Hi everyone,

I am looking for some advice and to vent a bit. So my scheduled FFS with facial team did not happen and so I moved up my breast augmentation from January to October 11th. It totally would be cheaper to do with GRS in January but I really need to do something for me, get past the mental hurdle of "so far everything is reversible". No, I need the commitment of that first permanent change both for myself and some others in my life. Plus I am really starting to get dysphoric over boobs and genitals as I am female but lack the parts.

Patience is a virtue which I have been proven not to have [emoji23]

Anyways, so I was originally scheduled to go to Dr Ley the day before thanksgiving, and my insurance covers that travel but I really didn't want to travel by myself if I can't really use my arms on the way home. So I started looking locally, and a local trans woman I know turned me on to Dr Chapin in Doylestown. He doesn't make a practice out of working with trans clients, however the practice and the consult were amazing! He and his staff spent around two hours with me, answering all my questions (I was pretty well educated by now having done my research and spoken to a half dozen surgeons), took my 3D pictures and got everything together for the insurance submission.

They showed me models of different sizes on an iPad and with VR glasses! How cool. I looked down and said "hey there! Where have you been hiding my whole life" [emoji5] They said I giggiles.

Anywho

I am 5-10, 165lb, size 8, currently wear a 34A and my midline size is apparently 415 with a 19.1 measurement. They suggested to meet my goal of healthy C but not D to look at 435, 455 and 485 but my range is 355 to 515. So based on the models, I ruled out the 455 because they are imperceptibly different from the 435 and 485. I can BARELY see a difference between the 435 and 485, with only a 0.2cm difference in projection. The difference between the 355 and 485 is 0.4cm projection, so clearly it's about fullness and not projection. That's good I guess. I go back on 10/2 for the ore-surgical consult and we will lock in a date at that point but we are targeting 10/11. The BCBS pre-certification came back last week so that's already taken care of and no worries there.

So I need help from you ladies who have done augmentation and are approximately the same size as me and got implants in this range - 455 average over a half A. Are you happy? Would you have preferred larger, smaller? What cup size did you end up in?

For opinions, here is the link to the model. This link is topless (3D model) so not safe for work. https://my.crisalix.com/services/309457/shared?locale=en#.W6i7_zmM6YY.link

So ladies, opinions?

I am over the moon and jumping out of my skin excited!

Hi Jill,

I'm afraid I'm not a great judge of these things. It's hard for me to see much difference between each picture (except the "before" of course. Considering that right now I'm 36a, I, too, would be over the moon with any of them.

What caught my attention and made me sit straight up is that your BCBS is covering it. Did you have to fight them on that or is it part of the policy? Here in Florida they consider it to be strictly cosmetic and won't cover it.

Stephanie

IBX (Independance Blue Cross Blue Shield) gender identity policy 11.02.09e (current version as of today) explicitly covers all bottom surgeries including vaginaplasty, clitoroplasty, labiaplasty, orchiectomy, penectomy as well as top surgery once 1 year hormone requirement met and assessment of "insufficient growth" by a surgeon.

Took 2 days to get the approval with no drama. Surgeon wrote a letter, included a letter from my therapist and submitted photos at -90, -45, 0, 45, 90 degrees from face on.

Unlike FFS which is considered "potentially cosmetic" and I lost all levels of appeal including external. I'm working with a few law firms on that one...

BCBS covers FFS in roughly half the states...

Quote from: jill610 on September 24, 2018, 07:48:42 AM
IBX (Independance Blue Cross Blue Shield) gender identity policy 11.02.09e (current version as of today) explicitly covers all bottom surgeries including vaginaplasty, clitoroplasty, labiaplasty, orchiectomy, penectomy as well as top surgery once 1 year hormone requirement met and assessment of "insufficient growth" by a surgeon.

Took 2 days to get the approval with no drama. Surgeon wrote a letter, included a letter from my therapist and submitted photos at -90, -45, 0, 45, 90 degrees from face on.

Unlike FFS which is considered "potentially cosmetic" and I lost all levels of appeal including external. I'm working with a few law firms on that one...

BCBS covers FFS in roughly half the states...

Thank you, Jill!

The first paragraph of one of the documents I turned up outlined the US HHS requirement that insurance companies cover transgender care. This is particularly applicable to a friend of mine whose insurance specifically excludes such care. Maybe because it's a private policy they can get away with it, but it seems to be a good thread to tug on.

I am apparently in one of those states in the "other half" that don't cover "cosmetic procedures." My policy does cover bottom surgery, but that's it. It's better than nothing, I guess.


Stephanie

I will first say that I am 48 days till surgery, but I have spent probably too much time researching and asking on this subject for about a year. I am 5'11, 167 lbs, currently a 36A. So take everything with a grain of salt...

