My chest ( a AA cup pre surgery) has bothered me pretty much since puberty. - Breast Augmentation with Fat Transfer - Boston, MA

About 5 months ago I started looking into getting a breast augmentation. My chest ( a AA cup pre surgery) Has bothered me pretty much since puberty. I am a very athletic person, so having a small chest isn't what bother me the most, it was how misshapen my breasts were (next to no breast tissue below the areola, extremely puffy aureolas when not stimulated). I have always had to wear padded bras just to hide my hideous nipple/areola area. I had heard of fat transfer to the breasts for augmentation prior to my breast augmentation surgeon search, but did not find enough information on it to be seeking out this procedure. After my initial consult with a plastic surgeon in Boston he suggested I consider fat transfer vs. implants (this may be partly because I was not looking for a "large chest", honestly I would be happy with the "before" breasts of a lot of his patients). He told me I had tubular or constricted breasts (an actual deformity) which is why what limited breast tissue i have is either located in my herniated (puffy) areola and in the upper pole of breast. After learning more about this option and realizing that I had 0 interest in having implants in my body, I took a few months to consider if I actually wanted to go through with the procedure. In the interim, I did some research into the procedure and its clinical efficacy. I primarily looked into its affects on mammography screening, the loss of fat after the procedure, and breast cancer risks. What I found was nothing to deter me from the procedure (my surgeon has actually been published extensively on fat transfer to the breasts, which helped put me at ease that I was in good hands). So in February I decided to go for it. For my particular surgeon, "going for it" required 3 weeks of tissue expansion with the Brava bra. This was not fun. The brava bra is really 2 large suction domes that you must wear on your chest for a set amount of time (for my surgeon 6 hours on week days, and 7 plus hours on the weekend). This breast expansion is critical to getting the final result you are looking for, especially in patients like who have limited breast tissue. My surgery only cost 9k, the bra cost me 1k. I'll be honest, there were nights where wearing the bra almost brought me to tears. Mostly, not because of discomfort, but because the gosh darn things would lose suction repeatedly, or a tube would come loose. By the day of my surgery my hands were extremely sore from all the hand pumping I had to do. Oh, and I'm pretty sure this is the case with all surgeons who use this device, they want to see you for your pre surgery appointments (weekly in my case to check expansion) with them ON. Meaning you have to take time out of work (or work from home) then drive/take transpiration with them them on, to the Dr's appt. And just an FYI the domes are HUGE. I would wear a puffy coat and hold my bad to my stomach to try and make myself look more proportional, but I don't know if I fooled anyone. Also the day before the surgery I had to wear the bra pretty much all day and then to the surgery facility. If my results come out well (and so far so good) it was all worth it. But I can see that sticking to the expansion plan would be difficult for anyone who had a family or evening obligations. I started a couple days late (bra took forever to get in) and fudged maybe one day on my hours (although I really tried to make up for lost time on other days, like expanding every waking hour on the weekends) and my surgeon was very pleased with my expansion result. As I mentioned, I am pretty thin (5'8, 136) and the Dr was a bit concerned about finding enough fat to get optimal results. He did encourage me to put on some weight prior to surgery (I'm a long distance runner so I pretty much cooled it on the running and ate a bunch of cheeseburgers). He ended up getting fat from my thighs (knee area, inner, outer and saddle bag area) and my flanks. I have no fat on my stomach so he didn't take any from there. I think thighs and stomach are the most desirable areas for fat for this procedure. In order to fix my herniated areola, my surgeon also made a circular incision around my nipple in the outer area of my areola to pull and tighten the areola skin to flatten the area on my new breast mound. The stiching may leave a light scar (in the dark pigmented area) but hey, it is totally worth getting rid of the puffiness. The day of the sugary went fine, it seemed like the nursings and surgical staff were all very pleased with out how got through the procedure and my initial recover. I had general anesthesia and felt typical side affects when I came to. I had a ton of leakage at the hospital and up until bed time that night (12pm or so) from where they performed the liposuction (they used traditional tumescent lipo on me with small cannulas, open drainage). When I got back from the surgery I was pretty numb, I even questioned if did lipo everywhere he said he was going to because I couldn't feel any pain in my flanks, or my inner thighs. I took prescription pain meds as instructed the first day. I pretty much woke up every hour that night (I slept on a chaise lounge chair vs. my bed for most of the night). Friday the soreness kicked in hard core. Probably because my body had finished draining the numbing fluids. Friday was definitely the hardest pain wise, and I pretty much got through it by taking my pain meds regularly and not moving much. After Friday, mobility has improved every day. My breasts looked great after surgery (size wise, I haven't taken the tape off my gauze/stitches around my nipple yet. They marked my breasts with how much CCs they put in in each,280 on the smaller breast and 260 in the larger one. My breasts have swelled since then, and are now I tad too big for my tastes, but that is to be expected. I have puncture marks on my breasts (especially below my areola where they had to deal with the tight tissue) but those are already beginning to fade (I took my first shower last night). Compared to the pain I've read about from others who went with traditional BA, I've really got nothing to complain about. I pretty much had full mobility in my upper body the day after surgery. I've iced my chest on and off to deal with any soreness or discomfort and that has worked just fine. I'm not wearing any sort of bra, and I need to follow-up with the doctor about what is appropriate to wear (as I'm going to try and go back to work tmw or Wed). 90% of the pain/discomfort from the procedure is from liposuction. I am still very stiff, although as of Saturday I could move around my home pretty well. I'm concerned about the swelling, especially in my inner thigh area. I'm wearing compression garments (around my flanks and thigh high compression socks). I'm sure I don't fit into my normal size clothes due to the swelling, and hoping I fit into a couple pair of pants that I have that are a couple sizes bigger. I strongly suggest taking a week off of work afterwards to deal with the post operative swelling. So on day 5 after the procedure, I'm pretty sure it is will all be worth it. My doctor had warned me that I might need a second procedure because of my "constricted breasts" but he called the day after surgery and said he thought one procedure would probably due. I guess I can expect to lose about 15-25% of what I saw right after surgery, but that would still make me a nicely shaped B cup and for me that would be stupendous! Final results for both the lipo and breasts can't really be seemed for 6 months out, but based on what I've been told/read, I should have a relatively good idea of what to expect 4-6 weeks out. Let's hope that is the case, and my work pants fit this week!