29 Years Old, No Kids - Much Needed Breast Revision - Bal Harbour, FL

Sort by:
*Treatment results may vary

Hi everyone! This website has been so helpful to...

Hi everyone!

This website has been so helpful to me during my BA journey. I wanted to also share my experience and give back to the community. I had my primary breast augmentation done a while ago. Though I went to one of the best doctors available in the country I was working in at the time (Seoul, South Korea, the Land of Plastic Surgery lol) - I experienced bottoming out and lateral displacement shortly after surgery. At the time we didn't know what happened, if it was from me healing poorly or from surgeon error. I was told to keep wearing my surgical bra 24/7 for 3 months to prevent it from getting worse. It helped at first, but unfortunately it got worse over time and I needed a revision since the dreaded double bubble was forming...

I have relocated back to the US at the beginning of this year and I started researching on surgeons. I have spoken to a lot of surgeons and I narrowed it down to Dr. Krau and Dr. Revis in Florida, Dr. Ciaravino in Houston, Dr. Pousti in San Diego and Dr. Pfeifer in New York City.

Since I currently live New York, I was inclined to go with Dr. Pfeifer for convenience and she has an excellent reputation for revising difficult cases but after reviewing a lot of her before and after photos, I am not sure if we have the same sense of aesthetics. Her results seems to be more natural looking while I am hoping for a lot of upper pole fullness :)

All of the other surgeons also have excellent reputations and have lots of experience with revisions as well and seems to do the high and full look that I love but I am not sure if their methodology would work for me. I have consulted with all of them through email and phone calls. I am very athletic and Dr. Revis, Dr. Ciaravino and Dr. Pousti wanted to use permanent sutures to do an "internal bra" to hold the implants in place and keep it from bottoming out/laterally displacing. It gets attached to the rib muscles and I've read some mixed reviews on that technique. It works amazing for a lot of ladies and they never had a problem afterwards, but for some they experience pain and discomfort - like an annoying nagging pain in their ribs that won't go away. Speaking to some ladies on a forum, some of them have ripped internal stitches as well doing upper body activity. Also, the idea that stitches holding me together forever doesn't sit well with me as well. But I am no doctor, this is just a personal preference of mine.

When I spoke with Dr. Krau - he said he prefers to use a thermal capsulorrhaphy technique. When heat is applied, the implant pocket will shrink up without the need for internal sutures. He mentioned that using internal sutures for fixing an implant pocket is like stitching your ear lobe to the back of your head. Yes, it will hold and sometimes it will hold forever but you are stitching two smooth surfaces together and they won't bond and form scar tissue so it will naturally fuse together in the long run. He was also the only surgeon that pointed out I had lateral displacement from the photos I've sent for the email consultations. He also perfers to use GalaFLEX as the ADM material instead of Strattice. Strattice has been around for a long time and is proven to be reliable but you need drains afterwards for the fluid buildup. Also the mesh in the GalaFLEX is also more porous so it encourages both collagen and capillary formation so when it dissolves after 1 year - 1 1/2 years, so you have strong scar tissue to hold up the implants after the mesh dissolves since it's made from a similar material as dissolvable stitches.

After much consideration I decided to go with Dr. Krau for my revision.

Deciding on a Surgeon and Preparing to travel to Dr. Krau

When I came back to the US, I was very excited since we have great surgeons here and breast augmentations are very common so most surgeons have a lot of experience. But I quickly learned that revisions are much more complicated than a primary BA. Unless you are going back to your original surgeon for a revision, it is a surprise for the new surgeon when they perform the revision. Different surgeons have different techniques. For the revision have to figure out if it's a problem was caused by surgeon error, poor healing or trauma. How the implants changed skin tightness, stretched the ligaments (yes breasts have ligaments too - who knew!), and amount of breast tissue coverage will also be a factor as well.

