top surgery

[DapperButch]

Another quick question.

Why can't it be done using laser instead of scalpel? Seems like
it would be less damaging to the surrounding tissue?

One more, ok? Do they do it with the patient supine or prone?
It scares me to be turned upside down. They'd better put me
out first!:seeingstars:

I don't know the answer to your first question, sorry.

They do your surgery while you are on your back. Most surgeons sit you straight up once or twice during the surgery (to have a looksee), and hopefully will have you in this position when they determine nipple placement.

You are welcome to ask me as many questions as you would like.

[DapperButch]

cathexis, one other comment.

If you have a preference for areola size, you should talk ask your surgeon what measurement he uses.

[cathexis]

cathexis, one other comment.

If you have a preference for areola size, you should talk ask your surgeon what measurement he uses.

Thank you for quick responses to my questions, I really appreciate it, Dapper.
Have a couple more follow-up questions.
Isn't the usual, dime sized? What other sizes do guys want? The skin stretches over time, yes? Do the surgeons normally leave the color unchanged? Men in my family had darker areolas.
Do most docs do their top surgeries out-patient?
How long do guys normally have pain after a double incision surgery?

[DapperButch]

Thank you for quick responses to my questions, I really appreciate it, Dapper.
Have a couple more follow-up questions.
Isn't the usual, dime sized? What other sizes do guys want? The skin stretches over time, yes? Do the surgeons normally leave the color unchanged? Men in my family had darker areolas.
Do most docs do their top surgeries out-patient?
How long do guys normally have pain after a double incision surgery?

The majority of surgeons still use nickel size. 2.5cm. Garramone uses dime size. I believe that dime size looks more masculine and this is what I have. I have noticed that the surgeons who have less experience with top surgery (are used to doing cis women's breast reductions), tend to go even larger than 2.5cm. Honestly, it was because I know your surgeon is not a trans surgeon per se, that I mentioned this to you. :)

Your areolas will be the same color as they are now. Your surgeon should remove your areola/nipple complex. He should cut down the size of each. He should stich the areola on first and then stitch the nipple into the center. Some surgeons make oval shaped areolas because they can stretch diagnoally over time. Did your surgeon not go over how he does his areola/nipples?

I don't know of any who do inpatient. What does your surgeon do?

Pain varies between people. I used pain meds for only a handful of days (2-3?) and then used extra strength Tylenol like twice. The bulk of the pain for me was the drains. If you have drains, they are tubes pressed roughly against your sides by either a vest or a wrap. It sucks. Will you be getting a vest or a wrap?

[cathexis]

The majority of surgeons still use nickel size. 2.5cm. Garramone uses dime size. I believe that dime size looks more masculine and this is what I have. I have noticed that the surgeons who have less experience with top surgery (are used to doing cis women's breast reductions), tend to go even larger than 2.5cm. Honestly, it was because I know your surgeon is not a trans surgeon per se, that I mentioned this to you. :)

Your areolas will be the same color as they are now. Your surgeon should remove your areola/nipple complex. He should cut down the size of each. He should stich the areola on first and then stitch the nipple into the center. Some surgeons make oval shaped areolas because they can stretch diagnoally over time. Did your surgeon not go over how he does his areola/nipples?

I don't know of any who do inpatient. What does your surgeon do?

Pain varies between people. I used pain meds for only a handful of days (2-3?) and then used extra strength Tylenol like twice. The bulk of the pain for me was the drains. If you have drains, they are tubes pressed roughly against your sides by either a vest or a wrap. It sucks. Will you be getting a vest or a wrap?

Will start off with a question my surgeon is not likely to know.
What size should I ask them to make the areola/nipple if intending to get good sized nipple piercings (12g) once healed. Do you recommend that I share those plans with him. Will the prospect of me getting re pierced (had piercings before that had grown out) effect his remolding of the areola or nipple. One of the nipples is split and the other has a
very shallow old piercing. Do I need to tell him about this, or
can it wait for him to discover in the OR?

