What I Wish I’d Known Before My Breast Augmentation

Dr. Houssock (00:04):
You are listening to another episode of Perfectly Imperfect.

Dr. Houssock (00:08):
So we know that Val mentioned she had a breast augmentation. So we're going to ask her some things about her actual experience, not as a nurse, but as a patient. So Val is a new mom, and Val, you of course, we just talked about, had a breast augmentation. Can you tell me a little bit about any concerns you had before Emory came about breastfeeding and having your implants?

Val (00:41):
I mean, my biggest concern was am I going to be able to feed her? So I did my breast aug five years ago before I got married. It was one thing that I've been wanting to do pretty much all my whole adult life. I've always been pretty self-conscious about my breasts and I knew at some point that I definitely wanted to do it. And of course when I got engaged I was like, alright, it's time. Let's do this. I wanted to do something to make me feel better about myself, especially on the best day of my life. So I did it. I don't regret doing it before I had kids. Except after they definitely change quite a bit after you have kids.<laugh>

Dr. Houssock (01:29):
<laugh> Talk about that a little bit, cuz that's the one thing we don't talk about or I don't mention much, is during pregnancy.

Val (01:36):
Oh my gosh.

Dr. Houssock (01:36):
How was it with your implants?

Val (01:38):
Frightening. I mean, when they say they change, they change. It also it's pretty amazing how, they just, they know what to do when your baby comes. It's like, alright, your baby's here. It's time to feed this little thing. Long story short, I had a NICU baby, so I had to pump right away. So I actually became an exclusive pumper. I did breastfeed her about a handful of times at 33 weeks when she was there, and I was very upfront to the lactation nurse like, Hey, I want to try this. If it works, great. If it doesn't, I got something going right now where it's working for me. And then Emory and I kind of had a mutual agreement where we're like, all right, this isn't for us. You just keep doing what you're doing. So I'm grateful that I could do it, but I did exclusively pump and I pumped for six months with my implants. I will say because of my implants, I constantly was very uncomfortable as far as with the engorgement, and I do think if I did not have my implants, I would've felt more comfortable.

Dr. Houssock (02:49):
That makes sense.

Val (02:51):
Working out was very difficult for me just because I was much more top heavy than I was. Definitely could feel it in my back and my shoulders. So I feel you breast reduction patients when you guys come in and you're just so uncomfortable. And that's exactly how I felt.

Dr. Houssock (03:09):
It's so interesting because it's almost a blessing and a curse where once you have an augmentation, you kind of have the perfect size that you want. That's why you pick it, and then you are engorged, especially during time when you are producing. And the only advantage I tell patients about it when it comes to that side of it is once you go through that phase of loss, meaning you stop breastfeeding, women talk about of course deflation and volume loss, but when you have an augmentation, you're never going through that.

Val (03:42):
There was no volume loss.

Dr. Houssock (03:45):
I never lost volume and didn't have volume because I always had my implants in there. So that was the advantage.

Val (03:52):
Yeah. Oh, for sure. And I stopped pumping in June, so we're in November now, and I will say, you can ask Dr. Houssock, she looked at them yesterday, my nipples stayed up. I was very surprised.

Dr. Houssock (04:07):
They do. They look great.

Val (04:09):
Thanks. Yeah, I was very surprised how much they stayed up north. So that's the one part I could say definitely having the implants, I have that support still. If I didn't have that support, I would definitely have that volume loss and that sagginess just because when the milk came in, our skin stretches and

Dr. Houssock (04:31):
Totally.

Val (04:31):
Yeah.

Dr. Houssock (04:32):
What do you got in there, Val? What brand and size and everything do you have in there?

Val (04:37):
They're a mentor. They're high profile, the extras, and they're 535 ccs.

Dr. Houssock (04:44):
What's the extra mean? Is that extra full or is it extra cohesive?

Val (04:47):
It's actually extra cohesive. Yeah.

Dr. Houssock (04:51):
Is there a particular reason you went for that cohesivity?

