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Category Archives: Surgical Fees

Why I Had A Boobjob

This is the week of my one year breast reconstruction anniversary. To celebrate, I’m telling it like it is. In today’s article I’m giving a no-holds-barred account of why I had the initial surgery that led to losing my breasts and the subsequent reconstruction.

This isn’t an easy article for me to write. I’m definitely not the same person I was then. Not by a long shot. Of course something like having my breasts basically rot off was going to have an impact. I would like to believe that it changed me for the better.

Now I’d like to take you on a trip in the Way Back Machine (My thanks to Mr. Peabody and his boy Sherman) to 1981. I was either 13 or 14 and in Junior High. That is, of course, the time when little girls start developing breasts. I was no different.

I had no idea that I was developing. I just didn’t notice that anything was different. Neither did my parents. I had to be told by a friend of mine that I shouldn’t wear a sheer dress shirt because boys could see my boobies. So because I didn’t know what was going on and neither of my parents paid attention to my development, I went without training bras for much longer than I should have.

Fast forward to 1983. I was 16. We were at the only decent women’s clothing shop in Powell, Wy. My mother had dragged me there to go bra shopping. The woman doing the fitting said I had pendulous breasts. Of course I had no idea what that meant then and there was no real way to look it up. There was no internet and research materials were really limited in a town no bigger than a hiccup. But that stuck with me. Somehow I knew from the tone of her voice that there was something wrong with me.

Fast forward to 40 years old: Two children and two decades later my breasts looked like flat wedges of flaccid flesh and my nipples pointed at my toes. I HATED my breasts. So I started looking for a plastic surgeon to give me perky boobs. I had two consultations and both said the same thing. My breasts had degraded as far as they could go. They weren’t, at least, going to get any worse. Both gave me a presentation about the anchor lift type of mastopexy because of the degradation level of my nipples. After a few days to research and review the information, I showed it all to Ken. Along with the price.

Here’s where my judgement went south and obsession set in. Ken said he didn’t think we could afford it. I told him the stories that I have written down above. He told me if I could find a way to do it for less, than I could do it.

That’s when I found the guy who did the initial surgery. He was part of our barter network. He offered his surgical fees on barter. All we had to pay for was the implants and the clinic fees.

Yes, I was so desperate and so obsessed that I went against all advice and had the surgery done by a doctor on barter.

I DID have the forethought to investigate him and there was nothing negative in his record. There was no indication aside from his abrupt, borderline-rude bedside manner that he was inept.

I say this with tears in my eyes: I just wanted pretty boobies. Every woman I had seen in magazines and on TV had pretty breasts and I just wanted that to be me for once in my life.

So I did something insanely stupid and it cost me dearly.

 

The 200th Post

As the title says, this is the 200th installment of BoobCast. Today I am writing about you, dear reader. Today’s installment is all about the support and the stories that people have shared with me since I first started this blog on Oct. 11, 2008.

When I first started writing this, I was also fairly active on a website called All About Plastic Surgery (http://www.allaboutplasticsurgery.com). When I posted what had happened to me it didn’t take long before I was inundated by questions about various aspects of the surgery. You can find that entry here: http://boobcast.net/2008/10/14/questions/ People expressed a great deal of concern about how well I had checked out the surgeon, what indications I might have had and what legal recourse I might have taken. During that period so many people gave their support and I am grateful for it. So my thanks goes out to the women of the All About Plastic Surgery forum. They were the ones who inspired the idea for BoobCast.

Now you’re probably asking yourself, “Gee Maria, why do you call it BoobCast? Were they wrapped in plaster or something at one point?”

No, dear reader. There are reasons this site is called BoobCast.  In 2007 the podcasting community lost a precious member by the name of Joe Murphy. He died of a vicious type of cancer that took him quickly. During his medical treatments he talked in vivid detail about what was going on, the testing and all of it. His strength inspired me. I wanted to be as strong and as brave as Joe Murphy. So I planned to podcast what was going on with my breast necrosis. The name of that podcast was going to be BoobCast.

I never met Joe but his life inspired me. It just turns out that I’m not that strong or that brave. To honor that bravery I have kept the name.

I also owe thanks to a very dear friend, Tee Morris. When I was trying to find the strength to create BoobCast, He was there for me. He gave me mental and emotional support by letting me know that I *could* do it. I’m sorry I disapointed you Tee but want to thank you for being a friend when I needed one.

In the time I’ve been writing BoobCast I have had people email me directly for advice. Of course, after reading the email, my advice was always “Contact your PS (plastic surgeon) and ask for [fill-in-the-blank]. Whether it was about bruising, skin texture or pain, I advised talking to their doctor. If they couldn’t get a decent answer from that doctor, talk to another one.

