Question #7 from the Interview on my life

7) Can you explain the process of the breast implant procedure?

This is actually a fairly common plastic surgery procedure in today’s society. Typically, breast augmentation procedures are done on an outpatient basis, which means that the surgery can be performed in an accredited office-based surgical center, outpatient ambulatory surgical center or a hospital. One of the most important decisions to be made between you and your doctor is perhaps the location of the incision. There are three types of incisions that may be used in breast augmentation procedures: under the crease of the breast, through the nipple or under the arm pit. Breast Implants may be placed above the pectoral muscle or below the muscle. This incision is usually done with minimal visible scarring. Another important decision is the type and size of your implants, depending on your desired breast size and shape. The most common types of implants are saline-filled and silicone-filled.

One thing I learned fairly quickly as I progressed through my physical changes----the doctors do not do this sort of thing on credit. Insurance does not generally provide any coverage for this procedure, or the subsequent sex reassignment surgery . That means you have to pay the doctor cash up front………………….. The major reason for this is that in the early days of the Sex Reassignment Surgery, there were no guidelines on who was a good candidate for procedures such as this, and there were certainly those who had such surgeries, and then decided they were nott happy as a girl. Oh, well…….. In the case of breast implants, it isn’t that complicated to remove them……but when one goes a little further, you get into a “no deposit, no return” situation.

On the day of the surgery, you normally report to the hospital outpatient surgery department and check in. You change into a gown, and the area of the incision is marked and cleaned. An IV line is inserted. Your doctor and/or anesthesiologist may come in and visit with you about the procedure. As the time for the surgery approaches, you are given an anesthetic to allow you to sleep through the procedure. The surgery lasts perhaps 30 – 45 minutes and you then are taken to the recovery room until you awaken. You then are returned to the surgical prep area where you are observed for a few hours until you are able to get up, walk on your own, and use the restroom. After 5 or 6 hours, the area is wrapped tightly with an elastic bandage of sorts which stays on 4-5 days, and you are discharged and sent home. You are normally off work for 4-5 days, the pain is minimal, but you need to be careful of your activities so as not to pull the stitches out. The normal time off work is 4-5 days, so I had my procedure done on a Wednesday to take advantage of the weekend.

In retrospect, however, I believe that most plastic surgeons overlook the psychological aspects of the surgery. The procedure itself is explained, as are any potential risks. Yet I do know that for some reason I had a major psychological shock when I took the wrapping off and looked in the mirror for the first time after the surgery. My first thoughts actually were “OMG, what did I do to myself.” I am not totally sure why I felt like that, since I knew I wanted the implants. I think it was the realization that I was now no longer going to be able to take them off anymore…….but that feeling didn’t last long. Today, I wish I would have gone with somewhat bigger implants…….not a whole lot, but enough to make them more obvious.