Val (04:55):
I'll be honest, it was my second aug within three months because they came out and I loved them and I was like, oh man, I really want them. I liked that they were a little firmer, so they definitely gave you some more support and with them being the extra cohesiveness, I like that for if a rupture were to happen, back to what you talked about with the gummy bear. And then I had done a moderate profile at first, and it was a little too wide for my footprint and that's why I went to high profile just to get more projection.

Dr. Houssock (05:31):
All these things, all these words she's using, these are all fancy words for that breast footprint we were talking about. So it's all in the thought process of choosing the right breast implant for you. You can choose the same volume within a different diameter, and that diameter, the smaller it gets, the higher the implant gets or the higher the profile gets. So we think about all that when we're choosing for you. And then the cohesivity really depends. Some companies will suggest that middle of the road cohesivity because it gives some structure without being too harsh. The most cohesivity is generally used for someone who has a breast cancer reconstruction because they really need the implant to create the shape of the breast. Most women have something more than that, so they don't need to be quite so stiff. But again, these are all new things for us because patients think about that whole Baywatch time. When Pamela Anderson was getting her implants, she had 10 choices. She's probably just 10 volume sizes. They had no choices like we do now. we have like 350 choices just for the one company we use. So it's just so cool to be able to have so many options.

Val (06:41):
For sure.

Dr. Houssock (06:43):
So everything she said was because of the thoughtfulness of choosing for what Val needed and wanted. What was your day like? Tell me about your surgery day. Do you remember it and your recovery?

Val (06:55):
Oh yeah. That was such a great day because I was just so excited just to get it done. My husband came with me. I think he was more nervous than I was and he was just, well, he kept joking about, he's like, if you want to go a little bigger, and I'm like, no, please stop. We're not doing that. Surgery went really well. It was about an hour, hour and a half. I did go below the muscle because at that time it was definitely a little bit more common to go below the muscle, and I definitely had a longer recovery than someone who went above the muscle for sure. Like I said, I'm a big weightlifter, so my pec muscles are pretty thick, and so that recovery was a little rough just because of things were so tight. So I woke up and I just remember feeling something was just kind of sitting on my chest, which I knew after all these years of being in breast augmentations, that's very common just because the pocket needs to form, the skin needs to stretch, everything needs to settle. So I knew they were going to be high and tight and boxy at first, and over time things would settle out. That day, I just remember laying low at home, really hydrating up and moving, and I rotated between narcotics and then ibuprofen. Those were my best friends. And then I would take Valium at nighttime just to help with muscle relaxing. Things were just so tight and that really helped keep me comfortable. I'm a crazy person. I did it on a Wednesday, went back to work Monday.

Dr. Houssock (08:28):
We don't suggest that. We definitely

Val (08:31):
Don't do that.

Dr. Houssock (08:31):
Do as I say, not as I do. Take the week off because we all regret it. We all regret it that we didn't do it ourselves. I don't know, moving forward, we need to tell each other that we're not going to allow us to do that, but we all do it and it's a bad idea. You need to take a week off because you really need the time just to

Val (08:49):
You do.

Dr. Houssock (08:50):
It feels like the flu. It feels like

Val (08:54):
You need that time.

Dr. Houssock (08:54):
You're so tired. Yes.

Val (08:56):
Because anesthesia is still lingering in your system too, so it definitely takes a couple days to really get those meds flushed out of your system, you feeling more like, and I don't take stuff like that on a normal basis. So it definitely took some time for me to get back to myself for sure.

Dr. Houssock (09:11):
Hundred percent. So take the time and really what we usually tell patients is take the time and do this at the right time. So if it means you have to wait a couple of months to do it, when it works best for you and your family and work and

Val (09:22):
For sure.

Dr. Houssock (09:23):
Just wait.

Val (09:25):
And definitely not during a stressful time in life too, because that really affects your recovery. If mentally you're not ready and it's just not the right time with life going on, then definitely do it when it's appropriate because that really is going to affect how you do afterwards for sure.

Dr. Houssock (09:41):
A hundred percent. Hundred percent.

