Friday, June 17, 2005

Having a little fun. I have Cleavage!

This is the pain pump. There are two small catheters inserted into the sides of each breast. It was described to me as creating a curtain of anesthetic down through the pocket created for the implant. It will last for approximately 60 hours. It's very light, but does make me look pregnant under my (hubby's) huge shirt. We (hubby) will remove tubes when the bottle is empty -- removal supposed to be painless.

Wow! Haven't seen boobies yet, but liking the results so far! Notice what hubby is watching while taking care of me -- US Open.

Other incision. The incisions are not covered. A pad is just folded over from out of the top of the surgical wrap.

Incision -- a bit of bruising.

Sunday, May 22, 2005

Preparing for a Consultation

On Monday, April 18th, I called Robin and she said noon would
work for the doctor for my consultation. She asked if that
would work with my schedule. I thought that was very nice of
her to consider that I might have scheduling issues as well as
the doctor. (No offense to any doctor's, but docs have the
habit of assuming that all non-medical members of the planet
will bow to their schedule.) I said the time would work for me
and all was set in motion.

My dear hubby assured me that we would be able to get to the
Dayton area early on Wednesday -- plenty of time to go to the
bra shop and then to the consultation. Keep in mind that these
assurances were made while we were parked in Boston,
Massachusetts. I have come, however, to completely trust in my
husband's ability to schedule traveling times in excess of 3,000
miles. It's rather amazing when you consider how often people
can't make it across town to be on time for an appointment.

That evening I went shopping. I bought a dress, sandals, and
hopefully my last 36A bra. I hated to buy a bra, but my white(
?) sports bras were all in the category of clean underwear in a
car wreck -- I didn't want anyone to see the sweat-stained
things. Why don't they make those things in the color of gray/
brown sweat? Isn't that what they're supposed to be for --
wearing while exercising?

Sure enough, early Wednesday, we were at a truckstop an hour
away from Dayton. We showered, and I put on my new outfit. I
was totally restless on the drive to Dayton. Hubby lived in the
Dayton area for years, so I acted something along the lines of:
"Are we there yet?" He should know!

There was no place to leave the trailer, so we had to take the
tractor and trailer into a rather exclusive business area. We
found the bra shop easily, and hubby had no choice but to park
on the street alongside the strip mall. As always, we made a
number of friends by doing this (not). Our new friends usually wave and everything. Of course, they don't use all their fingers, but they do honk to make sure we don't miss the gesture.

Scheduling a Consultation

The plastic surgeon that was recommended to me was Dr. Apesos in
Dayton, Ohio
. When I called his office, I immediately knew I'd
hit "pay dirt."

His receptionist, Robin, was a professional, kind, and helpful
woman. I got the usual information from her, then jumped off
the deep end about my scheduling requirements (Dr. Apesos does
surgeries on Wednesdays, not consultations). Not a problem, she
"penciled me in" for Wednesday morning, April 20th, and told me
to call on Monday the 18th to set an exact time. Wow! I
couldn't believe how easy she made it.

I told Robin how I had come about getting a recommendation from
Lisa, and Robin asked, "Did Lisa tell you you'd need to purchase
a particular bra before your consultation?" No, she hadn't.
Robin gave me the name and address for a specialty bra shop,
Alberta's, near the doctor and told me to go there before my
appointment. She said the people at Alberta's would help me
pick a size, then for me to bring the bra with me to the
consultation. She said, "The bra is rather matronly, but the
doctor likes to use it for positioning." She also told me that
I'd get really tired of the bra, because I'd need to wear it for
4-6 weeks after surgery. Yuck!

I was only mildly concerned about the assumption that the
consultation would result in me ultimately using Dr. Apesos for
my augmentation. Oh well, at worst, I'd have a bra to sell on

Saturday, May 21, 2005

My Specifications

I've mentioned that I had preferences about my breast augmentation. There are a number of choices to be made about the surgery, more than just size.

There are only two manufacturers approved by the FDA for breast implants: Mentor and Inamed (formerly McGhan). I had decided I wanted Mentor after reading both companies profiles and information pamphlets (available as .pdf files).

Round vs. Anatomical: I wanted round. This preference was based on numbers (the greatest majority of implants, by far, are round), and one statement I read about anatomicals. Someone had said that anatomicals looked fine until you laid down -- then they didn't look natural at all, because they maintained the teardrop shape. Good point. I hadn't thought about that.

Smooth vs. Textured: These are the two different surface type of implants available. There is an extensive explanation about the reasons for these at Nicole's FAQ. Again, I let the numbers lead me. There vast majority of implants are smooth.

