Free to drink, YAY!

I spoke with my doctor's nurse today. I was so worried when I got the packet that the patient coordinator sent me (more on that later) and read that I have to stop drinking alcohol for two weeks before the surgery.

Now, don't get me wrong, I'm not an alcoholic by any means. However, this month there are two weekends that had me concerned: St. Patrick's Day and my girl's sister's birthday.

I am all about having to be the DD if necessary. But I really didn't want to be...so imagine my relief when the nurse told me that the rule isn't really a rule...it's more of a guideline. Phew! Good to know.

Of course, she did warn me not to go crazy and especially not the night before. I was thinking that was a little obvious...would a chick really think about getting hammered the night before a big surgery? Especially when you have to fast EVERYTHING including liquids for the 12 hours before you go under? I guess you never know with some people!

I'm just glad I can raise a toast...even if it will only be a little one! (:

Example pictures of the ideal breast size and shape

My doctor and multiple websites say to chose pictures of what you want to look like ideally...So I decided to post a few here. What do you think?

Best after surgery advice ever!

After Breast Augmentation Surgery

• Make sure you have someone to carry you home after surgery, and stay with you for at least the first 24 hours, preferably the first 48 hours.  This is VERY important.
   
• Have reasonable expectations regarding the outcome of your surgery.
   
• Buy a few larger bras (preferably the cup-size you'd like to be after your surgery, but NOT padded bras), pad them, and wear them under your clothes.  This will help you get used to your new size.  Most women wish they had gone bigger, and by "trying the size on", you will realize how quickly you get used to having larger breasts.  See the Size page.
   
• Drink a lot of water in the days prior to your surgery.  This may help ward off nausea after your surgery (which is usually due to anesthesia).
   
• Eat something when you take your pain meds.  Sometimes, a few crackers don't do the trick.  Eat a piece of plain, white bread, or a piece of toast, or 1/2 or a whole peanut butter sandwich.  Pain meds can upset the stomach.  Eating usually helps ward off any potential nausea.
   
• You will want to practice sleeping on your back and/or propped up on pillows, because you will be sleeping like this for a few days (at least) after your surgery.
   
• Make sure you tell your surgeon about any and all medications (including, but not limited to, heart medication, blood pressure medication, insulin, antidepressants, etc.), vitamins, and herbal or homeopathic remedies you are taking.
   
• Stop taking aspiring, aspirin-containing meds/products, ibuprofen, and all vitamins and herbs for at LEAST 2 weeks prior to your surgery.  Some surgeons recommend not taking them for 30 days prior to surgery, so definitely check with your surgeon regarding the types of medications you need to avoid.  Many types of vitamins, herbs, and meds will cause the blood to thin, which is why you do not need to take anything w/o your surgeon's approval.
   
• Ask your surgeon if it's okay for your to take Bromelain, and Arnica Montana, for bruising and swelling.  You should not take these for more than 10 days.  Ask your surgeon about this PRIOR to surgery, and only take it with his or her approval.
   
• Do not drink alcoholic beverages for at least 24 hours pre-op. (My note: my doctor said to stop two full weeks ahead of time, so that's what I'm going to be doing!)
   
• Make sure you remove ALL jewelry/piercings prior to surgery.
• If your period is due around the time of your scheduled surgery date, make sure you let your surgeon know.  Some surgeons do not like operating if the patient is on her period.  Others don't mind.  Also, some surgeons prefer you to wear a pad, versus a tampon, so make sure you ask about these things.
   
• Wear loose-fitting clothes to surgery.  A button or zip-up top is preferable, with pull-on pants, and slip-on shoes/sneakers.
   
• If you smoke, you need to quit for 4-6 weeks prior to surgery.  If you cannot quit, cut back as much as you possibly can.  This is ESPECIALLY true is you are having a breast lift.  Smoking reduces the oxygen levels in the blood, which will inhibit healing.  In patients having breast lifts, this COULD lead to necrosis (tissue death).  So do your best to stop smoking prior to your surgery.
   
• Do abdominal exercises to help strengthen those muscles.  You will be using them a lot after surgery, so the stronger they are, the better.
   
• Have easy-to-wear clothes ready.  You will be wearing button-up shirts for a week or so (possibly longer), so have these, and pull-on pants ready so that you don't have to search for them after the surgery.
   
• Make sure you have your surgeons phone number, as well as emergency/after-hours number by your phone(s).
   
• Clean your house and do all the laundry a day or two before your surgery, so that you don't have to worry about it for several days after surgery.
   
• Have clean sheets and pillow cases on your bed.  You won't feel like doing this for at least a week.
   
