Tubular / Tuberous breast augmentation and lift with Motiva Ergonomix 360cc and fat transfer

Hi Ladies!
My surgery date is in 2 weeks on November 25th, 2019, so I’ve decided to finally start documenting my journey to help others who are looking for advice.
First, let's get the details out of the way. I am 31 years old, 164cm (5`4) short and weigh 68kg (150 pounds). I have tubular/tuberous breasts (more about that below) and the left is slightly smaller than the right. I'm having Breast Augmentation Surgery in the Netherlands where I'll get 360cc Motiva Ergonomix implants placed over the muscle + some of my own fat cells will be injected to correct the difference in size. My surgeon will also perform a periareolar lift and areolar reduction.
THE REALIZATION
Let's start at the start. I never liked my "small" boobs. I never understood why they looked different more my friends' boobs. I still remember when I asked my gynaecologist at 20 years old whether my boobs would grow bigger. She said: "I wouldn't hope for it." What she didn't tell me was that I had tubular / tuberous breasts, and neither did any of the other doctors that examined my breasts over the years. Tubular breasts is a genetic condition where the breasts fail to develop normally and fully during puberty. The breast tissue is often minimal and lacking especially in the lower pole, the areola is enlarged/"puffy" and the breast fold is higher than normal. (you can read more here: https://en.wikipedia.org/wiki/Tuberous_breasts). It wasn't until I was 30 that I found out that I have this condition. Finally, being able to afford surgery, I went to see a plastic surgeon in March 2019 and he broke the news to me. My boobs were not just small, they were deformed. Although I knew something wasn't right about my boobs my whole life, it was quite devastating to hear it from someone else. I couldn't stop the tears from streaming down my face. My self-doubts were confirmed. Everything made sense now - all the guys that wouldn't take off my bra during sex, my friends saying that my boobs look funny, no bras ever fitting the right way, etc.
OK! Time to learn to be okay with my condition and researching ways to fix it - in my next post.

THE RESEARCH
I started reading everything I could about tubular breast and breast augmentation surgery online. There are so many decisions to make:
- Finding your Surgeon
- Implants vs Fat Cells
- Implant Shape (round or anatomical)
- Implant Size (how many CC)
- Over vs. Under Muscle
- Lift vs. No Lift
- Scar Placement
If there is one thing I learned, it’s probably that there is no right or wrong. So, don’t expect to find a clear answer. In the end, you have to make your own decision based on the pros and cons for each option.
SURGEON
One thing that I kept reading online during my research of tubular breasts was that you should find a surgeon who is specialized in correcting tubular breasts as it is not comparable to a regular breast augmentation surgery. The Netherlands isn’t huge, so I only found two doctors who are specialized in correcting this condition. Getting an appointment for the consultation with both doctors took 2-3 months. A long wait list is a good sign, I thought. I got very contradicting opinions from both doctors.
Doctor 1 suggested placing an anatomical implant of any size with the dual plane technique through the breast fold and said a lift was not necessary. I do not want big boobs, but just a nice shape, so this doctor said a 255cc implant would be fine. He talked to me a lot about the potential complications and risks and showed me before and after pictures of his patients. There is a dutch website for reviewing plastic surgeons and he had 0 reviews on that platform despite being a more seasoned surgeon. I brought it up with him and he said that those platforms make surgeons pay to have their reviews published. He said that he has no need to pay for this as his wait list is long enough.
Doctor 2 (the surgeon I ended up choosing) suggested placing 360cc Motiva Ergonomix implants over the muscle through the breast fold with fat transfer from the legs (both doctors agreed that a fat transfer alone wasn’t going to fix the shape of my breast). During the surgery, he will lower the breast fold, divide the glandular tissue so it spreads more evenly and he'll also perform a lift with an incision around the areola. There was some discussion on whether or not to do an incision from the nipple to the breast fold (anchor scar) but I said that I'd want to avoid that by any means possible, so he'll try without it. He also informed me properly about all risks and showed me before/after pictures. The surgery takes place at a hospital and an overnight stay is included. I felt that this surgeon cared the most about the outcome of my surgery. He didn’t just tell me what I should get done but more importantly, he explained why. The fact that he had 145 reviews with great ratings also helped me make my decision.
IMPLANT SHAPE
The shape of an implant can be round or anatomical - or so I thought. There are pros and cons for both (which you can research online). I wanted anatomical ones because they make the breast look more natural, but then I read that there is a risk of implant rotation. My surgeon suggested Motiva Ergonomix - which is a mix of both. They imitate a natural breast as they look round when lying down and they drop down a little when standing up. With those type of implants, implant rotation is not a problem as they don’t need to be in a specific position like anatomical implants. I’m excited to see what they’ll look like!
IMPLANT SIZE
Selecting the right size was probably my biggest struggle. Two things that helped me make my decision were: understanding how breast implants work & the Rice Test. I wanted regular sized, natural-looking breasts. At first, I was shocked by my surgeon suggesting 360cc, but after he explained how breast implant sizing works, it all made sense and I now feel very comfortable with my decision. Implants have a base width, projection (how high the implant is) and volume (in cc). You should get a size that fits your body. For this, it is important to measure your breast / chest width and think about how big of a projection you want. If you get implants that are too small for your chest, you will have a wide gap between your breasts. If you get implants that are too big, they will look unnatural and stand over the sides of your chest. My breast width is 12,5cm and I wanted a normal projection. My surgeon uses Motiva implants and according to the Motiva size chart (see my pictures), 380cc Demi implants would be right for me. I decided to go for 360cc Demi combined with my own fat cells. Creating rice implant sizers can also help you make a decision on which size you feel comfortable with. Take a pair of stockings/ tights, cut off the upper and lower part, put a knot in one side, fill them with uncooked rice (cc grams, so to imitate a 360cc implant, you can use 360 grams) and close it with a knot on the other end. You can put them in a sports bra to see what it would look like on your body and wear your normal clothes over it to get a feeling for it.
IMPLANT PLACEMENT
Implants can be placed Submuscular (under the muscle), Subglandular (over the muscle) and Subpectoral (half under the muscle, also called dual plane). This was also one of the more difficult decisions and I’m just trusting my surgeon on this now. Different surgeons have very different opinions on this and there is probably no right or wrong. Here is some info on the pros and cons: https://www.marinaesthetics.com/breast-implant-placement-pros-cons/ Under the muscle / dual plane generally looks more natural, especially for girls who have little of their own breast tissue and mammograms are performed more easily with this technique. Placing the implant on top of the muscle is less painful and it avoids distortion during muscle movement, however, there is a higher risk of capsular contracture (make sure you google this).
LIFT OR NO LIFT
This is again a subjective decision depending on how bad the drooping of your breasts is. Two of the surgeons I saw would have placed the implant without performing a lift. My surgeon and a few others I consulted about this recommended the lift for a better result.
SCARS
There are a few options depending on the exact procedure you’re having. Implants can be placed through the armpit, the breast fold or the areola. Again, I’m trusting my surgeon with this and will have the implant placed through the breast fold. As I will also have a areola reduction and lift performed, there will also be a scar around my nipple. There was some discussion on whether or not to do an incision from the nipple to the breast fold (anchor scar) to receive the best result but I said that I'd want to avoid that by any means possible, so he'll try without it.
I hope this helps you girls. Let me know if you have any questions.

