James D. Namnoum, MD, FACS

I've always been slim. Breasts were a nice size 34b once I hit my 30's. But got into fitness immediately after my 30th birthday and my breasts went bye bye with weight lifting. They deflated and begin to sag which left me feeling very insecure naked. I've wanted a breast augmentation all my adult life but a recent trip to the Bahamas three months ago put my final decision into place. I worked so hard to maintain a great body but felt the last piece was missing with my fitness journey. I put on my swimsuit and still felt uncomfortable up top. I'm currently 2 weeks post op and I have no regrets. (Except boob greed) I have the Allergan 410's with 425 cc's textured. Under the muscle. The swelling has subsided and I'm around a 38C. I was hoping for a Large D cup but my surgeon was awesome and the look perfect for my size. 5'7 140 pounds Updated on 30 Jun 2015: Today makes it 16 days since my BA! I'm not feeling too much pain.. Mainly in my incisions. (Under the breast) I still have a bit of morning boob in the am but nothing to major. One change I wanted to note is that my nipples are SUPER SENSITIVE right now ... It's quite annoying. I'm having regrets on my size. I should have gone bigger (I know I know) lol so does everyone else. I really thought I was picking the perfect size. I could of done 475's. But overall I'm happy. They look fantastic and I'm just a little over two weeks in! Updated on 28 Feb 2016: Haven't been on here in awhile. And due to the lack of late updates that are hard to find on the Allergan 410's I decided to update. Hopefully it helps my Allergan sisters out. Well I'm about 9 months post op. I've truly been blessed in my Breast augmentation experience. I haven't had any issues. They have dropped and fluffed beautifully. They are soft, not as soft as I would like but hopefully my year anniversary they will get softer. They move beautifully. I have no rippling. No pain. Pure joy STILL in shopping. I'm just ready for summer so I can really enjoy them. ;) I'm measuring at a 34DD at Victoria's Secret. But they look like a large C cup in person IMO.

Hi! My name is Jennifer, I'm 47 with 3 children and was living a fabulous active life, other than some chronic back pain that was manageable until Christmas Eve 2012, while saying a prayer for a friend, I found "the lump". The next year entailed 6 rounds of chemo, a year of Herceptin and a double maatectomy, tissue expanders and reconstruction with teardrop implants. I had a hard time at first, I really did not want to loose feeling in my breasts. Doing research, I kept coming across a Dr in FL who offered this Brava system. My surgeon knew this Dr and at the time 3 years ago did not feal it was a good fit for me.... And I didn't have the energy or $10,000 to go down to Fl and pursue. Following this surgery, I started to develop horrific neuropathy, fibromyalsia, chronic fatigue, extreme chemo brain and open sores all over my body which would not heal. Also, I experienced black outs with my memory after each surgery which really concerned me.. I even drove by myself the day after a surgery and purchased items at an estate sale- telling my daughter I was fine and drove w my drains with no memory at all -waking up the next day to several large paintings in the den...My surgery itself had beautiful results. However, I then developed lymphadema on top of all else and my implants not only became encapsulated, I had developed "cording"... Which is extremely painful. I met with my plastic surgeon and he suggested a more round implant and took every measure to ensure that my implants did not encapsulate this time and the cording was also very minor. Again, the results were visually stunning. I felt so blessed to have such a talented and compassionate surgeon....especially when I would see pictures from other BC survivors who did not have access to the same level of care and I just could not understand how any Dr could leave such jagged and horrible stitching and scars on these women. While my implants remained soft, they still were not my favorite personally, I missed the loss of fealing and did not enjoy the cold harder feel of having implants....however, I was facing bigger issues. There was over a year where I could not get out of bed and the pain in my feet made it impossible to even stand, 4:00 pm was the worse time as the fibromyalsia pain would start to build and I would just be in bed rocking in the dark counting numbers over and over until morning because the pain was so great. My memory was gone, I was calling my husband in tears, lost even just going the two turns and two minute drive to my children's school. My oncologyst was very non supportive, claiming I should be better from chemo by now. And it was "in my head"... I followed his suggestion spending $4,000 on a Psychiatrist who just wrote scripts, each making my symptoms worse, never once looking at labs to see why I was not able to process or metabolize these drugs... Including Tamoxifen which truly crippled me to a point I could not walk and the bone pain was excruciating ( i still choose not to take this drug) and I was loosing tremendous amounts of blood going in & out of menopause and was also having trouble keeping food down. It was to the point we were thinking I had MS or an unlabeled autoimmune something. I started to see a holistic Dr. I tested positive for celiac as well as MTHFR, both were game changers for everything. Had any of my Dr.'s bothered with this very simple and inexpensive test... Three years of crippling pain could have been avoided. As I started to improve, I still could not alleviate the neuropathy and auto immune symptoms entirely and I struggled begining to think "the new you" they talk about with bc was going to be living