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Chest Surgery

June 17, 2003- Beginning stages

On the chest surgery front, I've set up an appointment for a consultation with Dr. McLean in Toronto, ON, Canada for August 22nd. Dr. McLean is a surgeon I haven't heard much about until recently, but he has a lot of experience doing FTM chests in his area and everyone I've talked to has had a positive experience with him. Unfortunately so far I've only been able to see photos of one chest that he's done, but it looks great. I have been in touch with a few guys who have gone to him or who are planning on seeing him soon, and I will also get to see some more photos of his work at the consultation. Hopefully I'll be satisfied with what he has to say and show me, and we will be able to schedule a date for surgery sometime in the late fall or winter. That will mean taking out a loan of some sort or putting a good portion of the costs on credit card, but that's okay with me. It will end up costing considerably less to have surgery with him than it would with any of the other surgeons I have looked into so far, which is great.

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August 27, 2003- Consultation

On Friday the 22nd I had a consultation with a surgeon in Toronto who I have been strongly considering for chest surgery. Everything went very well and as soon as I figure out finances I'll be setting a date with Dr. McLean. Right now surgery is looking most likely to be in early January or possibly around Thanksgiving. I will be applying for a loan to cover some of the costs.

The consult was comfortable and easy. I traveled up to Canada with my house mate, who was also having a consultation, and an old friend. We were the only people in the office other than Dr. McLean, the office receptionist and a nurse. The staff was very kind and professional. I met first with the nurse who took a polaroid of my face for their records and gathered a little basic info. Then the doctor came in the room and we talked for a while, he explained his process and checked out "what we have to work with", and answered my questions. From there I went to another room and met with the nurse again, who took some photos of my chest and went over some more paperwork with me. Normally the require their patients to come in three weeks before surgery to have a physical and go over some other things, but because I live so far away, they gave me a form to have my local doctor fill out. Before leaving, Dr. McLean met with me again to make sure there were no further questions and review the whole process one more time.

I am more than happy with what I've seen and heard from other guys who have gone to Dr. McLean, especially after meeting him and his staff and talking with him about the surgery. The cost for the surgery will be $5,350 in Canadian dollars, which is less than $4,000 USD. I'll be updating more about this sometime soon.

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June 9, 2004- Scheduling surgery

Last week I scheduled my chest surgery for the end of the month with Dr. McLean. I am amazed that I am going to be able to do this so soon. It was a big surprise. I am only able to do this because I am getting help from my parents. They very unexpectedly offered to give me some money because they had done some things for my sister and wanted to be able to do the same for me. This money, along with the amount I have saved on my own, is just about enough to be able to afford surgery, travel, lodging and expenses. I will still need to come up with a few hundred more dollars but I know it will all come together before the end of the month. It's funny, because over the years I have felt very strongly that paying for surgery on my own is something I really valued, and of course it still is. I even came down pretty hard at times on guys who got help paying for surgery, saying that they hadn't worked hard and didn't deserve it. I know a lot of that was envy and jealousy. Now I am in a position where I am accepting this help from my parents, which makes me regret ever projecting my own jealousy on other people. At the same time, this surgery is something I have waited a long time for, something I know I deserve, and my family is willing to help me out. It's something they offered and not something I would have ever asked them for on my own. I'll appreciate it forever. I guess we all do what we can, use the resources available to us to get where we need to be.

Since scheduling surgery, the way I am relating to my body has felt completely different. Knowing that my breasts will be gone soon has lifted so many of my inhibitions. I feel like I have less to hide, like I don't need to make excuses for the way my body looks or for the ways it doesn't match up with what I see in my mind. I feel lighter already.

breast in hand Physically, my body is ready for this surgery. I am in good health. Being on T for over a year now has brought some impressive changes. I have bigger and more well defined muscles than ever before. I can feel and see muscles in my chest under my breasts and it's not hard to picture what I will look like after surgery. I thought I'd post this picture here to show what four years of binding every day has done to my breast tissue. Of course I don't have pictures of my chest from before I started binding, but as you can imagine, the difference is pretty dramatic. This is why I am able to appear so flat when I bind. The tissue breakdown has made binding more comfortable and my chest less noticeable over the years.