Under vs. Over the Muscle: There are actually three choices here: over, under, and partially under. Most implants are partially under the muscle. I read the information I could find about the differences in placement and decided I wanted the partially under the muscle. This is the most common implant placement.

The Incision: There are four different incision locations: through the aereola (nipple), in the crease under the breast, endoscopy through the navel (TUBA), endoscopy through the armpit (auxiliary). The nipple incision gives me shivers to think about. Not only that, but I had read some statistics relating infection rates with this incision, showing that the infection rate was slightly higher, possibly because of passing through the mammary glands. The crease incision is very common, but hubby and I both thought: 'Why spend all that money for pretty boobies, then have a scar on them?' The TUBA method sounded interesting, but frightening. Not only that, but both manufacturers did not recommend this method. Therefore, for me, the obvious choice was the endoscopy through the armpit, or auxiliary incision. The scar is virtually invisible after a few weeks or months, and it is in one of the natural wrinkles in the armpit skin. One thing about this incision though, is that it is more difficult for proper placement. It does require specialized training and can't really be "eyeballed." So, I knew I'd have to find a ps with a lot of experience in this incision before I'd feel comfortable with it.

Saline vs. Silicone: Saline is by far the most common -- in the USA. This is not the case throughout the rest of the world. I personally think the reason for the ban of silicone is that we, as a nation, are "lawsuit drunks." In Europe, 95% of all implants are silicone. People that have silicone, are adamant about their natural feel as compared to saline. Although "banned" for use in the US in the early '90s, ps's have had no problems in "qualifying" patients for silicone implants -- there are loopholes. Of course, some of the loosening of the stipulations for use that has recently taken place in our government will result in even more use of silicone. Nonetheless, I wanted saline. Saline didn't present even the slight possibility of side-effects that silicone would in the event of leaking. Not only that, but silicone can cost anywhere from $1500 - $3000 more. The last point totally made my decision.

The last point was profile: There are low, moderate, and high profile implants. This relates to the size -- as in width -- of the implant. Low profiles have a very wide base, meaning someone would have to have a wide chest area for these implants to look natural. The high profiles haven't been around all that long, and they came as a result of the need for narrow-chested people to have projection. I wanted high profile implants.

So for me, the joke became that my boobies sounded like I was shopping for tires: "I'd like a set of Mentor High Profile 3000's, please."

Plastic Surgeon Search (part 3)

Well, as I said, there aren't many board certified plastic surgeons in West Virginia anyway, so my search wasn't nearly so extensive as that of some people no doubt. Nonetheless, I was in a state of near panic on how to go about choosing one for myself. So it came down to this: I just had to match a plastic surgeon with the specifications I had decided on after my research on breast augmentations. This sounded like such a simple idea. The idea was simple, the reality sent me into a tailspin.

Because I live on the road over 300 days of the year, I had no choice but to use email and the phone in my search. I took one of the questionnaires from Nicole's website and adjusted it to ask those questions that were relevant to my specs. Then, I went on an email scavenger hunt. I emailed every plastic surgeon in West Virginia that had a website. What truly surprised me, was that I received a reply from every single one! All but one office took the time to answer my questions. The one that didn't simply replied, "Thanks for your interest in breast augmentation." Needless to say, that was the last effort I put into contacting that doctor.

Next, I went to the phone. I'm not sure why, but I was so nervous about making the first phone call. The only thing I can compare it to is a job interview. I had clammy palms and butterflies in my stomach. Fortunately, that first call went very well, and it gave me confidence in making more calls.

After 15 or so phone calls, I learned the following: (1) There wasn't a single plastic surgeon in West Virginia that did exactly what I wanted. (2) That the cost was a bit more than I expected -- $6000 and more (only one office wouldn't give out their price information over the phone). (3) That the earliest I'd be able to get it done was two months. The last really wasn't a problem because I was planning to wait until my vacation time in June to have surgery anyway, but the idea of having no kind of window to work with made me feel cornered.

I went to a few information websites and posted questions about West Virginia plastic surgeons. I was hoping for some kind of referral. No more than I would pick a dentist out of the phone book, was I prepared to have my body altered by someone that I had reference to no one's personal experience. No luck. Considering the number of ba's (breast augmentations) that each ps's office claimed the doctor performed, it seemed none of these people used the internet to make their decision. Not a single person from West Virginia responded.

