At 40, I Finally Got My Boobs Back with a Subtle Breast Augmentation and Fat Transfer

To B-cup or not to B-cup: That was the question of 2024.

At 40, I’ve never felt better. I’m sober. I’ve piked through every Pilates class in the Big Apple. I eat clean—protein, fiber, fruits, and veggies. Therapy? Weekly and transformative. My social circle is a dynamic orbit of friends propelling me skyward. I’m flourishing. Yet, amidst the rock bottoms, glow-ups, and self-discoveries, two things have never returned to factory settings: my once-full breasts.

Was I ever busty? Not exactly. But back in my curvier days, with more weight on my frame, I was a full B cup, venturing into C territory if demi cups, French Leavers lace, and tulle came into play. About the weight, in the past few years I feel like I’ve walked through my “we finally figured it out” health portal. My diet and lifestyle (I’ve been sober for six years now) have dismissed the quick fix nutritional sales pitches I kept trying: vegan for almost two years, paleo, sugar-free—and I’ve landed on a daily menu that keeps me strong and satiated. But with this nutritional way of living, that’s focused mostly on protein and fairly Mediterranean, has resulted in weight loss in my breasts and butt.

Cut to spring of 2024, when I first truly noticed the change, thanks to some photographic evidence surfacing. First, there were the royal blue string bikini photos from St. Barths; as I arose from a post-ocean dip, unflappably sure I looked like Darryl Hannah’s body double in Splash, I saw that my chest resembled a sunken pirate ship. Then, a solo sojourn to Greece, wandering Athens in a white knit dress. My boobs? In absentia, like they’d been abducted by a Greek God—Hades and Persephone-style.

By August, like any good fashion stalwart, I turned to lingerie for answers. Under the harsh lighting, my sales associate dropped the truth bomb. “32A; perhaps, double A for extra oomph and lift?” Me? Double A? Never did I think my bra size would go from B to Energizer battery vernacular. I started to daydream about getting a breast rejuvenation. Just a little something. Small. To fill out tops and bustiers, and those cute corset-y waist dresses everyone’s wearing in Williamsburg. To ensure I was doing this for me and with full agency over my body, I went through my checklist: are you doing this for clout? For the male gaze? Was social media my muse? Nope. Nada. Not even close.

These *potential* breasts were for me. I wanted to feel empowered and confident again. I wanted to fill out my bathing suits, tops, and workout gear. This was a body autonomy choice. FTW. Thus began my quest for natural-looking breasts.

The Vision for My Breast Augmentation

When I closed my eyes my vision was more “Swan Lake” than “Baywatch”. At 5 '2” and under 110 lbs, I was aiming for understated. I didn’t want to look ‘done’. Kendall. Kate Hudson. Nothing bigger than a B-cup. Two breasts as balanced as my chakras. I jotted down my breast wish list: proportionate, small volume, a little cleavage (if you’re already at the ice cream shop, might as well get the sprinkles). I wanted “the chest I had in my 20s” before gravity had done its thing, topped with the freedom of “Bra Free”. I envisioned myself as that confident ‘Is she French or isn’t she French?’ woman, stepping out in jeans and a white tank with nothing underneath. You know, that sexy undone chic thing. Je ne sais quoi breasts.

Finding The Right Breast Augmentation Surgeon

We’ve entered the era of the subtle breast augmentation. “Yoga breasts,” “Ballerina Breasts,” and “The Perfect B” are buzzing across headlines, social media, and from plastic surgeons. Once my algorithms picked up on my newfound mission, it fed me a never-ending loop of ads and videos of surgeons that did fat transfers (which is harvesting fat with liposuction and grafting it into the breast), awake implants, over-the-muscle implants, gummy bear implants, and the latest-and-great implant on the market, Motiva. It was overwhelming and perplexing. What’s a girl to do?

New York City’s cosmetic surgery scene? A maze of who’s legit versus who’s trending. You can turn to Reddit. Get yourself a coveted spot in a beauty writer group text for some inside baseball. You can even take a wild chance and ask a woman at Pilates that you *think* might have had an augmentation.

What I learned: finding a board-certified plastic surgeon is key, someone with the real bona fides. It’s also important to check out their before and after photos. Reddit is a fascinating source. I consulted with a few surgeons, all reputable and performing smaller breast augmentations, all recommended to me through my inner circle—however, when you know you know.

Enter, Dr. Darren Smith, whose credentials include fellowships and extensive sub-specialty training in aesthetic surgery made me feel safe, heard, and totally comfortable. His Ritz Tower plastic surgery practice was modern, glossy, and chic, complete with a private operating room. It just felt right.

