Tall, Curvy, 38-year-old Missing my Formerly Bodacious Ta-Tas - Johannesburg, South Africa

I am in the beginning phases of thinking about...

I am in the beginning phases of thinking about getting implants. I actually have been extremely lucky boob-wise. I have always liked my curvy shape, and I had really great, perky 36C breasts until recently. While I still wear a 36C, it seems to take a lot more architecture to give my breasts that round shape they once had.

Of course, breastfeeding a baby took its toll in my early 30s, but I recently lost about 15 pounds--and it all seems to have come off of the upper pole of my breasts! WTF?! I look in the mirror and I just don't look as full and perky as I would like. And I like having bigger breasts to provide a counterpoint to my curvy hips--I LOVED my breasts when I was breastfeeding. They were awesome, full Ds. Those are my wish boobs: a full 36D or 36DD. I want to be an hourglass, not a pear. I like a natural look--full and round--not too hemispheric in the upper pole, but not droopy either. Since I am tall and about 155-160, my frame can pull off larger breasts without them looking out of place.

I am planning on doing the surgery in December in South Africa, with Dr. Potgieter who I met through a very reputable medical tourism company. I live in Kenya, and was evacuated to South Africa for a spinal surgery last year and had a great experience, and the hospital Dr. P works out of is nicer than where I had my facility. South Africa is known for medical excellence and Plastic Surgery in particular. Dr. P has been awesome so far, and in fact, his advice about chin augmentation led me to have a wonderful filler "Chin augmentation" that has been AWESOME.

But.... since it's long distance, I feel like I should see someone in person before finalising my booking. I am going to see a board certified German Consultant PS who comes to Nairobi and holds clinics here (Dr. Stasch with Valentis clinic) for a face to face consultation.

I have a lot of questions:
1. I am pretty sure I want silicon implants, but I want to touch and feel them and talk through the different projections. I think I want moderate or moderate plus, but want to talk about it with the docs.
2. I want to know if I will need a lift, and what kind of lift (I think a crescent lift will do it, if I need it at all... might an implant create the same effect?)
3. I am curious about over vs. under vs. dual plane vs. sub-facial placement and want to discuss it in more detail.
4. I made some rice sizers (and even wore them out--which made me feel like I was twelve and stuffing my bra), but I want to try on the implants and have time to think before showing up in South Africa for the procedure.

So... here we go!

A few photos...

One more picture

I would be thrilled with this result

Consultation TOMORROW!

So...the more I read, the more confused I get.

The only things I know for sure:
I want silicon
I want new boobs for sure, and will probably get them in early December
If I go "under" I will get smooth implants.

Everyone in the US--and in these fora-- seems to be doing "unders," but would those be right for me? There are some doctors with many years of experience who make a compelling case for "overs," on the boards and I believe I'd be a good candidate for a natural result. I want "perkier" but not necessarily Homer Simpson's eyes underneath my collar bones. I am really worried about snoopy deformity...and also about rocks in socks. Do I need a little crescent lift or not? It seems like if you go over, it would be smart to go with a textured implant--plus it might stick like velcro and "stay up" better (do textured implants help avoid rock in sock with overs?--I'm going to ask that on the board). But then you have to worry about a little bit of rippling, which could be worse with overs. If I go "under" then I will definitely choose a smooth silicon.

I am planning on doing the actual surgery in South Africa, and I have loved the interactions I have had with my potential PS, but the guy is "young" (has been board certified for 9 years) and doesn't do a million BAs per day like some of the surgeons we see on this site because he does a whole lot of surgeries for Project Smile and a whole lot of reconstructive surgeries. The aesthetic arm of his practice is a smaller part of what he does. I do know that practice makes perfect, but talent counts too, right? The person who referred me to Dr. Potgieter runs a very well respected, high end, Medical Tourism service and she says that he is really brilliant and that all his patients love him. She would not tie her business to anyone less than excellent. It's hard to commit because Dr. P only shows before and after photos on site--he won't send over email.