No, he tells me that it will be outpatient surgery. My Partner (also a RN) is really leery of that due to my health problems. She wants me to stay overnight, if possible.

We both appreciate having someone around that I feel comfortable asking the questions that I am unable to ask him.
Thank you.

[DapperButch]

Will start off with a question my surgeon is not likely to know.
What size should I ask them to make the areola/nipple if intending to get good sized nipple piercings (12g) once healed. Do you recommend that I share those plans with him. Will the prospect of me getting re pierced (had piercings before that had grown out) effect his remolding of the areola or nipple. One of the nipples is split and the other has a
very shallow old piercing. Do I need to tell him about this, or
can it wait for him to discover in the OR?

I think it is always best to talk with our surgeons openly. You need to be transparent. Definitely tell him your plans. He probably does breast augmentations and reductions all the time. He must be used to having discussions about piercings. I would think that he would be a good source for knowing how tall you would need the nipples to be to be able to handle thick piercings. I don't think it is inappropiate for you to draw what size areola you are looking for. You have to remove all body piercings prior to surgery, so remove the shallow one.

No, he tells me that it will be outpatient surgery. My Partner (also a RN) is really leery of that due to my health problems. She wants me to stay overnight, if possible.

I don't know what to say about this since I am not a medical professional, but I really haven't ever heard of a person getting top surgery staying in the hospital overnight.

We both appreciate having someone around that I feel comfortable asking the questions that I am unable to ask him.
Thank you.

10 characters.

[SleepyButch]

Finally had my top surgery on Wednesday.. I'm sore as hell but nothing I can't live with and a little pain medicine to help a long the way lol. I'm in a compression garment so can't really see my chest but it is weird to look down and see my stomach lol.

life is good..

[DapperButch]

Finally had my top surgery on Wednesday.. I'm sore as hell but nothing I can't live with and a little pain medicine to help a long the way lol. I'm in a compression garment so can't really see my chest but it is weird to look down and see my stomach lol.

life is good..

Congrats! And yes, you will realize you have "a stomach" (my way of saying belly fat) immediately upon getting top surgery!

Do you have someone helping you out? Drains or no drains?

[SleepyButch]

Congrats! And yes, you will realize you have "a stomach" (my way of saying belly fat) immediately upon getting top surgery!

Do you have someone helping you out? Drains or no drains?

Yes, I have a bunch of people taking care of me.. almost too many lol. No drains used.

[Femminator]

My Partner is going in July for theirs. It's been a long trip and I am glad that we are finally doing this. Just to see them finally be their self will be awesome.

I would like to ask what do you need most from a partner after our top surgery? I guess I would love to know how to make this easier for my partner.

[Liam]

Thanks, Dapper!

Staying overnight in the hospital is Dr. Kim's standard protocol. Given that I had no one caring for me, or helping me when I returned home, yes, my home health care nurse is being paid for, by my insurance, and he is a real gem. He will be visiting me once a week.

I thought I had made a post about staying overnight after my procedure. There it is!

[SleepyButch]

My Partner is going in July for theirs. It's been a long trip and I am glad that we are finally doing this. Just to see them finally be their self will be awesome.

I would like to ask what do you need most from a partner after our top surgery? I guess I would love to know how to make this easier for my partner.

I'm sure others will chime in here and give their opinion but since I just went through it, I'll tell you from my own perspective. This compression garment has made me pretty irritable lol so be patient with them if that happens. I didn't bind before this surgery so that's probably made it worse for me but try to keep them from wanting to rip the damn thing off. lol

Make sure they stay hydrated and also eat something with their pain meds, even if it's just crackers. Taking that stuff on an empty stomach can cause nausea and no one wants to feel like that after surgery. Make a schedule for their meds because it's hard to keep track of what to take when if you have several.

It's really hard to use your arms so they won't be able to reach for things so just be mindful of that. Lastly, just be loving and supportive, probably what you do on a daily basis anyway.

