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.
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 American Boyz 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 (at the time) 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. She was going to use the double incision method for my surgery, since I was still a large B or small C cup, combined with liposuction. This was to give my chest the proper conture and make it proportionate to the rest of me. She was also going to do a revision on some excess skin tags I had under my arms on each side from the reduction mammoplasty I had in 1998.
She advised me that my nipples would turn black and essentially die, since they were being completely removed, relocated, and reattached but that, when circulation was re-established to them, they might be ok. She also told me I would lose erotic sensation there, but would still have a sensory awareness of pain. The thought of possibly permanently losing my nipples to nipple death probably scared me the most, but I was pretty optimistic regardless of that, since I am basically a good healer.
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 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, I was driven 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.
I had my last visit with Dr. Fischer this 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. Dr. Fischer was pleased to see the rings of pink around the scabbing on my nipples, which was a sign that circulation and healing were taking place. 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.
The time has FINALLY come for me to get my drains removed. It is none too soon in my book. The last few days being back home and still having the drains in has not been easy. The tubing is so long I am getting them wrapped around anything and everything! Fortunately, Dr. Fischer took special care to double stitch the tubes in place so they could not be yanked out.
I had called my physician here in town before I had ever left for surgery and explained the fact that I would have this tubing in and that she may be the one who had to remove them. It's a good thing I did or I would have been scrambling around desperately trying to find a doctor to do it! When I got to her office I found that both she and her nurse were very anxious to see the results of my surgery. Needless to say they were BOTH impressed with Dr. Fischer's work, amazed that such a procedure could be done with such skill.
A couple of FTM friends of mine had told me the tubing would hurt badly coming out so I was nervous but anxious to be rid of them. My doc carefully cut away the stitches holding the tubing in and started to pull them out. They wouldn't budge! She then called Dr. Fischer's office and found out the reason. Since the drains work on reverse suction it was necessary to open the valves on the drains and let the air out, releasing the suction and enabling the tubes to be removed with ease.
When the doc did that, the tubes came right out with no pain involved at all. After those tubes came out I felt better than I had in days. I think at this point I KNEW that I had done the right thing for myself by getting this surgery and I had high hopes I would continue to heal well.
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.