Laura's Breast Augmentation

[LauraE]

July 7, 2021

First, thank you to Susan and Danielle for making this subforum possible. I DO hope to see many stories here about our BA journeys.

To BA or not to BA, that is the question.

When i first began HRT five years ago, and again when I recommitted to HRT two years ago, i had hoped for a "B" cup and would have been thrilled with a "C". With the prevailing knowledge that we tend to achieve one size under what our closest female relatives reached, a B seemed probable. Most of my relatives have C and D cups.

However, i stopped at an A cup a year ago and have seen no new growth since then. Yes, i do see many tennis players with my cup size or even smaller, but at least to me, since i'll never have female hips, i'd at least like to have breasts that are proportional to my frame.  A C cup would be ideal but i'd be happy with a full B.

When i had my yearly check-up last fall with my trans specialist, i began to inquire about BA and GCS. She was onboard with both decisions and recommended me to Kaiser's therapist which is the first gate that must be passed. My online conversation with the therapist informed me that the wait time for BA was currently about four months while the GCS timeline was closer to a year.

Because i wanted to give HRT more time, just in case a surprise spurt happens, i delayed an appointment with the BA surgeon.  That was probably a mistake, because now that the country is opening up, more of us MTF's are seeking procedures.

My current BA journey began two months ago when i asked my Trans doctor for a referral. When it came time to talk to my regular therapist (which is more like a concierge than a therapist), i found that appointments required anywhere between a three and four month wait. My own appointment is scheduled for late July, after which i'll be referred to a surgeon. The current wait time for surgery is about a year.

More about my journey to follow.

Onward,

Laura

[LauraE]

July 26, 2021

Gatekeepers
One of the things i enjoy about having Kaiser insurance is their support for our transition that goes far beyond just providing HRT. Through them, i've received FFS, electrolysis, and consultations for GCS. Today was my video appointment for BA, something i'd waited for a few months due to their busy schedule.
Kaiser's process begins with the Multi Specialty Transitions (MST) office which refers you to a therapist, which is actually part therapist and part concierge. This morning was my video conference with a therapist who spent 30 minutes updating my record, asking questions about my transition, and providing basic information about breast augmentation. This is essentially their informed consent process, which is fine.

Upon completion, she referred me back to the MST for the next step, which is an appointment with a nurse to ask more questions and connect me with a surgeon. While writing this post, i received their call and arranged for a nurse consultation this Friday.

One step at a time.

Laura

[LauraE]

July 20, 2021

Nurse Phone Call
Once you've talked to a Kaiser therapist and declared your informed consent, the next step is to talk to a Kaiser nurse about the procedure. This 15 minute call came today, just a few days after the therapist video conference.

Today's nurse works out of Kaiser's Multi-Specialty Transition (MST) department, which handles my HRT meds and is the first contact for all things transgender. He reviewed my medical chart first, asking questions about my HRT as well as other procedures and conditions from the past. At that point, we talked about surgical offices that are currently taking patients.

Unfortunately, while there are quite a few breast surgeons located within a 90 mile range, only a few offices are accepting new patients and work directly with the trans community. Because of this, i selected the busiest and more experienced office in San Francisco, which is about two hours away, a bit longer if i take mass transit there.
The nurse mentioned that wait times vary, but were within four to six months in the past. If, after my consultation with SF, their wait times don't work with my calendar, i can ask to be referred to the San Jose office, the other experienced set of surgeons.

Within the next week or two, i'll receive a call from them for an in-person appointment.
We discussed the location.... Sacramento has a hold on surgeries for BA due to turnover. There's a new doctor in Stockton who is experienced but San Francisco has the most experienced doctors. Because they are the biggest surgery hub, they may have longer wait times. (roughly 4-6 months pre covid).

If SF wait time is too long, we can ask for a second opinon asking for a new surgeron/location.
i should get a call from the surge in the next week or two.

Laura

[LauraE]

August 13, 2021

Today was my video appointment with Dr. Nanigian who works out of Kaiser in Stockton. He was one of the doctors offered to me during my  consultation with the Transitions office, being told that he was new to Kaiser but had "experience."

The out-patient operation takes around two to two and a half hours, with initial recovery being three weeks. The greatest discomfort comes in the first two weeks. For active people, like myself, it will take around five to six weeks before i can return to the courts. He told me to listen to my body regarding exercising or doing other activities.

