34 Year Old Mom of 3 - Breast Augmentation and Liposuction to Abdomen - San Francisco, CA

I never thought I would want any plastic surgery...

I never thought I would want any plastic surgery on my body. I've always had small boobs and a bit of a thick middle (it's my body shape), but I was always fine with both overall... then..*ENTER THE IMPACT OF CHILDBEARING AND NURSING.* I had all 3 of my kids before I was 30, each two years apart, and nursed all 3 pretty much for a year each. After all of the pregnancies and nursing, my boobs completely, utterly deflated; they almost look concave on my chest. I always wanted 4 children, but for a number of reasons, 3 will be the final number. I didn't get much of a chance to exercise regularly until all of the kids were in school, and I've been doing bootcamp and running for the past year and a half. I eat pretty healthy 80% of the time, and for a little while I was eating super clean. It was only during those super clean eating times that I would just start to see my waist trim down a bit. I felt like eating that way felt imprisoning, and decided I didn't want to live that way. I went for my very first consult with Dr. Bermudez back in October 2013, just to entertain the idea of surgery just for a breast aug, and ended up really liking my experience with him and his patient coordinator, Annalee. I didn't set my date until May 2014 because I wanted to finish off the holidays and plan enough time off from work. I also decided to add on lipo to cut down on additional future hospital fees, and I've heard the recovery time won't add too much on to the recovery from the augmentation. I saw another doctor in San Mateo County, who offered a slightly lower overall cost (the hospital fees are lower than the facility that Dr. Bermudez is associated with), and their office was great too, but I felt more comfortable with Dr. Bermudez. Another nice thing is that Annalee has never pressured me to set a date or pay my deposit immediately. So...I have exactly a month until the big day! My husband, I would say, is neutrally supportive. He was initially a bit against it, as he is happy with me the way I am (or at least my body haha), but he is coming around to empathizing with my perspective, if not necessarily agreeing. I am going with Sientra mod profiles, 280 CCs (I may go a little bigger), and have already picked up all my meds. I will update for my pre-op or any changes/thoughts I might need to share.

Before photos

Don't Feel Like Explaining

Let my bootcamp trainers know via email that I would need to put a freeze on my membership for a couple of months due to a "medical procedure" that would keep me out for at least 6-8 weeks. I left that purposely vague not thinking they would prod, but nope, I got an email response saying the membership freeze would be fine, but asking what my procedure would be, "if I don't mind" them asking.
I chose not to respond, and I'm not sure I will, mostly because I don't feel like explaining/defending myself to someone if they don't personally agree with plastic surgery...which I think is the case a good amount of time. Maybe the question came from a place of genuine concern, but even then I'd like to preserve my right to some privacy. One of my very best friends got a BA when we were pretty young, about 20 yrs old I think, and she pretty much told 2 people, me and the friend that drove her home. She went through the whole recovery process completely alone and thinking back, I wish I had known that I could have been more supportive. On the other hand, she also avoided a lot of questions and no one else ever suspected she had gotten the procedure done.

Pre-Op Today...I'm really doing this.

Went over the Sientra chart with Dr. Bermudez doctor and I decided to go moderate profile 305 CCs given my chest width. I really appreciate that he hasn't tried to sway me with any of my decisions...he provides well-informed opinions and presents me with the best options possible. We went over how the whole she-bang process will go, as well as what I should expect from post-op recovery. I can't believe I won't be able to shower or bathe for 3 days. Ugh. But I do like the idea of the pain pump, even though the idea of pulling out the catheters from my body is a little strange.
Made my anesthesia payment as well as surgeons fees. The hospital fees are pretty steep, sort of expected from this hospital group (California Pacific Med Centers), but I'll get hit up for those in a couple of weeks.

Life Craziness Pre-Op

Knowing that I will be out of commission for a week is freaking me out a little bit - other than the 3 kids, job and house, I take care of a parent with Alzheimer's, and as an only child, I'm responsible for all of the major decisions. So I'm trying to handle doctor appointments, prescriptions being filled, room getting cleaned - and none of it even my own! Then there's all the stuff for kids and household. My husband does things on such a do-only-needed basis, it is making me nervous that he won't be really prepared for this much time with me not available to do much. On one hand, I'm getting discouraged because of the idea that I have too many responsibilities to do something like an elective surgery. On the other hand, it makes me think that I deserve something that will be just for me. Did my phone pre-registrations with the hospital yesterday, another step toward the reality that I'm really doing this. Surreal.

