52 Yo Mother and Teacher, 5ft Tall, Tri-Care, 38M and Not sure of my target size after the reduction - Macon, GA

I've been dreaming of doing this since early in...

I've been dreaming of doing this since early in middle school when I was overflowing DD cups before most of the girls were developing noticeable bumps. I've had back pain since early adulthood, but didn't have the means to pay for surgery, and then I got busy, and had kids and kept putting things off. I am glad that I waited till after breastfeeding. I was able to manage the pain to some degree with the help of chiropractors. A few years back things got real bad and Tri-Care sent me for physical therapy. It had gotten so bad I couldn't move my arms temporarily, and the pain was as bad or worse than the worst I'd experienced in childbirth. PT did get me functional again to some extent, but not enough. The best time for me to have done this probably would have been ten years ago when my weight was down. It would have been a lot easier to keep the weight off and my overall health would be better today.

Tri-Care has been great. They allowed the referral and an in network surgeon was able to see me in a few weeks. They took about a week and a half to approve the procedure, though I was told to expect a month. I think they were quick because I have both documented medical history and a great deal of tissue to be removed making it very clearly medically indicated. It seems like it's a lot harder to get approved if you only want to go down a cup size or two and don't have the medical history documented.

I'm hoping I'll be able to go down 9 cup sizes and retain some sensation in my nipples. One or both of those things may be impossible or ill advised. I wish I could find out my options now instead of having to wait till the day before the surgery so that I would have some time to adjust my expectations before the surgery.

I've done some reading and it seems that when the nipple is very far below the inframammary fold they can't do a pedicle (a bunch of tissue that remains attached to the nipple, greatly increasing the odds of retaining sensation). What I can't figure out is why not. Is it to do with ligaments being stretched too far, so the shape of the breast becomes distorted because of the lack of support? Or is it because stuffing all that pedicle back up so high in the new breast area squeezes of the bloodflow and or nerves, leading to high complication rates? Or is it something I can't even imagine? Or is it unexplained higher complication rates? And will the doctor and his staff think I'm out of my mind if I call in with these questions? I do realize that reading a few articles only gives me a superficial understanding of this stuff, but my curiosity doesn't have an off switch.

Another worry is that my PCM (GP) has ordered a LOT of tests including a visit to the cardiologist and possibly the hematologist before the surgery. A few years ago I was having problems with a rapid heartbeat. They did a very thorough job looking into it and decided that my heart was in fabulous shape but I needed to stop taking a certain medication. I've not had trouble since so it makes no sense to me that she wants this test that may take a while to schedule and compromise the surgery date. Second is a situation I thought had resolved. My platelets had been slightly high at my checkup several months ago. She had me retest and they were still slightly high. She wanted one more test before sending me to the hematologist. When I didn't hear back from her I assumed the situation had been resolved. Yesterday she tells me that the third test was still a little off, 417 when they want it below 400. I'm a little angry that she hadn't called me weeks ago when she got those results! This could have been resolved by now, instead of possibly causing a delay now, which will mean me missing work to recover when school starts up in August. I'm glad she is thorough, but am a bit disgusted with her follow up.

Lots of pre-op testing and worries I won't be able to get the surgery.

A few months ago I had a check up and all was well. Now that my GP is trying to clear me for surgery there are all sorts of things they want to look into. My platelets have been slightly elevated, and still are, so I have to see a Hematologist. That isn't scheduled yet, and my surgery date is on the 22nd. There was blood in my urine, and my TSH was up so they want a full thyroid screening, which I've done and am awaiting the results. The cardiologist wants to do some more tests as well to make sure everything is good. I had a tiny bit of blockage, but was told it was OK a few years ago. I've been taking the meds they prescribed and there is no history of heart problems in my family.

My mom and my adult son both have hypothyroid and they've watched me for it since I was a kid. I'm symptomatic, but they never seemed to think much of it till now that I want this surgery.

I'm hoping all the specialists can get all the tests they want done fast enough not to have to move my surgery, and none of them find anything that will torpedo my plans all together. I guess if they do finally decide to treat my thyroid I'll have to postpone till that is stable, and still be able to have the surgery. If the hematologist or heart doctor have issues....who knows?

