235 Cc Sientra Textured Round + Shoelace Cast - Seattle, WA

My little A boobs were pretty (no kids, etc.), but...

My little A boobs were pretty (no kids, etc.), but I always felt a full B cup would suit me better. My rib cage is on the wider side and there is a space between my breasts and pec muscles. I knew not to expect cleavage, but I'm a little concerned that the textured implants were the wrong choice for my body.
I felt confident in Dr. Grenley's experience and went with textured on his advice: lower risk of CC and of implant displacement during exercises. Now I wonder if I made a mistake and should have gone with smooth to have a softer feel, less risk of rippling, and more ability to move around in the pocket.
I'll try not to freak out as I see how my breasts change over the next few months (I might love them), but I'm a bit concerned I'll be stuck with baseballs on my chest... I am wearing a bandeau 24/7, but it's not helping much (yet). I now read that textured don't really "drop and fluff" like the smooth, and are not ideal for someone thin and thin skinned like I am. (Wish I had done better research!)
The idea of ripping out textured implants in a year and doing this all over again is more than I can handle at the moment :/

4 weeks: Starting to soften and drop

Progress: they are finally starting to soften up a bit.The compression band is not as painful anymore and the fullness is slowly moving south. My tight skin is not happy about it, thought, and some light stretchmarks are showing (no biggie).
I'm pushing the implants toward my center to keep my pockets open, but as I said, I didn't expect cleavage ;)
Hopefully in the next few months my skin will stretch, and they'll drop and settle into the lower pole so I can have a bit of a fold instead of projectile boobs!

Bra shopping was a total failure: they don't really sit/fill out the cups, so it's hard to asses size (I can't wear regular bras yet, anyhow).

Anyhow, for all you who are in the early phases: hang in there!

Scars ~5 weeks

A few scar pics. I've been careful to stay low key and let these heal tightly. I've stretched open other scars on my body by being too active too quickly, so I've learned my lesson. I'm doing some light massage, but nothing too intense. I'll wait until I see my PS this week.
They are still irritated from the original tape, but the silicone tape I'm using now doesn't bother them at all.

Before & After Pics: Vive la difference!

So, I have an optimist's mind and did not realize *how* small and asymmetrical my breasts were originally! I still haven't fully D&Fed and am already loving the difference. Dr. Grenley did a great job correcting the asymmetry while he was in there. Amazing.
Why did I wait until I was almost 40 to do this?

Dropped & Fluffed: ~8 Weeks

The changes from week 6 to 8 are really noticeable. They are definitely softening up and bras are much more comfortable. Also, they shifted a bit lower to fill out my lower pole, which I am happy about. I don't have a fold/crease under my breasts, and I'm not sure I will since I never had any to begin with (and didn't breastfeed, etc.). My scars are a bit red, but I am a slow healer when it comes to scars. I'll just make sure to keep them covered and protected through the summer. I can fake some cleavage if I squeeze them together ;) Also, I sleep in a comfortable front-clasp bra with an extra elastic to prevent them from settling into my sides too much as I sleep. I'm so glad I went small: they are not very noticeable in work clothes and feel somewhat real, although even at this size I can feel the edges of the implant in areas where my skin is very thin. Overall, I'm really happy with the results and even happier to know they just keep getting better.

Still changing, but not in a good way...

So, I'm three months out and not sure I'm happy with the latest changes. I feel like my breasts have shrunken significantly (note to readers: go a little bigger) but more importantly, I feel like my implants have slipped down a bit. Instead of having a smooth transition from my upper chest/ribs (like I did at 8 weeks), there is now a noticeable bump above my nipples and I feel like the majority of the implant has shifted lower (without a fold, which I wish I had). I have been very careful about supportive bras and sports bras with good-fitting bands, but I still feel the implants sunk too low. I'm going to meet with my PS ASAP to see if there is anything I can do. My scars are healing up nicely --would hate to think I'd have to cut into them again :(

Shoelace Cast

So, I met with my PS and am going to try the shoelace trick: https://www.youtube.com/watch?v=Qwg2eABBjS4

Funny, I had the urge over the past few weeks to put a *very* tight band under my implants, so I guess my instincts were correct. My PS said I am still early enough in my healing to use this and that it will help close off my pockets at a crease location I am happier with (without revisionary surgery). The only downside is that you need to wear the thing 24/7 for ~2 months, but it's worth a try (I wish I had started a month ago!).

I've had a really hard time finding supportive underwires that fit me because my rib cage is 30-32 but my boobs are spaced more like a 34. The bras I have found have cups that are too close together and are too U-shaped (so my implant slips down lower in the center of the cup.

If any of you out there are having similar issues, try out the shoelaces with me ;)

Experimenting with shoelaces...

