My Bariatric Life Breast Augmentation and Revision with Dr. Joseph F. Capella - Excited to Complete My Total Body Transformation

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I had been contemplating body contouring plastic...

I had been contemplating body contouring plastic surgery after having lost more than 100 pounds from gastric bypass surgery in 2003. I met with Dr. Joseph F. Capella in 2006 and from that initial meeting I knew he was the one whom I wanted to perform my surgery.

I had met with several plastic surgeons but Dr. Capella stood head and shoulders above the rest. He had the surgical skills and expertise to produce optimal results on massive weight loss patients, as evidenced by his extensive online gallery of before and after photos. I still recall the photo that I fell in love with all those years ago. I thought, if he could do that for her, imagine what he could do for me!

The one thing that I remembered from our conversation during that long ago consultation is this: I told him about the body I wanted to achieve with plastic surgery but said I knew I’d never be able to wear a bikini. And he giggled and asked me “why not?” That must have been meaningful to me because I distinctly remember the details of the encounter to this day.

Finally in 2013 I moved forward with my long-held dream to do a total body transformation. It began with a simple tummy tuck with Dr. Capella on April 18 2013. So thrilled was I with my results that I decided to do "all of me." On October 10, 2013, I underwent another surgery with Dr. Capella that combined an upper body lift, lower body lift (no tummy tuck), and medial thigh lift. Then on December 12, 2013 I had my facial plastics with Dr. Catherine Winslow.

I am super delighted almost beyond words with my results. Never did I think I could have a body like this and a face like this at 49 years old, especially having been morbidly obese for most of my adult life. People now tell me that I look like I am in my 30s. Some people even say I look like I am in my 20s. I've been told that I have a body that a teenager would want and that my thighs are almost model-like. People write on my RealSelf reviews that I look stunning, fantastic, amazing.

This is all very mind-blowing to me because before I began my body contouring I had really let myself go. I was none of those things in the preceding paragraph. If you look at my other reviews, you will see many before photos and understand how truly amazing this transformation has been. It is life changing.

I did not believe Dr. Capella when he said I would be able to wear a bikini. But after my tummy tuck I did wear a bikini all summer. And when I went back to Dr. Capella for my second stage body contouring I told him that I wanted a body like Anna Nicole. I really did not think that I could seriously achieve that, but I am darn close! Her measurements were 36DD 26 waist 38 hips. My measurements are 36D 32 waist 28.5 hips. I just have to get my waist whittled down. I would be thrilled to be 29 inches.

My stage 3 surgery will be my final surgery. I will have breast augmentation and skin removal (tweaks to perfect what has already been done). Dr. Capella will shape my breasts during the augmentation to make them round and pretty. They have always been a little tuberous. And he will create upper pole fullness for me. He does the most beautiful breasts I have seen and he is meticulous with the incisions. I am super excited. I have always wanted beautiful breasts in the nude, as they've only been beautiful in a bra until now, although the breast lift that Dr. Capella did made them quite perky and youthful.

I am hoping to have my surgery in early June. I am eagerly awaiting that time. I am even excited for my consult and fitting, which I hope to do in March.

Stay tuned! There's more to come.

Typo above

My hips are 38.5 inches not 28.5 inches

Milestone reached: 159 pounds and size 2 jeans, and consult with Dr. Capella next week

Wow, I still cannot believe how wonderful this transformation has been and it keeps getting better. I began my body contouring plastic surgery journey in April 2013, a size 14 after massive weight loss following gastric bypass surgery in 2003.

After my breast lift my 38DD went to about a B cup. But in a few months they fluffed. Now I am a 36DD. My surgeon wants to know how my breasts got so big with me working out and losing weight since the lift. I guess I am lucky.

Today I woke up and I broke a new record. I am officially in the 150s. Yesterday I purchased a few size 2 jeans at Lucky Brand and they fit oh so well! And recently I purchased a size 36DD bra at Victoria Secret that looks super!

You can click through to my profile to access all of my reviews on the differnt procedures that I had.

Anxiety... oh boy, I cannot handle another emotional roller coaster

So the trip to see Dr. Capella that I was looking forward to has now turned into one filled with anxiety. I was a mess for the months leading into my last surgery with him. I cannot go through that again.

