I had a bilateral subcutaneous mastectomy, known to us transmen as "top surgery", on August 8, 2000. Below is a journal of my thoughts and experiences, as well as some tips for those transmen who have not gone through this yet to hopefully help make things alittle easier for them.
I finally made the decision to have top surgery after doing a lot of research on various doctors and surgical procedures. I had recently attended the 2000 True Spirit Conference in Alexandria, put on by the (now defunct) American Boyz Association and was fortunate enough to have a private consultation with one of the doctors I had researched, Dr. Michael Brownstein. Dr. Brownstein had given a very informative seminar on top surgery at the conference and was giving consultations for free afterwards.
While the consultation with Dr. Brownstein proved to be very informative, money was a concern of mine and the added expense of having to travel to San Francisco, where his practice is, was just not feasible for me. However, I walked away with a great deal of knowledge about the surgery I was going to have to undergo, which was the "double incision" method, as opposed to the "keyhole method", due to my size.
I remember thinking "Surely there MUST be a reputable surgeon closer to home." I was to find out later in the day about Dr. Beverly Fischer. I admit to feeling alittle let down after my consultation with Dr. Brownstein because I felt I would NEVER get this done. It was just TOO far to go and I didn't have that kind of money. I was excited to hear of Dr. Fischer and eager to find out more.
While I was at the conference I started asking around and found a number of guys had went to Dr. Fischer and were more than willing to talk to me about their experiences. One even volunteered for me to be the first one to see his chest up close. I do not recall his name but my thanks goes out to him. I know it took alot for him to do that for me!
Every guy I talked to about Dr. Fischer had nothing but good things to say about her and the quality of her work. I had found out she was originally going to attend the conference but had other obligations. I was given her website address and checking that out was going to be my first priority upon returning home!
When I returned home I looked up Dr. Fischer's website. While there was nothing on there about FTM top surgery, I WAS able to get her e-mail address and phone number. I sent her office an e-mail and waited anxiously for a reply. I was rewarded with a very prompt response from her nurse, who invited me to call and assured me that Dr. Fischer could help me. After that phone call I now had a scheduled consultation on August 7, with the surgery to take place the next day. This was to save me the added expense of making a SEPARATE trip to Maryland just for the consultation.
I was sent an information packet shortly thereafter, which included forms I needed to fill out and bring with me to the consultation and a list of area hotels and their phone numbers. This was because Dr. Fischer likes her patients to stay in the area for 24-48 hours after surgery. She is concerned about her patients and likes for them to be nearby if they need to come back in for anything.
It had been the longest six months of my life since I had scheduled the surgery. In reality, I had not just waited six months, but the better part of my LIFE to have this done. This was the day I was to leave for Maryland and I could not seem to get there fast enough!
My girlfriend and I arrived at the Red Roof Inn in Timonium, Maryland after a 7 hour drive from North Carolina. We were to find out that we were just MINUTES from Dr. Fischer's office. We spent the rest of the weekend up to the consultation doing the "tourist thing" in Baltimore and the surrounding area. I was getting nervous and even more anxious, but the activity helped take my mind off of it. The Red Roof Inn was nice enough and also happened to be one of the cheapest hotels on the list I was give from Dr. Fischer's office.
The day of the consultation had finally arrived and it was to be conducted initially by Dr. Fischer's nurse, Jayne, and then I was to meet Dr. Fischer herself. The nurse explained what was going to happen and I had to sign a form more or less authorizing that I was ok with the fact that they were not going to send the breast tissue to pathology and that it was going to be disposed of. I had not been given the prescription for antibiotics in the information packet that I received and didn't know I was supposed to be taking them, so the nurse gave me some antibiotics and told me to start taking them that day.
She then took some pre-op digital pics of me and also showed me some post-op pics of guys who had gone before me, so I could get an idea of what to expect. Dr. Fischer came in after that and I found her to be extremely compassionate and informative. It was probably the most comfortable consultation I had ever had with a surgeon! She helped to ease my fears and answered all my questions.
After 14 years of waiting (I was an early developer!)the day had FINALLY arrived for my top surgery. At 8:30 a.m. I left my girlfriend waiting anxiously in the waiting room as I was taken into the clinic. The anesthesiologist spoke with me and I was prepped for surgery. Due to the extreme coldness in the operating room, I was allowed to wear my socks and I was also allowed to keep my underwear on. I was told that I would NOT be shaved before surgery (like I had thought), but that I would be coated with a betadine solution to keep the surgery site sterile. I was relieved I wouldn't have to wait for all that chest hair to grow back!
The last things I remember before going under was the anesthesiologist running my IV and Dr. Fischer talking to me. She was very reassuring and I remember feeling comfortable with what she was about to do. Four hours or so later I found myself in recovery, feeling very groggy, with the nurse and my girlfriend looking down at me.
I had long surgical tubing with bulbs on the end coming out of me, one on each side of my chest. This was for the excess fluids to drain out. I was bandaged up and then placed in a compression vest, which I was to wear night and day for the next couple of weeks. The surgical drains wear also to remain in until I drained no more than 25 cc's of fluid in a 24 hour period. For most guys this is 3-5 days. For me it ended up being TEN!!
When I was coherent enough and able to move, my girlfriend drove me back to the hotel, where I was in and out of a "sleep state" for the rest of the day. I was given prescriptions for Demerol, for pain, and Ambien, to help me sleep, which we had gotten filled the day before. The Demerol was a godsend, as I was having some pain due to the fact that Dr. Fischer had also used liposuction in the surgery. This was so that I would have a good male contour and proportion. I was to sleep on my back, in a semi-upright position, until the drains were out.
We ended up staying in the hotel until Monday, August 14th. I had my last visit with Dr. Fischer that morning before our return home. She wanted to see how I was doing and to remove the gauze and the padding around my nipples. I am happy to report that my nipples are healing nicely and, while there was still alot of swelling and bruising, it looked like I would have a great chest when I was healed. Since I was STILL draining too much fluid, she was not able to remove the drains. I was to have this done back home by my own doctor. This was done on August 18th.
As I type all of this it is now August 21st. I can now sleep in my normal position and I have played it by ear as to how much I still wear the vest. Right now I am only wearing it at night, as I am a restless sleeper. I am only as active as I feel comfortable being, and I am still not to lift anything over 10 pounds. I am still probably a month away from being able to resume all of my previous activities, except those of a sexual nature, which can be resumed in most cases 10 days after the surgery.
I look in the mirror and I can't believe it! I am SO happy! Nothing compares to the feeling of "completeness" that I now have. No more chest binders. No more oversized shirts. No more self-consciousness about my chest. My prognosis is that there is a good chance my scars will heal completely and I could go shirtless. That day is at least a year down the road because it takes time for them to heal but I am content to wait. The feeling of freedom I have from just putting on a shirt and going about life is liberating. It makes the road to complete recovery alot easier to traverse!
I owe it to my girlfriend, who stood by me through all of this and took care of me when I was down, to thank her for her patience. I was not an easy "patient" as I am VERY independent and stubborn but, guys, you do NOT want to go through this alone, so make sure you have a SOFFA to help you through the rough parts.
I will add more tips as I think of them so please be patient and visit again soon! Also, please note that I DO have sort of a digital "pictoral history" of my own surgery, from pre-op, to a few right after surgery, on up through the present. I will not post these on this site but they CAN be made available to you, at my own discretion, if you will e-mail me. These pics are purely for educational purposes to help transmen who are new to transition.