Val (09:42):
And I definitely wish I took some more time just to really focus on taking care of myself. But overall, I would say by week four, I went back to the gym once I was cleared and I just started slow. I just listened to my body. I took day by day, but I gradually got myself back into it. Of course, I walked the whole time during that four weeks I couldn't sit still. You know me.

Dr. Houssock (10:06):
No, and that's okay. We like that. I mean, we like patients being active, meaning that they walk around, make sure that they're moving. We don't want you just laying in bed, but there's limitations to how much mobility you should do, especially with the upper body for sure. But moving is always good. I mean, day one, you should be moving, and that's exactly how she described it is exactly how it is. It's kind of like just a slow and steady getting back into your normal routine again, over time.

Val (10:36):
Just listen to your body and you'll get back.

Dr. Houssock (10:38):
Anything you wish you knew that you didn't know back then when you had it?

Val (10:45):
I really wish I knew what was going to happen after I had Emory as far as them changing, for sure. I think I would've waited, honestly. Yeah, I would've waited for sure. I wasn't sure about having kids at that time in my life, so that's why I was like, you know what? I'm ready to do something for myself is the right time. But yeah, if I could do it again or know something that I didn't know, I definitely probably would've waited for sure.

Dr. Houssock (11:13):
Yeah, and I think that's why we focus so much on that when we do our education during our consultation, because I don't think that there's a right answer to it, but I always want to make sure patients are informed.

Val (11:22):
For sure.

Dr. Houssock (11:23):
And we know for sure that during pregnancy the breasts will change and they may require a revision afterwards. So I think it has to be a huge part of the initial consultation as to what their game plan is, because if they're trying in the next year or two, there's no point in going through this breast surgery when your breasts are going to change so much versus those of us who did do it before, I did it the same as you. I did it before and had no idea that I was going to have children. So at the time, it was perfect for me and I didn't know what would come. And for those patients, I always say, you're not burning a bridge by having it done, but you just need to know that it's potentially that there can be changes. Yeah. I think my, oh, go ahead.

Val (12:07):
Go ahead. No. Oh, I also want to say sorry, that I wish, so my incisions are on my nipple and I don't make the best scars just with my background being half Hispanic. My scars tend to be a little bit on the dark side, so I wish I did the IMF incision, so underneath versus doing it around the nipple. So when I do switch these out, I definitely will switch my incision placement for sure. I also had some sensitivity loss around that area, and not that I'm saying that would happen with everyone, but I probably would've definitely done a different incision location.

Dr. Houssock (12:46):
Yeah, and I think that's probably my take home message for this whole podcast is really, there are so many ways to do this surgery and so many things that I think now with social media that patients do so much research and they kind of come in thinking they know exactly what they should have and what they want. I think at the end of the day, find the surgeon who you trust and have the conversations. And I am always okay with talking about the pros and cons of the choices we can make under the muscle versus over the muscle, what incision we use, what volume we use. And all of those things, quite frankly, are all fine because that's why we have the choices. None of them are a bad choice, but there might be a reason why one is better for you than the other, and that is part of the consultation. So find a person who's going to spend the time with you to go through those options and not just be in and out. Alright, great. Pick your size, goodbye, because it's so much more than that and you deserve to be a part of that journey and part of the decision making. So no matter what we think, ultimately you've got to figure out what's works best for you.

Val (13:58):
Couldn't agree more with that.

Dr. Houssock (14:01):
Alright, Val. Well, anything else?

Val (14:05):
No, thanks for having me.

Dr. Houssock (14:07):
Alright. Carry on, Val.

Val (14:08):
You too. I'll see you tomorrow morning.

Dr. Houssock (14:16):
Perfectly Imperfect is the authentically human podcast navigating the realities of aesthetic medicine. JEV Plastic Surgery is located in Owings Mills, Maryland. To learn more about us, go to JEV plastic surgery.com or follow us on Instagram at Dr Care Houssock, spelled D-R-C-A-R-E-H-O-U-S-S-O-C-K, or just look in the show notes for links. If you enjoyed this episode, please share it and subscribe to Perfectly Imperfect on YouTube, Apple Podcasts, Spotify, or wherever you'd like to listen to podcasts.