Thoughts that are weighing on my mind are, "Will he correct my tuberous breasts and make them beautiful?" "Will they still not be the breasts I dream of having?" "How will he fix my thick waist? " "Will I be stuck with this thick waist and be disappointed in my results?" As well, I am having some anxiety about the procedures he is going to perform in his office.

I could use some reassurances right now.

Surgery scheduled for May 29

Thankfully the anxiety I was feeling in my last post subsided quickly. My consults with Dr. Capella went very well. He told me that my results exceeded expectations and we discussed tweaks to make them even better.

We did the sizing / fitting for the saline implants and I was very undecided, as I knew I would be. I appreciated Dr. Capella's guidance in this regard. He listened to my concerns and desires and advised me on how many cc's to go that based on his experience would give me what I was seeking.

Mot of all I want breasts that look beautiful in the nude. My breasts look wonderful in a bra and I'd like them to look that good when I remove my bra. I want to look sexy and not matronly or like a puta. I do not want to look or feel fat. I will probably be a full D cup when I am completed. Currently I am a 36 DD but without upper pole fullness they are just not what I want. Dr. Capella is going to raise my NAC after he puts the implants in. He does very beautiful breasts so I am excited for my transformation.

Before Shots

A few shots taken after my breast lift but before my implants and revision lift.

Keep calm and go large

Walking through the mall and contemplating if I a want to go DDD with my implants, I happen upon a shirt at that very moment that reads, "Keep calm and go large." Hahaha

"I like big boobs and I cannot lie. You other brothers can't deny, that when a girl walks in with an itty bitty waist and those round things in your face, you get..."
-adapted from Sir Mix-A-Lot

So, yeah, I've always liked my big boobs and they've often got me noticed by both women and men. Currently I am a 36 DD in Victoria Secret Very Sexy Extreme Lift -- but let's be real, those bras are miraculous at making breasts look great and worth every penny of the $65 they cost.

I tried on the VS bra today that adds two cups sizes. It was a 36 D, so I was a 36 DDD with it on. The sales gal said plastic surgeon implants are a little different in that they are not so pointy in the projection and that there is nice upper pole fullness. Anyway, here are the shots of me in this bra and I do not look too large or matronly. What do you think? I am trying to get a clear idea if this is what I would look like with implants that would bring me to a 36 DDD.

Ewwww, I don't know...

I am looking at pix of nude breasts sizes 36DD and 36DDD. Some women look great at 36DDD and other looks way too large. Some women look great at 36DD and other look too small. How am I supposed to know how I will look???

Pushing out my surgery date

So... I will push surgery to the Fall to give my tissues time to settle and heal. I have had a lot of surgery in the past 12-months. Although I hate having to wait, the time will likely pass quickly.

I also will do another fitting a few days before surgery. I am undecided about size and very torn between doing 400cc saline and 450cc saline.

I very much look forward to achieving my ultimate body. Talk to you all after Summer!

Just had to share that I am super bummed

So I am at the airport and headed home instead of headed to NJ for surgery as I had planned at the beginning of this trip. I cannot tell you how very disappointed I am about that. I truly wish I was headed to sugary.

At least now I will not have to recover over the summer and miss out on all that fun and physical activity. And I am sure that September 29 will be here before I know it. And I am super excited for that!

Itty Bitty

I was wearing a bralette under my t-shirt today. It made my breasts very small. My husband had commented to me a few days ago that I have very large breasts. So I asked him how he liked them itty bitty. He said he prefers them that way and does not like large breasts. He said breasts should be appropriately sized for a woman's body, not make her look top heavy.

Ah... But appropriately sized is in the eye of the beholder.

The Great Boob Debate

I have been so torn on what size I wanted to go with my breasts. I am so excited for this procedure and have been talking to Dr. Capella about it for about a year now. I have high expectations as Dr. Capella consistently does the best breasts I have seen. There is some really bad work out there by other plastic surgeons - no one I know though... You all have beautiful breasts!

I have contemplated every size breast from a C cup to a DDDD cup. Initially, I was looking at a C vs a DD. Then as time went on, I began looking at a DDD vs a DDDD cup.