In any case, I have more pictures of boobs on my iPad than a porn producer, and an appointment with a Board Certified PS from Germany who runs clinics here in Nairobi TOMORROW to talk things out. Hopefully I will get some answers about what might work best for me to get the result I want, because right now I just feel confused.

First Consultation

So... I had a consultation with Dr. Stasch (the German doctor who holds clinic in Nairobi out of Valentis Clinic), and here is what he said:

1. I have a wide chest wall, and a wide breast base (15 cm), which means that there are a lot of implant options that could work to help me achieve my goal of a perkier look with some (but not too much) upper-plane fullness.

2. His first instinct was to do a dual plane 3-4, with a small lift, but when he realised that I wanted some size added, as well as perkiness, he thought the larger implant alone could achieve the lifted look. He said he would use an anchor-type incision if he did the lift, but wasn't sure it would be necessary, and that he would use sizers during the surgery and then make a decision.

3. I tried on the sizers and it seems we are looking at an implant of about 325-350 CC. My left breast seems to be slightly larger and lower, something I never even noticed until I started looking at my breasts all the time! He said he would use the same sized implant for both breasts, as the difference is very small, but that he would position them to be even.

4. He uses Mentor textured implants, with the more cohesive/dense, gummy bear gel. He uses a lot of anatomically shaped implants and some round--all with a more cohesive gel. He said that textured vs. smooth is an American/European preference difference, and the key is to have the surgeon use an implant that they are comfortable with. That makes good sense to me.

5. He suggested that for me he would definitely want to use a textured implant to make sure it didn't slide down (though I have fear of textured implants not dropping enough). We did not talk about projection at all (I was pretty surprised that his preferred implants were anatomical), though he said he would use sizers during the surgery and that he would be looking to make a very precise pocket to give the implant a "hand in glove" fit. He mentioned doing a little trick with the tissues at the bottom of the breast around the crease to make sure we didn't get a "double bubble" and said that he has never had implants bottom out in all of his years of doing BA.

6. He says that my own breast tissue will drape nicely over the implant, and that I have good skin tone to be able to cover it on my chest too (I'm not particularly slim). He said that stretching the skin won't be a problem for me--I think meaning that we will need to fill up the pocket of my emptied breasts. He did say that it would take about a month for the really high swelling to go down and 3 months to see the real result.

Here were some of my reactions:

1. It seems like dual plane is the way to go--both in terms of capsular contraction, rippling, natural slope and upper-pole fullness. The surgeon in South Africa suggested this as well. I am open to whatever placement will give me the best result.

2. I am concerned about my breasts feeling too firm. Dr. Stasch likes the more cohesive gel implants for the look they create, but I am concerned that they won't feel or move naturally--especially since the textured implants are a little bit "tougher" to begin with. When I held the round implant up, it didn't take on a natural teardrop shape--though I suppose that the muscle would compress the top of it a bit. Ultimately, for me, the breasts are about looking AND feeling natural, so that is a concern. My husband is a total hottie, and I really want them to FEEL good and be supple (if that makes sense).

So here's where I am now:

I felt reassured that if someone wanted to do surgery with Dr. Stasch in Nairobi, that it would be safe. He was very competent, answered all of my questions about anaesthesiology etc., and the photos of patients he has worked on were beautiful. He seemed serious and meticulous, and he says he really enjoys the precision and microsurgery involved in the aesthetic arm of his practice. He has done hundreds of breast augmentations for over 12 years and I would have no doubt that I would come out of the procedure with really gorgeous LOOKING breasts. He felt that in my case there were several ways to skin (stuff?) a cat (i.e., lift or not) and he would want me to authorise him to do what he felt was necessary during the surgery to get a gorgeous result (which would be fine with me).