The one that really broke my heart was the husband of a woman who, a few days previous the email,  had the same procedure I had. According to her husband, the pain pills her PS had given her weren’t doing much and she was in constant pain. She couldn’t eat or sleep and she was suffering. I told her husband to call her PS immediately and insist on different pain meds and not take NO for an answer. i explained that, right now it was his job to advocate for his wife since she couldn’t do it herself.

A couple days later I got an email from him saying that her PS had changed her meds and she was doing MUCH better. It’s emails like those that made BoobCast well worth the emotional pain of writing those early posts.

I also want to thank everyone who talked to me about BoobCast at DragonCon last year. Being told in person that I’m making a difference means the world to me. Thank you for taking the time to talk to me.

Finally, my thanks to Carol Montoya, Lolly Daskal and the Woman At Denny’s. I promise that once I’ve had nipple reconstruction and recuperate from that, I WILL write the book. The foundation is in the works already.

My thanks to you all for reading, commenting and talking to me. Here’s to another 200!

 
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Posted by on January 18, 2010 in anchor breast lift, Anxiety, barter, boob job, Bra Fitting, bra sizes, Bras, breast, breast cancer, breast health, breast implants, breast lift, breast reconstruction, breast size, breast volume, Cash fees, checkup, chemotherapy chemical, clogged surgical drains, communication, complications, compression bra, compression dressing, cortisone, cosmetic surgery, cryotherapy, debreiding, debridement, deformity, dehiscence, Depression, Drain, Drugs, emotional healing, emotional scars, Excise, excise fluid, fear, Flashbacks, flourouracil, Fluid, granular tissue, granulation tissue, Healing, Hospital, Hospital fees, Hosptial Costs, implants, Incisions, Infection, Insurance, interferon, Invisibility, keloid, keloid scars, laser, Latissimus flap, latissimus flap reconstruction, malpractice, mammogram, mastopexy, Medical, Medical Insurance, memory, Nausea, necrosis, negligence, Nipple prosthetics, Nipple reconstruction, Nipples, Pain, Pain Management, plastic surgeon, plastic surgery, Plastic Surgery Disaster, podcast, Post surgical depression, Post Traumatic Stress Disorder, Prescription Drug Addiction, Prosthetics, PTSD, radiation, Reconstruction, Recovery, Scars, Seroma, serous fluid, Sex, silicone sheets, situational depression, Sleep, slow healing, suicide, Surgery, Surgical complications, Surgical drains, Surgical Fees, Ta Ta Tuesday, Uncategorized, V.A.C. machine, Vacuum assisted wound closure, wet to dry bandages, wheelchair

 

Seven Month Checkup

Today I’m going to see Dr. Elliott for my seven month check up. Normally it would be six months but he cut me a little slack because life has been a bit insane lately with Ken’s new job, me taking over our business, school and general family issues.

I’m sure he’s going to say everything is okay. There are some things I want to cover with him though. First, a wide swath of my back still feels like it is covered in plastic wrap. I wish I had some other way to explain it. It just feels like a big square of my back has had a cracky plastic coating painted over the top. Or maybe like someone laid down wide strips of packing tape. I really hope he understands this analogy.

I also still have numb spots in places. The other night my right armpit itched abominably but I have no sensation in that area. You wanna talk weird? Try itching someplace that’s numb. THAT’LL throw your brain for a loop.

I also want to get his opinion on the small area of keloid scarring. Please see the entry on 9/30/09 for more about this topic. It’s not much but I think he ought to know.

I also need to tell him that we won’t be able to afford my nipple reconstruction surgery until around this time next year. Then I want to ask him what he thinks about the Japanese practice of inserting pearls under the skin for nipple protrusion. Unfortunately I cannot find a reference to that at the moment. As experienced as Dr. Elliott is though I’m sure he’s heard of it IF it’s something that is actually done.

Until recently about 2/3 of all nipple reconstructions failed. Dr. Elliott has gone to incredible lengths to reassure me that with current techniques that won’t happen. It IS normal for there to be some shrinkage though.

I’ll report more on this later.

 

Gimme Credit & Implant Fitting

In the business office we talked about various ways to pay for the surgery. Of course, as I mentioned the surgical fees were on barter. The fees for the surgical facility, The Bougainvillea Clinique, as well as the implants themselves, were to be fully paid for two weeks prior to surgery. That’s where Care Credit came in.

Care Credit does financing for a wide range of cosmetic surgical procedures. I got them to finance me for the full amount over a three year span of payments. If I remember right, the payments were under $200 a month. The interest rate was pretty rough though. It was somewhere around 9% if memory serves. Of course I didn’t care. I was headed full boar into this.