Discussing my desired aesthetic with Dr. Smith was like I was talking to a close friend, but one who also happens to be a surgical credentials king and is one of the most popular breast and body surgeons in the Tristate area. Dr. Smith assured me that it’s paramount to him that this would be a collaboration, telling me, “I’m here to provide my surgical expertise, but really, it's a partnership above all. You’re driving the ship, but I’m here to facilitate your journey to get you where you want to be.” Despite my binge of articles on smaller augmentations, I still feared the, “too done” look, Dr. Smith reassured me, “We’ll find an implant and fat transfer option that is in proportion to your petite frame. You’re going to love it!” I was thrilled, excited, and ready for take-off.

My Breast Augmentation Consultation

During my in-person consultation, we discussed my health, mammogram history, and Dr. Smith took before photos. I also showed him my dossier of inspo photos of B-cup breasts and celebrity examples. He said I was an ideal candidate for his “Rapid Recovery” breast augmentation, meaning Motiva implants, placed under the muscle, with a touch of fat transfer for more natural fullness. I was relieved—this was exactly what I wanted! He explained to me his Rapid Recovery process which was three-fold—meticulous dissection to minimize tissue trauma (sounded good to me); instilling a long-acting local anesthetic like Marcaine into the implant pocket at the time of surgery to minimize narcotic use post-op; carefully controlled early return to activity and range of motion exercises (maybe this wasn’t going to be as intense as the TikTok recoveries I was watching every night).

When I inquired about the above the muscle implant trend, he was candid, “When we go under the muscle you get the best looking result. The trending above the muscle, and subfascial augmentation techniques have not yet differentiated themselves as superior options in my experience. With an under the muscle implant, you achieve a seamless, natural transition from the chest wall into the breast.”

Motiva implants are the new-ish implants on the block and became available in the United States in September 2024. I’d read up on how this was a big deal for breast augmentations as Motiva have been celebrated for their natural look and feel and reduced risk of capsular contracture (a complication that can occur after breast implant surgery where scar tissue around the implant hardens and tightens, resulting in a breast that feels firm, tight, and painful). Once we had the before photos we went into his office and I was able to see what the implants would look like on my build with Dr. Smith’s advanced aesthetic 3D simulation system, Vectra.

This felt like creating a Build-a-Bear but for boobs. It was a neck below photo of me and we were able to try on both the Motiva Round and Motiva Ergonimix implants. The latter emerged as the clear winner with their natural teardrop shape when I’d be standing up and roundness when lying down. I also loved the feel of the implant which was smooth and natural and referred to as Motiva’s signature SmoothSilk Surface. I opted for 190cc implants to fill out my tops, workout bras, and bikinis and Dr. Smith planned to get a fat graft from my thighs via liposuction.

Leaving the office, my surgery date circled in red on my calendar, I felt a sense of calm excitement. I felt empowered and certain that I was making the right choice and that I found the right surgeon to do it with. Not once did I waver after booking this surgery.

Prepping for Breast Augmentation Surgery

In the weeks leading up to my surgery: I forwarded my mammograms to Dr. Smith’s office, and had a thorough pre-op physical for clearance, with blood work and an EKG with Dr. Andrew Moawad at Well by Messer. And the prep wasn’t only paperwork; it also involved stocking and styling my apartment into “Transformation HQ” for post-op recovery: Cure electrolyte mix for hydration, a special wedge pillow for optimal head elevation, zip-front tops and cardigans for ease, and ice packs tailored for post-surgery bras (these were pure genius).

I was a flurry of nerves and excitement the five days leading up to my surgery. Running thoughts: Am I going to be in throbbing pain? Did I go too small with my implant choice? Should I say no to everything on my calendar?A

Every time I reached out to Dr. Smith’s office they were prepared with answers and he would call me back within hours or even text with me. Since I was getting a fat transfer, Dr. Smith suggested a protein rich diet and told me I should gain some weight before surgery. Steak dinners became a frequent affair, alongside lots of chicken, eggs, and fish. My “last supper” before the midnight pre-surgery fast? Steak, French fries, brussels sprouts, and Le BonBon Swedish gummy candy.

Breast Augmentation Surgery Day

The morning of my surgery came with a foggy calmness due to fasting. Arriving at Dr. Smith’s office without my usual shot of caffeine, nerves quickly replaced my caffeine buzz. In the waiting room, a fellow patient whispered encouragingly, “You’re in great hands; Dr. Smith is the best. I’m six weeks out and my recovery was so easy.” Her words steadied me. It was showtime, baby.

Once inside my room, I was weighed and my eleven pound weight gain was greeted with high fives from my nurse. Next up, my anesthesiologist gave a clear rundown of what to expect, and then Dr. Smith came in with a magic marker to map my body. Observing him mark the locations for incisions and fat transfer was fascinating, a glimpse into the planning of his procedure. He talked me through every marking: where the incisions would be for my implants, and where he would be injecting the fat to the upper pole and inner part of my breast for a little bit of the cleavage that we had discussed.