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June 17, 2004

Things are in order for surgery. I am actually leaving home today because I have to go away to work for a week, and I will be leaving directly from there to head to Canada for surgery. On Monday I went to the doctor to have an EKG (electrocardiograph, where they attach electrical sensors to your body and measure your heart activity to check for abnormalities) and some other pre-surgery work done. It was just basic stuff, like blood pressure and heart rate, kind of a mini-physical. All of this was to assure that I was in good health and would be able to handle surgery and so the anesthesiologist could determine what it was going to take to knock me out. Everything checked out fine.

Here's what I wrote in my journal about what I was feeling on Monday: "In about an hour I am heading up to my doctor's office, to see a doctor there who is actually not my doctor, but I need to get my pre-surgery work up done and my doc isn't available this week. It's a little surreal that all of this is happening. After waiting so long, seeing so many friends and acquaintances go through it... to now have it be my time is amazing. It's funny though, I already know so much about it after reading page after page, and being with a friend through his surgery. I could write a manual on "how to have chest surgery". I almost feel removed from it... like these steps I am taking are things I'm adding to a resource page on my site or something, that it's not actually happening to me."

It's true, a lot of this has felt kind of surreal. It's only been in the past few days that it's started to sink in that this is really happening to me. Last night I had some friends over to get together one last time before I leave. We ended up watching some home movies from about two years ago, before I was on testosterone. So many things have changed since then. I have a lot of friends who are transitioning (FTM and MTF). Seeing them all on tape and sitting in the same room with them while we watched it, seeing how much we have all changed in that time, was beautiful. This next huge step could possibly be the last one I need to take in my transition. I don't plan on having bottom surgery, and there is the possibility that I won't need a hysterectomy... this could be it. It's going to be interesting to experience "life after transition", whatever that means. I wonder how it will feel different and how things will change for me.

So, all that is left to do, really, is pack my bags. Yesterday I put photos in a small album so I'll be able to bring all my friends along with me on this trip. It's going to be hard being away from home for so long. I am going to stay in Michigan for a while after surgery and will be heading back to Maine on July 17th, a month from today. The next time I'm able to update will be from Michigan, maybe a week after surgery. I don't think I have ever been away from home for that long before. This is all a big, exciting, overwhelming adventure and I am ready for it. Thank you to everyone reading this who has given me so much love and support along the way, and keep me in your thoughts on the 28th!

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June 27, 2004- 
Day Before Surgery

We got to Mississauga today. The hotel we're staying at is about a 5 minute drive from the doctor's office. I am here with my girlfriend and roommate, who had surgery with Dr. McLean last year. We went to the grocery store and packed a cooler full of good food that will be easy to prepare in the hotel room after surgery. I cut my hair really short, about half an inch long on top, and took a nice long shower and washed with anti-bacterial soap... my last shower for a few weeks. We will be getting to the clinic at around 11 tomorrow to get ready for surgery.

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June 28, 2004- Surgery Day

We got to the clinic at 11:30 and a nurse took me right back to get my blood pressure, blood oxygen level, and to take some photos of my chest before surgery. I changed into a hospital gown and a little while later Dr. McLean came in to talk with me about surgery and to measure and mark my chest. He explained the formula he uses to determine nipple placement, it's calculated using the girth of the chest and length of the breast bone. I went in to the operating room right around 1pm. I walked in and climbed up on the table, laid my arms out to be strapped down and watched the anesthesiologist connect my IV drip. I talked with him for a little while but as soon as I started to feel the effects I just closed my eyes and took a few deep breaths. I don't remember anything that came after that.

