155 athletic/slim build. I switched to 320cc smooth moderate classic silicone, had breast lift and lateral capsulorrhaphy to decrease the pocket size. It is only a week post op but I am already much more comfortable with the size (I feel in the end it will be a nice full C) but it will take months to know the final results. I could not find a lot of info on people who downsized, so hopefully this might help others considering this procedure.

Attached are a few before pics and some 1 week...

Attached are a few before pics and some 1 week post op pics (with shirt on). The nipples looks a little lumpy under the shirt due to being surrounded with tape. I will update soon with some post op pics without the shirt to show progress. The doctor decided to do a little bit of lipo under my armpits on my sides right around the bra line during the procedure to remove some of the excess fat and tissue that was present as a result of going smaller. That has been the most painful of the whole procedure. I actually don't really have any pain at all on the incisions themselves (of course they are still mostly numb) but the lipo area is SO sensitive and bruised. I do feel very tight, feels kind of like I can't stand up straight yet or else I might pull the crease incision apart. It may also be a combo of the capsulorrhaphy being on the sides as well, although the doctor said that should not cause much pain since he used existing scar tissue which has no nerve endings to close the capsule. On about day 3 I noticed some purple bruising on the nipples and started to freak out thinking it may be the start of necrosis. I had my first post op appointment and the doctor said it was normal bruising and everything looked good. They changed the tape over the incisions and after seeing the entire nipple, I felt a lot better and could see the tissue looked healthy. (The incisions are closed with internal dissolving sutures and covered in skin glue with tape on top). He advised me to change the tape every 5 days, and I will go back for a 2nd post op in about 2 weeks.

Just added some new 15 day post op pics. Things...

Just added some new 15 day post op pics. Things seem to be healing well. I changed the tape over the incisions today (doc said to change about every 5 days, not sure how long this will go on though). It is the 3M millipore tape in tan. Supposedly this helps to keep the incisions flat and prevent too much scar tissue from building up, as it tricks the skin into thinking it is scar tissue (at least this is what I have read!) I think I may be having the start of a few spitting stitches on the left breast in the vertical incision. I can feel some wiry edges poking out but no pain or anything, so I will leave them alone for now. I have another post op in about 4 days so we will see what the doctor says. The dark/bloody edge under the left nipple you see is just dried blood mixed with skin glue, it's hardened and isn't oozing; I will just wait on it to fall of naturally, as tempting as it was to just pull it off! On my sides on the rib cage right where the bottom of the bra line is it still feels kind of hard and very tender. I think this is where the lipo was because it's outside of where the incisions are and I think it's further out where he did the internal capsule repair. I will ask about this at the next post op. It also seems that my back around the sides where the bra sits is kind of puffy too right around the bra area but I am not having any unusual pain, leakage, or anything that seems out of the norm so I am sure this is typical.

So it's now 24 days post op. I feel like I am...

So it's now 24 days post op. I feel like I am having more pain than I would have expected at this point, and I consider myself a 'tough' person and fast healer. The pain is not unbearable but I am still not driving (mostly I am afraid of dealing with stick shift). I am taking extra strength Tylenol just about every 6-8 hours, not sure if it's really helping a lot. I can't pin point exactly where the pain is coming from; on the right side it almost feels like it's the inner part of the crease incision rather than the actual muscle, but then occasionally when I am reaching or pushing or if I flex the pec for some reason, I do feel some twangs in my muscle that is letting me know things are still tender in there. I am still kind of hunched over when I walk but that may just be me feeling like something will bust open if I stand up too straight, but it does feel like there is some tension there in the front. I guess that makes sense since I just had tissue cut out and there is not as much 'slack' to stretch there! I am still wearing the 3M micorpore paper tape and changing about every 5 days. I took it off today in the shower and it seems that it's starting to get gummy around the incisions and it's a little chapped around the inner crease part. Continuing to put on tape on top of the remnants that don't wash off seem to just be building and building and I hope they aren't going to cause more problems than good. The sticky stuff won't wash off and it will just have to wear off, but it can't really go anywhere constantly putting more tape on. I am going to leave the tape off until I go to bed tonight and let it air out. I will keep an eye out it and see what happens. My doctor said some surgeons recommend the silicone sheeting, steri strips, etc., but in his (and the nurses opinions) they said this tape is the best for scar healing. It seems like the nurse said to wear it for 6 months if I can tolerate it (she may have said 3-4 months though, but it was a long time). The doctor did trim a couple of stitches that were poking out. A loop had come out at the very end of each incision on my sides. He said that 3 weeks is usually the time they start to pop out if they are going to at all. These dissolving sutures should be absorbed at about 4 months. I have had some paranoid moments thinking what if I am one of those people who doesn't absorb the sutures and I asked him what happens if my body doesn't absorb the deep internal sutures from the capsulorrhaphy, to which he replied 'it will'. :) I can't seem to find a bra that I am happy with, I am alternating between a Genie bra and several different cuts of sports bras. It seems that the more snug the bra, the better they feel, although the tighter bras tend to cut into the incisions. I have these tendersorb pad things I got from my pharmacy and I cut them in half and place them between the bra band and the incision sometimes. That gives a little extra padding and seems to ease the tension.

Sorry this same comment is down in my 'comments'...

Sorry this same comment is down in my 'comments' section too, but I couldn't figure out how to delete it and I wanted it up in this section of the review!