Hope that helps some.

[Martina]

https://www.nytimes.com/interactive/2018/06/01/sunday-review/all-in-one-piece-gender-top-surgery.html?action=click&module=Opinion&pgtype=Homepage

[Dean Thoreau]

So next week I see the plastic surgeon... discuss the construction of male chest.
( I had bilateral mastectomy due to cancer, so I get top surgery done in 2 stages.)
I am pushing pretty hard for some liposuction in the gut area as well as skin removal... basically get rid of the pizza gut.
since all that extra fat can mess with my T and therefore my gender dyphoria will worsen etc. body image issues, Yada yada
it seems to be , being agreed upon I got the referrals and Recommendations for it from my gp, my endocrinologist, and the transition shrink...
So we shall see

[SleepyButch]

I had my two week follow up with my surgeon yesterday. Everything is looking great and no more wrapping my chest with ace bandages. I only have to wear a compression shirt, which I can certainly do. I feel so much better. Just sleeping lying flat is a huge relief lol. I love seeing my flat chest. It's something I've wished for forever.

[cathexis]

Been awhile since I've been able to get online with the house becoming condemned and bouncing around motel to Social Service apt and back to the Red Roof. My doctor left state, and haven't had T for 2 weeks past due. Have a gender appt. on 6/24 having to start over. TG we are moving to a larger town as there's no gender doc here.

Need to get a new PMD too. Loved the doc who moved away; though she ordered a renal US and a 24 hour urine test for glomerular filtration and creatinine clearance. She found me to be in Stage 3 renal failure. My brother died from renal failure at 60. I don't care. Sure his situation was far different.

The supposed easy cardiac clearance...ha...ha...ha
He is sending me for a stress test. Totally blindsided!

After all these hoops, who knows when I'll be able to get top surgery. Truly thought I'd sail through the clearance!

No T, no top surgery, the gender dysphoria is getting worse.

[JDeere]

Been awhile since I've been able to get online with the house becoming condemned and bouncing around motel to Social Service apt and back to the Red Roof. My doctor left state, and haven't had T for 2 weeks past due. Have a gender appt. on 6/24 having to start over. TG we are moving to a larger town as there's no gender doc here.

Need to get a new PMD too. Loved the doc who moved away; though she ordered a renal US and a 24 hour urine test for glomerular filtration and creatinine clearance. She found me to be in Stage 3 renal failure. My brother died from renal failure at 60. I don't care. Sure his situation was far different.

The supposed easy cardiac clearance...ha...ha...ha
He is sending me for a stress test. Totally blindsided!

After all these hoops, who knows when I'll be able to get top surgery. Truly thought I'd sail through the clearance!

No T, no top surgery, the gender dysphoria is getting worse.

Holy crap! I am sorry you are going through this, however keep your head up, you never know things may change!

[cathexis]

Holy crap! I am sorry you are going through this, however keep your head up, you never know things may change!

Thanks for the encouraging words. Found out the local Planned Parenthood
has a gender specialist who prescribes T...go figure. Will call today for an appt.

[DapperButch]

Thanks for the encouraging words. Found out the local Planned Parenthood
has a gender specialist who prescribes T...go figure. Will call today for an appt.

Yes, more Planned Parenthoods are doing that now. I think it might be something that is becoming standard care in all of them. I'm glad you have one near you.

[JDeere]

Thanks for the encouraging words. Found out the local Planned Parenthood
has a gender specialist who prescribes T...go figure. Will call today for an appt.

No problem! Awesome news, im glad to see PP has more services then i knew of.

