Going for shape over size! Anchor Lift with Implant Downsize. Over the muscle. Traveling to Golden, CO

Hi everyone, For the last several weeks I've been...

Hi everyone, For the last several weeks I've been reading reviews in this forum, which have been so helpful. In 4 days I'll be getting on a plane to Colorado for (breast lift with implant exchange) surgery with Dr. Vath, so I figured it was time for me to start a journal to share my experience. My surgery is scheduled for Aug 25, 2016.

The reason I'm traveling is because I want the best surgeon possible for this kind of surgery. From what I've seen (per my extensive research) Dr. Vath's appears to be a master in this type of surgery. It's probably costing me about 25% more after adding all my travel costs in to do the surgery as opposed to staying local. But this is something I only want to have to do one time..., so I feel it's worth the investment. I'm hoping my review will also be helpful for those that have considered traveling for surgery.

I decided to post my review in this forum (i.e. breast lift with implants), because my focus and concerns are more about the breast lift with implants... and not about the implant revision. I've never had problems with my current implants; and were it not for my wanting a breast lift, I would probably not be doing this surgery. The fact is many years ago I had an augmentation when I really should have just had a breast lift.

Specs and History: I'm 5'5" and weight 126lbs. Underneath my breast, I measure about 29 1/2" around. My original size was a 34b / stage 1 ptosis. I'm now a droopy 34DD. I've posted my before pics. I currently have 400cc moderate mentor texured implants over the muscle and plan on downsizing to somewhere between 215 and 255 moderate smooth mentor. Haven't decided on the exact size yet.

The reason I'm downsizing is two-fold. For one, I really never liked being this large. My concern has never been about size, but more about shape. I simply wanted perkier breasts. My previous PS told me that implants would fill me out and give me a lift. I had no idea what size he was going to put in; mind you this was many years ago when we didn't have the Internet and resources like we have nowadays to do research. My current implants did not give me the lift I wanted. They just made me larger and droopy. Secondly, I've been told that going with a reduced size implant will put less weight on the incisions... and this may result in better healing of the incision. I also have a genetic disposition for hypertrophic scars, so I figured I'll do all I can to prevent problems in this area.

I'm also plan on keeping my implants over the muscle because I haven't had any problems with them being overs; and the doctor thinks there's no reason to go under at this point. I look forward to soon having perkier breasts and a more athletic shape!

One other thing: I'll also be having a mini-lift (face) along with this surgery, which is the reason I'm not posting my costs. The two surgeries combined is saving me probably about 10% or more on the costs of having two surgeries individually.

Please move my review to Breast Lift With Implants

To RealSelf staff, The focus of my review is not about mentor implants. Can someone please move my review move back to the "breast lift with implants forum" where I originally posted it. I had even contacted your host Teddiemc prior to posting my review and got her blessing to put it in her forum.

Consultation/s & pre-op appointments

Thought I'd go ahead and share a little about my decision to travel for this surgery... and my preop appointments. Prior to my decision I had consultations with 4 doctors locally. Three of the four had great reputations and I was seriously considering having my surgery done locally.

In the meantime, I kept coming across Dr. Vath's patients results and reviews online. Initially when I first saw his work my thoughts were "I wished that I lived in Denver". I was very impressed with the neatness of his incisions and his post surgical results of his breast lifts aesthetically were very much in line with what I find attractive.

Eventually, I realized that there was no reason I could not travel for this surgery. I decided it would be worth taking the risk of traveling... rather than settling for a surgeon in town that has not demonstrated via any before/afters that he can produce as good of a result. I also know people first hand... and I've read a number of reviews from many that have had this type of surgery and were not please with their results - a number of them paying to have it redone by a different surgeon.

So far, I've been very impressed with the communication from Dr. Vath's clinic. Naturally, appointment so far have been over the phone. They could've been via Skype, but the phone has been a little more convenient for me. I had two very detailed phone appointments with the doctor regarding my needs. I also sent photos in advance for him to review. He was very patient and understanding with all my questions and I never felt rushed. Following these appointments I was sent quotes for the surgery.... along with a surgical package with consent forms. I was also sent a schedule for other appt's: my preop appointment, surgery date, and post-op appointments.

For my pre-op appt, the nurse allotted one hour and 40 minutes of time for me. I felt this was an extremely generous amount of time! She went over all the details of what to expect before the surgery after the surgery, etc, etc. I will also have an in person (office appointment) with the doctor and the nurse 48 hours prior to my surgery.

