Albert E. Cram, MD

Hi everyone, I first joined Realself in 2014 when I was beginning my quest regarding augmentation. It was absolutely amazing and so helpful to join this site and receive all of the wonderful information from everyone. I underwent breast augmentation in May of last year and it was one of the best decisions I have ever made for myself. My self esteem has received such an incredible boost, I'm so happy I did it and I'm so happy that I joined realself so I could communicate with surgeons and other women on the same quest. I'm posting again because although I am thrilled with the decision I made and had the experience of working with a wonderful surgeon, I'm considering a revision in the future. My augmentation was not as big as I was hoping and it's left a little to be desired, I guess. My doctor said that my body size made it difficult to give me as big as an implant as many women would get, so I only ended up with 213 cc's (silicone high-profile). I guess I'm a little confused because I see other women on this site that are also barely over 5 feet in height and the same weight (105-110 lbs.) and they have received implants that are much over that, usually no less than 300 some cc's. I guess I'm not sure why I ended up with such a small size and it's a little distressing because this was something that I was hoping would be a one-time expense and surgery. My doctor said at my 6 week follow up appointment that I could go bigger next time. For the surgeons out there, without being able to measure or examine me, and just from looking at my pictures, do you think I could undergo a revision and receive a larger implant size? Thank you so much for any input from anyone. And again, I'm so thankful for my experience and for my doctor, I'm just exploring options. Updated on 18 Oct 2015: Hello everyone! I am contemplating a breast augmentation revision. I am unsatisfied with the size implants I ended up with and would like to go larger. I'm trying to figure out exactly what it is that I would like to end up and am looking for some visuals so that I can communicate with my surgeon what it is that I am hoping to achieve. Where do you all go for "wish pics"??? Updated on 18 May 2016: Hello everyone, I'm in the first stages of looking into a revision. I have an appointment next Thursday and I'm looking forward to it. I had no complications with my first augmentation, it all went great but I am very dissatisfied with my size. I feel like now that I've done it once, I know really know what it is that I want and I'm really hoping I can achieve my body goal! I feel kind of greedy at the same time, but I really want to be happy with my body :( I'm once again looking at tons of pictures and reviews and trying to figure out exactly what I want so I can be sure to communicate clearly with the ps. I'm so confused about profiles. I currently have 213 cc's high profile silicone implants. I have no bottom boob, in fact the scars are pretty visible because there is no bottom pole fullness, it's all on top. What I really want is that bottom pole fullness, I want breasts that have a heaviness and that are full on bottom. I don't want boobs that look like I am always wearing a pushup bra. Does that mean I want moderate profiles? I'm so confused because high and even ultra high profile boobs on some people give lots of lower pole fullness?! I don't understand the profiles. I guess it's something to discuss at my appointment.

My arms have been bad since college, yo-yo dieting/weight gain didn't help but Mom has the same problem. After I lost 65lbs, went from a 22Womens to a 14-16Misses in my clothes but was frustrated that my hard work in body shaping did nothing for the arms. I finally found a wonderful PS who said I was the perfect candidate for the arm lift. 10 weeks later I still have some swelling but I wear the compression garment when I'm home and sleeping. I think the worst is the nerve damage I have in my right arm below the elbow - feels like a huge wad of something under the skin when I rest my arm on a table, don't have it on the left side. My incisions look great, still some redness with the ones armpit down but maybe my bra is just irritating that area a bit. I didn't go into this wanting to go sleeveless, probably still won' but to be able to go shopping and buy a L or XL top/jacket instead of the next size up just so the arms fit is a great feeling (hubby doesn't see the shopping charges, LOL!) I have more tingling going on so I know the nerves will come back. I do have some indentation just above the elbow a bit above the bend in the arm but the PS told me right up front that "mother nature will take her sweet time in making everything perfect, you just have to be patient"...easy for him to say to someone with little patience to begin with :) I think my arms look a little better each week so hoping that by this time next year I can be in a swimsuit at the pool in Vegas having the time of my life! Curious if anyone else has the nerve damage problem too... Updated on 17 Jul 2014: Marked Up Day Before! Updated on 17 Jul 2014: 3 Days Later in Sleeves Updated on 26 Sep 2014: Surgery was 5/1/2014. We took a picture on 3/25 at the consult, 1 month 10 days after 6/11 (brown tank top) and at my final visit on 8/25. Amazing to see the before pictures now... Updated on 2 Dec 2014: So here we are 7 months after surgery and I have some feeling back in my right arm but am noticing some new banding going on and it appears that while the healing was going on and the fat repositioning itself during the last month or so I'm getting fullness at the elbows on both arms. PS (now retired) did tell me I needed to wait a full year before checking in with a new PS on a mini-lipo procedure if I saw that happening . Anyone else having these problems?