• Make up your sofa with sheets, blankets, and pillows.
   
• Take your trash out the morning of your surgery.
   
• Do all of your grocery shopping is done.  Buy enough to last for 2 weeks or so.
   
• Buy 4 bags of frozen fruit (not vegetables, cause they don't smell very good when they start thawing) to use for swelling.  You may opt to put these bags in large freezer (ziplock) bags, to keep the moisture off of you.  Two of these bags can be kept in the freezer, while you are using the other two.  Another variable to this would be to put crushed ice in a ziplock back.  This is easy if you have an icemaker in your refrigerator.  You may also purchase reusable icepacks from the drug store.
   
• Buy simple, light foods at the grocery store, such as crackers, puddings, jello, soups, applesauce, etc., in case you don't have much of an appetite.  Ensure or Boost (which are nutritional drinks) will give you the vitamins and nutrients your body needs if you don't feel like eating anything.
   
• Have a heating pad handy for your back, as it may get sore due to your sleeping positions early post-op.  Do NOT put a heating pad on your breasts.  They will most likely be numb, and you could inadvertently burn yourself.
   
• Cook some meals ahead of time, and freeze them.  Some examples are soups, chili, spaghetti sauce, etc.  These can be put in the microwave later.
   
• If your surgeon will give you your prescriptions prior to surgery, go ahead and get them filled.
   
• Ask your surgeon if he will prescribe anti-nausea medication.  You may also want to ask if he prescribes Valium (or something equivalent) to take the night or morning of surgery, which will help you relax.
   
• If you don't get your prescriptions until after the surgery, get them filled at the hospital pharmacy.  If you have an insurance/pharmacy card, don't forget to take it with your on the day of your surgery.
   
• Use a pill-organizer box so that you can make sure you take all of your meds when you are supposed to.  If you don't want to use a pillbox, write down how much medication you take, and when you take it. 
   
• Make sure all of your bills are paid, so that you don't have to worry about that during the first week or two post-op.  Also, take care of all of your banking, etc.
   
• Have a good supply of magazines, books, and videos, since you won't feel like doing much of anything for the first few days/week following surgery.  Comedies are not recommended, especially if you have implants placed under the muscle, because they make you laugh, which causes your pectoral muscles to tighten/contract.
   
• On the day of your surgery, reiterate to your surgeon what you want/have discussed, such as the type of implant, size, etc.
   
• Make sure your vehicle has a full tank of gas.
   
• Have your cordless phone charged, and new batteries in your remote controls.
   
• Have common bathroom toiletries, such as toothpaste, toothbrush, contact lenses, mouthwash, make-up, hairspray, brushes/combs, etc., laid out on the bathroom counter/sink.
   
• Make sure you have a coffee can, or other container with a lid, in the car for the ride home, in case you throw up on the way home.
   
• Take a pillow with you for the ride home, for added comfort.
   
• Have water, Ginger Ale, or Coke on the way home, in case you want to "sip on" something.
   
• Have everything you need beside your bed/sofa/recliner.  Examples are: remote controls, phone, magazines/books, water bottle, medications, etc.  A trash can will also be needed, in case you need to vomit.
   
• Take a shower, wash your hair, and shave the morning prior to surgery.  If you are getting the transax incision, please take your time shaving.  You don't want to cut yourself, as this could introduce bacteria, which could ultimately lead to an infection.
   
• Put your toilet paper on the floor, in case you don't feel like reaching for it.
   
• You may want to refrain from wearing underwear, as that's one less thing you'll have to pull up after using the bathroom and/or taking a shower.
   
• Purchase Shea's Butter cream lotion, or the lotion of your choice, to use on your breasts.  (My personal favorite is Nivea lotion for extra dry skin.)  Your skin may get dry due to stretching.  If you get the nipple or crease incision, take good care not to get any lotion on your incision until it is completely closed. 
   
• Have new bottles of shampoo and conditioner.  If you don't, turn the shampoo and conditioner bottles upside down, so that you won't have to squeeze them.
   
• If you have pets, you should have their favorite treats on hand.  This will keep them happy when they want attention and you aren't up to giving it.
   
• Make sure you have taken care of cleaning the litter box, purchasing pet food, giving heartworm meds, etc., prior to surgery.
   
• If your dog(s) require walking, you will need to make arrangements for someone to do that for you for at least a week or two, depending on the size of the dog.
   
• Walk through your house with your elbows held close to your sides.  This will give you an idea of how you'll feel for the first few days after surgery.  Anything you cannot reach, you will need to get down so that you CAN reach it.  Examples are snacks, dishes, etc.
   