The next thing I knew I was the recovery room and Lionel Ritchie was playing on the radio. A nurse came in and put a warm blanket on my legs. She told me that everything had gone well and my chest looked great. I think it was about 4:30pm. I remember that she had to keep reminding me to take deep breaths... I was still a little bit out of it. After a while I was feeling well enough to move so I walked to the bathroom and then they gave me a little private room and let my girlfriend come back to see me. She was suppressed to see me sitting up in a recliner and smiling. I really was feeling pretty good. I think we ended up leaving the clinic around 5:30 or 6. We got back to the hotel and I slept on and off most of the evening. I threw up once around 8pm, but other than that I've felt okay. I am taking Vicodin every 4 or 5 hours which has kept the pain to a minimum... really just a bit sore, not sharp pain. I just feel kind of out of it. I was well enough to eat my regular Burger King meal though, it can't be that bad.

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June 29, 2004- 1 Day After Surgery

Things are still feeling great. My chest looks really good. I've gotten to see it a couple times when we've changed or adjusted the bandages. The most annoying thing is having the drains hanging off my body. I feel really clumsy and can't move much with them in the way. My right side is hardly draining at all, only about 3cc every 5 or 6 hours. The left side is still draining about 12cc each time we empty them. We went in to see if the drains could come out this morning but because the left one is still pretty active they decided to leave them in until tomorrow.

I slept for a good part of the afternoon, then we went out to dinner with friends in Toronto. It was great to get away from the hotel for a couple hours. I felt fine walking around town and in the car, just a little loopy after I took my pain meds at dinner. I haven't felt nauseous at all since last night. I think the secret is having a good amount of food in your belly when you take the meds. I'm excited to get my drains out tomorrow and get out of this hotel.

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June 30, 2004- 2 Days After Surgery

chest with drains Drains came out as planned this morning. I was prepared for this to be really painful because I had heard a lot about how much it burns when they come out. I didn't feel much at all. All I really felt was a little pinch when the nurse was snipping a stitch out where the drain hole was and a tug as she pulled the drains out. It felt like you would imagine... kind of like a worm crawling out of your chest. Yum. My drain holes are way up in my armpits. That's great because if there is scarring it won't be too visible there. I was amazed by how much of a difference it made having the drains removed. Walking out of the office I felt like a whole new person. I had a huge range of motion restored and I was instantly in a better mood. We made the four hour drive home with no AC on a really hot day and I was barely uncomfortable at all.

Once we got to Michigan we kind of took it easy for a little while then ended up going out to a movie tonight. We didn't get home until after midnight and I was feeling tired and worn out. I got in the bath and started to wash up for the first time since surgery, being very careful not to get the nipple dressings wet in the process. I ended up having a bit of a breakdown because I was so tired and frustrated. I know a lot of guys talk about having mixed feelings after surgery but I don't think I was prepared for it. It's not that I'm questioning anything about this surgery, I am so thankful that I've been able to do this. It's just that after four years of waiting and building myself up for this to be some huge kind of relief that just makes everything feel better, I am left feeling frustrated and disappointed right now. My chest is bruised and swollen, especially on the left side. It's sore, I can't get it wet, there are bloody scabs across my incisions, I can't move my arms the way I want to, and it still doesn't look the way I want it to in my mind. I look in the mirror and I don't recognize my own body because everything has changed so drastically overnight. Even though this is a change I really want and have been sure of for so long, it is still foreign to me. I know it's only been a few days and I need to be patient. I know I'm lucky because most guys aren't feeling as well as I am just two days after surgery, but I can't help but feel down right now. I had so much built up around this, so many expectations of how instantly great it was going to feel, how much was going to be lifted from my chest, literally and metaphorically. I hadn't prepared myself for the reality that healing will be slow and sometimes painful, I'm going to be laid up for a while, I still need to wear a surgical binder for weeks. And even when it's all healed, there are still things about my body that I am going to be unhappy with, still things that I need to make peace with. Having surgery is a gift, it's a huge step in a positive direction, but it's not a cure for my body discomfort and it hasn't instantly made everything better.

