My First Consult

Today I had my first breast reduction consultation. I did my make up and put on sexy lounge wear - I was headed to Carmel Valley after all! Where McMansions grow like mold spores and luxury SUV's clog the roadways. The doctor's office in the same building as my OB and pediatrician. It's ironic to me that a place I associate with snotty noses, pink eye, and the dreaded pregnancy scale also houses the office for my potential plastic surgeon.

I arrived 17 minutes early. I am never early. I sat in the waiting room with an overweight elderly woman wearing sunglasses and an Asian teenager with her mom. The staff was within a hair of being overly friendly. I sat down with a current (yes, CURRENT!) magazine prepared to waste ten minutes. Unfortunately (I had a babysitter!), I didn't even get to open the magazine because I was called back right away to the Consultation Room.

This room was basically a smaller version of the waiting room, complete with higher end waiting room vinyl furniture. There was a three-seater sofa, two arm chairs (How many people come to a consultation? Is this room ever full?), and my own private coffee machine. Well, not quite a coffee machine. It was more of a fancy, electronic hot/cold water dispenser with a nearby basket of Tao teabags and packets of instant Starbucks coffee. I selected green tea then discovered the hot water function was not working so I settled for a styrofoam cup of cool water.

I flipped through the March 2011 Glamour (did I mention how current their magazines are?) and tried on the new Coach perfume. A slight knock and in walked the affable Dr. S.. He's a bit older, fatter, and balder in real life than the picture mailed to me. I couldn't help but think I would have raised my eyebrows had this been our first date after meeting online.

He flipped through the medical history I'd sweated over the night before, asking me about the pain and discomfort my breasts cause. He was impressed I'd figured out to use antiperspirant under my breasts. Apparently many women don't think of this seemingly simple solution to sweaty boobs.

I asked him if he was a boob man and noted his Navy experience.

"Good question," he replied. "You'd be surprised how many breast reductions we did in the Navy. On average about 3-4 per week. It's amazing who comes out of the woodwork when price isn't an object. I would say I've done between 500 and 600 breast reductions over my career."

We exited the Consultation Room and he walked me to the Exam Room, handing me a gown that was more of a robe. I thought the formality of him closing the door to let me take my shirt off so he could exam my tits was amusing. My too-small hot pink bra with molded cups decorated one of the seat backs.

Dr. S. came back in with a tall blond nurse with short hair. He had me stand up and face the beige wall, dropping the cotton garment to my waist but leaving my forearms covered. He noted the grooves in my shoulders and how one shoulder is higher than the other. His hands checked my spine.

"Interesting," he said in a mild tone.

My eyebrows raised.

"I can see some slight curvature here in your upper spine."

He gently lifted the robe back up over my shoulders without grazing my skin asked me to turn around and face him. He adjusted the open robe off my shoulders, down to my elbows again. Before he could finish his next sentence, the nurse handed him a small black tape measure. He made a lighthearted but sarcastic joke about her always having to be asked twice for things.

He again noted my uneven shoulders and then pulled on the tape measure. The white tape was placed at the slight groove at the base of my neck between my collar bones and then ran to my left nipple.

"29," he said to the nurse.

"That's centimeters, right?" I apprehensively asked, terrified he say inches.

"Yes, centimeters," the doctor reassuringly replied.

The same measurement was preformed on my right breast.

"28."

He lifted each boob to check the chaffing and rash underneath then made note of my bigger lefty. There wasn't half the groping I expected. The two exited so I could put my bra and shirt back on. They instructed me to open the door once I was dressed.

Shortly, the doctor came back in and directly stated, "If you were my wife, daughter, sister or girlfriend I'd tell you to have the surgery. So what's stopping you?"

We discussed my fears: MRSA, disrupting my children's self esteem, being too small chested.

He said most women feel they can't have small enough breasts after they have the surgery. I learned I have fatty, not dense, boobs and therefore they will end up on the smaller side if we go through insurance. Lefty will require removal of an extra 100-150 cc's just to make sure the two girls are even (that's almost an entire cup size!!!!). Because I have so much extra skin on my breasts, I am not a candidate for the lollipop incision (incision and scar around the areola and a straight line down to where the flesh of the breast meets the chest). I asked about the Le Jour and he told me that it's a complicated procedure and the Canadian woman who developed it has a difficult time even teaching it to her fellows. Regardless, I wouldn't be a good candidate for that less-scar producing procedure because of the excess skin on my breasts.

So in Dr. S.'s view, I definitely need the traditional anchor incision and subsequent scar. I expressed concern about the "dog ears" - the flaps of skin that can form if an incision is too long. He told me that dog ears are not terribly common but if it does happen, it can easily be fixed with a little surgery under local anesthesia.

With my questions answered, Dr. S. left and a cute Asian nurse came in. She was my escort to the Consultation Room. Nurse M. asked me undress my top half so she could take photos of my breasts to submit to the insurance company. A total of six photos were taken: one of my back, one of the front (straight on), and two profile shots of each side - one at 90-degrees, the other at 45-degrees.

After the unglamorous photo shoot, I was ushered into another room where I spoke with the Patient Coordinator. She outlined everything for me. She's also the woman in charge of making all sorts of required doctor appointments that a patient must have before undergoing surgery. A sort of personal surgery secretary, if you please. She gave me the general time line:

Thirty days before surgery I go in for a full physical with my Primary Physician. I also meet with a Patient Account Representative, a Patient Service Representative and a Patient Educator all in this 30 day time frame and often in the same day (the appointments are short, some a formality). One week before surgery, I have my pre-op appointment back at their office. At this time, all my prescriptions will be sent to the pharmacy of my choice to be picked up before the procedure.

On the day of the breast reduction surgery, I must arrive 1-1.5 hours ahead of time. The procedure itself will last about 2.5 hours. Time spent in the recovery room: about 1-2 hours. I will then be sent home unless there is a very rare complication like high blood pressure that will require additional monitoring. The outpatient surgery is done at the Anderson Clinic which is directly connected to Scripps Green Hospital should an unlikely emergency arise.

One week after my operation, I go back to the doctor. Within 2 weeks of the surgery I will pretty much be back to normal. For the two months following the procedure, I will feel quite fatigued and will probably need daily naps. The recovery is faster than recovery from a c-section. Because I am young and healthy, I should heal quickly.

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This afternoon I made two more consultations. I have one next week and one in two and a half weeks. I might even be able to schedule the surgery as soon as May 1! We're going to three weddings this year so the timing of the surgery is crucial. After hearing about my spinal curve, I'm realizing this is more of a medical necessity than I originally thought (apparently chronic back pain, neck/shoulder strain complete with grooves, and rashes aren't a enough of a medical necessity to me!).

Being only a C cup is a little scary. A 34C equals a 36B. Dude, a fucking B cup!!!! That's really super teeny compared to where I'm at now. I think I need a glass of wine.