The day’s intensity melted into a blur. The last moment I recall is being in the OR and the team asked me what music I wanted to listen to, “Ariana Grande please!” I started singing to “No Tears Left To Cry” as I got my general anesthesia via IV.

I resurfaced in the recovery room, greeted by my nurse Ciara. I was wearing a Marena post-surgery compression bra and girdle (which I lived in for the weeks to come). Dr. Smith and the team caught the great reveal on camera. As my nurse opened up my bra for me to see, I cried tears of joy and said lots of, “Oh my Gosh! They’re perfect. Look at them’”. I was thrilled. These were my dream breasts! Comfort food orders were placed: a pureed vegetable soup, roasted salmon (the hunger was real) and a protein smoothie for the next morning. This step was clutch, I spent the night in Dr. Smith’s recovery room (an option he offers to patients) with Ciara.

She helped me get up and use the bathroom and helped me walk around his office for blood flow and to get me up and moving. We ate gummy candy and talked about life. It was honestly like a sleepover party, except I had new breasts. I fell asleep that night around 10:30 PM and slept through the night. I was woken up by Ciara before Dr. Smith returned to the office around 7 AM. He gave me a look over and checked my healing and vitals and I was released. Ciara brought me home and we went over all my take home instructions for post-healing and she mapped out my meds for me. I was given a few different options for pain medications depending on how I was feeling, which certainly helped with the tightness in my chest and general pain management.

48 Hours Post-Op

Contrary to the common narrative of intense post-op recovery, Dr. Smith’s rapid recovery breast augmentation made it bearable. My mom visited to refill my kitchen as I couldn’t carry bags or boxes. As an energizer bunny, the hardest part of those first 48 hours was taking it totally easy. I woke up, tracked my medications, I worked, and ate (I was voracious which happens post-surgery because your body is healing), and got a little light walking in. Showering was fine but I only shampooed the bottom of my hair as my raising my arms felt uncomfortable with my limited range of motion. I continued to wear the compression garments underneath sweats and leggings. I also put soft gauze pads inside the bra for oozing and cooling ice packs that I would put in the bra when I was feeling sore.

Five Days Post-Op

After five days, I was back at Dr. Smith’s office (which now felt like home) as he assessed my healing progress of both my implants and fat transfer. His news was glowing (yes, I’m an overachiever and even like gold stars relating to my breast augmentation healing progress), and he introduced me to the band. Picture a resistance band looking device that hugs your chest, which coaxes the implants into a position that is charmingly referred to as “dropping and fluffing.” Those five days flew by at lightning speed. Despite taking it easy during the days, I even managed a few social appearances with cautious optimism—like my friend Sarah’s birthday party five days post-op.

Two Weeks Post-Op

Week two was maybe the most challenging of my process. As the Rapid Recovery meds (Dr. Smith intraoperatively uses long-acting local anesthetics at the time of surgery to minimize narcotic use post-op) and my prescription meds tapered off, I found myself occasionally ensnared with a tightness in my chest—which felt kind of like an anxiety attack. These are entirely normal as your body is adapting to the implants. Week two also began my relationship with Mariela, my lymphatic drainage massage extraordinaire who came to my house. Mariela’s lymphatic drainage massages were nothing short of a miracle. They tamed my swelling in ninety minutes, soothed my inflammation, and relieved my stiff neck which I had from back-sleeping. Fast forward seven weeks, and Mariela is a steadfast member of my self-care brigade.

Four Weeks Post-Op

The four weeks were over in a blink. As someone who thrives on movement, I really listened to my body and this was the mark that I felt ready to reintegrate light workouts back into my routine. Mat pilates emerged as the champion for my body and I modified it as I wasn’t ready for pushups or overhead arm movements. I was excited (yet incredibly gentle) with adding some light working out back into my routine. While the settling process of “dropping and fluffing” may take an entire year, Dr. Smith told me my results will be pretty much set by three months and that changes after this point tend to be subtle.

How I Feel Now About My Breast Augmentation Surgery

My elation following my surgery has been boundless. The notion of I “should have gone bigger” has never entered my mind—there’s been no fretting, no second guesses, and absolutely no regrets. I feel more confident with every piece of clothing I put on. With a recent trip to Miami, I packed every bikini, every Fleur du Mal bodysuit, and tank with newly found boldness. Witnessing my body’s resilience and healing during this elective surgery has deepened my respect and admiration for it. My results were subtle enough to only be noticed by those I confided in, but personally, secrecy holds little appeal—I find it exhausting. So here I am, telling you all. Hi, I got my breasts done, and it was the best gift I could’ve given myself as I enter this fourth decade of my life. A little wiser, a little more clear-sighted, and a lot more balanced inside and out.

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