I consulted with some surgeons in the NY/Tri-State area and wasn't very impressed by the before and after photos or the surgeon's experience with revisions. So I started researching more on surgeons have lots of experience with revisions and managed to get a short list of a few who had very good reputations. I rather travel in hopes of having a successful revision. Since I have spoken to quite a few ladies who needed more revisions than anticipated due to picking a surgeon that projected confidence but delivered poor results.

So during my consultations with surgeons around the country hoping to find the best one for my case, I have reached out to Dr. Krau's office via email with photos and LOTS of questions and after a few hours, Cristina his office manager got back to me after she discussed with Dr. Krau. After reviewing his assessment and answers - I had more questions and reached out again via email. I got a reply from Cristina saying that Dr. Krau would like to speak with me directly and provided a number to reach him directly.

During our conversation, he said that I am bottoming out on both sides, worse on the left than the right, since a double bubble was forming on the left side. I was laterally displacing on the left side, and he pointed out that he sees there is more muscle attachment to my sternum since I had sort of a flat spot there, so due to that muscle not being released properly - it is forcing the implant to go laterally, hence the displacement. For my right side, my first surgeon didn't release my lateral side enough - so my implant was shifted over my midline and my nipple looked off center. On top of that, both my IMF scars are hypertrophic, which can be caused by the inplant weight from bottoming out sitting on the incision. So his game plan was to do thermal capsulorrhaphy, with 1 piece of GalaFLEX on each side to support my implants and to fix the lateral displacement and midline displacement. Jeez... if I didn't have lateral displacement on my left side, there was a good chance I could have have developed symmastia. Plus he will need to open up my implant pockets up higher so the implants have space to move up to and he will use my existing IMF incision to do the revision.

After speaking with him on the phone, I had a very strong feeling that he would be the surgeon I will pick for my revision. He was very detailed in his explanations and never talked down to me or felt annoyed that I wanted to know everything that needed to be done and I can be long winded...

After doing some more research and consulting with the other surgeons again, I decided to go with Dr. Krau and placed my deposit for surgery in April of 2016 and set my surgery date for September 29, 2016! Working with Cristina is great, she setup my pre-op appointment to meet with Dr. Krau on September 28th, emailed me all of the instructions for pre-op, and a request for blood work that needs to be done within a 30 day time frame prior to the surgery.

My total for revision was $8000, it included everything from the surgeon's fee, implant exchange, anesthesiologist fee and 2 pieces of GalaFLEX. Compared to the other surgeons, his fee wasn't the cheapest quote I got - Dr. Ciaravino quoted me less with no ADM material, but both Dr. Pousti and Dr. Revis wanted more for the revision - and their quotes do not include any ADM material like GalaFLEX, Strattice, or Seri Mesh either. I picked Dr. Krau based on gut feeling and his technique mentioned.

Since I was also traveling from out of town by myself, I needed to hire a nurse to be with me at all times during the first 24 hours and they were very helpful in recommending someone that can help me. She normally works with an agency that specializes in post-op patient care so she has lots of experience and it was much more reasonable to work with her directly than through her agency.

I booked a hotel in the mid-beach area (The Edition Miami) and was planning to use Uber/Lyft to travel back and forth. That worked out great! They usually recommend a few hotels that are reasonably priced and close by to their office for out of town paitents, but I wanted to enjoy Miami Beach as much as I can while I'm there. Being able to sit under an umbrella on a beach watching the waves calmly rolling in with someone constantly attending to your needs was the best thing for recovery.

So with the date set, and trip planned - all there was left to do was wait until it was time to travel.

Adding some Pre-Op Photos

Wow looking at the pictures was difficult. Both boobs were so low, double bubble was forming and everything was as lopsided.

Some pictures 4 days post op

Since I had to leave for home, these were taken 4 days post-op

Traveling to Dr. Krau - Pre Op Appointment

I travel to Miami on September 28th, arrived in the late morning and checked into my hotel to drop off my luggage. Thankfully my room was almost ready so I was able to have a quick meal, drop my luggage off, took a quick shower then it was off to Dr. Krau's office I go.

