top surgery

[DapperButch]

Originally Posted by Nadeest

Will do, DapperButch. I went there to consult with him about an orchidectomy (um, this is where they remove the testicles, but not the testicular sac, which is useful for later SRS), which he does do, as well as breast augmentation and lipo. The nice thing was that he didn't think that I needed FFS (Facial Feminization Surgery) or a trachea shave.

That is pretty great that you don't need any FFS or trachea shave! Awesome. I would bet that kind of surgery would be a painful recovery.

I know less about MTF surgeries than I do FTM. Since the testicles are being removed, does this mean one would no longer have to take t-blockers?

[DapperButch]

Hey, everyone! On 10/10/13, I had top surgery with Dr. Garramone in Florida. I had the double incision method. http://drgarramone.com/

My chest looks fantastic, and I couldn't be happier. It was a fantastic experience, and the man is a genuis.

As you all can see in my profile, I don't define as FTM, but as transgender butch (male leaning). I am not on testosterone. I thought it important to share that I got this surgery because I think that butches are getting these surgeries/thinking about getting these surgeries, but just aren't talking about it (I have seen them talk about it in the past, on other b/f forums). I am not sure why the change, I am wondering if butches getting top surgery is no longer supported by the community so they are afraid to talk about it? Don't know.

Anyway, it is the best thing I ever did. I agonized over the decision for 15 years. The struggle was not about whether or not I wanted a "male" chest, but how that would fit into my life as a person who professionally (and in some areas, personally), lives as female. I would be ok just binding for a few years and then it would rear its ugly head again. I would shove it back down and then carry on. I decided I was sick of dealing with it and the reality is that my presentation most likely wouldn't change all that much because my many years of binding had already resulted in looking pretty damn flat, anyway.

What I was hoping for and was pleased to see, is that you can still have a defined chest without testosterone. Although I know that some of it is swelling, Dr. Garramone was quick to point out that my definition is due to my own body composition. Again, I am extremely pleased.

I have a lot of information and suggestions to share with anyone considering getting this done. Being that we are mostly a b-f site, and it is mostly transmen that get this surgery, the discussion on this thread may not significantly increase, but I want to put out there that I would be happy to answer any questions on looking for a surgeon, the process, and recovery with all genders even though it is in the trans zone.

I considered posting this in the butch zone as I fear butches may not feel comfortable posting in the trans zone, but I think it is important all top surgery information/resources remain in one thread on this site (plus, of course I wanted to share with my trans* brothers and sisters here!). I think that Koop/The Oopster would welcome any gender who is considering top surgery, to this thread.

[BullDog]

Dapper, thank you so much for posting this. Those familiar with me on the site know I am a very proud butch woman and completely a She with no plans to transition. However, I am also a stone butch and not really in sync with my breasts. I would love to have top surgery and have thought about it for a long time. I have never seriously looked into it because I don't have the money for the surgery. I don't know if I will ever be able to afford it, or if my age will be an issue if I ever do have the money. I am 51 now. I also have wondered what issues it would raise for me, both medically and socially, if I did decide to do it. I don't know what issues would be different for someone like me who is not male or trans-identified.

We did have a discussion years ago on the Dash site with many butches who were not trans-identified who did discuss this issue. So that is why I decided to post. Thank you again Dapper.

[DapperButch]

Originally Posted by BullDog

Dapper, thank you so much for posting this. Those familiar with me on the site know I am a very proud butch woman and completely a She with no plans to transition. However, I am also a stone butch and not really in sync with my breasts. I would love to have top surgery and have thought about it for a long time. I have never seriously looked into it because I don't have the money for the surgery. I don't know if I will ever be able to afford it, or if my age will be an issue if I ever do have the money. I am 51 now. I also have wondered what issues it would raise for me, both medically and socially, if I did decide to do it. I don't know what issues would be different for someone like me who is not male or trans-identified.

We did have a discussion years ago on the Dash site with many butches who were not trans-identified who did discuss this issue. So that is why I decided to post. Thank you again Dapper.

