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My goal is to help provide EDS & Dysautonomia patients with resources to discuss with their healthcare team.

Breast Augmentation: Part 1 - Consults

Breast Augmentation: Part 1 - Consults

This feels incredibly vulnerable to be writing about. I’ve been thinking about Breast Augmentation (BA) (aka breast implants) since I was a teenager (I'm 30 years old now). Living in California, there are so many women I know that have had the procedure, it feels a lot less scary. Back in Wisconsin, I knew 1 person that had it done. Out here, if I mention breast augmentation in conversation, every single person in the group knows at least 1 or 2 women that have implants. 

After posting questions about BA in a few EDS support groups on Facebook and seeing how many other Zebras were out there wanting the information… I decided I needed to overcome my fear of sharing this part of my journey. Other women in our Zebra herd should also benefit from what I’m learning. 

There are so many decisions to make! Incision site, material of the implant, shape of the implant. All of these things should be decided with your surgeon. There are many things that need to be taken into account (based on the measurements of your existing breasts, breast tissue volume, base measurement, and look you're trying to achieve). Pictures below to help you visualize some of the options.

I’m going to keep each consult to just the bullet points because otherwise this is going to get quite lengthy. 

1st consult:

  • Female surgeon, only been practicing a few years

  • Drove 1 hr 20 mins each way.

  • Only to be told that the newly practicing surgeon was entirely uncomfortable with EDS, even though I explained it beforehand during the phone call. WASTE of time! And incredibly painful to think “this might not be a possibility for me”. Heart wrenching in the moment and for the long drive home.

2nd consult:

  • Female surgeon, Dr. Saltz

  • Loved the team, experience, felt heard & understood <3 <3 <3

  • Got to try on sizers (see pics below) of what implants would look like after surgery and healing. Surgeon & I decided that 400cc’s fit my frame best

  • Surgery would be within a hospital facility (definitely a bonus! If something were to go wrong, I’d be in a hospital already)

  • Has patients shower within 2 hours after surgery and start movement exercises within a few days of surgery (moving your arms above your head type movements).

3rd consult:

  • Female surgeon (not putting her name on blast). She was cold, distant, calculated.

  • No discussion with a nurse or anyone other than the receptionist to hand me paperwork to fill out.

  • Lavender diffuser in the lobby that made me incredibly tired and felt hard to breathe.

  • Waited over 30 minutes (after the start of my appointment time) to actually see her.

  • Office was NOT busy (one patient left, about 5 minutes after I was done filling out paperwork)

  • Surgeon was defensive. Rather than listening to me, she had it in her mind that I was set on a certain size and adamant about it… She asked me “What size are you thinking about?” and I answered “I’ve been to a few consults so far, and with the sizers I tried on, we had landed on about 400cc” She cut me off to say (I’m paraphrasing here) “I don’t know who you’ve been seeing that told you that’s possible while looking natural, but that won’t work”… I followed up with “It’s not that I’m set on a certain CC amount, it’s that that’s what looked good to both me and the surgeon for the natural look I have in mind when I tried on the different sizers with a shirt on”. She changed her tune pretty quickly after actually examining me. And looking at my ribcage, build, etc. And said 350, 375, or possibly 400cc could all potentially work. Great… thanks for getting to that now… after coming across like a jacka** and making me wait for you (without any explanation or acknowledgement that my appointment was set for 1045 and you strolled into the room at 1125am).

  • Hard pass on this surgeon

4th consult:

  • First male surgeon (We’ll call him “Dr. Smith”)

  • Doctor's office didn’t realize their intake paperwork had a spelling error. “List all medications you are currenly taking”. Team was happy I brought it up because no one had noticed.

  • 1st doctor not to take measurements

  • Overall amazing patient experience. Felt attended to and like he was trying to reassure me about the process, his approach, and concern for his patients.

  • Had a book to look at shape (not size) of implants. Surgeon understands that I want a natural look and is on board.

