So it’s been just over five months since my breast reduction at Sweetgrass Plastic Surgery with Dr. Dennis Schimpf, and during this time I’ve received more messages than ever before; some with lovely well wishes and support, and many, many others with questions about my procedure, my experience at Sweetgrass, and why I decided to have a reduction.
So I figured I’d try to save my finger bones from typing more lengthy replies to DMs, and shed some light on the most commonly asked questions as best as I can right here, as well as go over my whole experience.
So grab a snack or a glass of wine and settle in…
First, I should probably just talk about my overall experience and what led me down this path. I talk about the “why” a bit in this post that I quickly wrote in the wee hours the night before my surgery, but I’ll reiterate the important points again now.
In a nutshell, I have a vast family history of breast cancer, and after celebrating 40 trips around the sun this year, it really hit me that I’m creeping in on the age where many of the women in my family have been plagued with a devastating breast cancer diagnosis. I had already done some research on different prophylactic surgical options over the previous year or so, but decided to take meaningful action this year and booked a consult at Sweetgrass Plastic Surgery with Dr. Dennis Schimpf after hearing and reading testimonials from his past clients, and learning that he had done a lot of work in reconstruction in the past.
I already had a professional relationship with Sweetgrass as an ambassador for their spa services, but I hadn’t yet met Dr. Schimpf (the owner of all the Sweetgrass Plastic Surgery and Spa locations), prior to scheduling a consult. I’ve never had this type of consult before, so I wasn’t exactly sure what to expect. Thankfully, it went really well, with minimal awkwardness;)
It’s obviously a strange feeling to have your breasts examined by people you’ve just met, but thankfully that part actually went super fast. Dr. Schimpf took a quick look, did some measurements, which the nurse jotted down for him. Then I was able to cover up while we discussed my concerns, details of my family health history, and he laid out possible options and clarified several things for me.
I went into the appointment really eager to investigate a procedure I’d come across online called a “nipple sparing mastectomy,” but I soon learned that this procedure really only works well with an implant, which I was not interested in. Without an implant, you’re basically left with a pair of droopy, deflated boobs, as all (or most) of the breast tissue is removed. And my understanding is they can’t then do a lift with this procedure, as there wouldn’t be sufficient tissue to supply blood to the areolas (so they would become necrotic). I don’t know about you all, but I’d rather have a traditional mastectomy than a set of droopy, deflated boobs. So this was an important discussion, and mentally sent me back to the drawing board, as I didn’t realize a lift could not be done in conjunction with a nipple sparing mastectomy prior to my consult.
I have not had any genetic testing for BRCA mutations, as my insurance doesn’t cover it, and if I paid out of pocket, it would cost almost as much as breast surgery. Additionally, only 5%-10% of breast cancer cases are as a result of BRCA, or other rare genetic mutations. While this logic might not make sense, I think I’d rather not know whether I’m BRCA positive, as I think it would mess with my head and cause severe depression. Before going down the road of a traditional mastectomy, Dr. Schimpf recommended I consult with a specialist to have genetic testing, and also that I do additional research into the ages the women in my family were when they were diagnosed. I’m speculating here, but I assume he’d rather not perform such a drastic prophylactic surgery without his patient having the appropriate counseling, and possibly genetic testing as well.
I was feeling a bit deflated, but then he suggested a sort of hybrid option, which was a breast reduction to remove as much breast tissue as possible, which would mathematically reduce my breast cancer risk due to having less breast tissue, while also making early detection easier in case I ever do develop a lump. During a traditional mastectomy, or a nipple sparing mastectomy, he explained that there is always a small percentage of breast tissue left behind, as it’s impossible to get it all. With a breast reduction, he would aim to remove around 75% of my breast tissue, vs the roughly 95% that’s removed during a mastectomy.
I really liked this suggestion. It felt like a reasonable, logical solution, and fitting for my personal situation and current risk factors.
