40 Years Old, 3 Kids, 30A to 30DD - New York, NY

I've been flat-chested my whole life. When I was...

I've been flat-chested my whole life. When I was younger it didn't really bother me, then as I got older I became more self conscious about it. Then I breastfed my kids and realized how fun it was to have boobs. After every pregnancy, I've worked hard to get back to my starting weight, eating right and working out, but I just can't make those breasts grow!

So I began looking into breast implants. I had a few consultations with surgeons I liked. I was turned off though by the likelihood of additional surgeries and I hated the thought of something foreign in my body. One surgeon encouraged me to consider fat transfer to the breasts. Natural results, oh, and I get to slim down my bottom half too!

The downside is the pre-work that goes into fat transfer. From what I've read and what my surgeon has told me, the success of the procedure is directly correlated with use of the Brava - those dreaded domes that suction your breasts to enlarge them. The more you use the Brava, the better your final result. I had initially pooh-poohed the idea because I couldn't imagine fitting it into my life with three young kids and a full-time job. But then I considered how much time I would have to take out of my life with (potentially) multiple implant-related surgeries.

And here I am. Surgery date set, three weeks into my Brava use. I must admit that the Brava wear (knock on wood) hasn't been as bad as I had been expecting. It's definitely a pain in the boob, but I started slowly, have been very diligent about skin care and so far I haven't had any major problems. I added the black bulb pump to increase the pressure, so I've been using the higher pressures as often as I can. Before beginning the Brava, I measured 28 inches under the breasts and 30 inches over. Since then I've gotten up to 28/33. That seems like a fair amount of progress, but keep in mind that my starting point is t i n y ! So I still have a ways to go.

Since my initial visit with my surgeon, I've had one checkup on my progress and it was recommended that I add the turbo pump in order to increase the pressure even further and for more extended periods. I also need to create a "halo" to help keep domes from collapsing in under higher pressures. I'll update more on both and add some sexy dome pictures too.

Wish boobs

Because I'm starting off so small, I know I can't expect a huge increase in size, even with the Brava. I never wanted B I G, I just hope they're big enough.

Brava photos

Brava pics

So here's what the contraption looks like. In a word - ridiculous. Nonetheless, it's remarkable how even the most ridiculous things can become routine. At first I was embarrassed to have even my husband see me in the Brava, but now he and my kids are used to seeing me in it. (Though no one else is allowed to see me like this!)

The hardest part is just finding the time. I come home, feed everyone dinner, finish up homework and rush the kids off to bed so that I can get the domes on in time. And that's if I'm lucky - no crying kids, no other commitments in the evening. I generally get at least 10 hours a night, plus one hour of high pressure in the evening and in the morning during the last hour of wear. On weekends I try to do more and the last three days before surgery, I've taken off so that I can wear them for 24 hours straight.

In terms of skin care, at night I wash with baby shampoo, then use an aloe vera gel to protect my skin from the tackiness of the domes. After taking them off in the morning I wash with Aveeno soap, then put on coconut oil and Aveeno moisturizer. So far, so good.

Details on the Brava routine

Since I got a question on it, I figured I would post some more detail about the morning and evening routines for Brava.

In the morning after having worn the domes, you put on a cleansing spray that comes with them, let it sit for 10-15 minutes, then you rinse off. I usually put the spray on, take a shower then rinse and store away. Then I put on coconut oil and moisturizer. The process in the morning only adds a few minutes to my usual routine.

The evening takes a bit longer. I wash my chest area and apply the aloe gel, then I have to wait at least 8 minutes for it to fully dry. During that time I can wash my face, brush teeth, etc. Then I put on the domes, which involves placing them correctly over my breasts, hooking up the sport box and black bulb, and increasing the pressure to a point where the domes stay on without me having to hold them in place. Then I put on a large shirt and knot it under the domes to keep all the gear in place. (The Brava comes with a bra but I lost it so I've improvised.)

This routine took a little time to get used to, but now that I'm fairly efficient, and I can do it in 15-20 minutes. I started off slowly, only wearing the domes for 20 minutes the first time, then a couple of hours, etc. and I would send pictures to either my Brava contact or my doc for feedback on positioning, etc. I was paranoid I'd mess up early in the process and either wreck my skin or the domes in the process.

I really wasn't looking forward to having to sleep on my back. But I have to admit that that hasn't been much of an issue. I followed the recommendations in the Brava DVD and placed pillows under my knees, and after a few nights I was pretty used to it.