I wish I'd done this ten years ago when I had gotten my weight down and was exercising a lot. If I had I probably wouldn't have developed these other problems at all. I hope that is a warning to gals who are tempted to put off their surgery.

Photos

My apologies for my shyness about sharing photos. I've been stalked online before and I know the guy is still out there somewhere. I could make some sketches maybe, which would be pretty funny since I don't draw much more than stick figures.

Preparations

Thanks to all the ladies who have posted about what preparations they made, or wish they'd made I feel I have a handle on what to do to get ready. I've got one bag packed for the hospital and a plastic container filled with things I'll need for the recovery. Hospital Bag: Button Front PJs and a Robe Reading material A small amount of cash (in case my husband forgets cash and needs a snack) Updated prescription card Recovery supplies: Ice bag Gauze bandages Butterfly bandages Antibiotic ointment Body Brush (for hard to reach itches) Tylenol Wound Tape, two kinds Bandaids Straws to make drinking in bed easier Clean washcloths Hand sanitizer Body wipes I'm also trying to get the pantry stocked with things my family can make easily. One of my children has taken an interest in cooking so should be able to handle things very well with a little coaching. My husband is a terrible shopper, always buying too much junk and not enough real food, but he does it without complaint so I am blessed. I should write a whole separate post about how wonderful he is.

My wonderful husband

Bless his heart, this is hard for him, but he is completely supportive and amazing. He wants me to be healthy and happy and his concerns are about what would happen if something goes wrong and I'm not left healthy and happy. He respects me and my right to make my own choices which I find incredibly sexy and exciting. He did seem slightly disappointed about the possibility of loss of sensation in my nipples, but perked right up and made suggestions about how we would cope with that. Together we can get through anything, and I know that even if something goes horribly wrong and I end up disfigured, I can come home to love and support. How lucky am I?

More testing today

I had the first round of tests for my heart. There is a very small amount of blockage in one part of my heart, but that isn't news, and the doctors haven't seemed worried about it. I take a pill to keep it from growing, and get bloodwork every few months to make sure the pill is working, and so far it's been great. There is no history of heart disease in my family. I doubt I'd have it either if I'd gotten breast reduction ten or more years ago. I'd have been more active, and I think that would have made the difference for me.

In the afternoon I called to check up on the hematologist who was supposed to decide today if I needed to see him. I've had a very slight elevation in my platelets for several months. The hematologist was out last week but his staff said they had the file and all the tests on his desk ready for him to go over today. Today I called to see if my GP (PCP) had heard back, and they hadn't but gave me the number. When I called over they said they had no records for me, and the log they use to track incoming records didn't have anything listed for me either. I called my GP's office back and they resent them.

I expected a big fight with Tricare to get the surgery approved, instead I've had a big fight getting the pre-op testing sorted out. Go figure. That's me, backwards and upside down.

A picture, sort of, and bra sizing information

Sternal notch to nipple is 39cm on the right, and I think she said 37 on the left. My nipples have been on the bottom of my breast and pointed down since I was a teenager. The first time I put on a bras my mom coached me to pull them up and center them, so it's been that long. I wear a 38M, and it's a bit snug once I have everything positioned. When I get a new bra I usually use bra extenders till it stretches out a bit. I go up to a 40M it's too big along the side and digs into my armpits. If my PS does a bit of lipo along the sides I won't need the extenders, and might even go down to a 36(whatever cup size) if/when the skin shrinks back into shape. Until my early 40s I wore a 32, but what with age, increasing sideboob, backfat and extra skin, I've had to size up. I don't think my ribcage has actually expanded. A properly fitted bras is supposed to touch your chest between your breasts and not squeeze them together (uniboob). Each breast should fit comfortably into one cup with no slack, and no over spillage (quadroboob). The back and front of the bra should be the same height, not ridden up in back or in front. If it's too big it can also let your girls fall out of the bottom. If that happens, don't blame the bra, blame the fit. Straps should be adjusted to support this parallel positioning as well. Also the circumference of the cup changes with the band size. A 42M is a lot bigger than a 38M, which is a lot bigger than a 32M. In a bra with an underwire, the underwire traces part of that circle, just imagine if it were a full circle. Somewhere there is a great website with all of this explained, with pictures and diagrams. If I remember where it is I'll post the link. I mention all of this because a lot of the pics I'm seeing show improperly fitted bras, mostly bras that are too small. There are a number of ladies who think they are 38G (or whatever) but look to be a lot bigger. I think the M cup club is bigger than we think....I mean has more members.....

