Breast Lift: After LBL, or Before?

Okay, friends and neighbors, I need some advice:

I have found a PS that I like and trust, who has impeccable medical references and who does really beautiful work.  We agreed that I would be a very good candidate for LBL and for BL.   The initial plan had been to do the LBL first, because it would be easier to do a proportionate BL afterwards.  (The PS recommended against doing both simultaneously because it complicates self-care, I believe -- but I'm not sure I recall that very well.)

The BL will not be covered by insurance, but odds are good that at least part of the LBL WILL.  (This is important to the story.)  But it is important to get medical references for the surgery to support the initial insurance request.  The PS gave me sample-letters, using appropriate medical terminology and jargon, to give my internist, who has known me for more than a decade.

The internist screwed up the letter by not using appropriate medical terminology, or referencing the talking points that the PS suggested.  Based on my experience with the internist, who wrote a pretty poor letter, she is someone who frankly hates writing.  (This is not the only time she has produced poor quality correspondence -- I guess there are medical geniuses who have trouble with fundamental writing.)

I will be asking my ob/gyn to write the letter, since she also has functioned as my internist in the past, and I've known her for a quarter century (geez that sounds awful -- a quarter century).  But that means the insurance appeal is delayed.

Complicating all of this -- I'm a schoolteacher, and my term begins early September, so I'm going to need to have a LBL done about 6-8 weeks before the term.  (That would mean, roughly NOW.)  A BL, on the other hand, will only require one to two weeks before I return to work.

The doctor's office called today to suggest that I do the BL in the interim, while we wait for the various letters for the insurance shtick.  

Wow.  I thought we were going to do the BL AFTER.  The BL, by the way, will make my boobies a bit smaller, overall.  I fill a D/DD cup now (if I pour them in, carefully).  My anxiety is, that the BL will make my top half appear smaller, fully clothed, and cause my bottom half to appear LARGER, and me to look more pregnant than my non-pregnant body already does.

So ... I'm asking.  What are your thoughts on this?  If you had a BL before your LBL, what was the net visual impact when you were fully clothed?  Did it cause your lower half to look substantially larger, proportionately?  

I could certainly get this task "out of the way," THIS summer, and it would free me up for the LBL next summer ... but I'd like some feedback from you experienced folks.

So I had the same thing occur.  Originally I had the LBL sched first but the hospital did not have the date available when the insurance approved it so the BL was done first.  I literally called my dr having nightmares that if they did the BL first my boobs would be stretched back down to my bellybutton from the excess skin.  He laughed at me.  I had my BL and Arms done together at the Surgeons office.  They say arms are the most painful at the armpit and let me tell you I had ZERO pain. I did not take any after pain meds and I wanted to get up and move around but I refrained.  I had a BL with 670CC saline implants put in.  Are you getting implants? 

The LBL is no joke.  I did the 360 circum. LBL not just paniculectomy.  I had zero complications but let me tell you this.  Make sure you know your pain meds that work.  I dont respond to anything but opiates which require Dr physical signature and I had it done on Xmas eve and couldnt get the prescrip.  This was my only peeve.  I stayed overnight in the hospital and demanded they release me on Xmas... it was xmas and I wasnt stayin in a hospital bed so I lied about pain :)  Really after 2 days home I was fine.  But I walked like an old lady for like 2 weeks.  :)  I work from home and I only took Dec 18 - Jan 3 off.   I recommend borrowing a recliner if you can.  That was my saving grace.  Made it easier to get up and down and way more comfortable then my bed becase I thought I would die in a sea of my own boobs. :)  Let me know if you have any other questions.  I also have before and after pics :)

Thank you for your great reply -- I am most appreciative.

The doctor advised against implants, saline or no.  First of all, the lower half of me will be much smaller after the LBL, so bigger boobs will look disproportionate.  Actually, I would love bigger boobs, but it seems that the doctors think anything bigger than a C will look funky on me.  

Second of all, I have lupus, so any implant of anything at all whatsoever is ill advised at any time, ever.  I'm entirely in remission, and I want to keep it that way, so no implants for me (though I wi**** were otherwise).

Regarding pain and healing -- I would really hate to wind up back at work, and be in pain.  It's a physically draining gig, in the classroom, even when I haven't had surgery.  I went back to work 3 weeks after RnY ... it was okay, but I was really pooped out.  Maybe I would have been anyway, hard to tell.  But since I can't be taking pain meds while on the job, I need to be mostly healed ahead of time (even if I have to wear mu mus because of the swelling.)