Ok, just beginning my journey. I'm doing something just for me, that I've wanted for years. I have my first consultation next week and I have no idea what to expect. I have pictures of what I'd like, but it sounds like the result is mostly dependent on what you already have to work with. I've including pictures of what I have currently and what I'd like to end up with (not necessarily that big) What questions should I ask at my visit and what can I expect? Thank you so much for your input! Updated on 20 May 2014: Ok, surgery scheduled for Friday, May 30th. Going for silicone, submuscular, inframammary incision, between 213-265 cc's. I'm so excited! And nervous! Updated on 23 May 2014: One week until my procedure. Aaahh, the time is going so slowly! I can hardly sleep at night and my work days just crawl by. If anybody has any suggestions on how to magically make time go by faster, I'm all ears :) I went to the store yesterday to try to stock up on things I might need. For food; Gatorade, instant rice, soup, jello, canned peaches and a couple of bland frozen meals. I bought a body pillow and a couple of other pillows to prop me up for sleeping. Extra Ibuprofen. I made sure that I had some comfortable clothes that will be easy to put on. I tried to find a bra that clasps in the front, as others had suggested, but I couldn't find any. Not sure where to get those. Is there anything I am missing that others found helpful?? Updated on 24 May 2014: So, I'm going with silicone, high profile and between 213-265 cc's. I'm not quite 5'2" and usually between 100-105 pounds with a small frame. I've always felt "gangly" even though I'm not tall, just skinny and flat chested. I wear a 32" A cup, which is still definitely too big for me, or the smallest size little girl bras at Target, just to give you an idea of my body size. That number of cc's just sounds really small to me. I don't want to be too big and look really artificial and I definitely don't want balloons on my chest, but it seems like everyone else is getting close to or more than 300 cc's. What do you think, does that sound like a really small amount or do you think that's what my surgeon recommended by my frame? Updated on 29 May 2014: Holy cow, in less than 8 hours I'll be in surgery. I need to go to bed but I can't sleep!! Nerves suddenly kicked in yesterday afternoon. Now I can't believe I'm actually doing this. I'm excited and terrified at the same time! Here's a couple pictures of my bikini top. Can't wait to put this back on when I have real boobs!! Wish me luck :) Updated on 31 May 2014: Whew, had my surgery yesterday. I was the first one scheduled so everything seems like it went by really fast. Lots of people coming in and out, asking questions, taking blood pressure, starting the iv, putting on the pressure stockings and then wheeling me into the surgery suite. The nurses and anesthesiologist were very kind and lighthearted, joking around with me which kept me distracted. I don't even remember falling asleep, we were talking about tattoos and then the next thing I know, they are saying my name and telling me it's time to wake up. I will not lie, I've been in terrible pain and nauseated since yesterday, my family does not react well to general anesthesia. I know that some people can bounce back easily, and others have a much harder time. Finally able to eat something this morning and can sit up, walk around without feeling like I need to stagger into the bathroom to throw up :( Nausea aside, the pain from the breasts themselves is tolerable and while it's a very intense, incessant pain, I would rather deal with that and take Ibuprofen rather than take the narcotic pain killer that hurts my stomach. So, just being honest that it's been hard, but it'll take some time and I just have to be patient. On the upside, I have BOOBS! Wow! They are hard, tight and high right now, achy and bruised, but I can't wait until they start to drop and look and feel more natural. While I was waking up the doctors and the nurses told my mom that the procedure went well and they are very pleased with the result. So, we'll see! Updated on 1 Jun 2014: Today has been much better, no more nausea and the pain has lessened slightly. My appetite is back and I can get a little more comfortable when I lie down. I have my post op checkup tomorrow morning, so I'm looking forward to that. The chest band is really annoying, hopefully won't have to wear it too much longer! Updated on 1 Jun 2014: Here area a couple of pictures without the dreaded band. Super bloated and of course, I have many more weeks before I know what they will really end up looking like, but so far, I'm liking what I see! My doctor has been doing breast augmentations for decades and is retiring at the end of the summer, so I'm really fortunate I was able to get in with him. I think he's fairly conservative, but I'm okay with that because he knows what proportions will look attractive and is very into a "natural" look for his patients. I never wanted to look really big, and going any bigger would have looked unnatural on me. During the surgery he tried on a size larger and both he and the nurses agreed that they looked too big and unnatural so he went with the smaller size. So, here is an example of a "smaller" breast augmentation on a very small frame. I found out that I'm not even the size I thought I was, I'm 5'1 and 99 pounds. I received 213 cc's Allergan Natrelle Silicone-filled breast implants, high profile. And I'm a proud new member of the "Under 300 Club"!! Updated on 14 Jun 2014: Officially 2 weeks post op and I'm so happy! The first 3 days were rough but after that it has gone really well. I have very little pain left and it's amazing how quickly things have changed. The swelling has almost disappeared, they've dropped considerably and have become a little squishy and even have a little bounce to them! I've literally spent hours trying on bras, which has been fun and frustrating at the same time. In most brands I fit most comfortably in a C cup but a B in others. There is definitely no consistency between brands and it's true that bras are not made for augmented breasts. The back part tends to crawl up on my back, which is annoying. Even though I've been trying stuff on, I'm reluctant to buy anything yet because I'm sure there are still some changes that will happen. I have a couple of soft cup bras I have been wearing daily and even in those, I love the shape