The Pre-Op Waiting Game
I left the clinic that day with a copy of Dr. Schimpf’s book, “Finding Beauty: Think, See and Feel Beautiful,” and that night I cracked it open before bed, not knowing exactly what to expect. It’s a fairly short read, but I remember getting about halfway through it that night. It was exactly the information and insight I needed to solidify my decision to go forward with surgery. I contacted Sweetgrass the next day, and I was booked for my procedure about a month after my consult. Which was basically the most agonizing month ever.
During that month-ish awaiting surgery, I teetered between feelings of anxious anticipation, fear, excitement, and no feelings about it at all. I really felt no attachment to my breasts whatsoever, and sometimes I felt that maybe my attitude about the thought of getting rid of them, so to speak, was too relaxed.
I suppose it’s safe to say that any off feelings I had was about the surgery itself, vs the end result of a breast reduction. I would’ve had these same feelings if I was about to have my appendix removed. It’s the whole concept of going under general anesthesia that messes with your mind. Especially as you get older. However, whenever I had these feelings of fear or anxiousness, I’d refer the irrational part of my brain back to what I’d read in Dr. Schimpf’s book. In it, he details his journey to becoming a board certified plastic surgeon (an important distinction when selecting a surgeon), and a large part of that journey was his vast experience as a trauma surgeon. So if, for some highly unlikely reason, things began to go south while I was under, I knew I’d be in good hands. Dr. Schimpf is no stranger to saving lives on the operating table.
Aside from these sporadic feelings of nervousness, the rest of the month was a bit of a blur while in the thick of COVID19 and election season drama.
I had a pre-op appointment about a week before my surgery where we confirmed we were on the same page with the procedure and expectations. I would be having a breast reduction and lift, which involves an anchor aka keyhole incision. And he’d also do a bit of liposuction to remove additional breast tissue and fat in the armpit area. I received post-op prescriptions to fill, went over pre-op instructions with one of the many amazing nurses at Sweetgrass (pre-op instructions included taking stool softeners for three days prior to surgery). We also went over how to manage drains, and other post op care, and they collected my payment for surgery. Note: I did receive my surgery at a discounted rate in exchange for being open and transparent about my experience on my social platforms.
I was now totally prepared for my reduction, but somehow it didn’t quite feel real.
Until I woke up on surgery day.
*Please pardon the varying levels of quality of the images in this post. I wanted to fully document my experience here, and part of that experience involves crappy images from instagram stories;)
I didn’t sleep much at all the night before surgery, though that’s pretty much my norm on most nights. When I woke up, reality had finally sank in, and I briefly worried that maybe I hadn’t really given this whole idea enough thought. I wasn’t concerned about what I would look like afterwards. It was more about the actual surgery and recovery. I hate depending on others to take care of me, and Michael is always so busy with work, so I didn’t want to be a burden.
But before I knew it, it was time to hit the road for the Sweetgrass Summerville Clinic.
Thankfully the nurse anesthetist had called the evening before surgery and advised that I could drink a little bit of diet coke that morning, and she also told me to take extra strength tylenol right before I left the house. This was a HUGE relief for me, as I was very, very worried I would get a caffeine withdrawal headache without being able to have my morning diet coke fix (I know this is a terrible habit, but I don’t drink coffee so this is how I get my morning pick-me-up). I didn’t want to go into surgery with a terrible headache, as I was worried I would wake up with one that would be resistant to pain meds.
Thankfully, crisis was averted….I never got a headache, so my next biggest concern was being hangry. There was no fix for this, I was hangry, and unfortunately for my stomach, one of Dr. Schimpf’s other surgeries ran long, so mine was delayed about an hour.