A general idea of what I want post op

Good news

I saw my GP today to follow up on some bloodwork in regards to surgical clearance. My platelets are still up, but the blood in my urine is gone. My thyroid is fine too. She said as long as the heart doctor clears me she will clear me, and we can follow up on the platelets after the surgery. I will probably need heparin during my recovery to avoid clots.

My guess is that I will eventually need my gallbladder out. It processes platelets and when it starts to go platelet counts will rise. I had trouble with it during one of my pregnancies, so I think it is the most logical culprit.

Last test to get clearance

Today I had an echo cardiogram to make sure my heart can handle the surgery. Tomorrow I find out if the cardiologist clears me.

The gal who did the test was nice but asked if I ever tried loosing weight to get them down. I told her that I did and even at 100lbs a K cup was very tight on me. She seemed sceptical till I had to bare my chest so she could do the test. She had to really dig around in there to get her readings. I offered to hold one up out of her way but I guess that isn't allowed. She sympathetically told me they were the biggest she'd seen and told me I'd have to feel better after the surgery. I'm sure she is right.

Woot! I've been cleared for surgery!

The cardiologist said my heart is very strong and the small blockage isn't growing. Having smaller breasts will allow me to be more active which will only help keep it that way. I won't be able to run or do a lot of sports because of the orthopedic problems in my feet and ankles, but there are tons of other things I can do. One of my great loves in life is gardening and the kinds of projects I want to do involve lots of digging and heavy yard work. Over the years I've figured out lots of workarounds to accommodate my feet for that kind of work. I will be so fit, and my yard will be amazing!

I'm more excited about the garden than about being able to fit into normal clothes, weird, I know.

5 days till D Day, or maybe C Day

All I have to do now is stay healthy, make sure my GP doesn't forget to send the paperwork (she does that sometimes, but is so wonderful in other ways I don't mind so much), and show up. In four days I go in for the pre-op paperwork and any last minute bloodwork my surgeon requires. In five days I have the surgery. It's starting to feel very real.

How to find a great doctor

1. Ask medical people you respect who they would use or who they would send people they love to.

2. Get the list of who your insurance covers and bring it to a medical professional you trust and ask the above question if you need to stay in network.

3. Pay attention to the letters after their name. Look them up online and decide if that is the right kind of doctor for you. For example if the letters are D.O. they are not a medical doctor although they may do some things medical doctors do. They have different training and a different approach that may or may not be what you want. If the only M.D. they are a medical doctor but may not have some of the extra training available to a surgeon or have lost the privilege of using those letters.

4. Look them up online. Their legal history should be available and you can see if they have been sued for malpractice. Even the best doctor's can get sued but more than once or twice can indicate a problem.

5. Get your questions answered. Great doctor's don't always have great personalities and visa versa. Don't mistake charm for skill. They should be able to answer your questions or provide someone who can. Doctors with poor people skills sometimes keep someone else on staff who can do this for them, indicating that your questions are important to them.

Feel free to add more tips in the comments.

Feeling brave

Here are my pre-op photos.

Goal pics

I've been trying to find realistic goal pics to help when talking to my surgeon on Tuesday. I'm finding lots of pictures of ladies with great results, but most are of ladies who's results I like best are smaller, taller, or thinner than me. A lot of the ladies who match me better physically end up with bigger breasts than I'm hoping for. Maybe I will too. I'd rather that than have complications.

My surgeon has some nice before and after shots on his website. I hope I can turn out a little smaller than those women, but if I turn out like that I'll be very happy. Either way my back should be feeling great, physical activity will be a lot easier, and people will probably start looking at my face instead of my chest, so it'll be awesome.

All set to go

I've got a lot of blankets, towels, clean sheets, and supplies all gathered together so I can stay put and heal for as long as I need to.

Preop tomorrow

Two more sleeps till my surgery. I meet with the surgeon tomorrow then go to the hospital to get things all set up there.