My hesitation about what I heard today really didn't have anything to do with my confidence in Dr. Stasch's surgical abilities, or any problem with his bedside manner. He was very friendly and professional. I felt like we would have a similar aesthetic (i.e. we both felt any implant over 300 cc is a big implant!). I'm just not sure that the implants that he is most comfortable with and experienced using will give me the soft feel and natural movement I am looking for. I want to ask him about softer implants, and do some more research on gummy bears...

I ultimately think that forcing a surgeon to use an implant that is not their "go to" could be a mistake.

Finally, the cost to do it in Nairobi is almost $7000, which is all-inclusive (including a private room overnight, all meds, etc.). It costs less to do it in South Africa. This is not a primary consideration, but it is interesting to note.

Asked a Question!

And the answers I'm getting from the Docs are totally helping my head! I love this website...


So i ran into Dr Stasch today and told him i was uncomfortable with the super firm implants and he said: "then we would use soft ones!" He just didn't have an example of the softer implant in his office. Alrighty then... (But still going to South Africa). I didn't want to misrepresent a very good PS.


I have a date: October 9. Holy Crap. I can't believe I am doing this.

Body love?

Ok... so I'm having a totally weird (and nice) thing happening, and I'm wondering if anyone else has had this experience. As soon as I decided to do a BA, and set the date (October 9!!!) I found that I totally started enjoying my body more. I'm appreciating the lovely (if a bit too soft) breasts I have, and I'm just sort of embracing the lusciousness. I think deciding to do this is a declaration of physical independence, and it's having an interesting halo effect on my self-esteem--without even doing surgery! Is that completely bizarre?

New Year, New Boobs!

Ok... so I got all excited, and even planned the date of my surgery and then.... I chickened out! I just wasn't in the financial place I wanted to be, and I didn't feel sure that my decision was coming from a place of confidence. I'm still not sure that it's not motivated by a photo-shopped culture. But this year for some reason, I feel ok with that. I'm going for it. I am very confident in my decision to go to Dr. Potgieter in Johannesburg. He and his assistant, Alana could not be nicer. They have answered every single questions I have had, and were extremely understanding when I cancelled the surgery. I will still also work with Lorraine Melville as a "Medical Concierge." When I do it, I will have to stay in South Africa for 10 days, to have several post-op appointments, and I will stay with Lorraine the entire time. She was very wise in advising me as I was thinking about it the first time. I was thinking about taking my family for a vacation in South Africa at the same time as I did the surgery, and she really discouraged me from that saying I should make this my own journey about myself and my own healing. I thought that was wise. I will take my husband with me for the surgery and the first couple of days afterwards, then he will probably come home to be with the kids (who are 9 and 14). They also keep you in the hospital overnight (which I'm actually really glad about)--rather than sending you home right away. When I went under general anaesthetic a year ago, I felt like CRAP right after the surgery. So... new year... and this year will be THE YEAR. Here are a few more wish boobs...


So... A year has gone by. I have dyed my hair red, started doing fillers in my chin and cheeks, and am about to enter the DECADE OF POWER. New tatas are in order, and I want to do them in STEALTH mode before moving back to the US in the summer of 2016.

So... I am currently debating going to the UK and seeing Dr. Jonathan Staiano who has done about a zillion breast implants. He is a true specialist and he suggests overs for me. I have a lot of confidence that with him all would be roses. At first I was uncomfortable with the 'overs' suggestion, but have become convinced that it is probably right for me, and that American surgeons have an 'unders' bias based on using saline implants for so long while other parts of the world carried on with silicones. But the logistics and expense of the thing are much more complicated in the UK.

My other option is to go to South Africa and do it with Dr. Anton Potgieter. He seems like a darling, and is highly credentialed, but he has nowhere near the amount of experience/specialty as Dr. Staiano. He is more of a generalist Plastic Surgeon, and less of a specialist. His instinct, looking at my pictures, seemed to be "unders" and I think he has an "unders" bias (I am open to either which will achieve my desired look, I REALLY don't want a lift). I have just sent him my 20th email filled with questions, and these new wish pics.