that I have. I feel SO much more proportionate and even though I received a relatively small augmentation compared to what most women in the US get, I've gone from an AA to a B and even C cup! I bought a couple of bikinis and it is so exciting to be able to look at every style and feel like I could buy that and look good in it. I've never felt comfortable in a bikini before. I'm so happy I did this, it's been an amazing experience. Updated on 24 Sep 2014: So, it's been almost exactly 4 months since my procedure. So many changes! I just first want to say that making the decision to undergo breast augmentation was one of the best choices I have ever made for myself. My self confidence has grown so much and I'm so happy I went through with it. I said before that it was something that I was doing for myself, and it was. It's made me very happy. Well, the surgery itself wasn't really so bad, but maybe it's easy to say that months after the immediate pain has gone away! Really, it was about 3-5 days of kind of serious pain and after that it was a few weeks of more moderate soreness. Until the past month I had pain when I would lie down and change position, reach for something while lying down or when standing up from laying in bed. It wasn't serious, just painful enough to make me modify the way that I moved around in bed. I don't have pain anymore, but I will say that I don't sleep the same! It's not comfortable to lie on my stomach anymore, which used to be my favorite sleeping position. Oh well, I've adjusted to sleeping on my side and laying on a pillow just fine. Maybe someday I'll be able to go back to my stomach. Oh well, it's not a big deal! The shape of my breasts has changed so much in the past few months. The first month or so they were really hard and high up but they dropped down and are now squishy and I think really natural looking. I went with high profile because they are indicated for small women with narrow chests. High profile allows more volume to be implanted than would be possible with moderate profile for a small chest cavity. I was afraid they would look really, well, high! But my doctor is amazing and the way that he did the surgery they dropped down and sit in a very natural position in my body. I have 213 cc's (silicone gel) and this sounds like a really small implant, but on my body I don't think they look small! I feel very proportionate and busty :) I am thin and (sometimes) a little athletic so I didn't want implants that looked pasted on to my body. I just wanted to have breasts and to look natural and proportionate. I think my doctor achieved that look for me. What do you think? Other girls gave advice not to rush out and buy bras prematurely and this is true!! It was too hard though, and I didn't heed their advice. I was too excited to buy real bras and have since ended up with a variety of bra types and sizes, lol! I've been wearing 34C, but sometimes they seem too small and I look a little squished-in. I'm actually bra band size 32 but good luck finding that band size anywhere other than Victoria's Secret. After a couple of months of wearing 34C bras that are often a little ill-fitted I went to VS to get measured. Da-da-da-da, cue drum roll, 32D with 213 cc silicone implants. Although cup size really is arbitrary because it's inconsistent between bra makers, it still made me feel good that even though I got a relatively "small" implant I achieved such a dramatic difference from where I came from. 4 months ago a VS 32A bra was too big. Wow. I am very pleased. I love the way that I look at clothing now, because I feel so uninhibited. I feel like I could wear anything and look good in it. I don't feel like I'm lacking something, or that shirts or dresses make me look totally flat. I don't have much cleavage because my breasts are naturally set pretty far apart, but that's just my anatomy. They look great, they're are so full, round and perky! And I can wear a bikini now and feel great! I would recommend augmentation to anyone considering it, as long as it is something you are doing for your own self confidence and not for anyone else. And now I love to talk about it, too! Anyone can feel free to ask me any questions, if they like :) Here are some pictures! *I have a large tattoo on my arm that I've tried to blur out due to wanting to remain anonymous for personal reasons, so that's why my arm looks kind of funny :-p Updated on 24 Sep 2014: Ok, some sort of computer malfunction (or just plain user-error) so here are the other pictures I wanted to post. Updated on 30 May 2016: I had an appointment with a nurse and Dr. Kahlil Andrews of Physicians Clinic of Iowa last week. It was to discuss breast augmentation revision to exchange my current implants with a larger size. The appointment was great, almost 1 and a half hours which I wasn't expecting! The nurse, Katie, was very nice and listened to everything I had to say. I felt like she totally got was I was trying to express and I have to say, it was actually really nice to meet with a woman to talk about all of this stuff. I don't know why, it just was. Katie is a former patient of Dr. Andrews and was so happy with his work that she came to work with him. So, here are my stats: I'm not quite 5'2", I weigh about 115 currently, my breast width is 12 cm and I currently have 213 cc high profile silicone implants. I really think I'd like 400 cc implants, which Dr. Andrews said would be a very large implant on me, but the decision is up to me. I'm not in any hurry and I haven't scheduled anything further but I just have a lot to think about. The look I really like, all the profiles that I see that I'm like, I want to look like that, they all have about 400 cc's. I wish there was a way to "try on" boobs beforehand. I did make rice sizers and I love the way they look under a shirt. Any advice anyone? Updated on 31 May 2016: Ok, I apologize for the blurriness on my arm and stomach but I have some large tattoos that I've tried to blur out. It looks a little funny. I'm also in horrible shape currently and I'm extremely fair skinned so you may want to wear sunglasses to look at these photos, lol!! This is me currently with 213 cc's high profile. I took pictures at the doctor's office with the 400 cc sizers and also with the homemade rice sizers at home. I love the way they look so much better! I am very short but I have a big booty that sticks out and I felt like the 400's balanced me out a little.