I never thought my breasts were attractive. My...
I never thought my breasts were attractive. My mother also has tuberous breasts, but we didn't know that it was a congenital defect. We just thought ours were different. It wasn't until I failed to produce more than drops of breast milk when I had my first child. I researched and researched and finally found my answer: tuberous breasts and insufficient glandular tissue.
Knowing I had always wanted implants to "fix" my breasts, I approached my doctor. She confirmed my self diagnosis and informed me that my insurance would cover reconstruction. It has been nearly four years since that diagnosis, and I have experienced countless bumps in the road. But finally I am having them fixed this coming summer! I'll finally have normal looking breasts!
Tuberous breasts? What's that?
Many people have no idea what tuberous breast defect is (many of those people are doctors) and many of them don't realize they may have it too.
If you've ever been pregnant, your asked "do you plan on breastfeeding?" Whatever your personal decision is/was, that's not my place to judge. But many of us say, "yes, I plan to breastfeed." I was one of those women. I took the classes, talked to lactation consultants, and I kept being told the same thing, all women can breastfeed. I asked a certain LLC after a class if she could take a look at me because I wasn't experiencing breast pain or changes like my fellow pregnant people. My breasts were still the same, save for nipple darkening. She said that breast come in all different shapes and sizes** and I should be fine. I didn't believe her for one minute. She dismissed all my concerns as paranoia and first time mom jitters. When my first child was born, I made drops. Literally. Drops. I drank tons of water, pumped all the time when my baby wasn't attached, took fenugreek. Nothing worked. I threw in the towel and it didn't effect me. I just kinda thought "Oh well!" And moved on. By the time I got pregnant with my second, I was determined NOT to quit. I WOULD breastfeed! But this time, I had learned a thing or two. I had self-diagnosed myself with insufficient glandular tissue and tuberous breasts. (Let me interject here a second: tuberous breast defect=\=insufficient glandular tissue in every case. You can have great looking boobs that look like they could make milk for days but end up finding out you have IGT once you have a child. On the flip side, you can have tuberous breasts but still have enough mammary tissue to make enough milk for your baby. Sadly, the amount of mammary tissue cannot be fully determined until you go through pregnancy and child birth. There is a way to get an idea of your mammary tissue amount, dye injected through your nipples and then either an x-Ray or mammogram. But since most doctors don't know jackshit about IGT or tuberous breasts, this option may not be known to them.)
Anyways, I went to a new LLC class and asked in front of all the soon to be mommies there, "what about tuberous breasts and IGT?" She didn't know what to say. I had to clarify what those things were and she still just shrugged.
When my second child was born, I produced more milk, but not enough to sustain him. IGT can self correct the more pregnancies you have, but obviously that's not a quick fix nor an answer for many women. I made about 1oz total without any supplements. I took more milk plus, encapsulated Brewers yeast, encapsulated oatmeal, I even encapsulated my own placenta, a whole bunch of myo-inositol, and plenty of water. I put my son to breast as often as he liked and had marathon pumping sessions. This time, I had two wonderful women on my side. They actually listened. They helped diagnose and correct my son's posterior tongue tie, which helped him be able to remove my milk much more affectively. They also supplied me with an SNS (supplemental nursing system). It helped keep our breastfeeding relationship going long after I would have quit. With all the outside help, I was able to hand express 2oz total per day in addition to whatever he was getting out. I was very happy that we were able to breastfeed until he felt he was done (around 9 months old, a little earlier than I had hoped, but oh well).
About five months after my son was born, I got the official tuberous breast stamp by my PCM. She had given me breast exams before, but I had always been lying down. Once I showed her in a normal sitting position, she exclaimed "Oh wow! Yup, those are tuberous!" She offered to do the nipple ink injection (galactogram) to determine the extent of my missing mammary glands. I declined, I knew I didn't have enough. Knowing exactly how much I was missing wouldn't change much. I was referred to a plastic surgeon and went off to meet him. He confirmed (again) but told me I had to stop breastfeeding for 9 months before they would do surgery. I wasn't prepared for that yet, so here I am, nearly four years after the birth of my last child getting ready for the big day.
**In my personal opinion, normal breasts do not come in all different shapes. Breasts are naturally cone shaped with a wide, circular base that is set close to your sternum with a lowish mammary fold. Tuberous breast are usually wide set, well away from the sternum. Have a high mammary fold and virtually no lower pole. All different sizes? Yes. All different shapes? I disagree.
Correcting my breast appearance...with SCIENCE!