I plan on arriving in Denver three days before my surgery and staying for a full week after the surgery. Were it not for the fact that I'm having two surgeries (i.e. Breast and face) I would probably not be staying as long. My hubby will also be coming along to help me. He has been so supportive!

I've had a few surgeries in the past. I have to say this clinic has given me more time with their phone appointments than I've had with any in person office appointments in the past. Naturally this has helped to alleviate concerns I've had regarding traveling for surgery. In case I haven't mentioned this will be my first time traveling for surgery. BTW, if anyone has any tips to share regarding traveling for surgery I'm all ears.

One day before surgery! Another before photo

(I just posted before photos again along with a new one of the Side View)

And to continue my story: I arrived in Denver a couple days ago. I decided to arrive in Denver at least three days before the surgery. I figured this would be enough time to cover any possible airline flight cancellations and mishaps. The altitude in Denver is good 5000 ft higher /the air is a lot more arid... than where I live. I figured three days should give me enough time to acclimate to the changes. This is also my first trip to Denver, so it will be nice to have a few days to see the sights before I'm all bandaged up.

Yesterday (Aug 23- 48 hrs before surgery) I had my first in person appt with Dr. Vath and his staff. Everyone was so friendly! And it felt kind of like a reunion of sorts since I had spent so much time on the phone with these people. Dr. Vath is such a warm and caring person; and it was so easy to talk with him in person about my wants, concerns, etc. etc. I also brought along wish photos.

After careful examination he determined that I have plenty of breast tissue. In fact I have more tissue than he'd originally thought when just looking at my photos. Over the phone he thought it would be good idea to downsize to around 250cc. However after seeing me in person he determined that I should downsize to at least a 215cc (low profile implant) to get the results that I want.

As I mentioned above, I'm currently a 34dd with my 400cc's. My wish is be no more than a perky 34c when everything is said and done. And I don't my erring on the small.

So tomorrow is my big day! Don't know if I'll be able to get any sleep tonight. I'm both scared and excited! I'll keep everybody abreast (no pun intended) of my surgery and progress… ;-)

Surgery completed! 1st post op photo!

Well I made it through! The post op photo (selfie) uploaded was taken several hours after surgery. It was also taken it on a slight angle, so the two sides may not look identical due to this.

Having said that, the doctor did mention to me prior to surgery that the two breast would not be exactly identical. Close but not Identicle. This is partly do to my prior augmentation from a different doctor; in my prior aug the incisions and pockets were not symmetrical and one of the pockets was slightly lower than the other. After surgery the doctor told me he had to place the incision on the right side slightly above the fold... for the reasons I mentioned above. So far I'm liking what I'm seeing. Incisions look nice and clean… except for a few areas where there's been a little bleeding. I am a bleeder.

Anyway gotta go now. I'm all drugged up... and I need to rest.

1st Post Op Pic - A few hours after surgery.

Selfie photo taken in the post op room at the surgery center a few hours after the surgery. I was laying down at the time that I took it. The photo was also taken on a slight angle which is partly why the two sides look different. I posted more details about that in my prior post above where I meant to post this photo. areas that look like indentations are actually bruised areas. I've already started applying arnica gel on those areas.

48 hour update

It's been about 48 hours since surgery. My surgery was supposed to be fairly simple: "remove and replace implants in the same pocket... and do a lift." It would have been a breeze if it happened that way.

However that's not what happened. When the surgeon got in there he discovered that both my implant capsules were hardened. Apparently I have so much breast tissue that he could not feel the hardening from the outside of my breasts! Because my implant capsules were hardened he had to remove them (ie. Double capsulotomy) before putting in the new implants... and performing the lift. The surgery took him an extra 40 minutes due to this complication.

I'm thankful that he found the issue and addressed it properly; however the capsulotomies add extra trauma to the surgery also puting me at a higher risk for internal bleeding, bruising and tissue necrosis. FYI, my breasts were so bruised yesterday (one day after surgery) it was pretty scary.

Today I'm doing much better and the bruising has gone down considerably. That aside I've had little to zero pain. Of course the pain meds do help with that… ;-). I was told that a majority of the worst swelling would be within the first four to five days. I am on day three.