I did a lot of grocery shopping today. I got lots of things my kids like and can make easily. They are teenagers so this will be good for them.

Prowl is done

He said he could take out about a kilo from each side. That might put me down to an I or so. I am wearing an M and its a tight fit. I couldn't get him to explain why not more but I will try again after the surgery. I trust him to know what he is doing and have read enough to know that the more they take the bigger the risks for necrosis, hematoma and an assortment of other problems. His website and brochure are clear that he puts patients health first and that is what I want. If I loose weight maybe I can drop another cup size. I'd be droopy but I don't care. I will still be less droopy than I am now. He said he was planning a pedicle which I am very glad for. I asked him about doing Lipo to make me more narrow. He said it would be better to excise some tissue from the sides. I am very excited about that. It will mean more scarring but I think the look will be much better. Healing will be better too. I am waiting for the hospital to call with the time for the procedure.

Details

I will stay overnight. I will have drains. The drains will probably come out before I go home. I will have compression socks to prevent blood clots. They gave me a thingy to breath out hard into to help my lungs recover after the surgery. They want me to get up and walk as soon as I can after but not to do any exercise that will elevate my heart rate for at least a week or two (I forget which she said). They gave me Hibicleanse to wash my chest with. They will give me abx before the operation but not after unless I get an infection. The nurse told me to get a button up shirt for sure for after. She was pretty forceful about it. That was just a random list pretending to be a paragraph but maybe it helps.

Home and recovering

It all went well though it took longer than expected and apparently lefty took extra time. I don't know why yet. Dr Perofsky does good work but he is not a talker. I'm too tired to post a lot of details but so far I am very pleased. He took about a kilo from each side and I am smaller than expected which is a very very good thing.

Wonderfully tiny

It is too early to tell but I think they are really small which fits my frame very nicely. There is a lot of bruising but they look great.

My back feels great but that is also the pain meds. I'm sure the reduction is helping but I can't prove it yet. I am taking some powerful stuff, sparingly. I will take the regular dose on Monday when I get the drains removed.

My husband is wonderful. He gets me anything I want. He even went and bought me a bunch of new PJ's that button up the front. He makes a mean mango yogurt smoothie too. He has made this all about my health from the start and has been completely supportive.

Feeling good

I'm still sore but am feeling myself. My husband gave me a lovely sponge bath and washed my hair. Monday the drains come out. I think I won't need pain meds again till then. My ice bag is a huge help.

Drains are out

I took one of the pain pills they gave me before leaving for the appointment. I don't know that I needed to. The gal who removed the drains was super gentle. She is the same one who is helpful on the phone. If someone else did it I might have had more pain. I am glad I had drains but it feels great to have them gone. I also have some blistering along the incisions from the tape. It felt great to get that taken off too.

Very tired today

I did nothing today, but was tired all day. I think the trip to the surgeons yesterday wore me out. Otherwise I feel good. The raw spot on the right, where I had a reaction to the tape, is healing up.

I measured myself and got 42E. I wore a 38M, but used extenders till my bras were stretched out a bit. Bigger bandsizes poked me under the arms and had too big of a breast circumference. I want to shop for new bras in the worst way but can't go out to a store for another week or so, and have no idea if what I buy online will work. I'm very small framed, but overweight, and the proportions are never right.

I get a giggle out of how small my breasts seem to me now even though they measure an E cup, which is where some ladies start before their reductions. Perspective is a funny thing.

Today's Goal: Get some answers

First off, something happened during my surgery, but I don't know what. My breasts are great so far, so the surgery was a success, but something happened and they seem to be trying to avoid telling me what.

How do I know something happened? The first thing I noticed was the giant scab in the side of my nose that can't be intubated. It's "developmental" which means I was born that way. The sinuses and nasal passages are super narrow, I can't even really breath on that side. I told them, and could have gotten the ENT to fax over his report if they'd wanted, yet they still tried to jam something up there.

When I went under I had two bruised sites where they couldn't get an IV to thread and the vein collapsed, and one IV along my left thumb. When I woke up I had ten new bruises and needle marks and a second IV on the outside of my left forearm.