As far as size, we'll need to meet at his office so they can measure my chest wall and provide me sizers to place under a sports bra so i can help determine the size i prefer. As i've written earlier, i've no need to go big, but would be happy with a full B or small C.
Of course, he reminded me that bra manufacturers are inconsistent regarding bra size, which is why the silicon implants they use are measured in milliliters.

While i'd read that implants placed under the muscle look more natural, he said that there's been an evolution over time and while he does both under and over implants, he believes over may be better for me. Because i play tennis and am active, implants under the muscle could cause problems (something he called animation deformity). Those of us who have small breasts have less breast tissue to mask the underlying implant. For most of us, it's tough to look completely natural.

The current wait time for surgery is about two to three months, so i'm hoping for a November date which is when our tennis team breaks for the holiday season.

More details after my office visit.

Laura

[LauraE]

August 15, 2021

First, i want to thank those of you who chimed in with their thoughts and experiences with BA, which is one of the three major operations many of us desire. This is a major decision so approaching it carefully and well informed helps me understand what's best.
I decided to do some further research, confining my observations to surgeon's web sites. What i found was interesting and provides me a few questions to as my surgeon during my office visit.

Some, like my surgeon, mention that they were initially trained to place implants under the muscle, but said that conventional wisdom has changed over time. Many do both under and over, as my surgeon does, but make their decisions based on the individual patient. Larger implants seen to always be placed under the muscle. Sometimes the decision depends on how much breast tissue is present to mask the implant. As one doctor said, there's no one-size fits all.

I'm not going big though.

I've learned a few new questions to ask.

You mentioned that you do both under and over the muscle implants. What are the conditions that determine which is best for me?
Do i have sufficient breast tissue to avoid capsular contracture (rippling, or visible folds or wrinkles)? I've read that it's best to have a B cup for over the muscle applications.

Laura

[LauraE]

November 5, 2021

Visiting the Boob Fairy
I feel fortunate to have snagged a cancellation in my BA surgeon's schedule. By completing my BA in early November, i should have ample time to recover and be ready when our tennis season resumes in January.

A week before, my surgeon had ordered a COVID test as well as an EKG. They'd also require me to have someone with me who would drive me home and stay overnight in case there were complications.

This is where one of my friends stepped to volunteer.
I feel blessed that my partner, Yeng, came into my life, us quickly becoming close friends. Getting to know her other best friends was a wonderful experience, so when one volunteered before even being asked, i was humbled.

Wednesday morning she picked me up at 5:15am, arriving at the hospital around 6am. After paying my tab and demonstrating that i had a caretaker, they moved me into a pre-surgery room where i donned a gown and waited for a series of people to stop by to review the surgery with me. Around 7:30, they rolled me into the surgery suite where i was quickly sedated, waking up around 9:30am in the recovery room.
I had been cautioned that some people feel severe pain afterwards, which is why i left with a small bottle of Norco. The only pain i've felt the past three days comes from the incision area so i can't determine whether it's the compression bra's  tightness or if it's my body responding to being cut open. Doesn't matter though.

Recovery from BA is quite different than from FFS, but then FFS is a whole suite of incisions and actions. I left the hospital with written instructions about my tasks during each phase of recovery. i'm currently in the first phase, refraining from showering until after the fifth day.
The worst part of recovery is protecting my new boobs so that they settle correctly and don't end up wandering on their own. That's why i can't play tennis, lift weights, or raise my hands above my head.

I must also sleep on my back the first month because side sleeping might cause these ladies to roam from their placement. Now, i've never been a back sleeper and i always feel uncomfortable when trying. because of this, i've not slept well these first few days. i'm just hoping it gets better because i'm pretty loyal to the doctor's instructions about after care. My first
i've not seen the girls yet so my first view will happen next Monday when i'm allowed to shower.Currently they look much larger than i wanted, but this is due to the amount of dressings under my bra. i'm pretty curious though.

The best part of recovery have been my good friends. The woman who cared for me the first day, Gayle, was such a gift. I knew little about her history though, so the many hours we spent together included many reveals about each of our lives.