First of all, let me say: ouch. Not comfortable to have on 24/7 - this is gonna be a long two months.
Second, I tried 24 hours of the way the video suggests to tie the laces (a halter top coming from between the breasts) and I felt that would only encourage the space between my boobs. So now I am tying from the outside of the breasts and it feels much more supportive (so far).
I love the feeling of support along the crease and no longer feel a pulling sensation inside my chest. I really hope the scar tissue sticks together...

Shoelace Update #1

I've been anal-retentively diligent about wearing the shoelaces, and though I wasn't sure they were helping much, comparing pics there is definitely an improvement. You are supposed to wear the laces twice as long as it took to see the improvement you want. It took me about six weeks to get my tatas in the right place, so I spoke with my PS and am going to wear them a full 3 months. I'll probably wear them for extra support when I do bouncy exercise for at least 6 months.
The only question I have now is: Is this going to stick?!? My PS said these creases are as permanent as a surgery (meaning there is no guarantee with either, but the objective is a permanent fix).
I hope my experiment gives hope to some of you out there who are bottoming out or have issues creating a natural crease (because you started with nothing, like I did).

Comparison Pics: 2 months of shoelace cast

Here are some before and afters. I didn't see any improvement for the first month, but I'm glad I didn't give up! The changes are subtle, but at the same time impressive! Again, I hope it sticks! Here's to at least one more month with laces....

One Year Update

Hi ladies,

A year has passed and things are fine. Overall I'm happy with the implants, though I wish I had some natural cleavage ;) I might add one more post with advice/lessons learned from my experience.

The shoelaces seem to have done the trick. I feel like the textured implants finally "stuck" in the correct position. If anything, they are a little high (fuller top) which I don't mind because I know over time they will only fall. I'm still careful about keeping them supported.

When I'm hanging around the house, I sometimes prefer to wear only shoelaces (which support the crease) over a bra (which can sometimes push my implants up into my pocket/muscle and still feels kinda weird). But at least now I can occasionally go braless and not feel like my implants are ripping/slipping!

Here are some pics (sorry for the close shots - all boob!). Bras all fit differently.
Good luck everyone!

Opinions after being through it...

I wrote an email to a friend, and decided to paste the info here for anyone considering implants:

Choosing a doctor:
Go by their photos for sure - look at as many as you can. They often have larger binders of their work in office (way more than posted online), so you can get an even better idea. (If you interview remote doctors, see if they have more photos to send.) There is definitely an artistic aspect to it. Then check online reviews on realself and other sites. Go with your gut and go with someone who specializes in boobies.
Don't be afraid to meet with many doctors, even more than once if you have to. Come armed with a list of questions, get their opinions, and see who you trust the most.
Local is ideal because you can go in for follow-ups to address any concerns with scars, etc.
If they are pricier, in the end who cares. Go with the best. You only want to do this once, so do it right!

Sizing and projection:
You are limited by your breast width. So, if you have a narrow breast and want more boobage, you will have to go with higher projection, which looks and feels faker. the profiles are: low (rarely chosen), moderate (I have). mod+, high, and then *really* high (porn star like).
I actually wanted a low profile (I like flatter, wide, natural boobs), but my boobs are so narrow that if I got low profile, there would have been so little implant - it basically would have been like sticking two little hockey pucks in me. So I went moderate, which look good, but note that they never really "flatten" like real breasts. Again, someone who already has boobs won't mind because they have tissue above that is squishy and flattens, but mine never do. C'est la vie!
Don't be afraid to go 25cc larger. Try on the sizers in the office, and also use the rice bag trick (see online) and wear your new boobs for a while. Then, your surgeon will select the best size (from your range) once they are in there (assuming you have faith in your surgeon, which you should!). I was open to going up to 255CC, but he had to scale down to 225CC. I still would have liked them bigger, but my boobs were so narrow and he knew I didn't want projection. Make sure you explain very clearly the final look and profile you are going for.
Don't go by other's size numbers. It's all about body and breast width. Some women who got 350CC have boobs that look smaller than mine. The Dr. will help you understand what CCs will actually "fit" in your body. And in the end, a little bigger a little smaller - not really a big deal.

Above or below the muscle: Having met a few women who developed CC years later, I wanted to go under the muscle 100%. If you don't go too big in size, your doctor will only need to detach very little muscle. The recovery is longer (no lifting kids, etc.), but in the end a better result. Above the muscle is still popular, esp in Europe, because they move around more like real boobs. But my Dr. insists that as women age and their fatty tissues start to droop, the top of the implant becomes more visible. And then there is the statistically higher risk of CC. If you decide to go over the muscle, then consider the textured shell (Sientra if you can get them, since they've done a ton of studies and include a guarantee).