Neither of those things impressed me until my husband told me some things and my surgeon started being evasive. One hour into the surgery someone came out to tell my husband they were halfway done, one breast was finished and they had started the second. Three hours after that they came out to tell him that the second breast had take extra time and they were now finishing up, but that I was OK.

When I saw the surgeon in the hospital afterwards my husband hadn't told me about the extra time, yet. I told the surgeon that I had a big scab in my nose even though I'd told them a tube can't fit up there, and that my arms looked like they'd had a class of future phlebotomists in to practice on me. I asked if everything went OK. He said I was fine and we would talk at my follow up. Then he told me to schedule that for Monday.

On Monday he wasn't in the office, and the gal who took care of me wasn't at the surgery and didn't have time to answer questions.

Today I am going to make some phone calls.

Answers

I got lucky and the helpful lady at the surgeons answered the phone. I do not have to wear a tight bras, in fact they don't want me to. They want the blood flow to my nipples to be unimpeded. I may wear some light support if I feel more comfortable that way, and she expects I will want it. She says that after the drains come out all that liquid can build up and some support can help relieve that. She likened it to being engorged when breastfeeding. (I wonder if cabbage leaves would work....probably not). She said my T Shirt and ace bandages were fine as long as I wasn't pressing on the nipples. This is a bit different than what a lot of us are being told, but I'm going to go with it. It makes sense. I can get the surgical reports, and they are sending me the request form. Whatever happened is probably not that exciting, but until I know I'm going to imagine all kinds of stuff. I'd rather just know the truth.

Massage and ooze

Today I started feeling a bit engorged. I did a little light massage and it cleared right up. It was never that easy to get rid of breastfeeding engorgement. I just rub lightly on the hard lumpy bits and they go away. I'm careful not to stress the incisions.

I am having a lot of ooze from under my right breast. It keeps soaking into whatever I am wearing. I have tried using bandages and pads but they either rub me or fall off. The ace bandage over a t shirt works OK but it's a bit hot and sweaty and I am running out of shirts I don't mind staining.

I tried using bandaids to hold some gauze in place but was reacting to the bandaid. I must be allergic to the adhesive, which is a new thing for me.

My doctor does not like snug fitting bras and I'm finding it very hard to deal with the ooze without one.

Any suggestions are welcome.

First shopping expedition

As much as I hate Wal-Mart, it is the only place I could get most of the stuff I needed without having to go from store to store. I drove for the first time and it wasn't bad. The seatbelt sat lightly across my chest and didn't bother me.

I got several things that should solve my dressings dilemna, see post above for details. I bought some sleeveless men's t-shirts. The ones for women were too flimsy. Right now I am wearing one like a sports bras. I have it on backwards, and rolled up under my chest. It isn't binding, as per my surgeons preferences, and the rolled up fabric is putting just enough pressure on the incisions to stay put and not rub. I also got an assortment of sports bras, and some sewing notions to make a contraption for holding gauze on the incisions.

I could not find antibiotic ointment that I can use. I have never had a problem with antibiotics, but petroleum products like mineral oil and petroleum jelly give me hives. I thought I had some that I could use, but when I put it on my incisions they got all red and inflammed. I got out the magnifying glass and checked the small print and, yep, it has little bit of petroleum jelly in it. The inflamation was gone by the next day, so it wasn't a bad reaction, but I sure don't want to keep putting that stuff on there.

Right now all I am using is soap. A lot of commercial soaps are mostly or all detergent. They can call it soap because it does what soap does, sort of. Detergent is great for getting dirt out, but isn't very good at killing bacteria. Real soap is brilliant on bacteria. Since I can't use the ointment, I'm using soap.

Twice a day I take a damp cloth and soap it up. I pat down incisions, going back and forth a couple of times. Then I rinse out the cloth and wring it out, and pat down again to remove the soap. It's very soothing and the wounds dry out very quickly.

Big mistake: too much too soon

I knew better and did it any way.

Yesterday I went out for the first time. I drove but my husband was with m just in case, as per my surgeons instructions. We went to the big Wal Mart so that I could get a few things from different departments. We did not get groceries because I felt that might be too much walking. These were all good decisions.