After much deliberation, here are my assessments. I hope this helps someone when she is deciding on her implants.

1. Several post MWL women and a few PS here on RealSelf have warned me about going large with my implants. One surgeon said I would probably need another breast lift in a year. Patients echoed the same concerns. One said the only thing worse than a rock in a sock is a boulder in a sock. That is quite a visual!
2. I am considering if the use of Alloderm or Strattice used to create a sort of internal bra to support the implants would be the best approach to ensure long term that the breasts do not sag.
3. Larger breasts will make my torso more shapely, especially since I have a thicker waist and narrow hips.
4. Smaller breasts make me look and feel thinner.
5. I do not have any money left for future surgeries (truth be told I cannot even afford my next surgery of $5k). So a future revision to further lift the breast or change out the implant is out of scope. Furthermore, I made a promise that this is my last surgery.
6. My breasts are still ptotic after the lift so a good lift revision is needed. The larger the implant the less my breasts can be lifted.
7. My breasts need to be shaped and the NAC repositioned on the center of the breast mound.
8. The breast tissue of a post massive weight loss woman does not have the elasticity of the breasts of a normal woman, making them prone to sag.

What do I want?
Beautifully shaped breasts that are higher on my chest wall and perky, with more tissue under the NAC than above it. Nice cleavage and upper pole fullness, and Breasts that are sufficiently large to make me feel and look sexy but not so large that they make me look top heavy or feel fat. No need for revisions in the future.

Funny that for so long I wanted big beautiful breasts and now I am radically changing size preferences. I was really sold on the idea of 36DDD or even DDDD. And I showed wish photos to Dr. Capella. At that time he recommended 400cc mod profile saline filled to 420 and with the martial add another 20cc, so roughly 450cc.

Now I want a D cup and no more than a DD. So he will give me 325cc saline mod profile filled to 375cc, plus the material adds 20cc, so roughly I was,looking at 395cc.
What changed my mind? Well, I appreciate all of the many comments I got from readers on RealSelf both "for" and "against" large breasts. I considered those comments very deeply.

What really was eye opening for me was when I did an experiment on myself wearing 36DDD and 36DDDD padded bras. Initially I really loved the large beautiful breasts. But when I took those bras off at the end of the experiment during which I wore the bras for several weeks, I found that I felt very lean in my 36D bra. That was very eye opening for me.

I feel very good about this decision :-)

I am appalled and deeply hurt. And it's not the first time.

Dr. Capella's PA Scott who has been with me for all of my surgeries now refuses to assist in my last surgery. I am appalled and deeply hurt.

Scott became very offended by my inquiry about his credentials on a recent phone call. He spoke to me in an emotional and unprofessional manner. And although I tried to calm him down, Scott remained angry. What is worse, Scott now refuses to assist Dr. Capella in my breast augmentation and revision surgery, putting both my safety and my results at risk.

I even went so far as to attempt to reconcile with Scott face to face when I was in NJ, using Dr. Capella as a conduit, but Scott did not respond to me. This speaks volumes to Scott's integrity and patient care and safety.

And this is not the first time I have been treated poorly. If you have been following my journey then you know I was treated very badly by the former surgical coordinator at Capella Plastic Surgery.

So much for my wish that this last surgery would be the nice experience that all my surgeries should have been but were not. Now a senior plastic surgery resident whom I do not know, and whom has never operated with Dr. Capella, will be operating on me.

Reading between the lines

I believe in the power of the now; the past is over and done, never to be repeated so it need not shape the present. To quote the Landmark Forum, “People keep taking the past and putting it in the present thereby ruining their future.” Our futures have yet to be created and as we don’t have the power to un-create the past, let it go. Our power of creation lies in our awareness in the present. We have the power to not only create our futures, but also to create acceptance of our pasts.

Therefore, I thought it best to let sleeping dogs lie. However, the Universe is sending messages that I need to clear my karma (cause and effect is the basis of everything) with Scott regarding my post above. It’s taken a while to known what to write that would result in more good than harm to anyone, myself included. Love keeps no record of wrong, yet digging up these memories is painful.