Bef/After Photo. Bruised, swollen, taped - 4 day Post Op

To remind everyone I had a breast lift, double capsulectomy and implant exchange to downsize (from 400cc to 215cc). Were it not for the unexpected capsulectomy, there would not have been as much bruising. The bruising and swelling was actually much worse days 2 and 3; it's gone down considerably in the last couple days.

Should mention my breasts are shiny in the after photo because I have applied arnica gel and vasoline. The arnica gel is to help reduce the swelling. And the Vaseline provides moisture which helps to protect the skin when swelling. I got the go ahead from my doctor to do this.

I had my first Post Op appointment yesterday - 4 days after surgery. Normally the first post op is one week following surgery, but because I'm traveling from out of town they wanted to see me at least a two times before I left.

The nurse thought I looked great considering it was being four days since surgery, not to mention and all I've been through (ie. unexpected capsulectomy). She said four days post OP is when you usually look your worst. And she must be right because today I'm looking and feeling a little better. She alsosaid my breasts are boxy looking now because of the swelling and as the swelling goes down they will become rounder. Honestly I don't mind the shape that they are right now! I'm very pleased with what I'm seeing compared to what I had before. Now it's just to continue healing.... I will add more photos later.

5 days Post Op photo - bruised swollen and taped (front view)

I meant to include this front shot in my prior post. The illusion: my new Implants are about half the size and half the weight of my prior implants, however I don't think that they look very much smaller. I believe that's due to having more lower pole fullness... giving my smaller breasts a rounder fuller appearance.

As mentioned above the nurse told me as the swelling goes down the boxy appearance (due to swelling) will subside and they will have a rounder shape.
I also imagine that as the swelling goes down they will get smaller. Doesn't bother me if they do; it's the overall shape that I'm concerned about.

Six days post op - Did you know that bruising works its way down?

So yesterday I was feeling pretty good about the fact that the bruising in the upper areas of my breasts were fading... and everything seemed to be going well! However, later in the evening before going to bed I took off my bra and noticed new bruises in the lower pole region of my left breast. My left breast also appeared to be slightly more swollen than the right one. Being somewhat concerned (okay very concerned) I put in a call to Dr Vath's after hour emergency line.

A nurse (Jen) called me back within 2 minutes. She asked me to text her photos... and she also calmly explained to me that what I was descibing to her sounded quite normal. She said that following surgery the bruising usually starts higher up... and within about 4 to 5 days it starts to work its way down toward the lower regions of the surgery area... sometimes even below the surgery area. Also as long as there were no sharp pain and/or one side isn't significantly larger... she did not believe it was anything to be concerned about.

After texting my pics I got a quick call back from Jen. She explained that she was having issues with her Internet and was not able to download the pics. After more discussion, she decided that she would come to my hotel room and take a look in person. She still didn't think there was anything wrong, but she thought coming over would at the very least give me some peace of mind.

Jen (nurse) arrived within 10 minutes; and she was able to assure me that everything looked okay. The new bruising in the lower pole regions of my breasts were quite normal. Jen was also very gracious and told me that she totally understood why I would be concerned... and that it was no trouble at all for her out to come to my hotel room to look at my breasts in person.

I suppose if I had known about this bruising pattern going from higher to lower areas..., I wouldn't have freaked out as much, which is why I thought It would be a good idea to share this experience here. Learn something new every day.

One thing for sure is that Dr Vath's after-hour emergency line is really great! It is so comforting to have them available 24/7... to address any issues (or panic attacks) that might be of concern. Before Jen left she gave me a couple hugs. Afterwards she followed up with a couple more texts to make sure I was doing ok... once again reassuring me that everything was looking good. Have to admit it's nice to have the pampering. ;-)

Still waiting for the tape to fall off - 13 days post op

Hi everyone, Thought I should do an update. I'm doing much better at 13 days post op, although I still have a bit of swelling. Healing has been slower for me then many others here I've noticed. I've always bruised easily, not to mention the unexpected double capsulectomy certainly didn't help matters.

It was quite terrifying at one point, but I trusted the PS and nurses... as were telling me that my bruising was within "norm although perhaps leaning more to toward the moderate." However, I won't deny that in the back of my mind I was wondering if they were just telling me that so I wouldn't totally freak out. Anyway, I am so relieved that a lot of the bruising had gone done considerably since days 5 and 6.

I've decided to let the tape completely fall off by itself instead of trying to remove it by any other means. Taking the tape off too soon is equivalent to picking a scab, which can delay healing and can cause a larger scar. I also have a genetic pre-disposition for hypertrophic scarring, so I'm taking extra care in this area. Another real self told me it took about three weeks for her tape to completely fall off, so I figured I have at least another week or two to go....