• Purchase paper plates, cups, etc., so that you can cut down on dishes.
   
• Make sure you do not wear fingernail polish (on hands or feet) when you have surgery.  Oxygen levels are sometimes monitored just by looking at the color of the nail bed.  If it's blue in color, this means that you aren't getting enough oxygen.  It's very important not to wear polish.
   
• Do not wear makeup to surgery.
   
• Wear cotton underwear to surgery.  Your surgeon may allow you to keep your panties on during surgery, but some surgeons won't, unless they're 100% cotton.  Best to be safe than sorry, if wearing no underwear bothers you.
   
• Have bottle caps loosened, so they're easy to open.
   
• Have a backscratcher handy, in case your back itches.  It's also helpful for reaching things. 
   
• Make sure you have snacks handy by your bed/sofa/recliner, when you are alone, or late at night.  Crackers, chips, pudding, drink, etc.
   
• If you have a helper, you may want to invest in a whistle.   Bells may not be heard.
   
• If you're planning on using something to treat your incisions, such as vitamin E, silicone sheeting, etc., have this ready prior to surgery. 
   
• Keep a journal.  Write down how you're doing from day to day, what aches and pains you're experiencing, swelling amounts, etc.  This is really good to help track your progress, and is also good when you see your doctor.  You won't forget to mention the "little" things that you might otherwise forget.
   
• If you have long hair, you may want to wear it in a ponytail, or braid/french braid it for a few days after surgery.  It will be easier to manage like that.
   
• Take after photos, including front, side, and oblique shots.  This will help you to track your progress.  You will most likely be looking at your new breasts often, which makes it hard to notice the small changes that take place daily.  Take photos of yourself in the same clothes you took your before pics in.  You can then compare the before and after clothed pics, as well as the before and after topless pics. Taking photos on a weekly basis is sufficient. 
   
• If you have problems with itching, you may want to put lotion on your breasts (being careful to avoid the incisions).  Putting ice packs on may help as well.  Seems a temperature change helps sometimes.  Itching is usually due to the skin stretching.
   
• Purchasing canned drinks will help, so that you don't have to lift 2 liter drinks.  You may do the same with milk, etc.  Have straws handy as well.
   
• Your surgeon will most likely mark you prior to surgery.  These blue markings can be removed with rubbing alcohol, or fingernail polish remover.  Make SURE you do not get this on your incisions.
   
• Constipation is common after surgery.  Pain meds often cause it.  Have a mild laxative on hand, such as Correctol, FiberCon, or Metamucil, just in case.  Continue drinking lots of water, as this will help move things along as well.  It's also great for your skin!
   
• You will most likely have swelling after your surgery.  Do NOT take a diuretic, unless your surgeon has approved it.  Drinking lots of water and moving around a bit will help the swelling dissipate.
   
• If you have nausea, you can take the anti-nausea meds your surgeon prescribes.  If you don't get any nausea meds, or if you run out, you can try ginger, or peppermint, both of which are supposed to help with nausea.  Taking a quick sniff of rubbing alcohol has also been known to help nausea.
   
• Shaving your underarms may be difficult at first.  Use a hair remover like Nair or Neet until you are able to shave again.  Alternatively, you may opt to have them waxed.
   
• Keep a positive attitude. 
   
• Don't slouch.  Walk with your shoulders held back.  This will save you some back pain.  Slouching only aggravates the situation.
   
• Make certain that you know the signs of infection, which include (but are not limited to) fever (especially over 101), pus, redness, inflammation, breasts that are hot-to-the-touch,  excessive swelling, and flu-like symptoms.  Call your doctor immediately if you have any of these symptoms.  Infections can be very serious, so know the signs.
   
• Have natural (not synthetic) vitamin E on hand to start taking after surgery.  Vitamin E may help prevent capsule contracture.  There is no evidence of this, but it doesn't hurt to use it.  HOWEVER, you must wait until you are at least 2 weeks post-op before starting it, because it thins the blood.
   
• Do not take aspirin, garlic supplements, or ibuprofen for at least 2 weeks after your surgery, as they thin the blood also.  Talk with your doctor before taking ANY over-the-counter drug, or vitamin/herbal remedy/supplement.
   
• Get a lot of rest.  Even if you feel you are having an easy recovery, it is important to remember that your body has been through a lot, and it will take a while for you to heal on the inside.  The body needs energy to promote good healing, so rest as much as you can.  Don't push yourself to do too much too soon.
   
• Make sure you get your device cards from your surgeon.
   