Post Op pics

Felt so gross immediately post-op, mostly nausea, even though the nurses said is been given 4 kinds of nausea meds. I didn't actually vomit though, so I'm guessing that's a sign that all those meds worked. The nurses at the hospital, all of the staff, were really nice, from admissions, to prep, then recovery. I felt very well attended to, which I didn't totally expect since I wasn't actually sick.

Got home and just slept a lot. I didn't need to take any additional pain meds, and only took 1 pain pill right before I went to bed, to get ahead of the pain more than needing it right away. I think the pain pump is great in that aspect; definitely require taking less pills. I also like that the meds are focused on the areas needed and not having to go through my whole system.

I noticed I am more stiff and sore immediately after trying to get up from sleeping or when I've been laying or sitting around for a long time. Getting up and walking around the house is pretty helpful.

The lipo sites are pretty tender and swollen, and the girdle and foam are definitely nice for holding it all in.

The boobs -- I'm really happy with how they're looking so far. A really good fit for my chest, especially the width. The mod profile will be perfect too. I was afraid of looking bulky since I have a broad back, but I now see that won't be the case.

Itching, chafing and noisy kids

Got itching & hives, apparently from bromelain and arnica supplements that I'd been taking (got them from my surgeon to take 3 days pre-op and 7 days post). I hadn't had a reaction to them previously, though, but doctor said to stop taking and take Benadryl as needed.

The itching and chafing underneath the compression girdle has been horrible. I switched back to the bra I got post-op because the Marena one was cut smaller around the armholes and irritating my armpit skin, and cut out a section of a thin cotton shirt to place between my skin and the garment - seems to be helping right now.

I took a very slow stroll one block around my neighborhood yesterday evening, since moving around helps relieve the soreness. I'm going to try not taking any Percocet today.

Husband and kids will be gone at church, which will be nice so I can have some real peace and quiet. I feel guilty not wanting to hang put with them while they're at home, but other than the day of surgery, when I locked my room, I haven't had a good amount of time for real rest.

Swelling of left breast, Percocet allergy

Yesterday was great - I removed the pain pump, took a shower and managed to (carefully) be out and about. My rash was still present, so I made an urgent care appt. with my primary physician today. I had stopped taking all meds. Well, my left breast got very painful and swollen. I tried 650 mg of acetaminophen and ice, but it didn't work, so I took a Percocet. The Percocet relieved the pain, but I felt nauseous and had a lingering headache, and my primary physician (who is pretty well versed with allergies) told me it was likely the Percocet that was causing the rash. Ugh, what a setback! Now waiting for a Dilaudid prescription and trying to drink lots of water to flush out the Percocet. I feel like crap and now thinking I overdid it yesterday.

Post Op yesterday/Being Inactive is Driving Me Nuts

A friend drove me to my post-op yesterday, it was nice to have female adult company and talk openly about my surgery and just laugh and chat. The appointment went well, the swelling in my left breast isn't a hematoma and my recovery, other than the rash, is going as planned. Anti-inflammatory prescribed to help with both the rash and swelling, and a prescription for acetaminophen with codeine instead of the Percocet and Dilaudil. (I found out that Dilaudil is hydromorphone/pure synthetic heroin....holy cow. Inspired me to re-watch Drugstore Cowboy).
Being inactive is driving me insane, but I definitely don't have the energy to resume all my daily living activities. Me and husband went to brunch, and I walked over to Anthropologie hoping to browse. Unfortunately, the 2 block walk plus the 80 degree weather didn't bode well with me, and I spent most of my time at the store sitting on a couch and flipping through the Alexa Chung book. My appetite has been reduced to less than half of what I usually eat, since I'm not generating enough activity for greater corresponding calorie intake. I can't believe it's only been a week.
San Francisco Plastic Surgeon

My experience with Dr. Bermudez has been wonderful so far. He has a warm yet professional mannerism, is obviously experienced and skilled, and never condescending. He is a proponent of a natural looking result, and knows what it takes to deliver it. He answered my phone call on a Saturday (one day post op) when I got an allergic reaction to some supplements, and his staff has always returned my calls promptly. Also had a GREAT experience with the hospital, California Pacific Medical Center, Davies Campus. The overall surgery fees were higher, largely because of the high hospital fees, but I had such a positive experience, I think the extra cost is worthwhile. All of the nurses were so kind and attentive, and even the anesthesiologist made me feel very comfortable.