Dr. Christensen, if you read this, I apologize in advance for being probably one of most annoying, picky, and know-it-all-y patients. Having researched and researched why my boobs are so messed up looking for the majority of my adult life so far, I've learned a lot more about the "perfect breasts" than I have about my condition. It seems humans care only about how breasts look than how they function :[
The most "beautiful" breasts are called "beckoning breasts". They have 45% of their volume on the top pole (TP) and 55% of their volume on the bottom pole (BT) and the nipple angles up at a 20 degrees. This is not only what the majority of the world considers perfect, but what I consider perfect as well. I'm personally not a fan of the high profile implants, they remind me of bubbles rather than breasts (no offense to those readers who opted for the high profile or are wanting that profile).
My doctor has her work cut out for her considering I have zero lower pole. Going from 0% to 55% is going to be an interesting challenge.
My magic number goal: 45-55-20!
Tuberous breasts? What's that? Part Two
According to wikipedia: "Tuberous breasts are not simply small or underdeveloped breasts. The effect of the condition on the appearance of the breast can range from mild to severe, and typical characteristics include: enlarged, puffy areola, unusually wide spacing between the breasts, minimal breast tissue, sagging, higher than normal breast fold, and narrow base at the chest wall. The condition can affect the ability of women to breastfeed as in some cases the breasts, including the milk glands, have not developed enough to produce breast milk. However, other physical aspects of fertility and pregnancy are not affected by the condition."
Unfortunately, the cause is unclear. There could be genetic links or environmental, or possibly both if something in the individual's environment switches on a gene. Several women who suffer from PCOS also suffer from tuberous breasts and/or IGT. Many suggestions have been made for both conditions, low progesterone levels during puberty or insulin resistance. Personally, I am lucky that I only suffer from one condition rather than both.
There are several Internet communities and blogs dedicated to women with tuberous breast defects and their journeys with breastfeeding and reconstruction. Before you make the plunge to correct your tuberous breasts, contact your insurance companies and see if congenital breast defect reconstruction is covered. I can't say anything for other companies, but Tricare covers reconstruction.
Bump in the road #1
Earlier this month, my doctor put in my referral to have my surgeries approved. They turned around and requested my medical records and a signed pre-authorization form. My doctor sent in the pre-authorization, but not my records. SO referral denied. I just want to call my doctor and scream "GET YOUR SHIT TOGETHER, MAN!"
UGH! Starting the appeal process once my doctor sends my records to them. After that, who knows how many more bumps there will be.
Due to my doctor and his nurse sucking at doing their jobs, I decided to switch from tricare-overseas prime to tricare standard in the west region. I knew I needed to switch to the west because if you go to another region for more than 30 days, you have to switched to that region. Rather than stay with prime, I just switched to standard. The difference? I don't need a referral to anything, I just go. Even specialty care. I still need prior authorization (I called it pre-authorization in my last update, that was incorrect). I now have to pay a deductible of $150 rather than $0 and I'll have to pay a maximum of $1000 out of pocket. Some may or may not be reimbursed, I'm still unsure on that. I'd gladly pay the $1150 to have it done rather than sit and wait for my doctor to try to understand what is needed for a referral.
Anyways, I saw Dr. Christensen yesterday. She. Is. Awesome. She said that we'd probably have a fight on our hands with tricare and them covering my breasts. They are tubular but they aren't extreme. Having children definitely changed my breasts because they used to be super constricted. She said she's ready to fight for me which is awesome because I plan on fucking up tricare's world if they deny me.
She suggested "dual plane" placement, saline implants, and a slight lift on the right breast. Sizing wise, I'd like 350cc on the right and 425cc on the left. I was very adamant that I didn't want huge boobs, I just want to be normal looking and balanced. But I do have to go to a small D or so because I'm pretty sturdily built. Trying to stay on the smaller side wouldn't give me a natural look at all.
I brought all my records that mentioned my breast defect, she took pictures, did her paperwork, and said that everything will be submitted on Monday most likely. I'm a little impatient because I'm only in Minnesota until August 5th and want this to be put through ASAP so that if they do deny me I have time to fight it. But I understand that paperwork stuff takes time. So, I have to be a good person and not be pushy.
Bump in the road #2 then smooth sailing!