• If your caretaker does not get a list of written instructions from your surgeon after your surgery, be sure to tell that person to write down what the surgeon says.  It's very important for you to follow your surgeon's post-op instructions.
   
• Your menstrual cycle may be thrown off a bit after surgery.  So be prepared for that.  However, if you feel as if something isn't right, or if you aren't comfortable with it, call your gynecologist.  If nothing else, it will put your mind at ease.
   
• You may experience mood swings after your surgery.  This is normal.  General anesthesia, along with pain meds and lack of sleep, can cause this to happen.  This will pass, and again, is normal.
   
• Your nipples may be very sensitive after your surgery.  You can try numbing creams, nursing pads, and silky camisoles, if your nipples are overly sensitive after surgery.
   
• You will be the most uncomfortable during the first 3 days.  After that, things will start looking up.  It's common to experience more soreness in the morning. However, once you get up, and start moving around, those muscles loosen up a bit, and you'll feel much better.
   
• Do NOT submerge your incision in a tub bath until it is completely closed.  Doing so can introduce bacteria/infection.  You may take tub baths, as long as you don't do this.  Taking showers and allowing the water to beat down on your chest will help the muscles relax.  Make sure the water isn't too hot. 

from the website http://www.justbreastimplants.com/breast_augmentation_surgery/tipsheet.htm 

Scheduled and Progress

Yesterday I put my big girl pants on and scheduled my breast augmentation.

I decided to go with Dr. DeChiara, and I chose March 30th, a Friday, as my surgery day. The scheduling coordinator was really cool, and told me that I would be sent a packet about four weeks before to go over everything that I needed to do and have ready before the big day. I also scheduled another consult for two weeks before the surgery to make sure I finalized everything.

I am pretty sure I am going to have the Dr. put a 400 cc implant on my right side and a 375 cc implant on my left. I also decided to chose silicone for my implant type. It's were my heart and my gut were leading me and I'm sure I'll be happy with my decision. There were just too many more positives to them that outweighed the extra cost. I'm also not concerned with the safety issues like I once was. Call me crazy, but it's how I feel.

Now I'm going to concentrate on saving money and continuing to get in shape. With Weight Watchers I've already lost almost 7 lbs in six weeks and by the time I go under the knife I'm hoping to be back to where I'm more comfortable with my weight. (And buttoning the top button of my pants again!)

There's little things to work out still, such as transportation and whatnot, but I'm really glad it's finally in the books. My timeline is going pretty well so far, so my fingers are crossed that it continues to be that way!

Here's to hoping!

Stats on Dr. DeChiara

Here is the breakdown of what would happen if I go with Dr. DeChiara:

I have a choice of saline or silicon, she doesn't have a preference. Her own were saline, but that we before the silicone was legal, and she's very happy with hers. The brand she uses is Mentor and they have a limited warranty for life that will replace them for free, and there is an additional insurance I could purchase (For roughly $100 the nurse said). She said getting future MRI's to check for breakage is not popular anymore. Any revisions during the first year may require another surgeons' fee. She didn't mention anything about cost for complications.

She has been doing breast and other cosmetic surgery for over 10 years now. She does them in the attached hospital in one of four cosmetic surgery only suites. There would be an FEMALE anesthesiologist, the Dr. herself, her nurse (my friend!) and a surgical tech in the room.

The surgery is done with general anesthesia. While in, they give an IV of antibiotics and then prescribe them afterwards along with heavy pain medication (Percocet). She told me she could get me something stronger if that was necessary because I told her I have a low sensitivity to pain meds. Because I am young and healthy she told me it wasn't necessary to go off my medications, though she did say that I needed to be careful on the actual antibiotics because some aren't effective while talking them. The incision can be however I chose, and she said that the idea of infection under the arm wasn't anything to be worried about. She places them under the muscle. They use dissolvable stitches and two small strips of surgical tape around the incision.

The procedure takes two hours total prep and surgery time, and afterwards I'm required to stay a few hours for monitoring. They'll make sure my pain meds are working and that I'm safe to leave. I have to be there 1 1/2 hours early. She only does BA's on Tuesdays and Fridays.

We didn't discuss aftercare. (I figured that I know enough now that I'll decide after I book). The after-care and post op visits are included in his fee, and they see you right after the surgery, 2-3 days later and then in 3 months, 6 months, and once a year. Sleeping was recommended to do sitting up for the first couple of days to keep from straining muscles used to maneuver.

The Dr. suggested that I give myself at least four days to do absolutely nothing so that I recover well. She said that it is extremely painful (contrary to other's) and I'll want to be comfortable. I will be able to shower the next day.