After snapping some before pics with one of the nurses, Dr. Schimpf came in to triple check that we were on the same page. My only instruction was to take as much breast tissue as possible, and once again he clarified that he would have to leave some tissue behind to supply blood to the nipples. Fair enough;)
It was around 2:30-3pm when I got the green light to head on into the operating suite (I think surgery took about 2.5 to 3 hours). I was more than ready to be put to sleep at this point. Mainly because I knew I could eat as soon as I woke up.
Even though there was a delay, the time leading up till now went by really fast, thanks to the precious staff at Sweetgrass who kept me entertained. They even humored me when I expressed my third biggest concern to anyone who would listen, including Dr. Schimpf (poor guy), which was that I was afraid I was going to poop myself on the operating table. Yes, I said it…POOP. The fear was real. I get constipated when I’m stressed and sleep deprived, so even though I had already been taking stool softeners, they hadn’t kicked in…yet, so I was terrified they’d magically start doing their thang while I was relaxed under anesthesia. The good news was nobody could recall a situation where that happened….or at least that’s what they told me. Since they were only operating on my top half, they let me wear my comfy pants and undies during surgery, so I joked that if I woke up in a pair of loaner scrub bottoms, then I’d know things went terribly wrong in the GI department.
After a few minutes getting situated in the surgical suite on the operating table (which is actually more similar to a comfy dentist chair that fully reclines), the last thing I remember is Jessica, one of the sweetest nurses at Sweetgrass, telling me a story about her new kitten. And I never did hear how that story ended (that was their sneaky equivalent of having me count backwards into snoozeville).
My first post-op memory is sitting in a wheelchair all dressed in my comfies, trying to shovel goldfish crackers in my mouth. Some of which were definitely not quite making it down the hatch because I was basically white girl wasted. I did have enough awareness to realize I was still wearing my own pants (woohoo!). And someone from my care team was going over my discharge instructions with Michael, and I’m sure most of the info was going right over his head.
First Night Post-Op
Immediately after surgery, while I was inhaling all those goldfish crackers, I was in excellent spirits from the anesthesia. I wasn’t making much sense, and possibly drooling a little, but I do remember telling whoever was in the room that I could feel a burning sensation in my chest. I’m not a hundred percent sure, but I think this may have something to do with the instrument they use to minimize bleeding, but I didn’t ask so this is just my best guess. The pain was tolerable, but it certainly didn’t feel great. I had all of my post op medications with me, as instructed, so we got some pain meds on board right away. Then I was wheeled out the back (or maybe the side?) of the building where they had arranged for Michael to be waiting in his truck.
This is either an indication of how tolerable the pain was, how hungry I was, or maybe a little of both, but I made Michael take a detour on our way home for a Chick-fil-A milkshake and some chicken nugs, and it was glorious.
I assumed I would be exhausted and pass out as soon as we got home that evening, but instead I just laid in bed with the dogs, snacked on dried prunes and ice cream sandwiches, made some questionable pain med-induced online purchases, and watched The Office for the 89764235th time until the wee hours of the morning. Pain-wise, I was feeling pretty good. Like, I was aware my breasts had just been sliced open, but it was totally bearable. The best way I can describe the discomfort is it’s a similar sensation to wearing a bra with a sunburn.
At some point before Michael fell asleep, I remember gleefully announcing that I felt one of my nipples in its new and improved location when my arm grazed it. Kind of amazing, really, especially considering the trauma they’d been through and how much padded bandaging was covering everything.
I get asked a lot about drains. I was fully prepared for them, but I didn’t end up having drains. I’m not sure if Dr. Schimpf typically uses them, but for whatever reason, he didn’t feel the need to use them in my case. I’ve helped someone out after a surgical procedure who did have drains for several days, and while they’re not a huge ordeal, I was glad I didn’t have them bc it made it that much easier to feel normal.
Note: My surgery was on a Tuesday afternoon.
48-72 Hours Post Op – I was allowed to take a shower at 48 hours post-op, but I actually waited an extra day and showered on Friday. I wanted to give my incisions a little extra time to heal in case they got too wet (you’re supposed to put your back to the shower head, but I was still worried I’d screw that up haha).