Yeng, my best friend and tennis partner, came over in the afternoon, bringing me egg rolls and noodles she'd picked up from a restaurant. Her other best friend, Celeste, visited me yesterday, again to see how i'm doing. Never have i had this many friends who care about me.  I feel blessed.
As i begin to feel better,  I'll begin taking walks as a form of exercise, moving to our gym's elliptical in a few weeks to improve my endurance and prepare for January's matches.
More after my first follow-up with the surgeon next Tuesday

Onward

Laura

[LauraE]

November 9, 2022

It's day five after the surgery so i was finally able to take a shower and see what the girls look like. Overall,  I'd say they're Goldilocks boobs; not too big, not too small, just right.  I'll have to wait about a month for them to "drop and fluff" into their final position, but at least the worst is out of the way.

I've a follow-up appt with the surgeon tomorrow afternoon, so i hope to find the answers to lots of questions.

Do wish i could work out, but doing too much too soon would cause problems with the implants. Miss you ladies.

Surgeon Follow-Up Questions
How will i know when my breasts have dropped and fluffed?
Will they look larger or smaller after the fluff?
At what point will it be ok to raise my arms above my head to  put on tops without buttons?
At what point will it be ok to raise my arms to do light weights?
when may i begin using the eliptical?
When may i begin using light handweights?
I must wear the bra 24/7 for a month. After that, need i wear a bra at night? I'm a side sleeper.
Are their any exercises or massages i must do to my breasts this month? forever?
How will i know it's ok to play tennis without pcausing damage to my breasts
Are their future follow-up appointments with you? If so, what intervals?

Laura

[LauraE]

November 9, 202

One Week Surgery Follow-Up
I traveled out of town for my one-week follow-up with the surgeon yesterday and i came armed with plenty of questions about when i'll be able to do a variety of things. It's hard enough not to play tennis for four to six weeks, but at least i'd like to stay in shape for when i do.
The surgeon is pleased with my progress as am i.  When we met several months ago, i had settled on the smallest implants, 250cc which would probably take me up one cup size. Part of me was concerned about going big and standing out too much, but mostly i just wanted to be larger so a B cup is just fine.

When i see myself in front of the mirror, it's obvious i'm larger that i was which is all i ever wanted. I won't really know where i fall cup size until i go in for sizing after the girls drop and fluff.  I'm not in a hurry.

When i met the surgeon in the pre-surgery room, i told him it would be ok to increase the size up to 300 if he felt that looked better. During surgery, after he created the pocket for the implants and experimented with different sizes, he felt the 250cc looked best for my right breast and 275cc looked best for my left. He mentioned that the nurses were encouraging him to go bigger (which made both of us laugh), but since he knew my wishes and my body, he felt these sizes were best for my body.

And I'm perfectly happy with his decision.
Beginning today, i'm able to walk long distances, but must refrain from running or using the eliptical until the three-week mark. I am allowed to begin using my five and eight pound hand weights for arm strengthening exercises which please me since tennis requires a fair amount of upper body strength.

I'm allowed to sleep on my side now (thank goodness because i wasn't getting any sleep on my back). As long as i continue to wear either the compression bra or a sports bra 24/7, i'm good.
yes, i am...

I love the new girls.

Onward

Laura

[LauraE]

November 28, 2021

Last Wednesday, on the third-week anniversary of my BA, i was allowed to begin using the elliptical at the club for exercise. Until then, i was only allowed to walk which i did but found that not only does it not get my breathing and heart rate going, the constant beat of quickly walking made my knees complain. Oh, the joys of getting older. The elliptical, though, was a joy and something i'll continue doing to get back in shape.

When i reach the four week mark this Wednesday, i'm allowed to begin playing tennis and to start wearing regular bras instead of the compression bras i've been wearing 24/7. Believe me that the tightness of these are often very uncomfortable.

Bra Shopping
I've been looking forward to this for weeks, so on Black Friday i trekked over to the Victoria Secret at our local mall.  Yes, that wasn't  the best to go shopping, but Macy's had a sale on wool coats so i stopped there and found a wonderful, knee-length coat for a great price. Walking over to VS, i was required to wait in line outside the store because of the crowds. (Oh, the line to pay for goods snaked all through the store, reminding me of the lines at Disneyland.)
Once inside the store, i found the bra section and asked for help getting measured and shopping for wireless bras. The sales people were wonderful and patient, making this first-time shopper feel at ease. In the end, i'm a 38B as anticipated, although i felt more comfortable with the 38C bras in the wireless line. Oh, i'm NOT a C, which is just fine with me. I DID get a 38C push-up bra which looks marvelous, though.

In all, a good experience. In six to eight months, after the scars have completely healed, i'll return to find some wired bras.

Laura