After my consultation, I was told that my paperwork would probably be put in on June 20th (my appointment was on the 13th). That made me inwardly groan a little because I'm impatient, but the reasoning made sense so I just needed to smile and deal with it like an adult. So a week later (from the 20th), I called tricare to ask for an update on my authorization request. There was nothing. No pending things. Nothing. So I called the nurses line at the office and asked what their status was. It hadn't been sent >.<
Luckily, Nurse Jane is an awesome woman and got right on top of it. The paperwork was signed and mailed on the 29th. Ok, but mailed? Like, snail mail? Yup! Since there had been pictures taken, they had to send it via post. Well what's the longest that could take? It's not going half way around the world, so a few days tops.
I call tricare on the 8th. Again. Nothing. Now I'm panicking. I'm due to leave Minnesota in four weeks from that point and my husband leaves in 11 days. I called the office again and spoke with the scheduling lady, Jane (different Jane).
Poor Jane! I'm freaking out, panicking, holding back tears because I'm so frustrated with both sides not knowing what to do. Jane was totally out of the loop, so I had to fill her in. Once she got everything, she snapped into action! She faxed all of my paperwork to the urgent authorization line and attached a note that pictures were in the mail. I asked why the pictures were needed as I had never been asked for them before. She said that tricare/united health will usually come back asking for pictures, so they were sent with all of the initial paperwork to save time. Ok, sounds good. She assures me she is off to fax it as soon as we hang up but let's me know that it may not be approved in the short time frame that I have. That the soonest she can get me in is July 20th *if* everything is approved with no other hang ups. It sucks because it's the day after my husband leaves, but okay, I'll deal.
I got off the phone with her around 4:00 or so. An hour and a half later, I call the tricare hotline just to see if they have it in their file now. Low and behold, one of my procedures is approved (I'm also have scar revision on my c-section scar) and my breast procedure is still under review. Holy shit! Within an hour and a half, half of my surgeries were already to go!! That was around 6 pm on Friday night, I didn't call back all weekend because I figured the breast authoritization would take longer.
Fast forward to this morning. I call tricare at 11am, scar revision, still approved. Breast procedure..............
EVERYTHING GOT APPROVED ON JULY 8th!! But because I didn't call back all weekend, I didn't know until now! Next step, scheduling. I have a tentative date of the 20th. Barbara, the other scheduling lady, has to get the confirmation and will call me tomorrow!
I can't believe it's all happening now! I've wanted my breasts done since I knew what breast implants were! And my painful scar from four years ago will be gone too!!
Frankly, I try not to get my hopes up for things because things never seem to work out the way I want. Finally, it's all working out!
Today, I finalized my size! 350cc on the right, 425cc on the left, dual plane with a lollipop lift on the right along with several inches of scar removed from my c-section scar. Tomorrow is my pre-op physical and surgery is set for ~8:00am next Wednesday!
Surgery tomorrow morning!
Eeeek! I don't k own how I'll sleep tonight :D I went out and bought some post surgical scar strips. I found some that are specifically for breast surgeries, we'll see how those work out!
It's done :D !!!!
Surgery was uneventful, which is great. Dual plane, lift on both sides, slight nipple reduction, 350 on the right, 425 on the left, old c-section scar removed.
My pain is nice and minimal, it mostly feels like I have been doing push ups for three days straight.
I'm still exhausted from the anesthesia, so I'll write more later. But here are some pics, including the scar removal.
two months later
So here I am, a little over two months later. I've healed up great, no infections, no big problems at all. My bruising went away rather quickly, swelling wasn't too bad, and the pain was not bad at all.
The few "problems" I have had are probably just from me not being super patient. My left (your right in the picture) breast has more fluid around the implant making it appear larger than the right (your left in the picture). Other than the size and swelling, the left one looks great! It's full and has a beautiful lower pole. My right one, the one that used to be the good one, is now worrying me. The implant is still high, and I'm worried that as the implant drops, it won't fill out the lower pole, it'll just sag. As of right now, my nipples are still level with each other but the fullness in the left side and the lack of fullness in the right one makes it look weird. I'm wondering if the scar from the right side is keeping the implant from dropping nicely. It has a different incision than the left. It's more of an "L" while the left is a classic lollipop look. Everyday, I press and hold the implant down for 30 seconds.
My c-section scar revision was a complete success! All the doctors I talked to, even my PS, said they didn't know why I was in pain and weren't sure if surgery would help. My PS said that when she got in there, there was some good, rope like scar tissue that connected to my abdominal wall. That explained all the pain I had when I moved. Now that it's all gone, my range of motion is back, I can play with and chase my kids! It was a total bonus that a good amount of my "mommy flap" was removed as well :)
Even if the right breast does drop differently, I'm extremely happy with my corrections! I feel more confident and more womanly than I did before and clothes fit me properly :) Now I just have to lose the weight I gained while recovering :p