my life like this...I didn't know what else to do, I was gluten free, sugar free (minus fruit), low estrogen and inflamatory, non preservative, juicing organic diet. I did very simple yoga at home, walked 3 -10 minute walks a day, did mindfulness, took tumeric and supplements and prayed alot... I was at my wits end.....Then one of my implants began to slip under my arm, the other also had slipped some as well... I started to experience neuropathy down my arms at this point. I had my implants out, again losing three days of memory.... But I also woke up crying that Saturday morning in bed... My husband came running asking what was wrong... I was crying because i had woken up pain free and was so happy for the first time in three years, i could step on the floor in the morning and it not hurt, i had energy and was actually laughing and happy and excited to see my friends... I had not realized what a shut in I had become. I'm a type A event planner-- so being alone in so much pain was not normal. I can not tell you the dramatic night and day difference in my body having my implants out made. I wonder how many other women suffer like this as I did. Technically, I'm not allergic to saline or silicone... However my body was attacking itself 24/7.....and i still deal with and probably always will some autoimmune issues and challenges but not to the extent pre implants out.. So I went back to my surgeon and three years later we now decided the Brava system was for me. I just completed my first round and am so pleased with the results, my breasts are now soft and warm and I'm starting to get sensation back as well. I had a very aggressive BC so my chest wall had been scraped so to have these results is amazing. I even have one nipple that now functions! And I think it is amazing that through all of these many surgeries... I still just have one inch and half hard to see scar under each breast. It really is difficult to tell I even had a double mastectomy! This last surgery went great, along with this MTHFR ( which 1/2 to 1/3 of everyone has) is my doing research and having a consult with anesthesia. With MTHFR you can not tolerate Certain anesthesia and verdat as it depletes your B vitamins and then interferes with your methylation process -- therefore the memory lost etc in past. This time we switched the anesthesia and I woke up very clear headed, happy and alert.. Had no idea that was how it was suppose to feel. There was zero memory issues. This is an extremely long post but one I hope can maybe shed light on or help someone else ... Even if some Dr's read this and started testing for MTHFR... It's a simple methylation issue that requires metholated B vitamins but that methylation process has such far reaching consequences. And I'm happy to explain mthfr in another post. I'm also glad to continue to post about my Brava journey. I do like that my surgeon uses a wound vac after two weeks with the brava provided box to get better suction/results. Also, I would strongly urge anyone doing Brava to research for themselves the three products the include with your domes--- they contain known carcinogens and toxins that are banned in the EU, Canada, Australia and Japan. The lotion which you use bc your skin is irratated actually contains an ingrediant that is banned by the FDA as it is a direct causative agent causing liver toxicity in burn patients and is banned for any use on irratated or damaged skin... As a bc survivor with a chance for a fresh start with fresh tissue... I personally don't want to start that journey knowingly putting carcinogens on my skin.... Thank you for bearing with me on this long post. If I can ever be of help or answer questions or visit with you regarding any of the above, please let me know, it's only by sharing the stories that we are all able to heal and thrive as our beautiful selves we are meant to be! Xo jennifer Updated on 25 Feb 2015: You look fabulous and congratulations!! I'm 47 and 11 days out from walking an almost identical journey...your story just brought tears to my eyes. I sadly went down this BC road with about a dozen close friends.. I was more "in the know" and caught up on gossip by going to chemo than I've ever been before-- sadly. Afterwards my friends recovered quickly and they all looked great and were thrilled with their new look and implants and I just could not get there. My implants looked fabulous, but I just was so unhappy. Besides facing crippling autoimmune issues -unknown at the time partly from my implants- on an emotional level, I hated my implants, they never felt like me, they were cold, hard and uncomfortable ( and they were technically soft my surgeon had done a beautiful job) I personally just hated them, my husband was uncomfortable too. I love to dress sexy and sassy and low cut and scoop neck dresses and T's are looks I love, by I also faced the same initial discussions with plastic and oncology surgeons three years ago, all claiming I would regret being 43 and doing nothing or this "brava" and natural fat graphs I kept reading about.. I pass no judgements on my girlfriends with implants... They do look amazing and Everyone needs their happy hat... Mine just aligns with yours... I even loved my look and feel with even just the implants out before the surgery.. It was the best sex and most intamcy my husband and I had shared since BC, because one I was finally pain free, but mostly because I finally felt like "me".I was comfortable in my own skin.. I'm so happy with this fat transfer... Your right.. No pain to my breasts at all, lipo .. Well it is what it is. Thank you for sharing!! Cheers to our sexy happy au natural selves! Xo, jennifer Updated on 1 Mar 2015: Hi! Well wasn't expecting to walk in and have 166 cc's of blood drained from