I definitely recommend having someone available when you see your boobs for the first time. Michael was working upstairs when I took off my bandages, and despite my rational mind thinking that everything looked really good, my subconscious mind was like “Whoa girl….that don’t look right. What the f*#K happened to your boobs?!? And I almost passed out. I texted Michael to come downstairs to get the dogs out of the room while I laid in bed and gathered my bearings. I was back to normal and in the shower after a few minutes. It’s definitely an odd feeling taking the bandages off, as gravity becomes very apparent without the support of the surgical bra + ace bandage that had been holding everything together. Frankly, I couldn’t wait to get everything securely wrapped up tight again, which marks the first time in my life that I actually wanted to wear a bra.
4-5 Days Post Op – I was done taking the prescription pain meds by Saturday, when I made a switch to Tylenol. I’m not sure I even needed the Tylenol, but I took it anyway to prevent any lingering pain from rearing its ugly head. This is also when I had my first bowel movement, which suuuuccckkkkked!!!! The constipation from pain meds is real, yall. I took stool softeners around the clock, ate prunes, ice cream, lots of salad…..none of it worked until my intestines apparently ran out of real estate, and my poor food choices had nowhere to go, except out. Afterward, I told Michael I will never be the same bc that experience was probably more painful than the actual surgery. =\
I know, I know….tmi.
8 Days Post Op – I had my first follow up at Sweetgrass, which could not have come at a better time. The day before my appointment I started getting super itchy and red around my incisions, and benadryl wasn’t helping. When one of their nurse practitioners checked everything out, she said I was having an allergic reaction to the surgical tape that was placed over the incisions. Usually they leave the tape on until it either falls off naturally, or when the sutures/suture ties are removed, but she went ahead and removed the tape (obviously), and lemme tell ya…..that was the most amazing feeling ever after roughly 24 hours of incessant itching. Other than the redness from the allergic reaction, she and Dr. Schimpf were very pleased with how everything was healing. I left feeling great with a prescription for hydroxyzine in hand to help with the itchies, and was told to try zyrtec or claritin as well since the benadryl hadn’t helped.
Unfortunately my bliss only lasted until I got back in my car. It was a super hot day, seeing as we were in the middle of a typical sweltering Charleston summer and all, so as soon as I got a little boob sweat going, I started getting hives and my itch level went from around a level 6 out of 10, to a 6,000 (I know this doesn’t make sense….basically, the discomfort was off the charts). I barely recall the frantic drive to walmart to get my prescription filled, but I know 100% of it was spent with my hand down my shirt aggressively scratching my boobs, all while trying not to touch my incisions (not an easy task). It felt like a thousand fire ants were biting me all at once.
I took several deep breaths and got in a few scratches before scurrying into Walmart with my mask on, which didn’t help my comfort or anxiety level. Thankfully they weren’t busy, because I didn’t last two minutes before I had to stuff my hand back down my shirt to relieve the insane itching.
Shout out to the incredible pharmacist working that day. She could see how badly I was struggling and walked me over to the OTC meds and recommended I take Zyrtec, Benadryl, Famotidine, plus the prescription Hydroxyzine I was getting filled to curb the itching. The Famotidine was kind of a long shot drug, but there was a science behind why she thought it might help (I guess because it’s an histamine-2 blocker?), but she knew I needed all the help I could get. Note that she also said she wouldn’t recommend taking all of these meds together long term, but confirmed it would be fine for a few days. I bought a bottle of water and ran out to the car so I could get the OTC meds down the hatch, get another intense scratch sesh in, and then ran back in when my prescription was ready, which she thankfully processed quickly. I’m sure I looked like an absolute lunatic….especially when I was spraying hydrocortisone down my shirt in one of the aisles (don’t worry, I bought the bottle, of course). I was almost as good as new by the next day. 48 hours later, so 10 days post op, I basically felt back to almost normal activity level, and I had very minimal discomfort.