Today I went out early on my own to a small supermarket nearby. My plan was to get a few things then return home. That was a good plan. What I did instead was to fill my cart going up and down all the aisles, then I had to put all that on the belt then put the bags in my cart, then put them in the car. At home I had my teenage sons bring them in and put them away as well as to load up the crock pot with veggies and stuff for some great soup later.

Now I am sore and swollen. I slept for 5 hours and feel a bit better. I have decided against going clothes shopping any time soon. While I am having no trouble dressing in anything at home changing my clothes a bunch of times is probably not a good idea.

I also think my immune system is working hard enough without me going out in public and trying on things that have been handled and possibly tried on by other people is too much.

Saw the surgeon today

I woke up in a funk. I felt weepy for no particular reason. It's probably because I can't exercise. I have some mobility issues with my lower body and am not allowed to do my usual routine which consists of the PT assigned stuff and some other fun things I do with cans and weights, that gets my heartrate up nicely. Exercise is so important for a stable mood. I came home and looked for some good seated leg workout routines. I couldn't find much, a few sites with the same five moves. It's something anyway.

To top it all off the visit with the surgeon was very uncomfortable. I wrote down my questions so I could ask them efficiently and not waste his time. He made this awkward joke about being glad they weren't legal papers. It was one paper folded into quarters with a few words on it. I felt bad, like I'd put him on the defense. I thought I'd made it pretty clear that I'm happy with his work, but curious.

The doctor and assistant took out my stitches together on either side of me. She was on the less tender side and still hurt me a fair bit. I didn't feel a thing on Perofsky's side, impressive! While they did that I asked my questions. At the end I was sitting there with my gown open, we were still talking. It was very uncomfortable, but I thought they had more work to do, like dressing my wound, or whatever they do. I was waiting for them to tell me they were done so I could close it. They just kept talking and at some point it became a conversation with my gown inappropriately open. Is it just me or do you guys also think they should have let me know I could close it? They do this all the time and know their routine, how could I know when they were done?

Better today

First, let me apologize for being so verbose. It has always been a failing of mine. I try to be concise, but don't often pull it off. I don't blame folks for skimming, or skipping what I write, I know it's a lot. I think I just need to get stuff out.

Yesterday my stitches came out, and today I'm a little sore and am having some jabbing pains. I hope that pulling the stitches through the incisions did not introduce bacteria. The way they did it, they were pulling two-four stitches at a time, so the thread would be going in and out of the wound as it wound it's way out. I was surprised to see that they hadn't done all individual stitches, when I came out of surgery, and more surprised to see them pulling them out like that, not one at a time. I guess that is now they do them now.

I also notice that I have some weird little veins showing on the bottoms of my breasts, that didn't used to show. It looks like it could be due to skin thinning, but I don't know if that is possible. I tried to visualize where this skin was before, and noticed that one spidery red vein, or artery (I always forget which is which) is close to a mole that I've always had, and there never was a vein like that positioned like that. I'm not worried, I just want to know what is going on.

Also, there is a strip of yellow skin about 1cm wide running along the medial side of Righty's incision. Righty also has some yellow bruising that has been hanging around for quite a while and not clearing as fast as usual. The surgeon saw this and said nothing, but then I think he doesn't really believe in sharing much information with patients, so he could have been concerned and I'd never know. I hope the circulation is OK there. If it doesn't clear up I will start to worry soon.

Almost called my GP today

Everything looks great and I feel fine until I do stuff. It doesn't take much for me to get fatigued. I find that short frequent exercise works best. Last time I weighed myself, 11 days post op, I had lost 12 lbs. None of this worried me until the surgeon said he didn't know why I was easily fatigued.

I have been wondering what is wrong with me ever since. In the past I have had trouble keeping my iron and other nutrient levels up. At one point I worked with a nutritionist on it since the usual fixes were not working. I thought maybe that was happening again.

I wanted to call my GP but was afraid that she would just tell me to call the surgeon. Since I had already told him and gotten such a cryptic and unhelpful response I won't do that again.

I looked through the RealSelf questions and answers to see how the doctors here responded to similar questions. They seem to think it's pretty normal. I am going to go with that and hope for the best. I am starting to dislike my surgeon. He did a good job on the surgery itself but his bedside manner and ability to guide me through the recovery process are more than a little lacking. If I run into trouble I do not feel comfortable calling him and that isn't good.