During the pre-op appointment, I finally got to meet with everyone in person. I left like I knew them already since we've been corresponding by phone calls and emails for so long. They are such a lovely group of ladies. After filling out all of the paperwork, I was asked to go to the waiting room shortly after and I was speaking with Sonia whom is the recovery nurse and we were going to take my pre-op pictures when Dr. Krau walked in.

Meeting with Dr. Krau was great, he reassessed everything and gave me his opinion on what we should do. I wanted to stay at the same size with the same profile and he had no problem with that. I wanted to go smaller with my left implant since that is naturally my bigger breast - but he said that the difference is very minor, all breasts have minor asymmetry and different sized implants are usually helpful for patients with rib cages that are more recessed on one side than patients with minor breast tissue asymmetry. Since I was bottoming out more on my left breast, it can also make it feel like it's bigger since it's stretching out the lower pole more than the right one. I trusted his judgement and... he wasn't wrong.

He also said that in order to fix my bottoming out - he needed to do a periareolar incision instead of reusing my IMF. The tissues are already compromised and he does not want to thin it out further. Plus he would also have better access to my entire implant pocket with periareolar incision. Though I was terrified as hell at the idea of my nipples being cut at all - I also wanted to have the best results so I agreed to do so. Since my IMF scars were hypertrophic, he was going to do a scar revision for during my surgery. Even though he is going through a different incision now, he still wanted to revise my IMF scar instead of telling me to get kenacort injections and laser treatment for the hyper pigmentation, so he will add an extra step at no charge and do a surgical revision anyway.

After speaking with Dr. Krau and he answered allllllll of my many many many questions, he left me and Sonia to finish up with taking the Pre-Op photos and then I also met with Nora his RN to go through the post op instructions, medications, and she gave me a run down of what to expect for my surgery date.

Afterwards, they gave me a folder with all of the instructions printed out, along with Dr. Krau and Nora's mobile numbers in case I need to reach them for anything. Then it was off to fill my prescriptions and eat and drink as much as I possibly can before midnight since surgery was set for 3:30pm tomorrow, and to come to the office by 2:30pm to get prepped. Dr. Krau sets his surgery schedule the day before and I was the last surgery for the day.

Surgery Day

So after much planning and prepping, the day is here! Since my surgery time was late afternoon, I tried to stay asleep for as long as possible - so of course I woke up at 6am full of nerves...

Did some light reading, then took a walk on the beach which I quickly regret because it was so damn hot and I couldn't drink any water. Went back to my hotel room to watch TV and try to forget about how hungry and thirsty I was until about 1:00pm. I gave Dr. Krau's office a call at 1:30pm to see if they were running on time - they were, so I took a shower with antibacterial soap as instructed, put on my front zip dress, packed a pair of swear pants and hopped into a cab to Dr. Krau's office.

When I arrived I was given more paperwork to fill out, and I had to take a pregnancy test also. After I was finished, I was brought into a waiting room and Sonia was there to help me get into my paper gown and I put my sweatpants on too. Alexandra asked me if I wanted a blanket and she brought me a warm one that was nice and toasty. Dr. Krau then came in and we had a quick chat again about what he is planning to do during surgery. I told him he better hurry up because I am about to die from dehydration, I'm sooo dehydrated my facial fillers are shrinking. He laughed and said if I am dehydrated, the fillers will still be more pronounced since the rest of me will shrink as well. :P

He then asked me to stand next to the wall so he can mark me up. I got really nervous at that point since this is it - he started talking to me and said that he usually doesn't mark up a lot of areas, most what needs to be done is already in his head. Asked me about things back home to keep me talking and not focused on him marking me up for surgery.