While the allergic reaction sucked, I was actually glad to have the surgical tape removed, as that meant I could clean my incisions really well with soap and water (after it was safe to get them wet).
Two Weeks Post Op – I was back on the Peloton doing low impact rides (staying in the saddle so I didn’t involve my upper body), and some lower body strength training.
Three Weeks Post Op – I had my second follow up appointment to have the sutures around my nipples removed, as well as to have the tie-offs of the dissolvable sutures snipped off (I’m not sure of the technical term for those little knots that anchor the dissolvable sutures). To clarify, he used regular sutures around the nipples, but used dissolvable sutures for the incisions under the breasts, and the vertical incisions that went from my nipples and intersected with the under-boob incisons.
It was also noted at this appointment that my incisions had opened up slightly at each of those intersecting points under the breasts, which I think is somewhat common. Especially in patients who do too much too soon (oops!). It was no big deal though. I just had to keep the areas covered in vaseline, so that the granular tissue could heal from the inside out.
One to Five Months Post Op – Over the months following my breast reduction, I was quite comfortable and back to normal life, for the most part. But there were still lingering reminders of what my boobs had been through in the form of nipple sensitivity, and some lingering soreness. The nipple sensitivity is not what you’d think. I’ve described it previously in a way that only cat owners will understand.
The nipple sensitivity is similar to the feeling when you realize that your cat must have done a burn-out on your boob while you were sleeping the previous night and left a scratch through your shirt. But in this case, it’s as if this hypothetical cat, or in my case, “Odie,” left a perfect scratch outlining each areola. The reason I use this analogy, is because if this has ever happened to you, it’s usually something you don’t notice right away because it’s not that it’s painful, just kind of annoying once you’re conscious of it.
Then there’s the lingering soreness, which is more deep under the surface. I found it most noticeable first thing in the morning when getting out of bed (ie. when my boobs shifted with gravity). Or if I’ve been laying on my back for a while, and then shift to my side, same thing. For this reason, I wore a sports bra 24/7 until very recently, which made those gravity shifts less frequent or intense.
Five months later, that somewhat uncomfortable nipple sensitivity is gone and they’re back to having normal sensation, and the intermittent deep tissue soreness has almost completely resolved.
I get lots of questions about scarring, and truthfully I couldn’t have cared less about scars, so when people ask me how I’ve taken care of them since surgery, the simple answer is: I haven’t.
Basically, I was instructed to keep vaseline on my nipple incisions for about the first month or so, and then I was also instructed to apply vaseline to the small areas under each breast that had opened up a bit so everything would heal properly. Otherwise, I’ve done absolutely nothing, and my incisions honestly look great. They will only get better over the next several months as they continue to lighten up.
Tips for Prepping for Surgery
- Obviously you want to be as healthy as possible going into any type of surgery, so eating well and exercising leading up to a breast reduction is likely going to make recovery easier if you’re in optimal physical condition.
- Stock up on any foods that will help you poop (trust me!), and begin taking stool softeners prior to surgery (your surgery center should give you specific guidance on this). I was also told recently by one of the nurse practitioners at Sweetgrass that taking miralax is really your best bet, as the pain medication literally makes your GI system seize up, so it’s not necessarily a matter of not having soft enough stool. The miralax helps keep things moving along when your intestines get lazy.
- Purchase dressings ahead of time, as you’ll use sooooo many. I was sent home from surgery with several of these ‘abdominal dressings’ stuffed in my surgical bra, and I continued to use them for a good 1.5 to 2 months post op so my incisions under my breasts wouldn’t get irritated by my sports bras or surgical bras. I ran out a couple times and had to improvise with maxi pads, but they weren’t nearly as comfortable. I had purchased non-stick pads to go directly on my incisions, but they made me super itchy, so the second most used type of dressing I purchased were these simple sterile 4 x 4 gauze pads. Of course they offered me dressings at my check ups, but I didn’t want to clean out their supply so it was easier to just purchase them on my own, and thankfully they’re very affordable.