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July 2, 2004- 4 Days After Surgery

I'm feeling a bit better about things than I was at my last update. The swelling on the left side of my chest which was huge on Wednesday night has gone down a lot since then and isn't too noticeable anymore. There is quite a bit of bruising there now but that doesn't make a difference because I am still wearing the surgical binder with gauze and padding over my chest anyway. I'll be wearing the binder for a few more weeks, not a lot of fun in July but I guess that's a small price to pay. I haven't taken any Vicodin since Wednesday morning (2 days after surgery). I've taken Motrin a couple times for pain and swelling and I've been taking arnica to keep bruising and soreness to a minimum. I have an appointment on the afternoon of the 14th to head back up to Dr. McLean's office to have my nipple dressings removed. I think I'm going to feel a thousand times better about my chest at that point. I can't wait to see what my nipples look like.

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July 6, 2004- 8 Days After Surgery

Things continue to go well with healing. I am moving with more ease and getting used to the binder. The actual binder itself is an elastic abdominal binder like a lot of guys use pre-surgery. The part that is so hot is the thick padding I have to wear across my chest and more gauze over my nipple dressings. I spend some time each day with the binder off, probably about 45 minutes. It feels good to let things air out some and to be able to breathe more easily. I know having the binder on does make a big difference though, because even after just that short amount of time I notice a little more swelling than before.

8 days post-op My nipple dressings are really driving me nuts. They are bulky and I worry whenever the binder is off that they are going to get caught on something and pull on the grafts. I can't take a shower because I can't get them wet, so I have been taking baths or just washing up at the sink. I have eight more days until they are removed and I can't wait. I am not in a lot of pain. Of course there is some soreness, mostly on my left side where it is more bruised, but also in the area at the top of my chest and out towards my armpits. I think this is where Dr. McLean did the most liposuction. I have normal sensation in my chest down to about where my nipples are, and then starting again below my incision lines. There is some feeling in the space between, but it's a deeper sensation, not really on the surface of my chest. It's like touching a limb that is really asleep before it turns to that pins and needles feeling. Some areas of my chest are really soft, some are harder and more lumpy. I assume this is from the bruising and healing tissues and it should even out in time. The scabs are coming off my incisions slowly but surely. No rush there. I think my scarring is going to be pretty uneven. It's been nearly impossible for me to be as sedentary as I probably should be, so I wouldn't be surprised if I don't have the least prominent scars ever.

One of the hardest things has been not being able to get comfortable at night. I am pretty able to sleep on my sides (right is more comfortable than left) and even on my stomach now if I lay on top of a fluffy pillow. For the first four or five nights I didn't sleep well at all and ended up napping or feeling really exhausted during the day. I've also been frustrated with not being able to hold or wrap my arms around my partner the way I want to, although even this is getting almost back to normal now, thankfully. I joked for a while that I had "T-Rex Arms" because I felt like they were about 6 inches long and I couldn't move them the right way. But overall things are great, I feel about 75% back to normal and haven't slowed down much at all. I'm really thankful for all the support my friends and my partner have given me. I'm a really lucky guy.

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July 9, 2004- 
11 Days After Surgery

I'm feeling a bit concerned because there seems to be fluid building up on the left side of my chest, and that can't be good. It's different than the normal swelling that was there before (swelling on the right side is almost gone now). I can actually feel fluid moving around in my chest. The left is the side that was draining much more than the right before my drains were removed. I'm now thinking that we probably should have kept the drains in for a while longer, at least on that side. I'm back to wearing my binder with additional padding and as tight as I can get it in hopes that that will help some but I'm afraid I'm going to need to have it drained. I remember reading about another guy having a similar experience after his surgery. I don't know if a lot of people experience this... if it's normal or if it's something I should really be concerned about.