[theoddz]

What exciting news about the Planned Parenthoods providing gender specialists or other professionals who are willing to provide HRT for transfolk!!! :cheer:

Of course, the BAD news is......The frippin' RIGHT WING nutjobs and their current villiage idiot, Trump, are trying to get rid of/defund Planned Parenthoods. Ugh!!! :seeingstars:

~Theo~ :bouquet:

[cathexis]

:firetruck:What exciting news about the Planned Parenthoods providing gender specialists or other professionals who are willing to provide HRT for transfolk!!! :cheer:

Of course, the BAD news is......The frippin' RIGHT WING nutjobs and their current villiage idiot, Trump, are trying to get rid of/defund Planned Parenthoods. Ugh!!! :seeingstars:

~Theo~ :bouquet:

Wouldn't have known about the their transgender HRT program if the doc the that moved to PA hadn't told me that she was doing educational inservices for regional PP Assn physicians on HRT and other aspects of transgender care. She may have left the area, but also left a bit of her transgender care knowledge behind. This area needs much remediation in various alternative life situations.


O

[Vincent]

Been awhile since I've been able to get online with the house becoming condemned and bouncing around motel to Social Service apt and back to the Red Roof. My doctor left state, and haven't had T for 2 weeks past due. Have a gender appt. on 6/24 having to start over. TG we are moving to a larger town as there's no gender doc here.

Need to get a new PMD too. Loved the doc who moved away; though she ordered a renal US and a 24 hour urine test for glomerular filtration and creatinine clearance. She found me to be in Stage 3 renal failure. My brother died from renal failure at 60. I don't care. Sure his situation was far different.

The supposed easy cardiac clearance...ha...ha...ha
He is sending me for a stress test. Totally blindsided!

After all these hoops, who knows when I'll be able to get top surgery. Truly thought I'd sail through the clearance!

No T, no top surgery, the gender dysphoria is getting worse.

Oh mate,im really sorry to hear that.
I just moved to a new area to and was freaked out,about the medical shit,but the local GP has been cool,well so far he hasnt done a script yet,so until I get one i'm a bit nervous,In OZ it has to be cleared by the govt every script.
once again I hope this gets sorted for you.
cheers

[RockOn]

cathesix, thinking of you ... sending best wishes and hugs ...

sleepybutch, huge congrats! so happy for you ... how freeing all of it sounds!

I am not big in the chest parts area but still want top surgery one day ... I have not taken the brief time out to have the surgery. Reading sleepybutch's post is reminding me of what a wonderful gift to myself it would be. And less pain -->> just yesterday I bruised the leftie on a 5" screw I deliberately left sticking out 3.5" of a 4x4 until I could get some other boards lined up. When wood-working, I wish for 8 hands. I finally finished something about an hour after dark last night I have been working on/off for awhile.

[JDeere]

Where are the hefty ftms? I have some questions for y'all about top surgery and weight, etc!

[Vincent]

Where are the hefty ftms? I have some questions for y'all about top surgery and weight, etc!

I can try n help :)

[JDeere]

I can try n help :)

Are all top surgery docs worried about weight? Or are there ones who will work with you on weight stuff?

[Liam]

Are all top surgery docs worried about weight? Or are there ones who will work with you on weight stuff?

I believe all doctors are concerned about weight, particularly surgeons. There are risks and issues with weight when it comes to any kind of surgery. Talk to your doctor.

[JDeere]

I believe all doctors are concerned about weight, particularly surgeons. There are risks and issues with weight when it comes to any kind of surgery. Talk to your doctor.

Im talking about the ones that are obsessed with a persons weight and bmi. To the point they are assholes.

[Vincent]

Im talking about the ones that are obsessed with a persons weight and bmi. To the point they are assholes.

I dont know about over there,but in terms of outcomes,it is best to lose weight,and build as much muscle in your chest as you can,then they can reconstruct around the muscle.
Also outcomes depend on if your on T or not.

regarding doctors I talked more to other transmen,there is a doctor here who hates fat people,I didnt go to her.
my guy,did surgery in 2 stages,masectomy first and then reconstruction 6 mths later.

being both fat and lean,my chest looks much better when I'm lean,and have built up my pecks,its harder being nearly 60 now,but these days I like being healthy.