left breast. It was actually the breast I liked best because of the lift. I truly thought hardness was just normal as half my body has hard lumps etc. This was also side were my cancer was and there was a lot of scar tissue especially in my nipple that had been scraped as well on that side and I wanted it to be worked on with new fat in hopes of getting as much "normalness" and potentially hopefully maybe even some feeling or function back eventually. Breast was def. Instantly softer once drained and now matches other side much better. I did know going in this would be a 2-3 step process so I'm still very happy. Updated on 1 Mar 2015: So just over 15, 16 days and weight starting to slowly come off. As we've come to discover the hard way I tend to be "special" and "unique" in the way my body reacts to procedures. Dr N did take most of the fat from my lower back and hips. I was very surprised- hoping for my stomach and thighs. However , Dr N has a certain method and I trust him entirely, but he chooses where the fat will come from and the order (over the 2-3 times) it comes from as well in order to get best results- especially for double mastectomy patients . Fat has a different composite/ viability factor in different places. All fat is not the same-- who knew? I was shocked and miserable the first few days as I went from 150 to 185! The Bruising I expected, I did use Liquid Magnesium Oil, which my Dr. Was not familiar with using and my bruising was gone within 48 hours! I discovered Magnesium oil / gel for neuropathy in my feet. I purchase at Whole Foods, $20 bottle and it's fabulous for relieving pain, bruising, swelling... However, I still am not able to lay on my sides. My hips have multiple knots, I try and massage, but still can not sleep on my side. The worst is my back. I have had back surgery & multiple procedures & deal w chronic low back pain (L3,4,5, S1). But I still need pain medication daily to function and have to lay down at night very carefully- there is one spot that sends me out of roof - I can't see straight... There is a lot of swelling and numbness... I'm walking, stretching, massaging.... Is this normal? Are y'all all still this sore too? Thanks!! Jennifer Updated on 1 Mar 2015: Throughout this three journey and multiple surgeries- one of the things I truly appreciate is Dr N's effort to minimize my breast scars. Below is the picture of the only scars I have- one underneath each breast- period. Side Note: i also had a female oncology surgeon who made a vertical vs horizontal incision/ scar for my port. She actually marks where your bra strap would be so that this scar can be hidden going forward by halter or sundress straps, tank tops going forward. I didn't realize this was not standard... Just one of those small acts of kindness that means so much... So please pass on if you know someone going forward.. Just nice to be able to dress freely and remove that question about your scar there off the table! Xo jennifer

Dr. Namnoun beside manner was great, outcome not so great. Telling me I was beautiful didn’t help the year of pain I have been through and it continues. He did a lip lift and another surgeon in office completed a nose tweak to the dent in my nose. He also did a lower face lift to fix where my chin has skin hanging in an odd spot (no change l, exactly as it was, just more scar tissue) he also inserted fat to face. This fat is almost completely gone as well. Within months of operation my septum between nostril was collapsing and the other surgeon went in and sewed many stitches to get my nose to be as straight as possible. The aftermath was more pain and infections from those stitches. Since then, I have learned from several sources that these two items (nose tweak and lip lift) should never be done together unless highly trained and that is up for debate. Also there is no such thing as a tweak, a full nose job is what you need with someone who has a twisted cartilage between nostrils. The one thing that stands out is Dr Namnoun stated the other surgeoon redid how he attached the lip lift, but oh well. I wonder if that oh well has caused me all this pain still to this day looking for anything to get help get back to me. It’s been a long hard journey and taken this long to even put this on a review. I have since received a complete nose revision by another surgeon for my face to nook normal. My nose was very distorted after 1st surgery and felt horrible. The new doctor was honest and stated it may or may not help my pain from lip lift. It didn’t, that scar tissue is still there below my nostrils with many adhesions. I am going to dry needling sessions, any kind of pt to stop help this pulling pain. To breakup this scar tissue: It’s been a nightmare since this began 2/23. Lesson learned, be very careful of face and do lots of research on any doctor that touches your face. Ask lots of questions. When I met dr Namnoun I thought he was going to be my go to surgeon for treatments as I age, very sad of what the impact has been to my life socially, physically, and mentally.

I went to see Dr. James Namnoum, MD as an in-person consultation for breast revision. I had complications from a previous breast aug and Dr. Namnoum came into the room and immediately commented that the masks my husband and I were wearing "don't really work that well anyway". Weird way to start a conversation? He proceeded to tell me my situation was very bad (I understand this), and went to put his hand over mine a lot. He called me sweetie and honey a few times, which made me uncomfortable. I left not feeling listened to, and not comfortable. Sorry, Dr. Namnoum. I had a really bad complication but I never was made to feel 'bad', or called sweetie by my other doctor. This is not the doctor for me.