I called Dr. McLean's office but he is on vacation until Wednesday, when I am going up to have my nipple dressings removed anyway. The receptionist said I could call on Monday and talk to the other surgeon who works in the office but I don't know if that will make much of a difference. I am also trying to get in touch with someone local for another opinion.

This is really frustrating. I don't understand why it's happening now because everything seemed to be healing fine in the beginning. I don't have health insurance so it's not simple for me to just go get it checked out here. Bah.

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July 11, 2004- 
13 Days After Surgery

Last night I was kind of freaking out about my chest. My right nipple graft is looking kind of funky/unhealthy and like it might have been pulled and is lifting a little on the side. It's red and sore and as the nipples heal underneath the dressings, it kind of seems like they are shrinking (maybe it's just swelling going down) and they are pulling at the stitching. More than anything, still having these dressings stitched on to my chest is driving me crazy. They're uncomfortable and make binding awkward. I can't shower or get comfortable in bed. In general I feel kind of gross. So I called and talked with one of the nurses from Dr. McLean's office about my worries about the nipple, and she said to just use medical tape to hold the dressing down in place better so it doesn't pull anymore and it should be fine until Wednesday when I am scheduled to go in. It felt better to talk to her and not have her sound super-concerned. I was upset though. It's scary to not be able to actually see what is happening under there, just know that there's a piece that is lifting and it's bleeding a little, which isn't right for work that was done two weeks ago. I don't want to go in on Wednesday and find out I have a dead nipple sewn onto my chest, you know? I am sure what happened is that I moved or banged it or slept on it the wrong way and pulled at the sponge which tore the edge of the graft some. I just really hope it heals. But, in the end, the worst possible scenario I guess is that I lose the nipple and end up getting a tattoo there to cover it up, right?

It is so not like me to flip out about this kind of thing. I almost never get sick/hurt/injured (except recently, apparently) and when I do it doesn't freak me out. I guess this is a lot different though, seeing as it's something I've been working toward for so long and just want it to be okay. There's a lot at stake here. Argh. It helped to talk to a friend who had the same surgery and hear him tell me that his nipple dressings had bothered him so much that he contemplated cutting them off with a nail clipper. Made me feel less crazy about considering the same thing, and at least I have access to a suture removal kit. (That's a joke. I'm not really going to do it.)

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July 20, 2004- 
22 Days After Surgery

This morning I woke up and put on a t-shirt and shorts and left the house for the first time in 10 years with no bra, no binder, no dressings on my chest. I love the way my chest looks under a white t-shirt. I love sleeping in just an A-frame and boxers. Already my new chest feels so natural I can easily put out of my mind what it was like to have to bind for so long. That is both exciting and a little scary for me. It makes me realize how disconnected I have been from that part of my body for so long.

new nipples Having my nipple dressings removed was better than Christmas. In the days leading up to it I was really starting to bug out, worried that my nipples weren't healing well underneath. Fortunately I didn't lose either of them, but there actually are patches on each one that were necrotic (dead) when the dressings were removed. I don't know what caused this, but it's resulted in spots that are basically just scar tissue and not my actual nipple/areola tissue. It looks okay, just a little more ragged than I was hoping. I covered my nipples with Neoprene and gauze for about a week after having the dressings removed. They are almost entirely healed at this point, just small amount of scabbing left. In the picture my nipples look shiny because there is Neosporin on them.

When I had my nipple dressings removed, my surgeon also drained quite a bit of fluid (about 50cc) from the left side of my chest using a really big needle. I thought this was going to hurt a lot but it really wasn't that bad. The relief of not having that fluid sloshing around in my chest far outweighed the discomfort of having it aspirated. After getting my dressings removed and my chest drained, I started binding using a x-small Frog Bra rather than the abdominal binder my surgeon had provided. This was way more comfortable and worked just as well for compression, probably even better because it provided compression further up my chest. The Frog Bra was less bulky, cooler and easier to put on and take off.

