Happy 40th to Me! Saline to Silicone Revision Coming Soon :) - Louisville, KY

I'm a 39 year old mommy of 1, and full time RN. I have decided that my birthday gift to myself this year - I'm turning the big 4-0 - will be a breast revision. I had my first BA in 2000, a few months before I turned 24.
I was always very self-conscious about my breasts and the "weird" appearance they had. Although I did not know it at the time, I had PCOS. My breasts didn't develop the way most women's do, and they had kind of a tubular/constricted appearance to them. I basically had no development or fullness to the lower part of my breasts. I hated them. I had to stuff my bra or use silicone breast enhancers to give myself a normal appearance underneath clothes. I finally expressed my concerns to my doctor, and she referred me to an excellent PS here in Louisville. At the time, saline was the only option available for breast augmentation. So I started the journey to re-shape myself and boost my self-esteem.
My PS did an amazing job. We decided to go under the muscle, and she said she would release some of the constricted tissue that was preventing me from having that fullness and normal shape to the lower part of my breasts. I don't remember what size we chose, but I told her I didn't want to appear to be much bigger. My priority was just looking more normal clothed as well as nude. My incisions were in the breast fold, as I told her I hoped to breastfeed someday and wanted to keep the nerves around my nipples intact. The outcome was better than I could have imagined. Granted, I knew that I'd never have [RS bleep] star boobs, but that was never my intent anyway.
Fast forward almost 16 years and here I am. Since my original BA, I've gotten married, had a beautiful daughter, gained & lost a good amount of weight, and completely switched careers, becoming a nurse. Breastfeeding didn't work out, as I had no milk production. This was likely due to my PCOS and probable insufficient glandular tissue, something that kind of goes with PCOS anyway, and not a result of my previous BA.
I decided a few months ago that I'd like to do something nice for myself for my 40th birthday. I started researching surgeons, implant types, and all the other details that I'd need to decide on. I was having trouble tracking down my original PS, so I started to look into some others. I called one and made an appointment for a consultation with her (which is this Friday, 2/12). My "homework" was to get a current mammogram (something I'd need this year anyway since I'll be 40), try to get my original medical file from the other PS, and to at least get a copy of the operative report from my first surgery. The mammogram was a breeze. The other stuff, not so much. Let me tell you, it has been like pulling teeth. I found out yesterday that my original PS has in fact retired, and may or may not still have the files from 16 years ago. My state board of medical licensure gave me an address where I could write to her and request my files. I'm not holding my breath on that one...
Anyway, I am excited to begin on this journey again. My wish for this time is to get a bit more fullness and shape to my breasts. Again, I don't want to be huge, I just want to have something that is proportional to my frame. I'm not a tiny girl. I'm 5'6" and currently weigh about 190. One of the things that has been bothering me a lot recently is the fact that my breasts are spaced very far apart (at least I think they are). I have no cleavage, and the only way I can get cleavage is to push the girls together with my hands! I still feel like certain clothes look bad on me because of the amount of space between my breasts. I'm hoping that can be somewhat corrected by selecting the right kind of implant. I'm looking at doing silicone unders, maybe one of the cohesive gel (gummi bear) styles.
Not many people outside of my family and very close friends know that I've had a BA done in the past. I am not really the type to advertise something like that, but as I get older I find that I don't care as much about people knowing. It's my body, and I'm doing this for myself. That's the most important thing about all this. I'll update as I go along. I'm going to work on a list of questions for my consultation on Friday, and hope that I feel comfortable with the PS and her plan for me.

I had my initial consult with my new PS on Friday. My first PS actually trained with her, and was in practice with her for a while. Anyway, we discussed my options and what surgery would be like. Since I will be a revision, she will put in drains that will stay in place for about 10 days. She recommended smooth round silicone for me. We still aren't certain what size my current saline implants are, as I have completely struck out in obtaining any of my previous records. I can't even find my warranty card from my first surgery. While examining my breasts, she said they are probably about 375 CCs. If I still can't find any info from the previous augmentation by the time I get my revision done, she can at least measure the amount of saline from my current implants during surgery so she knows what I had before. She also said I have a small Baker II capsule on the right side, and that my left side is slightly lower than my right (something I didn't even notice until I took my before pics).
I checked out the silicone rounds, and I think I might want to go with around 450 or 475. My surgeon does intraoperative sizing, so she will have some pictures of my "ideal" size (along with "too small" and "too large" references) and choose what looks the most proportional to my frame while in the OR. I trust her judgment, as she has been doing this a long time, and she does a lot of revisions on other surgeons' patients.
I'm looking at doing this in early June, after my daughter gets out of school for the summer. The PS said there is no restriction on when I can go back to work, as I do not do a lot of heavy lifting or difficult patient care in my line of nursing.
In the meantime, I'm going to try to lose a few pounds (something I'm always trying to work on anyway)... I'll probably try to schedule the actual procedure sometime in the next few weeks, since summer is a high demand time. I'm excited about the prospect of my new and improved "girls"!

After more than a month, and numerous phone calls to the health information office of the hospital where my original procedure was performed, I finally have a copy of the operative report! Looks like I have Mentor smooth rounds, with a fill of 300cc on the right and 275cc on the left.
It's so nice to know, once and for all, what size I'm starting out with. My next step is to get this info to my surgeon, and to go ahead and get my procedure scheduled. I'm now looking at somewhere around mid-May.
I googled more "ideal" sizes and found some pretty good ones that I will give to my surgeon. I tried to look for girls with larger frames like mine, so I'd get a better idea of true proportions. I'm definitely getting more excited about this!