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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Comments (21)

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Hi JuneRam. Your results are looking great so far. I hope you are feeling better? I had different medication than you but did not react well to it either. I only took three pain pills total. And regretted all of them! Thank heavens for that pain pump huh?
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The pain pump was fantastic, I don't know why every surgeon doesn't use it. My left breast is still more swollen than the right, but I can at least breathe more comfortably now, and it's not a hematoma. Yes, all of the narcotics were awful. Not just with the allergies, but also the whole feeling of being a drugged zombie. I'm so bummed that the hernia repair didn't take for you. What happens next?
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2 reasons, cost, and typically not needed. Some don't even give for a TT. Now I think that's rediculous
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We just wait and see with the hernia whether it "glues" back together on its own. Hopefully without looking awful. Even longer for me with no exercise. That is hard for me. Anyway, looking forward to seeing more photos of your results!
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I was on Diluadid in the hospital, that's some pretty heavy stuff. I don't know if you've taken it before but just to prepare you a little, it will make you very drousy. I have a high tolerance for pain meds and the Diluadid was just enough to take the edge off but unfortunately it made me a zombie. Fingers crossed your left breast cooperates more with each passing day!
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My husband picked up the Dilaudid prescription for me, he said it was the most interrogative process of any prescription he has come across. I took just one last night, I have low tolerance for pain meds, and it knocked me out cold in a matter of minutes...definitely for use sparingly. Thank you for the well wishes, I'm going in for follow up today.
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You'll do and look great. And with a pain pump, you'll prob be up and about before you know it
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Thanks! The more I hear about the benefits of the pain pump, the more optimistic I feel.
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They're aren't that many ps that use pain pump for ba because the pain is usually managed well with rx pain killers. Some like myself have a pretty easy recovery and don't need the meds although I was super paranoid about the pain and asked for one and was told I wouldn't need it which I didnt. They are some women that have a difficult and painful recovery and could benefit from one but after a few days you should be ok.
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Hey there! Hoping everything goes smoothly for you tomorrow! You definitely deserve to do something just for yourself! It is so hard that you have the additional responsibility for your parent. I hope your husband steps in and lets you rest and recover sufficiently. One of my biggest anxieties going into this was the recovery process and the fact that I have to rely on my mom and husband to assume all my responsibilities.
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I am 5'6" and 118 lbs and got 304cc which seems just right to me. I like being a 32C, particularly after breastfeeding 4 kids left me feeling conspicuously flat. I think I look natural but not "hey look at me".
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Thanks, that's good to know! I read through your experience, I also hate that my stomach sticks out more than my chest because of that concavity/loss of volume from breastfeeding. Your results look great. It is so helpful to hear from this realself group. I'm 3 days away from surgery and super nervous.
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Good luck! I think you will look great with 305 cc. You will achieve natural look for sure. Keep us posted!
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Thanks fpr the reassurance. Your results are gorgeous, and I really appreciate the detail in your reviews/experience, very helpful!
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You are very welcome! Good luck again! And thank you so much for your comment!
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Hi! I have selected Dr. Bermudez too! My surgery is scheduled for 5/20. I am still feeling a bit uncertain. Funny - I would describe my husband as neutrally supportive too. He told me he really does not think I should do it but supports my decision. I am looking at the same implant too! I was thinking 275 cc but I guess the Sientra come in 280 cc. Still need to do final selection with Dr. B. Anyway, best of luck. I look forward to hearing about your results.
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Oh and I visited 3 surgeons. Dr. B seems like the best choice though he is the most expensive. :)
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Thank you for starting your story on RealSelf! I'm glad your husband is coming around. I think "Neutrally supportive" is a great description. Here's a list of recovery supplies that might come in handy. Please keep us posted as you get nearer your day!
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Welcome to Rs, I had BA, TT, and lipo on flank area last April 1 2014, now 3 weeks post op and I'm doing really good. I had Sientra mod profile 305cc, I was 32c small, and now 32d probably, i loved the looks of my boobs just enough size for my chest frame. My stat is 5'1 ft 112lbs , 46 yes. old with 3 kids and 1 cs. Its good to have a husband coz he can be a big help. Good luck to you.
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Thank you for the encouragement, and glad to hear you're recovering well. Yes, my husband is not super encouraging, but I know he will help me. I won't have other help, as I'm not telling a lot of people. My in-laws are the family we spend the most time with and I KNOW they would be judgmental and non-approving, and I just have to gradually avoid them for the couple of weeks before so it doesn't seem like I've disappeared out of nowhere. ha.
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