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Thanks to genetics and massive weight loss years...
I was not really sure what to expect (my surgeon didn't give out too many before/after examples) and I went into the OR not really sure how my results would look. I knew the technical details (type of implant, incision, below the muscle, etc.) but the rest was still a mystery. I ended up getting Allergan Natrelle silicone implants under the muscle with "lollipop" incisions due to my need for a breast lift in addition to the augmentation.
My surgeon got the shape and size perfect based on what I told him I was hoping for. I am an attorney and needed them to look as natural as possible as I couldn't afford to have some crazy, stripper-sized implants and still be taken seriously at work. He made it so they eventually fit my body perfectly by using two differently sized implants to even out my breasts (one was naturally larger than the other). He used Allergan silicone implants, so one implant is one size larger than the other. Note that this was very noticeable directly after surgery. I was originally worried about how uneven they seemed at first but as the swelling subsided and they dropped into place, they're almost identical in size. One is *slightly* fuller - it's barely noticeable now. Had he used the same size implant, I would've not ended up with such a close match. So it was great that he made this call to use different sizes on me. It looks very, VERY natural and aside from the scars from where I had some complications, you wouldn't even suspect that I had surgery.
The procedure itself went well. Pain was easily controlled with oxycodone (low doses) - I was off of them within 3 days. I had minor complications during the first two months due to my body's rejection of the self-absorbing stitches (never had this issue before, so there's no way we could've known beforehand) so there were plenty of follow-up appointments to see how the scars were healing. Sometimes, I would get shooting pains where things were healing, so we controlled this with lidocaine cream and oxycodone (when it was really bad).
The big complication came six months after the surgery; I got a large staph infection where one of the permanent Goretex stitches were placed. Ended up in the ER where the attending doc took one look at me and ran for the plastics doc on-call. They texted my surgeon and he ran over as soon as he had a break in his schedule at his clinic. I needed to have an ultrasound to see how far the infection had spread, so my surgeon arranged to have his radiologist of choice do the scan with him present instead of just leaving me to the hospital's schedule and waiting for a radiology report.
From this experience, I would say that it is imperative that you get a surgeon who has close ties to the hospitals where he operates; I needed help urgently and he was able to make sure that I could get it without waiting for the bureaucracy to get around to putting me on the schedules. He also sat in the room during the ultrasound and made requests of the radiologist so he could see the images from multiple angles so he had a better idea of what to expect when he started cutting. This was MUCH better than just having him get a short report and a few basic images of the tissues.
My surgeon and his surgical resident ended up doing minor surgery on me right there in the ER to remove the infected stitch and drain the abscess. They stitched me up and sent me on my way within a few hours with antibiotics and a bunch of Tegaderm bandages because, of course, I was flying to Honolulu within a few hours for my first vacation in years.
Swimming with an open wound was not recommended, but my surgeon took pity on me and gave me the Tegaderm bandages so I could at least go in the water (salt water only) from the waist down and not worry as much about getting splashed. I was able to "go swimming" this way later in the trip with no issues but, per his instructions, took great care to wash myself off with antibacterial body wash after "swimming" and before I removed the Tegaderm so that I would reduce the chance of any nasty bacteria getting near the incision.
I had plenty of follow-up calls from my surgeon's PA the next day to make sure that I was doing ok and that I had no issues with the antibiotics or pain. My surgeon also emailed me the name of another surgeon in Hawaii I could go to in case I ran into any trouble while I was away.
I'm just going to stress again how important it is to get in with a good surgeon who also has a good team working with him and good ties to the healthcare facilities in the area. Any medical procedure has its risks and things do happen even months out of surgery. If my surgeon had not been well-connected and very hands-on with his patients, I probably would've been held up long enough for the infection to spread to the implant, which would've resulted in at least 2 more surgeries to that breast. So take your time and choose your providers wisely.
Provider Review
This is a fantastic doctor who has a great team and really good bedside manner. I cannot say enough good things about him. Now be prepared - he often has plenty of residents and trainees with him and he has a habit of talking to them and not directly to you when you're being examined. It may feel a bit awkward to go around topless in front of so many people, but remember that he's teaching them and that this whole team will be around to help you. Take advantage of your time with him - if you have a question, do not be afraid to ask him. He will take the time to answer your questions and explain things to you, but you have to be the one to ask the questions in the first place. He knows what he's doing and is very good at it, so he's thinking about the whole picture and not necessarily the specific details that are worrying you. Come to your appointments prepared with your questions so that you can make the most of your appointment time. The initial appointments were not what I expected from descriptions from other friends who have had similar work done by other surgeons - you first meet with his PA and then him and his team. There was no discussion of the size of the implants or showing pictures of his before/after results; Dr. Shestak just asked me what cup size I hoped to be, asked some lifestyle questions, told me how some things would be difficult to fix thanks to my natural body shape (thanks, Grandma) and that was that. I pretty much left the whole thing in his hands (very hard for me to do given I'm a Type A control freak), but I felt confident that he knew best and would do good work. I'm very happy with my results and recommend him to anyone considering plastic surgery.