I'll write a separate update on cycling with the black bulb.

Black bulb/Hand Pump

Once I got used to using the domes with the sport box, I added in a hand pump to increase the pressure. I started with an hour in the evening and I would increase the pressure as much as possible with the hand pump, leave it there for two minutes, then release the pressure for one minute. I gradually increased the number of pumping sessions and the lengthened the amount of time I was at max pressure. Luckily my skin has held up really well, so I've been able to keep the max pressure for extended periods (like 45 minutes). The bulb definitely helps to increase my expansion.

The bummer is that I can't do much else while I'm pumping. So I've been watching a lot of Netflix.

Adding in the Turbo

Two weeks before my surgery date, I started using the turbo - a high-powered electric pump that increases the pressure in the Brava to create more expansion of the breast. It essentially does the same thing as the hand pump, but more gently, at potentially higher levels of pressure, and all day/night long. It's made a big difference in how large my breasts have gotten.

I'm in the final "stretch" in which I'm supposed to wear the Brava (+turbo) for 3 days straight, only stopping to clean myself and the domes. Since I was home for the weekend anyway, I increased it to 5 days hoping for a little extra. I tried on a 30DD bra yesterday morning after taking the domes off and miraculously it fit. I'm sure that's not going to be my final size, but it was fun to see.

Surgery is just 3 days away! I have my pre-op appointment on Wednesday, surgery Thursday, then back to work on Tuesday (yikes).

Pre-op appointment

On 2/11, I went to see Dr. Ahn for my pre-op markup. I was so nervous about having to wear the domes into and out of her office, but I was able to conceal them pretty well with a large wrap.

I spent a full three hours there, with her marking up the donor sites and then taking tons and tons of pictures. I kept the domes on until the very end, then only took them off for a few minutes so she could take a few more photos. She's incredibly meticulous and was very kind answering all of my questions.

I spent a full five days wearing the domes, stopping only to take a shower and clean the domes. By the end, I was quite sore, itchy (Benadryl spray was a life saver!) and had pain along my lower ribs. But boy did those boobs grow!

Surgery and Recovery

Dr. Ahn is now doing most of her surgeries in a hospital (as opposed to many other PSs who work out of surgical centers). Mine was at NYU. The upshot is that you have all of the hospital's resources available to you should you need them and Dr. Ahn felt that the staff are better. The downside is that you're mixed in with people who are getting all sorts of other procedures, so the nursing staff in the recovery area may not be familiar with the procedure you're getting. Either way, I didn't have any issues and I liked the extra security of being in a hospital.

I got to the hospital at 6am Thursday morning, filled out paperwork, answered the routine questions about my medical history, took a pee test to confirm I'm not pregnant, and then Dr. Ahn came by to mark up my breasts and take some more photos and a video. She was incredibly sweet, braiding my hair for me to keep it out of my face and warmed me up with a warm blanket.

Heading into the OR and seeing all the surgical staff and equipment laid out, I had that O-M-G, what-have-I-done moment. Luckily they kept me moving along so I didn't have any time to dwell on those thoughts. They had me lay on my belly to start and propped me up so that I wouldn't squish my breasts. Within a few minutes I was out. Dr. Ahn had me in a twilight sedation so that I was able to answer when they spoke to me, but I don't remember any of it. I think that also made my recovery easier.

The surgery took about three hours, just as expected. When I woke up in recovery, a nurse was sitting by my side and started chattering away, which helped get my mind off of things. I was in some pain, but I would describe it more as discomfort. The more I was able to move around a bit, the better I felt. Once I was able to eat and drink something, they sent me down to a secondary post-op area to get ready to be discharged. In the end, I left an hour earlier than expected.

Before I left, I took a zofran (for nausea) and 2 percocet (for pain) just to keep comfortable until I got home. Unfortunately, I threw up shortly before reaching home, then luckily the nausea went away. After lying down for a bit, I was able to have some soup and hang out with the kids. They kept wanting to hug me, but it felt more like a game of bumper cars.

That first night, I set my alarm for every five hours or so to take another percocet so that I could stay ahead of the pain. By the next day, Friday, I downgraded to tylenol with codeine and now Sunday I'm only taking Tramadol, a much lower dose pain reliever.