With the financing in place and confirmed, we set a date for October 6th. All that was left was to figure out what size implants I wanted. Now THIS is a process in and of itself.

I was told to get some knee high stockings and raw rice because rice is the most accurate type of filler as far as weight goes. One cup of raw rice equals approximately 236 ccs. The following table gives more conversions.

1 cup = 236cc
½  cup = 118cc
¾  cup = 177cc
¼  cup = 59cc
1/3  cup = 78cc
2/3 cup = 156cc
1/8  cup = 30cc

So you start by filling two knee highs with one cup of rice, lightly tie it off so that you can untie it again later and stuff them into a properly fitting sports bra. I did four different sets so that I could compare the various volumes. 425cc is an approximate full D cup so play with the volumes and see what looks best. I ended up with about 625 ccs which is about a DD.

Once I had the implant size figured out, I called in the volume that I had settled on. NOW I think I should have been fitted in the doctor’s office, but they had their own routine. I figured these people knew what they were doing so I just went along with it.

Two weeks before the surgical date I received a box in the mail. In it was vitamins to fortify my system, antibiotics as a preemptive strike against infection and Arnica for bruising. I was given instructions for what to take at what point. So at  two weeks out I started the regiment.

Tomorrow I’ll talk about the surgery itself.

 

You Get What You Pay For

As I said yesterday, I found a plastic surgeon on barter. So I called to make an appointment for a consultation. Before long both hubby an I were headed for the office.

I mentioned on Twitter yesterday that I still blame myself for this. BUT, part of being a literal cautionary tale is that you fess up. This is my confession. You would think the fact that the office is in a strip mall might have been some kind of indication. Here in Florida you’ll find some really nice restaurants in strip malls though. So I shrugged it off. I did more than shrug it off, I stomped flat that obnoxious little voice in the back of my mind.

Legally, because of the settlement that came later, I cannot reveal the name of the surgeon. Nor can any of my relatives, friends or even people I am acquainted with. Maybe one day I’ll auction off the name the way Carly Simon auctioned off revealing who “You’re So Vain” was about.

We arrived a little late to a well appointed office. There were cosmetic products in a glass case and up to date fashion magazines in the waiting room. I was nervous but excited. We were called back to a comfortable examination room and I was asked to strip from the waist up so that the doc could see what we were dealing with and I was given a thick comfy robe to cover up with.

The doctor came in and took a look. During the exam he actually pinched, hefted and squeezed (albeit briefly) my breasts to get an idea of volume and elasticity. He explained the anchor procedure to me and asked if I had any questions. I told him that I wanted my boobs put back where they were when I was 17. He told me it was not possible and that was an unrealistic expectation. He said that he could make them look perkier and fuller but they would never be like that again.

He also explained that I had wide-set breasts so it was not possible for me to have the kind of breasts that I brought in photos of. Yes, some plastic surgeons ask you to bring photos of breasts you like so that they have a visual reference of what you want.

He also asked me if I understood that I would have scaring. These people want to make good and certain that you understand that with the anchor lift, it’s not all sunshine and roses right out of the box.

Once all my questions were answered that’s when I dressed and we went into the business office to discuss the financial aspect. The surgeon’s fees were on barter but the anesthesiologist, the implants themselves and the facility fees were cash. I was given a brochure for a company called Care Credit that finances cosmetic procedures and the breakdown of costs and we went on our merry way.

Tomorrow I’ll talk about financing and the build up to my first surgery.

 

The Check Up

This afternoon I’ve got an appointment with Dr. Guy, the local Uber plastic surgeon. She’ll be checking on the progress of the tissue overgrowth on my back in that one spot. According to Hubby, who can actually SEE what’s going on back there, it’s closing up FINALLY. I’m still going to hold off on wearing bras for a few more weeks though. Just to give that spot  time to FULLY heal.

I’ve also found a way to make these shelf bra camis more supportive. There’s a bra-maker supply shop here (http://www.bramakerssupply.com) that has everything I need to replace these flimsy straps with wider ones. The elastic under the breasts is pretty wide already so i won’t have to replace that. All I have to do is hand dye the new shoulder straps to match and sew them in. VOILA! New, supportive cami shelf bras. Since I live in Florida, wearing two tops in the middle of summer is just too hot. So this solves both the problem of support and the heat issue. I’ll post pics when they’re done.

The *other* checking up thing I have to do is call Patti at Dr. Elliott’s office. She was supposed to call me about where I could get silicone prosthetic nipples locally. Since I don’t have an existing nipple to be cast and copied I may not have to see someone to be fitted. But then as large as the new Twins are, I may. I have NO idea ho that works really.