At one point, I contacted my dentist in the small town where I live. I did this because I had read a number of entries at different sites mentioning dental work and infection. It seems it is rather common for women with implants to start taking antibiotics before having dental work done. I'll expand no more on this for fear of giving misinformation. Anyway, the women at the dentist's office were more than a little surprised when I asked if there were any patients that notified the doctor of their implants before having any work done. They acted like I'd just announced that a spaceship had landed on my lawn, but said, "No," no one had ever informed the office of such a thing.

I was near despair at this point. I'm not being overly dramatic when I say that. For all these years, I'd battled with myself about whether or not to have this procedure done. I had always believed that after making the decision, the doctor, and even procedure itself, would follow a simple, straightforward path. I can't explain why I thought this, I can only say that I did, and that I was very wrong.

Fortunately, the Universe comes to our rescue with quick flashes of insight just when we need it. I remembered that my next door neighbor is from Charleston and has only been in our small town for a little over a year. I picked up the phone and called her. She was an absolute doll. She said she knew of two friends that had had ba's and would call me back in the a few minutes. Few people can be depended on to do exactly what they say, she is one of those few. Within half an hour, I had the names and numbers of two Charleston plastic surgeons that her friends recommended.

With this information, I called the offices again (yes, I had already spoken with both on my initial round of phone calls). Neither did exactly what I wanted, but I decided I'd just have to compromise. I had no idea...

One office didn't even use the manufacturer that I wanted -- there are only two. This office was also the one that wouldn't give me price information. I decided to put that idea on hold for now, and contacted the other office. This ps didn't use the incision I wanted, but everything else was fine. Next we tried to schedule my consultation. Well, it seemed the only days the doctor had consultations was on Tuesdays and Fridays. I explained that I was a truck driver and on one end of the country on Monday and the other end on Friday. I wasn't being difficult or picky, I just had to have my consultation on a Wednesday, and couldn't the doctor make an exception because of my circumstances. The answer was, "The doctor does consultations on Tuesdays and Fridays," as though I hadn't heard that the first time. I went ahead and scheduled a consultation for mid-June, during my vacation time, because that was the only Tuesday or Friday I'd have available. I was more than a little disappointed, when my husband decides to say, "Maybe it's a sign that this isn't meant to be."

There are not many times when I feel truly ready to commit physical violence. This was one of those times. I rounded on him, and said, "What?!" He immediately realized the idiocy of what he'd said, and explained, "I mean, he doesn't use the incision you want, and he won't see you on the day we have to have, so maybe it just means he's not the right doctor." I put the knives and blunt objects away and tried not to cry. "You may be right," was all I could say.

From this "dead in the water" feeling, I decided to start looking at surrounding states. Virginia, Pennsylvania, and Ohio, were the ones we thought were the most obvious. Although, because of the prices, I did investigate one ps in Oklahoma (less than $4000). For that price, we could camp out in a hotel for a week or so while I recovered. Anyway, I did the same online search as before and finally narrowed my search down to two plastic surgeons, both of them in Ohio. I was tired for the day and decided to spend a little time in Nicole's chat room (an amazingly addictive chatroom!).

Now put your hands together for the beautiful pattern of Creation! As is not often the case, only one other person was in the chatroom: Lisa. Lisa and I started talking about our boobies, and future boobies. She was in her mid-thirties also, had children, and had had her ba about three months earlier. She talked about all the difference it had made for her and said she was sure I'd never regret having a ba done. She asked if I'd found a plastic surgeon and how many consultations I'd been on. Then I told her of my current plight. I ended by saying that I'd narrowed it down to two ps's in Ohio, one in Columbus, and one in Dayton. She said, "Really?! What's the doctor in Dayton? That's where I am!"

Of all the doctors, in all the states, on all the websites...that's right, one of my two candidates was Lisa's doctor. She couldn't recommend him highly enough. From there, she and I exchanged "real" information about each other (names, email addresses), and I thanked her profusely. I came mighty close to tears.

You can probably imagine the self-satisfaction my husband experienced, and completely failed to hide, when I told him about all that had happened. Not quite smug, but pretty darn close.

Plastic Surgeon Search (part 2)

The best way to find a plastic surgeon is from personal referral. Do keep in mind though that just because your friend's plastic surgeon made her look like a million bucks with the new nose, that doesn't necessarily mean (s)he's just as much the artist with breast augmentations. For that very reason, Nicole's website has a terrific faq that includes a checklist of questions to take to your plastic surgeon during a consultation. It seems quite common for people to go to more than one ps before making a final decision. I was fortunate in that the one consultation I went on landed me a terrific ps with whom I feel 100% at ease.