I see he has other reviews that are different. He even gave his cell phone to one gal so she could text him if she needed reassurance or had questions. Maybe he just doesn't like me and is normally different. At least I don't have to see him for 2 weeks.

Progress

I went to the grocery store again and played it smart this time. I brought one of my sons to do the lifting and I didn't buy much. I can reach for stuff, l just move a little slowly and stop if I feel pulling. I was shaking a bit at the end but I feel pretty good.

Found some useful products

I've had trouble finding wound care products that don't irritate my incisions. Even things I use all the time, like bandaids, irritate the incisions and skin near the incisions. I was able to find plain cotton gauze squares, like the ones in doctor's offices on Amizon, and they arrived today. I also found a new antiseptic product made by Neosporin. It has Benzalkonium chloride, and the innert ingredients all seem to be OK so far. For some reason petrolatum gives me hives and it is in almost every wound care product.

I still have the gel the Doctor recommended but this new stuff kills bacteria and I feel better having that option.

How they look 26 days post surgery

There does not seem to be any significant swelling or bruising though there is a slight shadow a bout the size of my palm on the medial side of the right one. There are still a few small scabs around both areola. Both nipples have sensation but there are numb spots on both areola, more on the left.

The incisions on the breasts are flat and mostly sealed. They have small areas with something white on them. The wound under my right breast where the tape left blisters is healing slowly. It has two areas that are still open and oozing. 70% of the original wound is closed with shallow red scarring that should fade. The incisions under the breast have some spots that are red and open but most of it has flattened though some ropiness can be felt under the skin. In places there is still a lot of red along either side of the incision. The drain sites have scabs and the left one is sore and a bit swollen. The medial ends of the incisions, between the breasts are still raised. On the right there is a small hole about 2mm that is not oozing or scabbed.

The shape is still quite boxy though some settling has started. The shape on the right is a bit distorted and it seems like the seam wasn't cut evenly so instead of a smooth curve it dips in to the shape of the breast. Perhaps the skin tore a little and had to be sewn up that way. I think it will stretch out and be OK in time.

Nipple placement seems odd. They seem very high and wide. Googling for NIH standards brings up lots of articles and mathematical formulas. To sum up the nipples a d sternal notch should form something close to an equilateral triangle and normal measurements should be about 20 cm, give or take a bit, and with some adjustments for body type and frame size.

I am very short and heavy but most of my weight is in my legs and since menopause my belly. My belly is not wide, it goes straight out. My nipples are both 20cm from my sternal notch and 28cm apart. They appear to be equal distance from my medial line, but this is harder to measure on myself.

Although the width is pretty far off the other measurements are right on. They seem high to me only because I am so used to them being so low. The headlights definitely are pointing out but they are doing it symmetrically, which is a first for me.

Tomorrow I see the surgeon and I will add anything useful I learn.

One month post op

It was a pleasant visit. The doctor thought things looked good. I did not bring up the nipple measurements because I haven't decided what I think of the width. Everything is so symmetrical and I may like the wide placement.

I pointed out the small hole and he checked it out right away. He said it was a stitch. He opened it up a little and dug it out. It didn't really hurt. He put bandaids on the small wounds and told me to do that at home too. I go back in a month.
Macon Plastic Surgeon

The website took out the FACS from behind his name, but he is in fact a Fellow of the College of Surgeons as of this writing. He seems very conscientious, and I am confident that he has my health as his first priority. I'd rather have a doctor tell me they can't or shouldn't do what I want than take extra risks with my health to achieve an unrealistic goal. He isn't much of a talker and I still have unanswered questions. However the work he did is top notch. I asked about Lipo for the side areas and he instead said he would excise some tissue from that area. For me that was the superior choice and I am thrilled with the result. His office staff has been great. Everyone I've talked to has put me at ease and been very helpful. I like his staff a lot. The appointment was made quickly after my PCM put in for it. They sent out a nice packet with information about their practice and where and when my appointment would be. I will update my review when I've been through more of the process.

5 out of 5 stars Overall rating
4 out of 5 stars Doctor's bedside manner
2 out of 5 stars Answered my questions
3 out of 5 stars After care follow-up
3 out of 5 stars Time spent with me
3 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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