That’s one more thing I’ll have to report back on one I know something. I REALLY want to have the prosthetics in time for DragonCon. I’m still REALLY not in a head space for another surgery yet. Even if I COULD afford it right now, the last thing I’m looking forward to is being cut on more even if it IS just minor, in-patient surgery.

I’m afraid I can’t find any photos of the star flap nipple reconstruction. I did put up a link in an earlier post though. I’ll dig around and see what I can find and edit this post if I can find an appropriate image.

 

Nipples Or Not

For my regular readers, do you remember when I was vacillating about surgeons or even whether or not to HAVE another surgery? Well it’s that time again. This time I’m starting to research and contemplate nipple reconstruction.

I read some older articles that indicated that up to 40% of all nipple reconstructions fail. Most flatten out within 6 to 18 months. There is also a higher incident of infection and necrosis according to those older statistics.

THEN I talked to Dr. Elliott. He explained that those complications are not as frequent anymore. In the last two years or so surgical techniques have been greatly improved. He reassured me that usually those complications are due to poor blood supply. My tissue is healthy, according to him. He also went to lengths to reassure me that recovery time is going to be greatly reduced since this is an out patient procedure only dealing with topical tissue.

He also suggested that I research the Star Flap Nipple Reconstruction. The link shows the basic steps starting at  Media 7 http://emedicine.medscape.com/article/1274411-media – star flap That’s the nipple flap reconstruction he wants to ue for me. He believes that specific type of flap reconstruction will work the best.

I really don’t want to have ANOTHER surgery so soon. I’d rather wait until this winter. So in the interrim, I’m going to get prosthetic nipples. Dr. Elliott is having his PA, Patti Bergley, look into it and see what she can find out for me. I’m expecting her to call today.

Talking to Dr. Elliott made me feel more comfortable about my outcome. I’m still tempted to get a second opinion when I go back to see Dr. Guy’s people in another week about the tissue growth isue on my back. I’d like to see what she has to say too.

The problem is now really the cost. Nipple reconstruction and any tweaking that needs to be done for aesthetics will cost us an additional $7000 on top of the $18000 we have already paid AND the $6000+ we still owe the hospital and the anesthesiologist. Nipple prosthetics on the other hand are only around $200 per pair for the really good silicone ones.

Really, I don’t think that it’s so much a matter of “if”. It is now a matter of “when”.

 

Questions

I posted about this blog on the ORIGINAL Implant Forum and within hours I had questions.  So I thought I’d take the time to address them here.

1) Did I have any hints that the surgeon might be negligent:  I checked with HealthGrades.com and bought the full report.  According to the side there were no disciplinary actions either in the past or pending.  The surgeon had been in good standing for over 15 years.

2) Did I pursue legal action:  I spoke to a malpractice lawyer who told me that plastic surgeons in Florida are only required to carry $100,000 in malpractice insurance.  The burden of proof also falls to the plaintiff’s lawyer.  So by the time the law office did all the research and found a way to prove malpractice, most of the 100K would be eaten up by legal fees, leaving me with nothing for the reconstruction surgeries I’ll have to have.

Instead of a law suit, I did the next best thing.  I threatened legal action unless the surgeon gave me back all my surgical fees.  It was agreed with the provision that neither my family nor myself give the name of the surgeon or the name of the center.

I just wanted to be done with the surgeon for good.  Another odd thing is that while I was under the care of that surgeon, no other plastic surgeon would see me for a consultation.  At all.

3) How can I tell if my surgeon is like that? : One of the most valuable lessons I learned is that when it comes to surgery, do NOT go cheap!  If you think it’s a good deal, there’s every chance that person is probably a hack. ANY doctor can call himself a plastic surgeon even if he hasn’t studied the specialty. Always make SURE your surgeon is board certified.

You know what they call a doctor that graduates in the bottom 10% of the medical class, right?

Doctor.

4) So what’s next?:  Because of the way my chest healed, I’ve got to have reconstructive surgery along the same vein as cancer survivors.  I’m seeing THE best cosmetic surgeon in the southeast for the official consultation on Oct. 24th.  In the initial one though Dr. Elliott said that he wanted to use a procedure called the Latissimus Dorsai Flap procedure.  Information can be found here: http://www.breastreconstruction.ca/living_latflap.htm

I’ll be posting more about my consultation when we get back from Atlanta.

If you have any questions, you can post them here.  You can also email me at boobcast@gmail.com or Follow me on Twitter under Boobcast.

 
 
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