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November 16, 2004- 
About 5 months post-op

5 months post-op Here's a picture of how my chest is healing at a little less than 5 months after surgery. The contour has continued to improve and look more natural over time. It looks a little weirder from the side than it does in this picture. I think there is more fatty tissue left above my nipples, and it's a little flat below the nipples. I am probably the only person who notices this though. My scars have healed very lightly, I am lucky and thankful for that. My chest feels more natural now than it did soon after surgery, as well. The tissue in my chest has softened up and moves freely now, whereas before it felt like it was kind of tacked down. I don't really know how to explain that any better. I have regained some sensation but not 100%. I have no feeling in my right nipple, but I can feel pain in my left nipple if I squeeze or press on it. I can feel a little bit of my chest above the nipples, but pretty much nothing in the space between my nipples and incision lines.

So, onto the stuff that seems more important. My life has felt different and more improved since surgery. It has allotted me more freedom than I expected or realized I would experience. It may sound cliche, but I really feel like I didn't even know what I was missing before surgery. Now I'm able to comfortably sleep and swim topless, and get up in the morning and throw on a shirt and jacket without having to struggle with a binder. These aren't things I take for granted, but I am very aware of and thankful for them every day. I am looking forward to being able to go shirtless more next summer without having to worry so much about protecting my scars from sun damage.

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January 28, 2005- 
7 months post-op

7months chest Today marks seven months since surgery. Everything is pretty much healed. I have some adhesions underneath my nipples. You can see what I mean a little better in the picture on the right. I have been working on massaging the areas a couple times a week in order to work things out. It seems to be helping. I also have tiny puckers at the end of my incision lines at each side. They are less noticeable than they were right after surgery, but I think they have evened out as much as they are going to on their own. I don't know if it bothers me enough to look into having a revision to correct them, but I have been thinking about emailing some pictures to my surgeon to see if he could take care of the problem easily. We'll see. 7 months chest

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June 18, 2005- 
One year post-op

Just under a year from my surgery date and things are looking and feeling great. I am very happy with my surgery results and I feel confident going shirtless to swim or hang out at the beach. I am so thankful to be able to do those things, to be able to throw on a t-shirt on a hot day and not worry about binding. I may not have the most perfect chest out there, but it has improved my quality of life immeasurably and there's no way I could think of it as imperfect.

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October 2005- Sixteen months post-op

16 months post-op

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June 15, 2006- 
Two years post-op

It's been two years since surgery. Not a whole lot has changed in the past six months or so. I have regained a lot of sensation across my chest since surgery. I have feeling all over my chest, both light and heavy pressure. I have no erotic sensation in my nipples, but I can feel pain and light pressure.

2 years post-op

I am still very happy with my surgery results. I chose to post this slightly unflattering photo because I think it shows the worst aspects of my chest, and that's important to put out there. Keep in mind that I am kind of scrunching my shoulders together in an unnatural way, but I am doing so to show how the skin on my chest folds and pleats. I think this is a result of my chest being stretched and damaged by binding before surgery. The skin on my chest lost a lot of it's elasticity in those years, and if that's going to repair itself, it's taking a very long time to happen. So for what it's worth, here's a little caution against completely destroying your chest prior to surgery, if you can help it.

[note: this is not the original picture, but a replacement taken during the same month]

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June 2007- Three years post-op

3 years post-op

Over the past winter and spring I have been putting a lot of work in at the gym, eating right, and working hard. I've been running and biking a lot as well as lifting weights. Last month I ran a half-marathon, something I could never have imagined myself doing before. I am in the best shape of my life and loving it. I don't think I would have ever gotten to a place like this if I had not transitioned. Seeing my body masculinize even further is such a reward, and I wouldn't be able to do it if I was still fighting with binders and feeling uncomfortable in locker rooms. I have spent the last four years literally molding my body into what I want it to be, and I am finally starting to really see it. Amazing.

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