- Make sure you have a good pillow situation so you can sleep comfortably in an inclined position. Many people recommend this type of pillow, but I didn’t get my stuff together in time before surgery, so I ended up just propping myself up with like five regular pillows. I also wore this airplane neck pillow to bed most of the first week, so that my head and neck were supported while trying to sleep in an elevated position.
- Buy an extra surgical bra. You’ll go home wearing one, but it’s nice to have two or three, so you have something to wear during wash cycles. This is the one I purchased from Amazon. It wasn’t as nice as the one Sweetgrass sent me home in, but it got the job done.
- I was instructed to wear a top that buttoned or zipped down the front on the day of surgery. I wore a white button down there, and naturally, I ended up bringing an extra outfit because I’m a serial over-packer. I woke up from surgery wearing my back up top, which was this little cotton spandex, zip front athletic jacket (similar to this). I’m sure the zip-front made it the more attractive choice for whomever drew the short straw and had to dress my limp body. But it was also perfect because it was a bit snug, so I felt super comfortable and secure wearing it post op, as it held everything in place, and wasn’t bulky.
- Have Benadryl and/or Zyrtec on hand to help with the itchy sensation you might get from the pain meds. They’ll help you sleep too;)
- Block off about 5 days where you aren’t obligated to be active. Again, my surgery was on a Tuesday, and I was pretty much up and moving around the house as usual by the weekend, but I still had to limit heavy lifting, and raising my arms above my head. Even the day after surgery I was taking the dogs out for their potty breaks, making my own meals, straightening up the house a bit, etc etc. The following Wednesday I had my follow up and allergic reaction debacle, and then the next day I was up on my feet all day into the wee hours making a giant batch of dog food in the kitchen, which is quite the task, and my boobs weren’t a factor at all.
All that said, you could probably forget to do most of my pre-op recommendations, and still do quite well post-operatively. While the surgery seems like it’s a major ordeal, at the end of the day, it’s just a bunch of soft tissue being removed or manipulated, so this recovery is definitely easier than say…bunion surgery (speaking from experience here), or knee surgery. It also helps that the Sweetgrass surgery centers aren’t uncomfortable and cold like a typical hospital setting, so the experience is more like going to a dental appointment…..just a really, really involved dental appointment where you leave a couple bra sizes smaller (or bigger, depending on your preferences;)).
Aside from its intended potential health benefits, I couldn’t be happier with my new tiny boobs for aesthetic reasons as well. Being on the shorter side with broad shoulders and a big butt, having a smaller bust makes me look and feel more petite. Honestly, I wish they could be even smaller. Little breasts have opened up all sorts of new wardrobe possibilities. It’s much easier to pull off an elegant deep V-neck gown now. Though, with the giant dumpster fire that it is 2020, I’ve barely put on real clothes since March, let alone any sort of ‘elegant gown.” I have high hopes for 2021 though.;)
I’ve also noticed a big difference in my posture, as well as an improvement in my chronic lower back pain.
I have another follow up at the end of the month to discuss possibly going in with lipo to try to take more breast tissue now that my nipples have fully healed. I’m not sure if I’ll go forward with that, but I’ll certainly keep you posted.
Hopefully I’ve shed light on any lingering questions you might have had about this procedure. Clearly I’m an open book, so if there’s something I haven’t covered, please feel free to comment or message me. And if you’re in the Charleston area and looking to have plastic surgery, I can confidently recommend Dr. Schimpf and the entire Sweetgrass team.
Whew! If you’ve made it this far, thank you for reading. And a HUGE thank you to Dr. Schimpf and his staff for a wonderful surgical experience and my incredible results!
UPDATE: I have big surgery news and you can read it HERE🙂