After he was done, he said he will see me soon and after waiting for a little while - Nora came in and asked me if I had any more questions and went over the medication/post op instructions 1 more time. She then told me that they will call my nurse Olga who will be taking care of me for the next 24 hours after my surgery when I am about finished so she will be there when I wake up and that Seng the anesthesiologist will be in shortly. I met with Seng who is great, he is very talkative, which is exactly what I needed to keep me from running away. He asked me my entire health history again, told me what to expect from GA, and after we were finished, Nora came in and said the operating room is ready.

We walked over to the operating room and after I laid down on the table, Seng started my IV. He said that he will be there with me the entire time, and when surgery is finished he will stop the sedation and I should wake up in 5 minutes after he stops. He won't be using any sort of intubation down my throat, he uses facial mask instead so I won't have a sore throat when I wake up. I told him to be careful with my nose since I also had that done in Korea and I don't need any more revisions and he laughed. After he put something in my IV, I noticed a bit of a burning sensation. He said he will be starting my happy hour now, and that I would like it and injected more stuff into my IV tubing. I remember looking at the IV in my arm , and then at him, then back at my IV - saying ohhh yea, I do like this, this is good stuff - then passed out cold.

When I woke up, I was OUT OF IT. The room was spinning, I was dizzy, cold, shaking and nauseous. Even though I was covered in blankets, I still felt like I was FREEEZZIINNGG, which is normal. I remember Sonia saying that I'm ok now, everything went well and I just gave her a thumbs up. Every time she asked if I was ok - I was like I'm ok, thumbs up sign. After a while (I don't even know how long) of resting, Sonia and Olga (nurse who will be taking care of me for the next 24 hours) said it was time for me to go. I tried standing up, but then decided I didn't want to so I laid back down and said no I think I'll stay now. I was so out of it - but they laughed and said ok and I laid down for at least another 30 minutes. By the time I felt ready to go - it was already 9:30pm!!! Wow, I was resting for quite a while... and they were so nice they didn't rush me at all. I thought I was ok walking, until I got nauseous and started dry heaving in their parking lot. Olga was holding me up, while Sonia went to grab a plastic container so I had something to throw up in. When I got into the front seat of Olga's car, the world stopped swimming but for the ride to the hotel I was not very... cognizant of anything. GA is a trip!

When we got to the hotel, I realized I was wearing my sweatpants and my front zip dress over it, with my surgical bra and strap peeking out from the armholes. It's a very trendy look. Once we got back to my hotel room, Olga gave me my medication and asked if I wanted anything to eat. I thought chicken soup and peppermint tea was a good idea. It was just what I needed, a little bit of food and fluids. I liked the peppermint tea so much I called room service for 6 more - they must have thought I was nuts.

After a combination of pain killer, muscle relaxer and Ambien - I was able finally to sleep. Woke up the next morning and I was hungry, but had no appetite so I had a small breakfast. Then we had to go to Dr. Krau's office at 10:30am for my first follow up appointment. When we arrived, we waited for a short while and chatted with some people in the waiting room. They can't believe I just had surgery last night since I looked so pain free.

I wasn't really in pain after surgery, I was more tight and stiff than in pain. It was very different compared to my first surgery. I remember being in a lot more pain in general the first time around and it took 3 weeks before I was comfortable doing things like opening doors. For my revision, certain areas of my breasts hurts more, like really really tender and it is all of the areas that Dr. Krau said he will be reinforcing - but I wasn't in as much general pain and I was not supposed to touch those areas yet anyway. I was able to recover a lot faster from my revision than my initial surgery. The only times it really hurts was when I wake up and I go from laying to sitting up. I can feel the implants move with gravity on to the reinforced bottomed out area in my lower poles. That. Really. Hurts.