  • Weirdest part… had me change into the paper 1/2 gown… and then just looked at my breasts (with a female nurse present) and showed me where he’d put the incision. Then talked about the overall look, size, shape, and that I was a good candidate for surgery. and then proceeded to talk with me for another 5 minutes or so about his approach, mentality, etc (all great information to have) but I’m sitting there in this front opening paper gown… not exactly the way I want to have a conversation. To the point where I didn’t ask the questions I meant to.

  • No mention of EDS (Ehler’s Danlos Syndrome) at this appointment or JHS (Joint Hypermobility Syndrome) because they didn’t ask about it on their form or give room for it. But I did mention it in my phone call to setup the consultation.

  • Surgery would be at a surgical center (not a hospital)

5th consult:

  • Another male surgeon - Doctor Brown

  • No paperwork to fill out at the office because they had me fill everything out online long before the appointment.

  • Small office in a large hospital facility. Staff was kind and welcoming. The patient coordinator went above and beyond to make sure my concerns were addressed.

  • Doctor acknowledged that I had done my research and asked what questions I had for him. I said my two concerns were EDS & healing process and what size options will work with my frame & measurements.

  • After taking my measurements and evaluating my tissues mobility (EDS related) - he determined that my skin involvement is normal and that the pocket will hold up as well as normal people without EDS. But because of my small measurements (specifically my base size), that if I want a “natural look” I could expect to go about 350cc or maybe 375cc on my smaller side (to even them out. Almost all women’s breasts are slightly asymmetrical). For my size, that means I’d end up around a overly full B-cup, or possibly a small C-cup.

  • I couldn’t picture what this looked like and I had been rather set on the size and look of the 400cc sizers from the previous consultation. I brought this up with the doctor and the patient coordinator. They said they’d bring out the sizers for me to try on now. Well, all the sizing bras were missing. So I got to see the implants but still couldn’t picture them on my body. They took things a step further and brought out virtual reality goggles and set it all up so I could see what they would look like on me. It was so surreal! I could look down and see the difference in size and then look around and see all the different views of what my future implants would look like.

  • They truly understood what I was looking for and made sure all of my concerns were addressed.

What I’ve learned so far and what I’m looking for:

  • A surgeon that understands EDS (and that my case is pretty minor in comparison to others I’ve heard about. The only scar I have is from scratching chickenpox as a child. The rest of my scars have healed on their own.)

  • A team that doesn’t waste my time in the waiting room.

  • Silicone implants (because I’m working with a very small amount of breast tissue and saline has a higher chance of “rippling” aka being able to see the edges)

  • Leaning towards an inframammary incision site because one of my biggest fears is losing nipple sensation (but “Dr. Smith” assured me that I wouldn’t lose sensation).

Thoughts on the possible surgeons so far:

  • Dr. Saltz is the one that I feel the most comfortable with but I need to know more about the details. Incision would be inframammary (under the breast). Down payment for surgery would be $600 and the total cost (with deposit included) would be around $7,200.

  • “Dr. Smith” feels like he has a concern for patients and what their overall experience is. And that patients are considering all the different things. Insisting on spending a lot of time with patients, and bringing in several different outfits for the pre-op sizing appointment. Also gives his personal cell phone number to patients (in case of complications, questions, etc.). Incision would be periareolar (on the nipple, on the bottom half where the nipple changes color) and create a scar that is barely noticeable. Deposit would be $200 to reserve a surgery date. Total cost (including deposit) would be about $6300

  • Dr. Brown is the doctor I will go with. He addressed all of my concerns, made me feel comfortable, and didn’t waste my time. Incision site will be inframammary but he also secures it in place so it doesn’t migrate up the breast tissue. They’ll make sure I have an extra supportive garment for after surgery (because of EDS). I’m passed the point of the discount they were offering, so I’ll have to wait until the next time it comes around. But it would have been $1000 deposit to secure the surgery date. Total (including deposit) would have been $6500.

This post was a lot longer than I expected! I’m still processing all the information I’ve been taking in. And figuring out what and how I need to follow up with the surgeons I’ve narrowed it down to so far. 

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