So ... you felt that you looked adequately proportionate having done the BL first ... ?

How would things have been, would you guess, if you had not had the saline implants?

Also, I know this question is asked to death, but what became of the sensation in your breasts -- did it change after the BL?

 

I was about to wonder why they wouldnt suggest it unless you had a ton of tissue left over.  I went from a DDD/F to a small B but with all the excess skin I was wearing a D cup.  I am 6'1 and used to having boobs plus i have a peaked chest bone so no boobs = disgusting on me. 

Glad to hear you are in remission and of course go with what the Dr says.  because obviously he knows best based on your condition.

I used to teach 1st grade PE so I know what you mean.  All that energy is draining.  I would do it during the summer too.  I was back at the gym in 6-8 weeks.  And no pain meds after 1 week only for LBL.  And I have ZERO pain tollerance.  And I was at disneyland in like 4 weeks :)

Haah!  MU-MU's  I invested in an ex boyfriends zip down sweatshirt and target workout pants.  hehe Your binders will keep down most of the swelling.  When worn right I really didnt have any swelling. 

I hated my stomach because it was ugly but my boobs looked great.  Then again I wasnt supposed to do anything and my surgeries were 6 days apart so it wasnt that bad.  You can see my surgery pics on my page.

I would feel fat without boobs... but then again keep in mind im 6'1 and about 160 lbs with hips and a high chest bone. 

My doctor is AMAZING.  Maybe because his specialty was burn victims so he is good with nerve and skin tissue?  I actually feel more now then before.  haah!  If you want to see the before and after pics I am more then willin to show you by email because they are in just a thong - and an ugly paper one at that.  sooooo shoot me an email with your email and I will be happy to share.

I know I was thirsty for information before I went under the knife.

KIT

The doctor says I'll wind up a C-cup.  I'm 32DD right now (poured in, like pudding) ... I have trouble imagining myself as a C, and frankly .... the flabby saggy boobs are quite demoralizing.  But at least I do fill a D/DD!!!  Is a 32C going to look okay?  Over a big flabby-skinned belly?

And what is 32C, anyway?  If he does lipo on my back later, is it going to be 30C?  Where do you buy a 30C?  I have trouble finding 32D ... is 32C harder?

If I had a trustworthy Magic8Ball ... this would all be so much easier.

(And to let you know, I LOLed out loud for realz because I thought I read "I invested in an ex boyfriend" and thought .... well THAT would be one helluva exercise regimen for me!!!)  

It will be a bit of an adjustment to you at first but they wont be floppy pancakes so thats a plus.  Its kinda like oh well my stomach sucks but my boobies are fantastic!  lol thats what I think about my legs now. 

I am a 34D/DD now and the bras are just not cute.  32 C is common.  30 I dont know about.  Do you have excess skin or fat because I had like zero fat but I had back skin so I had the flanks done.  Totally worth gettin ridda the back boob.

HAHAHAHAH Yuck!  My ex spazzed and became a royal ass about my new body...  but my new boyfriend is worth the investment hahaha who needs the gym ?!?  lol

I joke I joke I kid I kid.

So your profile is private or I would have emailed you the password to the photos I just uploaded of the DR before and after plastic... You will see what I mean by PANCAKE TIT... lol And now i have huge boobs.  And my back skin - disgusting.  Shoot me a friend request and I will send you the PW if you wanna see.

Hey Kit, I would love to see your pics...looking into plastics. What is your password if you dont mind.
Tammy

Hi, if there is any chance they would do the BL at the same time as the LBL I would do it that way.  I litterally had no problems with the BL.  Whatever pain came from the BL was totally masked by the pain from the LBL.  Another nice thing is you get it all done at once and don't have to take time off later.  and meet your other concerns of being proportional. My mobility was still fine as I had use of my arms to move myself around. 

I have heard that if you have the BL first, sometimes the LBL procedure will pull down the breast slightly.

I did my BL without Aug then went back 4 months later for the augmentation.  I found I was not happy with my shape/size.  i just did not have enough tissue for a natural aug.  Are you able to use some tissue for your breasts?  Sometimes Dr's will do that if you feel you wont' have enough left with a lift.

good luck in your decision.

 It had never occured to me that my boobs could be dragged down by a LBL, and I will definitely have to ask about that!!!

And I suppose that if I'm really miserable with my size, I could ask the Dr to find some way to augment it, but I'm guessing that I won't risk it with the lupus.  Now, if having bigger boobies was genuinely a LIFESAVING measure I would consider it.  Gee, I'll have to consider that angle!