Dr. Ahn is also having me take arnica pills every hour (she had me start 5 times a day for the two weeks before surgery), plus two types of antibiotics. Then there's the stool softener, probiotics, and vitamin C. I had to make a detailed schedule of all pills in order to keep track of everything.

Saturday, two days post-op, I was able to take off the garments for the first time and have a look see. I had had some drainage in a few areas when I was first in recovery, then nothing more after that. My bruising isn't terrible, especially considering that I bruise pretty easily. I was disappointed to see my breasts at first - they seemed a lot smaller than before surgery and I know that they'll go down in size. But they're looking better now, thanks to putting the Brava back on (more on that below).

It's hard to see much of a difference in my lower half, though my curves look a lot smoother. Out of curiosity, I measured around my thighs, which are my most stubborn areas of fat and they measured the same as before. So there's probably still a lot of swelling.

Saturday, after taking off the garments and having a divine shower, I had to put the domes back on for 3 days, 24 hours/day at the lowest pressure. I was so dreading it, especially given how tender my breast area was. But I have to admit, once they were on, it's been no big deal. My breasts looked all flattened out when I first took the bandages off, then after wearing the domes for a few hours, they've been pulled into a nice shape. And compared to the discomfort of wearing the domes at much higher pressures, the sport box pressure feels like nothing. Funny how things are so relative!

Today - 3 days post op - I'm feeling great. I'm sore, swollen and tire easily, but that is all way better than I thought I was going to feel. I'm especially thankful because I have to head back to work on Tuesday. No idea what I'm going to wear though!

Post-op photos

Post-op Brava wear

As I mentioned earlier, wearing the Brava post op has helped pull out and shape my breasts.

What I had done ...

I just realized I never posted what exactly I had done. I had liposuction of the inner thighs, outer thighs, inner knees, flanks and waist. My bra size was 30A (on a good day) before. I'm 5' 4 1/2" and 127 pounds. Once I get further along, I'll update with more detailed before and after measurements of the lipo areas and breasts.

CCs transferred

I finally asked Dr. Ahn how much she put in my breasts and she said 450ccs!!! That compares to her initial estimate of 250-300ccs. I guess all those hours with Brava and the turbo paid off. Now it's my job to hang onto as much of it as I can.

Continuing to heal

I'm now one week post-op. I went back to work three days ago. The first day was okay, though I felt out of it. Then yesterday I felt pretty awful. I actually put my head down one desk and fell asleep. I don't think I've ever done that in my whole life! So that was my signal that I was pushing myself too much. Today I'm working from home and tomorrow I might as well.

Some of the swelling into bottom half has gone down. I measured around my thighs again and they're down 1 inch from my Preop size, which is great and hopefully there's more to come! I'm also weighing about 131 pounds, so a bit heavier than Preop which also tells me there's still some swelling. So I'm keeping up with the arnica and drinking lots of fluids.

My breasts are measuring a bit bigger than they did right before surgery - 29.5 under breast and 36.5 around. The bruising has mostly resolved ony left side, but the right is still very bruised. And they're both rock hard. Can't wait until they soften up a bit.

Pics: before and after

Thanks to a comment I realized I never posted a before photo. So here's one taken after my first few minutes with the Brava and the second is one week after the procedure.

3 week update

I am almost 3 weeks post op and feeling great. Most of my bruising is gone and my lipo areas just feel a little tender. I ended up taking the heavy duty pain killers for a few days and Tylenol for another few. I actually had more pain in my breasts than the lipo areas, which I was surprised about. It's probably because Dr. Ahn released some tissue on the lower part of my breasts to make room for the fat.

But now my breasts feel much softer, though still a little tender. My nipples were very sensitive for the first two weeks after the procedure. I couldn't bear to put a bra on, even the surgical bra I had. I discovered that if I wear a camisole and put a piece of gauze over each nipple, they're much less sensitive by the end of the day - and I can hide the fact that I'm not wearing a bra. Cardigans are also my breast friend these days - they hide all sorts of things!

My breasts have also gone down in size. I knew it would happen, but it's still sad to see them go. I now measure 29.5 under the breast/33.5 across, compared with 29.5/36 right after surgery and 29.5/30.5 before starting the Brava. So still a significant increase for me, even if I lose a little more which I'm sure I will.

As my breasts are getting smaller, so is the rest of me, which is nice consolation. I've lost an inch or two off my hips. While I haven't lost any inches off my thighs yet, they look smaller and my pants are hanging off me. I'm trying to hold off buying new clothes until I stabilize a bit more but it's going to be hard!