I'd double check about recovery time between BA and GCS. I had the same dilemma, and I chose to go at the same time due to any possible issues with recovery between the two surgeries. From looking at the renderings, I like the 435, but I kinda prefer a sportier model.

Picking breasts is tough... perhaps try them out with a few of your favorite outfits to see what will "get you there". I also looked at the numbers and it was a <not allowed>, while the changes are subtle, they really do make a difference. A quarter inch in some cases makes a lot of difference when it's in the right spots.

If you're early in transition, a smaller implant will give you room to grow if you hit a growth spurt... if you're later on in transition go for the larger end of the spectrum.  Just an observation from years of strip clubs, I have noticed that a lot women seem to grow into their breast size. They get augmentations, and seem to (within a year or 2) gain the curves all over to balance them out.

Quote from: Harley Quinn on September 24, 2018, 08:32:49 AM
I will first say that I am 48 days till surgery, but I have spent probably too much time researching and asking on this subject for about a year. I am 5'11, 167 lbs, currently a 36A. So take everything with a grain of salt...

I'd double check about recovery time between BA and GCS. I had the same dilemma, and I chose to go at the same time due to any possible issues with recovery between the two surgeries. From looking at the renderings, I like the 435, but I kinda prefer a sportier model.

Picking breasts is tough... perhaps try them out with a few of your favorite outfits to see what will "get you there". I also looked at the numbers and it was a <not allowed>, while the changes are subtle, they really do make a difference. A quarter inch in some cases makes a lot of difference when it's in the right spots.

If you're early in transition, a smaller implant will give you room to grow if you hit a growth spurt... if you're later on in transition go for the larger end of the spectrum.  Just an observation from years of strip clubs, I have noticed that a lot women seem to grow into their breast size. They get augmentations, and seem to (within a year or 2) gain the curves all over to balance them out.

I was planning to do both GCS and BA at the same time in January, however did not really want the double at once recovery. It would be financially advantageous to wait until next year, but after my FFS getting canceled I have a need to do something affirming.

I have been on hormones for 18 months and my gp says I'm done with growth, since I've had no growth in 10 months. OTOH fat distribution is in full swing now and I'm developing curves yay.

Quote from: jill610 on September 24, 2018, 08:42:16 AM
I was planning to do both GCS and BA at the same time in January, however did not really want the double at once recovery. It would be financially advantageous to wait until next year, but after my FFS getting canceled I have a need to do something affirming.

I have been on hormones for 18 months and my gp says I'm done with growth, since I've had no growth in 10 months. OTOH fat distribution is in full swing now and I'm developing curves yay.

Congratulations on the progress... curves are wonderful. 😁

I wouldn't say you're done at only 18 months, but I'm no doctor. I truly understand the need to do something... for me it was hair restoration 2 years ago. A step forward is always beneficial to self esteem. Best of luck, and I'm sure you'll get plenty of great advice from the lovely ladies here.

Quote from: Harley Quinn on September 24, 2018, 10:12:59 AM
Congratulations on the progress... curves are wonderful. [emoji16]

I wouldn't say you're done at only 18 months, but I'm no doctor. I truly understand the need to do something... for me it was hair restoration 2 years ago. A step forward is always beneficial to self esteem. Best of luck, and I'm sure you'll get plenty of great advice from the lovely ladies here.

Due to a massive spike in my E that was uncontrolled for a few months, breast buds are done growing according to my doctors.

Have you considered adding rice sacks to your bra to help you get an idea of a size/weight that feels right to you?
http://www.clevelandplasticsurgery.com/wp-content/uploads/2015/08/Rice-Test.pdf

Yes, I did not find it helpful because even 500 felt small nd my kid was like "really, all this for just that little bit?"

They have a bra with sizers you can try on, so that will be next Tuesday I guess.

Hi Jill,

I am large, you saw me at the PTWC. I had 555 cc partial below the muscle cohesive silicone Mentor implants.

I was told I would be a full C. I am a 42B/ 40C. 40 is a bit tight. I am 6'2" 176 pounds. I am happy with my implants but if I were to have a second wish I would go to 800 cc. I would want to see if there was an implant that could provide less of a gap between breasts.

Having the 555cc BA allows me to be more athletic easier and fit into more tops that are fitted to a large size in woman's and yet not be tight.

50 or 60 CC does not make much of a difference. I would go to the larger if I were to choose again.

I see my surgeon the end of October. I have a little thing to get corrected with my GCS revision. Some skin healed over and formed a very small loop that will be cut. When there I will ask if I can go larger and can she close the gap between the breasts. If I get a letter of need then my insurance will cover the second BA.