Don't mean to scare anyone with my pics posted showing me at my worst. The photo was taken close up in pretty good lighting, so it looks brutal. I thought it would be a good idea to show these pics, so others here that have similar bruising and swelling... will know it's possible come back from this.

Forgot to mention - the photos above go from 5 days PO to 13 day PO

1st pic above was at 5 days post op at my worst. The 2nd pic is at 13 day post op / much better.

4 weeks post op with photos & scar treatment

Hi everyone, I'm about four weeks post op and I figured It was time to do an update. To remind everyone I had a breast lift with implant exchange downsizing from 400 cc to 215 mentor (overs). I also had a double capaulectomy.

The swelling is down considerably, especially on the left side which was giving me the most trouble. I've noticed my left aereola is slightly more contracted due to bruising in that area. I was told it will take a little while for it to soften up… and look more like the other one. At this point I'm not really worried about it.

My scar therapy started about a week ago. As the steri strips started to fall off bit by bit... I would clip off the hanging pieces of tape and apply biocorneum and/or 3M Kind Release tape if the incision looked healed enough.

There's one small area below my right breast wear a small piece of tape has still not come off. I'm leaving it alone because it appears there is a dark scab underneath that area and I certainly don't want to remove it prematurely. As I've mentioned before removing tape too soon is equivalent to picking a scab... which can delay healing and create a bigger scar.

Overall I'm pleased with the way things are coming along, although I realize I have a ways to go. That's all for now. ;-)

Six weeks post op pics with clear silicone tape!

Hi everyone, Thought I'd go ahead and post an update with some photos. A few days ago the very last Steri-Strip under my right breast Came off. Actually out of inpatience I decided to help it along. And a little piece off a scab came off along with it leaving a small wound at the juncture. So much for taking my own advice about not removing the tape too soon. I sent a photo of it to the nurses they responded back saying it was very minor and not to worry about it. I'm treating the small wound with a little Polysporin covered with a little gauze and 3M tape.

I switched from using 3M tape (on all my incisions) to a clear silicone tape. So far I haven't had any bad reaction to the tape. And what a difference it has made having the silicone tape; in 48 hours since using the clear silicone tape I've already noticed a big difference. My left Areola which had bruising is softening up and spreading out... looking more like the right one. It's very gratifying to see everything healing before your eye through the clear tape. I hope everyone else is doing well and healing nicely!

The update & photos above are actually 38 days post op. Not quite 6 weeks.

Wish we could edit here.

Before / After - side comparison @ 39 days post op

Before and After's – front & 3/4 profile @ 51 days

It's almost 8 weeks post op for me. Not much to report. Things are going well. I do notice my incision lines are a little darker. Nothing unexpected as it's my understanding that scars usually start to look their worst between eight and 12 weeks... and gradually start to improve after 12 weeks. So at this point I'm completely taped up with clear silicone tape. I plan on using tape for at least three months.

I've posted some photos before / after at front and 3/4 profile. Hope everyone else is doing well!

10 weeks post op – Dropping and fluffing?

Hi everyone, At 10 weeks post op I'm doing very well. I thought I'd post another collage (before; at 7 weeks; and at 10 weeks) for fun. I think the photos demonstrate a little "drop of fluff". I can see more lower pole fullness between 7 and 10 wks. I have to say some of the added fullness is partly due to my gaining back the 5lbs that I'd lost during my first couple months PO. Before my surgery my weight fluctuated between 126lbs and 128 pounds. By 7 weeks PO I was around 122lb. I'm now back up to 125lb and trying to maintain that weight. I'm still covered with silicone sheets for scar therapy.

That's all for now. Hope everyone else is doing well!

areola scars @ 10 wks post op

I just changed the tape on my Areolas so I took an opportunity to take a few quick pics to show how my areola scars are looking at 10 weeks post op. Mind you now (between eight and 12 weeks PO) is the time where your scars will be the angriest. I don't think I'm doing too bad considering I'm half Asian and I've experienced hypertrophic scars with past surgeries. So far all my scars are flat! I expect them to improve after 12 weeks PO.... Ignore the lines from where the tape was removed and the redness around my right areola- a little irritation from removing the tape. That tape is no fun to remove!
Denver Plastic Surgeon

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