When it was our turn, we met with Nora who checked everything. I got to take off my surgical bra and look at everything for the first time. I was amazed that there was no real bruising, just some faint yellowish marks. It felt so nice to have breast creases again. I was told I can shower with antibacterial soap, and to pat the tape dry before I put my surgical bra back on. After they gave me another surgical bra and my implant warranty cards, I was told I will need to come back in three days - before I head back to NYC so I can meet with Dr. Krau again.

Almost 2 months post op!

Wow time just flew by, I can't believe it's been almost 2 months. My recovery is going well for the most part, I am so very pleased with my results. The difference is day and night.

Dr. Krau and his staff are amazing to work with, I had a spitting stitch on my left peri-areola incision two weeks after my surgery when I removed the surgical tape. I was able to text Nora and she responded with instructions on how to take care of t in less than 5 minutes even on a Saturday. I had spitting stitches for my previous surgery as well, but it's much scarier for me for my peri-areola incision since scarring there is harder to treat. Thankfully it closed right up in about a week, phew!

The girls are still settling but I can already tell they are going to be great when they are fully healed.

Some more pics

How I am feeling

Hi everyone!

I am officially 2 months post op today! I just wanted to give an update on how I am feeling. Normally on a day to day basis, if I didn't know I had a revision just 2 months ago I wouldn't even be able to tell.

I have full mobility for my upper body. I am able to go to the gym, but not doing any direct chest work like push ups, focusing mostly on working out my legs. I will wait until later on when I feel ready. I am not in any pain or discomfort. No sore spots or feeling like anything is tugging on my chest/rib area. I can't even tell there is GalaFLEX installed - cannot even feel it, my breasts are softening up nicely.

So far so good!

3 Month Post Op - Update

Hi everyone!

Wow I can't believe it's been 3 months since I had my revision. So far things are healing but I am having some complications during the healing process. When Dr. Krau did my revision, he had to open my implant pockets up high so my implants had somewhere to go since they were both so bottomed out. Since it's an all or nothing maneuver as Dr. Krau described it, he had to open it all the way up. I woke up with a compression strap on from my surgery not so they can push the implants down, but it's to keep the upper poles compressed so they can heal and seal up properly.

My right side sealed up just fine after a month, had no issues with it what so ever. Lefty on the other hand - upper pole never sealed up properly. When I reached out to Dr. Krau about 3 weeks post op - I was told absolutely no laying down without my strap and to wear it as close to 24/7 as possible so the capsule can seal up. I even bought a surgical bra with a built in compression strap so I can be strapped in at all time, and sleeping with it on for the last 2 months + and still no improvement so far.

Now I notice my midline looks off center... Reached out to Dr. Krau's office to see what he says.

My goodness... I'm so done with Lefty. It had the same operations as Righty yet it never heals as well.

More pics

Whoops for some reason these didn't attach.

Heard back from Dr. Krau!

So Dr. Krau reviewed my photos and concerns and said that he can definitely close up the pocket, but wants me to wait a year. He will only be charging me for OR and anesthesiologist fee. If I need more GalaFLEX it will be additional as well but they won't be charging me a surgeons fee. That is extremely fair in my opinion.

He did the same operation on both breasts, I don't know why my left breast never heals as well as my right breast. I took care of them both breasts the same too. Even for my primary surgery my left breast was the one with more complications.

So I will hope for a miracle and that the implant pocket will seal up on it's own. If not I am very happy I am working with an ethical surgeon that won't just abandon me when I have a complication. Will keep this page updated as I progress in my healing. :)
Miami Plastic Surgeon

Amazing doctor, listened to all of my concerns and told me how he planned to address them. He even pointed out things that I never noticed like how my right breast is over my midline and needed to be reinforced. Straight forward and gives you a realistic expectation. Right before surgery I was getting a little nervous and he talked to me about NYC to distract and calm me down as he was drawing on me. Made sure I had his mobile and his nurse's too in case I needed anything. Loved working with him.

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
Was this review helpful? {{ voteCountOthers + ' other' + (voteCountOthers == 1 ? '' : 's') }} found this helpful