For me I wanted to be a full C and not a D and now that I see my gap I want to reduce it. Just me being overly critical of myself.

If my surgeon declines I may be off to Dr. Chapin. What hospital does he have privileges in?

Good luck in your decision. I am sure you will pick the right size

@Rachel

Thank you for the advice, I met another woman tonight and am also thinking larger now. I want to be "well endowed" but not huge. Seems like a fine line between the two.

Dr. Chapin operates at Doylestown Hospital, or at least that is where the pre-authorization is for.

Quote from: jill610 on September 24, 2018, 08:20:43 PM
@Rachel

Thank you for the advice, I met another woman tonight and am also thinking larger now. I want to be "well endowed" but not huge. Seems like a fine line between the two.

Dr. Chapin operates at Doylestown Hospital, or at least that is where the pre-authorization is for.

Hi Jill,
   I was worried that going bigger might move me out of some of my tops. Instead of the 470cc I originally thought,  I ended up with 640 cc. (A Double D instead of a C cup)  I stayed with the moderate profile and my clothes all still fit. If I had  gone with the higher profile, that may have changed. Sometimes I think about the higher  profile but they might have made me look more top heavy, more trans looking. I think the bigger implants helped some with the gap Rachel, but I have seen some cis women with the  same gap as I have. Mine don't look real big until my top comes off. Good luck Jill!
Moni

Moni, out of curiosity what is your band size?  I'm having the big BA consult tomorrow and am kind of curious as to what frame a moderate profile would work well on.

Colleen, hi! I really need to get to a fitting to be sure, but I am in the 38-40" range after surgery. To me it is about proportion. If you have the inverted triangle shape and are bigger up top, the higher profile might add to that top heavy appearance. I many times will now wear a slightly pads underwear to give just me a bit of confidence that I look proportional. If I had more butt and hips, I would have wanted the higher profile. My thoughts!
Moni

@Colleen_definitely

Thanks Moni, that's really helpful. I'm ina similar band range but probably have a bit more hip. I'm just afraid of getting the"refund gap"

Be up front with the doctor about your concerns. Get a sizing done. Not sure how good the computer animations are that some doctors have. Make them spend the time on you to get it right.Good luck.

@HappyMoni

I have spoken with about five surgeons and they are all recommending in the same range, though I am increasingly settling on "I'd rather be bigger than smaller" and have been hunting for pictures of women about my size to show what I want to achieve. I have asked the office to add 515 to the simulation.

I have done the rice thing and keep coming in around 500-550, which seems huge to me but maybe it's just because I'm so small now? When I go back on Tuesday for the pre-surgery consult where they will finalize the size. They said they have sizers I can put in to get a better idea of the sizes, the sim and rice bags are useful but hard to relate to.

I met with a woman last night who got the small end of the range and was my exact same presurgery measurements and I know that is smaller than I am hoping for. She got 415s and is a C, so maybe what I have in my head is really a D. I'm 34" band (right on the button), 37" bust atm.

These are all Sientra moderate plus profile with projections of 4.4 to 5.0cm in the range 355-525cc. The 435-485 are 4.6 and 4.8cm so pretty close in size and 13.2/13.4 width.

One more week till we finalize and I can't wait.

Jill,
   When I tried on the sizers, they seemed humongous to me. It is kind of a real sudden mental adjustment to go from, perhaps small, to sizable up top. The doctor and assistant kept telling me that if I was undecided between 2 sizes, go with the bigger. His point was that he saw a lot of woman wish they went bigger I guess. I will offer no opinion for you obviously, not my call. I would suggest one thing. Bring  a couple of tops that would be good at showing what you might look like on average. My first consult, I had a baggy tunic on and it was difficult to see the size and shape. I would get close to the size you want and see how those tops look. The majority of the time that people will see your boobs is when you are clothed and not when you are naked. Naked volleyball players excluded.
Moni

Quote from: HappyMoni on September 25, 2018, 03:56:25 PM
Jill,
   When I tried on the sizers, they seemed humongous to me. It is kind of a real sudden mental adjustment to go from, perhaps small, to sizable up top. The doctor and assistant kept telling me that if I was undecided between 2 sizes, go with the bigger. His point was that he saw a lot of woman wish they went bigger I guess. I will offer no opinion for you obviously, not my call. I would suggest one thing. Bring  a couple of tops that would be good at showing what you might look like on average. My first consult, I had a baggy tunic on and it was difficult to see the size and shape. I would get close to the size you want and see how those tops look. The majority of the time that people will see your boobs is when you are clothed and not when you are naked. Naked volleyball players excluded.
Moni

Thank you, great advice as always. Good news it my presurgery consult got moved from next week to tomorrow as I guess they had a cancellation. So I'll try the sizers then.