So... this is it! This is a difficult decision.

Around the World for Tatas

As a medical tourist, having a world of options for surgery can be a bit overwhelming. Over the last 1.5 years as I have considered doing this surgery I have consulted:

1. A German PS doing clinics in Nairobi (Seemed competent. Very academic approach. Wanted to get me "PERFECT" boobs (in clothes) of a 20-year old with dual plane and a lift. $8000.)

2. A UK-based PS who is a super-boob specialist (Wonderful bedside manner, lovely practice. Not at all set up for medical tourists. I would have no support structure in the UK, so cost would be very high--over $10,000 for everything. He was totally convinced that textured silicone overs are the way to go with me and convinced me. I had total confidence in him technically, as he has done thousands of breast augmentations and really specializes in them)

3. Phuket International Aesthetic Center (PIAC) (Amazing service for medical tourists. Low cost (about $3000). Very responsive. Ultimately, I am uncomfortable meeting a surgeon and doing surgery the same day, though I am sure they get beautiful results)

4. Dr Potgeiter, a PS in Johannesburg (more below).

You guys should see the decision matrix. It includes: Cost, Aftercare, Hospital comfort, PS experience, PS bedside manner, Timing convenience... etc. Each factor is weighted and scored

Well, I finally met Dr. P in person yesterday, and he's The One.

All worries, doubts, and confusion are resolved. He spent over 2 hours with me discussing breasts and chin liposuction and was both meticulous and kind. He is a gentle soul. He walked me through his thoughts around developing a surgical plan, and since he knows I'm interested in the medical nitty gritty he went into a lot of detail about the procedure itself, how he manages Capsular Contracture risk, why he uses drains, why he doesn't use the funnel for placement, etc. etc. etc. He gave me a detailed tour of the topography of my breasts. He actually made me feel beautiful, which is a pretty amazing thing when you are in a PS's office! He is so authentic and honest. I loved it when he told me flat out that he refuses to do any sort of neck lift on me and then walked me through many other options.

Also, the aftercare plan is pretty awesome. Outside of the US they never discharge you the same day as your surgery. You stay overnight. The Sandton Mediclinic has an "executive/luxury suite" rooming option, where you have a private room that is kitted out like a hotel room, with a comfortable recliner, a jacuzzi tub, and a sleeper bed for a guest of your choice. Posh. All of this is the price of a local hotel room, which my husband would be paying for anyway. That was exciting, because I totally want him close the day of/night after the surgery, and this way he'll be really comfortable. Once I'm discharged I will stay at Lorraine Melville's Surgeon and Safari guesthouse. It is really homey, with a kitchen full of food, a constant stream of eccentric guests recovering from various medical procedures, and Lorraine herself who is one of those wise women.

So the surgical plan is this:
Textured Silicon OVERS (which I have gotten excited about!), fold incision, 375cc moderate (or mod+) profile. If I need it, he may do a little 1 cm crecent lift above the areolas, but he'll decide on that in the operating room. I will also do some chin liposuction at the same time.

I've scheduled it for January 11th!

1-Month to Go!

Surgery is on February 15th!

I had my mammogram and ultrasound scans last week, and all is well! I wish I were a little nearer to my "ideal weight"--it would have been nice to use this surgery to kickstart a great fitness routine, but between the holidays and work being completely overwhelming right now, it's not happening. Sigh. I just printed off a bunch of consent forms, which I accidentally left sitting on my desk at work--doh! Good thing my office door closes, and I hope they are at least under another sheet of paper. I am not telling anyone I am doing this other than a few close friends. Everyone else thinks I'm going for a different medical reason. ;)

Any other ladies heading towards February surgery? I'm starting to have surgery dreams! How are you feeling?
Dr. Potgieter

So far, on email, he has been great.

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 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
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