Hi Ladies!

Yesterday was THE day!

First of all, lucky me got a bit sick in the week leading up to the surgery. I had an elevated temperature and a cough. This is something that never really occurred to me as a risk. I read everywhere online that surgeons won’t perform elective surgery if you’re sick. I really didn’t want the surgery to be moved as I had everything planned perfectly. Time of work. My mom taking time off and coming to take care of me. But I also didn’t want to take any risks. So I rested as much as possible, slept and drank a lot and took some vitamins (make sure you know what vitamins you can and cannot take before surgery e.g. no fish oils, garlic or vitamin E). In the end, I told my surgeon and anesthesiologists and after taking my temperature and listening to my lungs they decided it was safe to go ahead with the surgery. So my recommendation is: stay away from people as much as you can within the last two weeks before surgery - especially if it is flu season. And make sure you have a strong immune system. Vitamins might help with that. You definitely don’t want to cough after surgery. It hurts like hell. Thankfully, my cough is not that bad.

Quick overview of what happened on the day of surgery: I arrived at the hospital at 10, changed into the sexy gown and slip, they took my vitals and prepped me for the OR. Then I was taken up to the pre-OP room at 11:30 where I talked to the anesthesiologists and my surgeon who drew on me (where to place the implants, where the new breast will bw, where to extract and inject fat, etc.) and we talked about the surgery in general again. At noon, I was put in the operating room. They tied my arms to the stretcher I was laying on (50 shades of grey style) and gave me the anesthesia. 3..2..1 and I was gone. Next thing I know I’m in the wake up room. People are talking to me, asking me how I’m feeling. I’m confused and dizzy. I look down on me. I have boobs now. Yay. No pain yet. Just a tight feeling in the chest. The surgery took 3 1/2 hours - a bit longer than expected.

They did a tubular breast correction with 360cc Motiva Ergonomix implants, a circumareolar lift and a fat transfer from the thighs to the boobs, 110cc each side. I’m all bruised and swollen now (as you can see in the pictures). Even the nurses were worried enough to call my surgeon again to check on me but he says it’s normal and it’ll just take some time. I had stretch marks before the surgery and you can clearly see them now on my bruised boobs. Hopefully they’ll be less noticeable once the color is back to normal. I like the shape so far but I think I may have a bit of a memory line already where the old breast fold was. That’ll hopefully go away with time with the help of the breast band. I had one overnight stay at the hospital, as I had drains to prevent fluid from building up in the wound. One thing that I didn’t read about anywhere was the gas that builds up in your stomach after anesthesia. I had to fart all night haha and usually I hardly ever fart. Sorry for the detail, but I wish someone had told me before my surgery. I had some issues with dizziness every time I got up but you just have to keep trying slowly to get up and walk a few steps to get everything running again. I was released the next morning and now I’m gonna continue the healing journey at home.

I got a special post surgery bra and a breast band to push the implants down. And I’m also wearing a compression suit for the legs (peeing in this thing is incredibly difficult hah). I have a super tight feeling in my chest and feel like I can’t really stand upright because it feels so constricted. Anyone else had that? The doctor this morning told me to do some shoulder rolls to loosen it up a bit. The pain is manageable with the pain killers. I got OxyCodon, Diclofenac, paracetamol, antibiotics, stomach pills to prevent acid reflux and some laxatives (as the oxy makes you constipated). Yup, I’m pretty much high the entire time.

My first check up appointment is in two weeks. But I’ll post some more pics in a week :)

~ Kay x