I dont know if I really answered your question,no matter the surgery,doctors always go on about weight.

cheers

[JDeere]

I dont know about over there,but in terms of outcomes,it is best to lose weight,and build as much muscle in your chest as you can,then they can reconstruct around the muscle.
Also outcomes depend on if your on T or not.

regarding doctors I talked more to other transmen,there is a doctor here who hates fat people,I didnt go to her.
my guy,did surgery in 2 stages,masectomy first and then reconstruction 6 mths later.

being both fat and lean,my chest looks much better when I'm lean,and have built up my pecks,its harder being nearly 60 now,but these days I like being healthy.

I dont know if I really answered your question,no matter the surgery,doctors always go on about weight.

cheers

Yes you helped, thanks. I came across a doctor that is a fat hater/ shamer so I left. Now I'm looking for one who isn't rude and is actually willing to help and understands.

[Bard]

Going through the hoops to schedule my top surgery now should be scheduling it in the next couple of months. Little nervous as with any surgery but the result is worth it. Kind of getting excited to finally do this

[theoddz]

I thought I'd stick my nose in here this morning to give a friendly shout-out to my bros here who are looking into and/or wanting to get chest/top surgery.

There is a good doc out in California (Newport Beach, just south of Los Angeles) who does a GREAT job and does NOT fat shame or refuse to do surgery on overweight trans guys. His name is P. James Voloshin (aka "Dr. V") and his contact info is below. He did my surgery, back in 2009, and several other guys from here have also had their top surgeries with him (The Oopster, Linus, to name a couple). I give him a 5 out of 5 stars for both his skills and his great bedside manner. He understands and respects us fellows and he is both kind and compassionate. His fees are also reasonable, when you compare him with many others. Back in 2009, I remember paying just under $7K out of my own pocket, but that was before insurance started to cover it. He did a great job on me and you can't hardly see the remnants of any scarring on my chest. Everything is symmetrical and looks like a completely normal male chest (complete with lots of hair!!LOL). I'm completely confident about going shirtless in public, when it's appropriate to do so, ie, swimming. You'll have to call him for specifics about what he charges now, but he has his own surgical suite (located in his office) and his own team of surgical nurses and anesthesiology specialists. It's kind of a "one-stop shop", which makes it both economical and convenient. :winky:

Here's Dr. V's info:

Dr. P. James Voloshin
360 San Miguel, Suite 406
Newport Beach, California 92660
(949) 759-0995


~Theo~ :bouquet:

[JDeere]

I thought I'd stick my nose in here this morning to give a friendly shout-out to my bros here who are looking into and/or wanting to get chest/top surgery.

There is a good doc out in California (Newport Beach, just south of Los Angeles) who does a GREAT job and does NOT fat shame or refuse to do surgery on overweight trans guys. His name is P. James Voloshin (aka "Dr. V") and his contact info is below. He did my surgery, back in 2009, and several other guys from here have also had their top surgeries with him (The Oopster, Linus, to name a couple). I give him a 5 out of 5 stars for both his skills and his great bedside manner. He understands and respects us fellows and he is both kind and compassionate. His fees are also reasonable, when you compare him with many others. Back in 2009, I remember paying just under $7K out of my own pocket, but that was before insurance started to cover it. He did a great job on me and you can't hardly see the remnants of any scarring on my chest. Everything is symmetrical and looks like a completely normal male chest (complete with lots of hair!!LOL). I'm completely confident about going shirtless in public, when it's appropriate to do so, ie, swimming. You'll have to call him for specifics about what he charges now, but he has his own surgical suite (located in his office) and his own team of surgical nurses and anesthesiology specialists. It's kind of a "one-stop shop", which makes it both economical and convenient. :winky:

Here's Dr. V's info:

Dr. P. James Voloshin
360 San Miguel, Suite 406
Newport Beach, California 92660
(949) 759-0995


~Theo~ :bouquet:

Theo,

Much thanks for this info!