A deposit of $500 is suggested for booking my surgery, but she said not required.
Exact fee breakdown:

Saline:

Dr. Fee: $3900
Implants: $750
Facility/Anesthesia: $2625

TOTAL: $7275
*not including FAF discount

Silicone:

Dr. Fee: $3900
Implants: $1600
Facility/Anesthesia: $2625

TOTAL: $8125
*not including FAF discount

Last consultation!

I went to my last consult last week, and I have to say it turned out really well. The office was down in Mt. Kisco, which is about an hour south from me. I was hesitant to actually go, because of the long drive and the fact that I was really into the last doctor. Plus, the consult was going to cost me money and I want to save every penny for the actual surgery.

But, I made myself go. Mostly because I realized that I get taken for a ride when there are bright lights and fancy words and I didn't want to let Dr. Fiorillo's office do that to me. I really liked him, but I wanted the last and final opinion. Plus my friend was going to be waiting for me there and I didn't want to be a jerk.

I got a little lost, so when I arrived I was late. But the lady at the desk was friendly and I filled out my paperwork and waited until the doctor was ready. Her name is Dr. Sharon DeChiara, and I love the fact that she's female. (I have a thing against male doctors that I have no idea where it came from but is there nonetheless).

First I talked to the nurse, who was actually a little off-putting. She wasn't very friendly or warm and I wasn't really comfortable with her, especially when I had to get naked. She asked me a few questions and then gave me implants to try on. This time I was asked to use my own bra, which was a little strange to me considering I don't want to be the same size that I am now and I also wear bra's with a lot of padding so it wouldn't be realistic. She also had me put my shirt on over them, and once again I was in love with how I looked. I know for certain I'm going to be super happy once this is done. While with her, my friend came in to say hi, all scrubbed up. It was nice to see a friendly face. I love the fact that she'd be in the room during my surgery, as that makes me more comfortable.

After that the doctor came in. She was incredibly sweet and sat really close, talking right into my eyes. She didn't have too many strong opinions as far as incision or implant type, but did recommend that I do what's called "high profile" implants as opposed to the other type that tends to have more volume in the sides. That was the first time a doctor has even mentioned that to me. She also took measurements of my chest area and remarked that I have one nipple that is lower than the other. GREAT. Since I'm not having the incision there, that's not something that is going to change and she wanted me to be aware. Funny, I've stared at my chest a million times and never noticed before. Now I'll never forget!

I told her I was having a hard time deciding between saline and silicone. She wasn't much help because she told me that in her opinion they are both very safe and it's personal preference. Because I want them to be more tear-dropped and natural feeling she thought I'd probably prefer silicone. Also, she said they never leak even if ruptured because they are made as a "gummy bear" substance now and so they just stay in place. But the actual shell is thicker than saline so it's harder to pop, and also the makeup in general keeps it from having a rippling effect under the skin. She said I have enough tissue to make them both feel natural enough (WHERE?), and since she insists on going under the muscle (which I want anyway), she wasn't too worried about feel. Over all she said I was a perfect candidate for the surgery.

She had me try on the implant "sizers" again so that she could personally see them. The nurse had given me 200 and 300 cc to try, and I wouldn't even touch the 200. The 300 looked nice, but I wasn't sure because once again I was using my own bra and it felt deceiving. Dr. DeChiara brought in a zero padding almost-bandaid-looking bra that was a little to big but had a pocket for the implants so that I could have them right up against me without the added bra effect. She told me she thought the idea of 350-375 would be best for me and we all liked the look. In surgery she puts in what she called sizers that aren't actually implants first to see what looks best before actual insertion. I like that, also noting that she sits the patient up to get a "gravity look" before she finishes. After the fact I'm beginning to lean towards silicone and as far as size I'm definitely doing 375 and may just go to 400 for the heck of it. Especially since the difference is only three tablespoons of the liquid anyway.

I know I wanted saline because of being able to even out both sides, but I'd rather have them look more natural than even...

After the doctor, I talked to the nurse to get my final questions asked and also a woman who does the billing. I was approved for a friends and family discount which was awesome news and all the answers where satisfactory.

Now I'll I have to do is finalize my date, type and do a little research on the anesthesiologist. My gut is leaning towards her though...and I need to schedule soon. Hope I make the best choice!!!

Third time the charm?

I had my third and (thankfully) final consult today. Had a late night yesterday so I'm too exhausted to write about it tonight, but it was a really good appointment. I think I've finally made up my mind!

Stay tuned!