Overall, I love my shape. I look like me, just more shapely and in proportion. My husband told me I look more girlish on the bottom and more womanly on the top. I'll take it! I can't believe I'm actually looking forward to trying on some bathing suits.

I haven't had a chance to take more photos but I'll do that as soon as I can.

4 1/2 weeks post-op photos

My breasts are holding steady in terms of size. I'm still 29.5/33.5 and I can fill out a 30DD bra that I have. My breasts don't look like they're that big, partly because 30DD isn't as big as it sounds, partly because my breasts are more wide, rather than projecting.

I'm wearing the Brava at night, 9-10 hours most nights. Dr. Ahn wants me to wear it for another 2 months and she told me that I should expect to lose a little more size once I stop the Brava.

4 1/2 weeks post-op, lipo photos

When I look in the mirror, I feel like I don't see much of a difference where the lipo was done. But then when I compare before and after photos, I think it does look much better. Hopefully, I'll lose a bit more in time. Overall, I love the shape.

Bra fitting at VS

Out of curiosity, I went to Victoria's Secret to get fitted and I am currently a 32D. (The band was big so I'm really more like a 30DD but they don't carry smaller band sizes.) I'm thrilled! Previously, the only time I was able to fit into a VS bra was when I was pregnant.

I didn't buy anything because Dr. Ahn wants me to stay braless or in a loose fitting bra for another six weeks or so. But I can't wait to have some fun!

Refund from hospital

Even though I paid the hospital for my procedure upfront, a few weeks after, the hospital sent another huge bill. After a few phone calls, including from Dr. Ahn, they said they would investigate. Then a few days ago, I received a check in the mail, refunding some of what id already paid. Go figure. Turns out my procedure was quicker than expected. So I've updated the cost to $13,000, not including the Brava, which is another $1,100 or so.

Interestingly, I found estimates that I had gotten from some other surgeons I had met with last fall. All of the estimates for breast implants and lipo or fat transfer were more expensive than Dr. Ahn. So even though $13k is a lot of money, it was good to be reminded that that is in line for Manhattan.

Nearly 3 months post op and thrilled!

My size has held steady since the swelling went down about three weeks post op: 29.5 ribcage, 33.5 around breasts and 30DD/32D bra size. My breasts look very natural and while I've lost some fat on the lower part of one breast, I think I've had great retention. In fact, when I investigated getting implants, I was told by several surgeons that I wouldn't likely be able to get more than a natural looking full 32B/small 32C because I had so little breast tissue to begin with. So with fat transfer I've been able to get even bigger and without the trouble of implants. I wore the Brava until about a week ago so I think that really helped with retention.

I also think it really helped that I've taken very careful measurements along the way. One of the toughest parts about this procedure is that you see your breasts get so large immediately after surgery, then they go down as the healing continues. So it feels like you're losing a lot. But by having clear before photos, measurements and bras in different sizes, you can truly see how much bigger you are compared to before beginning the whole process.

3 months post op

Bra pic

10 months out - still happy!

It's been over ten months since my surgery and I'm still very happy with my results. My size has maintained for the most part. A few bras that I bought 4 or 6 weeks after the surgery still fit, maybe just a little looser. I continued to wear the Brava post surgery for 11 weeks, 8-10 hours a night which I think really helped with retention. I haven't had any lumps or cysts.

The scars on my breasts are unnoticeable. The lipo scars are noticeable. The only ones that really bother me are right under my butt cheeks, which you only see when I'm wearing a bathing suit. They just look very obvious if I bend over (which I do often when I'm running after the kiddos at the pool).

I love my new shape. My legs are still curvy, but are more in proportion to my top. The only area I don't like is my stomach - which Dr. Ahn didn't touch. I'm about five pounds above my desired weight and it has tended to settle in my stomach now. But the fact is I'm not very motivated to lose those five pounds because overall I like how I look. One of these days I'll have to update with pictures.

Still happy!

13 months post op and I'm still happy with my results. I went from completely flat chested to nicely endowed and more importantly, confident in myself. My husband loves the results too! I haven't had any cysts - and I just had my annual ob/gyn exam. My doc was very impressed with how natural everything felt and looked. M scars have completely or near completely faded. My one breast is less full on the bottom than I'd like, I definitely lost some fat there after the procedure. But given where I started from, I'm thrilled.

Updated bra pic

New York Plastic Surgeon

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