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...

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 porn 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.

Met with my new PS! Looks like we have a plan!

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"!

Finally got my op note from the first surgery!

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!

Save the date!

Finally!! I know when I'm getting my upgrade! Thursday, May 19 is the day. Kind of funny, since it will be exactly 15 years and one day since my first BA (done in 2001, not 2000 as stated in my first post). The procedure will begin at 8am at an outpatient surgery center, a sister facility to the hospital where I work. I'm really excited, and a little bit nervous, but I am very much looking forward to this "new" part of me. I've decided I'm going to apply for FMLA to cover a few shifts post-op. I don't really want to go to work with drains in place. The higher susceptibility to infection is not something I'm comfortable with, so I will most likely take off 4-5 shifts before going back. I'll have drains for about 10 days, so being off for that length of time will ensure the drains are gone by the time I go back to work. That will also help me get over the initial hump of recovery. Pre-op will be about 2 weeks before surgery. Hooray for new boobies! :)

Just over a week away!

I'm nearing the one week mark until my revision surgery. I met with my surgeon again last week to sign all the consents, get my prescriptions, go over post-op info and wound care, and to get a better idea of what size I will be after everything is said and done. Since we are doing intra-operative sizing, Dr. Samuels is going to be bringing several different size implants into the OR with her. I could go as big as 500cc. My current size is 275 (right)/300 (left). I'm excited about getting everything done, and can't wait to see what the new me will look like!


Surgery was this morning. I'm a little sore and pretty tired, but feel pretty good considering everything! Compression bra is on and drains are doing their job. Post-op appointment on the books for tomorrow. Really can't wait to see what these girls look like. More to come after my appointment tomorrow!

Post-op day 2!

Here I am, post-op day 2, and feeling pretty well. I had my post-op visit with my doctor yesterday and everything is going great.
Dr. Samuels ended up going with 650s. She tried 500s and thought they still would be a bit small on my frame. For a while she and her assistant were stuck between 600s and 650s, but ultimately went with the larger size because they looked better on my frame, they would help my nipples look more centered, and would give me a nice amount of cleavage (something I've never really had).
I can't wait to see how they look once they start settling into place. I'm still pretty swollen up top, but I know that will resolve in time. Showering with the drains won't be fun, but I know they won't be there forever.
Dr. Samuels told me I don't have to wear my bra continuously, pretty much only when I sleep. I'm getting around pretty well, and have my husband, my mom, and my 7 year old daughter all helping me with things. As a nurse, it's hard to be the patient, but I'm taking it easy as much as I can.
I've had absolutely no trouble sleeping, no nausea, and am taking my muscle relaxers more than my pain pills. I'll post some pictures in a few days most likely.

1 week post-op!

Can't believe it's been a week already since my surgery! I'm feeling great. Absolutely no pain meds since Sunday night, and haven't taken a muscle relaxer in a couple of days either. Drains are my biggest nuisance at this point. Less than a week until I get them removed! My daughter has been such a great helper to me this week. Mom and hubby have been going the extra mile for me as well. Haven't attempted driving yet, but may go a short distance tomorrow. Don't want to overdo it or go very far until the drains are out. Excited to go shopping for new stuff and can't wait to see how some of my clothes that used to look awful in the chest area will look now that I have some cleavage! Going back to work in about 2 weeks. I think I'll be more than ready at that point!

One more thing... A few must-haves!

There are two products I am so happy I bought before surgery: a pouch to hold my drains, and a wedge pillow for sleeping!
I can't sing the praises of the mesh drain bag I purchased from Brilliant Contours. This thing is a life-saver! Since I am a revision patient, and my surgeon places drains in all her revisions, I knew I'd have two drains to deal with. I did not want them to be dangling the entire time, so I decided to get the mesh pouch to keep them better protected. When I went for my post-op day 1 checkup with Dr. Samuels, she was very impressed by the pouch and thought it was a great idea! Well worth every penny of the $24.99 I spent on it. Brilliant Contours has a website, as well as an Etsy shop.
The wedge pillow I bought has made it so much easier to sleep in an elevated position without having to mess with placing a bunch of random pillows behind me. I got it on Amazon. The one I purchased has a 1" layer of memory foam, which makes it much more comfortable, and it came with a 400 thread count Egyptian cotton cover that is washable. The dimensions are 25" x 24" x 12" and the level of incline is about 25-30°. Kind of pricey, but hey, I haven't had to use any of the Ambien prescribed to me by Dr. Samuels.
Anyway, just my two cents about things that make the immediate post-op phase a lot more bearable!

A couple more pix

Here I am, 1 week out. Still high and tight, but hey, I'm not complaining. They will look fab once they've settled!

Drains are gone & real bra is on!

I've never been so happy to go back to the doctor as I was today. After almost 2 weeks, I got my drains removed! I feel so much more human with them gone. And I'll finally be able to wear some of my other clothes again!
I was also given the thumbs up to get a good, supportive bra, something that wouldn't irritate my incisions. I went with some wire free bras from Bali that are both comfortable and supportive. Bye bye ugly white surgical bra! My boobs look fabulous in them too!
Feeling great. It seems like the girls are starting to soften up a bit already. Dr. Samuels was very pleased with how they are looking. She started me on Singulair for 3 months to help prevent capsular contracture. Back to the office in one week to check the drain sites, and in two weeks I'll check in with Dr. Samuels again.

Two weeks, and wow, what a difference!

Just did a comparison shot of before and now, 2 weeks post-op. Still have a lot of settling and evening out to do, but holy cow! Me likey!!!

3 weeks out & loving the girls!

I am noticing changes every week! Still on the hunt for the perfect bra to help push the girls together and give them the right support, but I think I'm on the right track. Drain holes are getting smaller & smaller. Doing great & loving what I'm seeing!

1 Month Out!

Today I am officially one month post-op. I'm feeling fabulous! So happy with my decision to do this!

2 Months New!

Can't believe it's been 2 months since my surgery. I feel great, and I absolutely love my results. Can't believe how much they've changed since the procedure. I am so happy I decided to do this! Dr. Samuels is the best!

3 Months!

Today marks 3 months since my surgery. I'm feeling great, and I love my girls! I've started to do some light exercise, and most of it feels fine. Sometimes I'll avoid certain things if it feels like I'm not ready for it. All in all, I'm still able to do most of my workouts. I couldn't be happier with my outcome or my decision to have the surgery.

4 Months!

Can't believe I've had these girls for 4 months already! I love them!!
Louisville Plastic Surgeon

Dr. Samuels has been amazing! Her years of experience are evident, as she uses her expertise to help her patients choose their desired outcome. She is very patient and listens, while also answering any questions and addressing any concerns her patients may have. I'm so happy I chose her to do my revision. Her artistry and perfection speak for themselves!

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
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