Post op day 26 - I emailed the doc office today and asked about what to do for the tape adhesive that is sticking on my skin. I had been reading that some doctors recommend oils (even vegetable oil!) for pulling tape off easily and getting the residue off the skin. They are going to mail me some adhesive remover to help with the sticky stuff. Hopefully this will get the skin nice and clean before applying the new tape every 5 days. I have another post op visit on Halloween, at which point we are going to start the massages. At this point I can't imagine massaging them...they still feel WAY too tender, I am almost afraid to even touch them and I wash them so gently in the shower. All the years of my previous implants I was religious about remembering my massages a couple of times a day, even if I did it really fast or just while I was walking through the house or sitting on the couch. Oh yeah - I meant to mention that before I had this revision surgery, the doctor had me get a mammogram first. I am only 34 but they said it was best to do it now and make sure nothing was wrong rather than doing this revision and then finding something on the operating table or later down the road. I think I was more scared of the mammogram than I was of the surgery, but it was a CINCH. I had a great nurse who I made very clear to her of my fear of getting squeezed and she assured me she had been doing it 20 years and would be gentle. It helps to make sure the place you get the mammo does a lot of people with implants (which most places probably deal with this frequently). I think they took something like 4 or 8 pics on each breast, once with the implant being squeezed with the breast tissue, and once with the implant 'displaced' (basically just pushed back and the breast tissue kind of pulled and pinched in front of the implant). Imagine kind of hunching your back and slooping your shoulders forward to make the implant go really close to your chest and then grabbing up your own existing tissue off the front of it. Anyway, I thought this would hurt SO bad because my breast tissue seems dense and there was a good bit of it, but it was fine and didn't take any time at all.

Just added some 29 day post op pics. Things are...

Just added some 29 day post op pics. Things are healing well. There is a teeny spot on the top of the left nipple that was open just a hair when I pulled the tape off. Also when I pulled it off from the crease a stitch was stuck to it right in the spot where the vertical incision meets the crease (right at the T intersection). I am still having a little pain, especially when I take the bra and tape off for a while, but they may be because I over did things a little. Things are definitely getting better day by day, I can actually get out of the bed now and push myself out a little bit rather than just relying on my ab and leg muscles to lift me out. I am doing light things with my arms like sweeping, moving laundry from washer to dryer, washed a few dishes, scooping cat litter, etc. At the last visit the doctor said I could start doing some light exercise to get my heart rate up a little if I wanted (nothing with arms though of course). I may try and start back at the gym this week just walking or doing something simple like that. Said the risk of bleeding has passed and that is the main concern with keeping the heart rate and activity low for the first few weeks. Taking Tylenol still about every 8-10 hours or so. You may notice it kind of looks like the bottom of the left breast is kind of dented in where the vertical incision is. I am thinking this will round out a bit more after the implant settles in a little more.

Today is 45 days post op. I am feeling pretty...

Today is 45 days post op. I am feeling pretty good. I had a post op last week and the doctor said everything is looking good. Still said no vigorous exercise and nothing with too much over head arm movements. We agreed that I can get back into the gym and if it's uncomfortable, don't do it. I have done some treadmill, bike, and stairmill. They feel like they are bouncing a little too much on the treadmill so I like to walk slower and at a higher incline. Pulling myself up onto the stairmill was a bit of a strain. Pushing out of bed or coming from a sitting position on the floor or something like that is still a challenge; I can tell that my chest is not ready for the strain of full body weight. The incisions are healing great though, no issues there at all. The vertical scars especially are clearing up nicely. Some areas around the nipple are a little pink but I think it looks pretty good. My nipples never really had a defined edge (they were very light and I also like to tan) so the scars kind of make parts of the edges of them very apparent. I am still wearing tapes and changing them out every 5 days. I go back for my next follow up appointment in 10 weeks. This will put me at about the 4 month mark. I do feel like part of the cleavage is still a little raised and swollen feeling and I pointed this out to the doctor, but he seemed to think it was nothing to worry about and said that the 'tissue integrity' was good so nothing to be concerned about. I have gone to the tanning bed but was very careful to keep everything covered up. I had tapes on, then put the tendersorb pads over all the scars, then a sports bra, then I layed a shirt over them and tucked it around the edges, then laid my pair of jeans and a jacket over them. I basically just piled all my clothes over my chest! It seemed to do the trick. I feel like they are getting bigger though. At first they seemed so small and now it feels like they have grown back! I am happy with the size though and know they are smaller when I compare them to what they were before. I actually believe these implants, although less cc and projection, are each actually each about .5 cm wider than my last ones.

Let me tell you. I got some of this stuff called...

Let me tell you. I got some of this stuff called bio oil (got it at the local grocery store, so should be widely available) and I have only put it on my scars for 2 days and I swear I can see a difference. The scars were already fairly flat (thanks to wearing tape for 2 months straight!) and the ones around the nipple are white, where as the vertical ones were more pink. Those especially have faded over the last couple of days. Maybe it's due to the moisturizing but so far I am pleased with the stuff!
Atlanta Plastic Surgeon

I chose this provider from a recommendation from a friend who also had a breast augmentation done by him. She has also since had a breast augmentation revision and tummy tuck. He did a great job on my original BA, so I chose him again for the revision to smaller implants and the breast lift.

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