Shell:
Smooth
- Pros: less chance of feeling the shell. Less chance of rippling.
- Cons: are not "stickey" so, when under the muscle, higher risk of displacement, moving to your armpit, etc. Higher risk of CC when used *above* the muscle. This is because scar tissue forms in parallel strands around the implant, creating a shell that is more likely to cintract in a single direction. Below, muscle it's debatable = equal risk.

Textured:
- Pros: Lower CC risk above muscle. Not all textured are created equal. Sientra textured is less gritty than others yet has been studied to create a nice scar matrix. So the scar tissue is forced to form stands in different directions. The theory is that because it is a more complicated matrix, in cannot "squeeze" into a contracture as easily. Also, less chance of implant displacement. But, as you know, mine dropped and I had to correct that (shoelaces) bc my tissues are so damn weak. But I'm the exception.
- Cons: Thicker shell that you can feel around the edges of your boob. I definitely feel around the bottom edges (bc my skin is so thin). Possible rippling.

Incision/scar: Infra-mammary incision i guess makes the placement easiest for the doctor. Plus you dont risk losing feeling in your nipples or strange scarring there. Even with my nothingness, I am fine with the little scars. My Dr. he had me use silicone tape 24/7 for at least 6 months (I still use it). It has been working really well, but there is still a faint scar. But I really don't care. I don't lie about them being fake :P

Feeling/seeing the implant: The more breast tissue you have and the thicker your skin, the less chances you will have of feeling the edges of the implant or having visible rippling. I had nothing, and tissue-paper thin skin, so I can feel the edges of the implant around the bottom of my breasts bc there is nothing there to cover it up. I have no rippling bc my doctor sized the implant correctly for my breast width and used cohesive silicone, which is firmer but helps to prevent rippling of the capsule (not as watery/flexible). Also, as I mentioned, textured are thicker and and more likely to be felt or ripple. Mine I can definitely feel, but fortunately they dont ripple. But hey - they're fake.

Types of fill: Cohesive silicone is safer, but I think it feels pretty damn firm. Anatomical implants for the most part use even firmer gel, FYI. If you have enough boobage, it's fine, but for someone like me, they definitely feel firm when hugging, etc. I wish my boobs were squishier (but there are issues with that, too). Some companies (esp. outside the US) offer softer silicone:
- Benefits: feels more natural/squishy.
- Risks: higher chance of visible rippling, higher chance of leaking undetected, which means you have to plan to get semi-regular MRIs to check on it throughout your life.

Shape of implant: I've heard of people being happy with both round and anatomical. Some people avoid anatomical bc of the risk of shifting angles, and over time, the round settle into the exact shape of an anatomical implant anyhow. That said, I might have benefited from anatomical bc the top of my round implants look pretty "round" when in a bra because, again, I have nothing above it besides ribs and tissuey skin. For a "normal" woman with some boobage or meat, I can see why there would be no difference.
Round: pros: if they shift around, it doesn't matter because they are round :)
cons: my situation: can look "round" if you go too big or have no layers on top.
Anatomical: they have a texture shell to help prevent shifting, but I hear that for some women they still shift, so then you have this weirdly oriented boob. The firmer gel can be even less squishy. That said, some women loves theirs, so look at online reviews if you are considering.

Healing: Very important to follow a healing protocol strictly, including sleeping positions, etc. My Dr. is anal retentive about this. The "rapid healing" method sounds a bit sketchy to me... If you choose under the muscle, it's even more imperative that you follow a strict healing regime because you do not want them to settle in the wrong position. My friend did not follow her sleeping protocol and one of her boobs is permanently displaced.

Other general thoughts:
1. In the end, THEY ARE FAKE and at times they will feel fake. It is what it is. They won't be perfect. But natural boobs aren't perfect either.
2. You are almost guaranteed to have a mental breakdown and feel regret. Just know that it will pass, you've done your research, and you will be happy. They're just boobs.
3. If you really hate them, you can get them taken out. Many woman have and they return to their original boobs in a few months. A little scar, lessen learned. Not a big deal in the end :)

Possible dangers of textured implants

One more thing to consider:
https://www.nytimes.com/2017/03/21/health/breast-implants-cancer-deaths.html?_r=0
and
https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/ucm239995.htm

"BIA-ALCL is a very rare condition; when it occurs, it has been identified most frequently in patients undergoing implant revision operations for late onset, persistent seroma. Because it has generally only been identified in patients with late onset of symptoms such as pain, lumps, swelling, or asymmetry, prophylactic breast implant removal in patients without symptoms or other abnormality is not recommended."

I met with different surgeons a few years ago and felt the most comfortable with Dr. Grenley; he listened to my wants and concerns, and gave honest answers - and I liked his work. I recently decided to take the plunge and again felt he was the best surgeon for me. Also, I appreciate his more conservative approach to post-op healing and his concern about long-term health and satisfaction. Dr. Grenley and his team are great to work with: experienced, super supportive, and quick on responding to follow-up questions.

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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