I genuinely cared for Scott. He always had been there for me, providing patience and very detailed answers. I found him to be a wealth of knowledge. In fact, I told patients that I wished he could have been my PCP. Scott may have once even saved my life. I relied on Scott and I respected him. There are very few people I can say that about. I write these words in past tense but they remain true in the present, of course (otherwise if I did not care then I wouldn’t be writing this post now). And all of this is why this drama hurt so much.

Something went very awry on our call that day. We each got on the phone out of concern for the other. This was in the midst of my protracted arm lift complication, the period when the z-plasty had opened for the 4th time, and I was very scared something was seriously wrong (and in the end it turned out I was right). But the reason I'd called Scott was because I’d sensed he’d misunderstood the tonality of an email I’d sent to him earlier and I wanted to make sure he was OK. He’d taken my call because he thought I wanted to talk about the complication and he wanted to make sure I was OK. Instead we had a big misunderstanding. I never questioned his credentials. I had no reason to do so, because as I wrote above, I respected his abilities. As well, I’ve known about Scott’s education and career for years because he and I had discussed it in mid 2013.

A few weeks ago I was in NJ visiting an amazing person in SICU who was sedated into unconsciousness and intubated. During that visit the respiratory therapist caring for this person and I struck up a conversation. And it came to light that this man held a B.S., a higher degree than the majority of respiratory therapists hold. I told him that I knew a respiratory therapist who also had held a B.S. and went back to school to Johns Hopkins to earn an advanced degree (because his friends told him he was too smart to be a respiratory therapist — although to tell that part would have been rude to this man; I am only telling you). I went on to say that my friend became a P.A. and has operated in plastic surgery for very many years, and at the time I had met him, he was operating as my plastic surgeon’s right hand and had performed my surgeries. The respiratory therapist then asked if by chance the PA is Scott Woehrle. It turns out that Scott worked at this hospital when I lived in the area many years ago.

Scott is hard working and high achieving -- a self-made man. He's been with Dr. Capella for 8-yrs, I believe, and worked with at least one other plastic surgeon before that. I am pretty sure that Scott put himself through med school. It would not surprise me if he graduated at or near the top of his class. He’s a Capricorn; that’s who they are (my mom and daughter are Cappys and achieved the extraordinary).

Both Scott and I are very nice people with big hearts. But we each did something that was harsh; we made a mistake in the heat of a moment and it changed everything. I don’t blame either one of us for being human. Its very sad that we both got so deeply hurt, along with Dr. C who was caught in the middle, because we had had a nice relationship, one which was very important to me. If you know a little about astrology it will come as no surprise that I’m a Pisces, the most compassionate sign in the zodiac. Actually, I’m Pisces-Aries cusp -- Aires are the initiators.

I have learned and grown a lot through this experience, and I know that it had to happen. Understand that we are the total summation of every single experience we have had. Its what we do with it afterwards that makes the vital difference: Was a lesson learned or do we have to repeat the learning by going through another difficult life situation? Hiding from our difficulties is the most dangerous thing we can do. Anything we hold in that is stress, anxiety, etc is hell on earth. These experiences help to shape us into the people we are today. Train yourself not to judge past events as good or bad, but as opportunities. My life has changed in profound ways. As transformative as the physical body was because of the surgeries so too have mind and spirit transformed, and for that I am grateful.

Words spoken or written can heal or they can harm, lift people up or tear them down. Words give life to to everything (it is symbolized in every religion that G-d spoke creation into existence), to love and compassion. The Law of Love must underlie all relationships and service to the world. Our entrenched negative habitual thought patterns and way of being (ego) in the past can only be overcome when spiritual will accompanies love’s warm embrace (soul). You may be surprised at how people respond to this. I was.

What have you learned from the past that will help enrich your future? Focusing on the past and letting it dictate the direction of your future is taking your power away from yourself. Your are the creator. You hold the power. Reflect on the lessons of the past and use your current power to create your bright future.

May I act as a shining beacon in any difficult life situation that directs words toward that situation which produce miraculous healing. I wish Scott well. I wish him love. I wish him miracles.

And so it is.
Ramsey Plastic Surgeon

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