Hey, Bulldog. Glad you posted. Maybe a thread in the Butch Zone for Butches (of all genders - women and third gendered, other?) to discuss top surgery is warranted. I didn't want to muddle the thread here with that discussion as I wanted to keep the focus on information/resources, as it was designed.

I would love to read/participate in a discussion over there. In respect of the butch zone, even though I identify as butch, I think it would be great if a non trans-identifying butch started that thread. What do you think?

Yes, the dash site is what I was referring to. I remember reading about it in the Transgender Butch section, but I hear you saying it was discussed elsewhere.

---------------

To respond to your comment about age, I can tell you that I have seen youtube videos of older people (admittedly, they were all on testosterone) who had top surgery. With a double incision the skin is cut and pulled tightly, so I don't really see age making a difference (if you are speaking to the issue of how our breasts/chests sag as we age).

[Kelt]

Originally Posted by DapperButch

Hey, everyone! On 10/10/13, I had top surgery with Dr. Garramone in Florida. I had the double incision method. http://drgarramone.com/

My chest looks fantastic, and I couldn't be happier. It was a fantastic experience, and the man is a genuis.

As you all can see in my profile, I don't define as FTM, but as transgender butch (male leaning). I am not on testosterone. I thought it important to share that I got this surgery because I think that butches are getting these surgeries/thinking about getting these surgeries, but just aren't talking about it (I have seen them talk about it in the past, on other b/f forums). I am not sure why the change, I am wondering if butches getting top surgery is no longer supported by the community so they are afraid to talk about it? Don't know.

I think it is great that you posted this. I am in a similar boat in that I am not on T and for a number of reasons it is not practical for me. I have been basically ignorant of this possibility. When I knew T was unlikely for me I shelved the whole idea because I had the impression it was a prerequisite. I don't know about the community support with butches. Maybe it could be as simple as being like me and just not knowing it is available as a stand alone procedure. One can hope.

This is really encouraging and I am starting into researching options now that I know there are some! I am fairly small chested so a reduction would not be of any particular help to me and would not give me the result I would want (male appearing chest) anyway. I have done some other things along the way that would fall into the category of transition steps and have been very happy with them. This would be a terrific step to add.

It would be a couple of years down the road due to unrelated family issues and I have to consider my age, 52, but I think this looks like a really great option. Since there will be some wait for me it will give me time to really get my research down. I like Garramones work a lot, his results look great. I am also looking into Brownsteins practice. It has recently changed hands and is now being run by Dr Crane. I will be able to see how he develops over some time but his credentials are solid. The fact that it would be local for me would mean quite a savings in travel as well as being able to recover at home.

Thanks to Oopster and the other guys for this thread. You don't know it, but I have been reading back through all of the trans threads and been getting really helpful information from all of you. Thanks.

[DapperButch]

Originally Posted by Kelt

I think it is great that you posted this. I am in a similar boat in that I am not on T and for a number of reasons it is not practical for me. I have been basically ignorant of this possibility. When I knew T was unlikely for me I shelved the whole idea because I had the impression it was a prerequisite. I don't know about the community support with butches. Maybe it could be as simple as being like me and just not knowing it is available as a stand alone procedure. One can hope.

This is really encouraging and I am starting into researching options now that I know there are some! I am fairly small chested so a reduction would not be of any particular help to me and would not give me the result I would want (male appearing chest) anyway. I have done some other things along the way that would fall into the category of transition steps and have been very happy with them. This would be a terrific step to add.

It would be a couple of years down the road due to unrelated family issues and I have to consider my age, 52, but I think this looks like a really great option. Since there will be some wait for me it will give me time to really get my research down. I like Garramones work a lot, his results look great. I am also looking into Brownsteins practice. It has recently changed hands and is now being run by Dr Crane. I will be able to see how he develops over some time but his credentials are solid. The fact that it would be local for me would mean quite a savings in travel as well as being able to recover at home.

Thanks to Oopster and the other guys for this thread. You don't know it, but I have been reading back through all of the trans threads and been getting really helpful information from all of you. Thanks.

Kelt! Good to see you on the thread, my friend!

Yes, I am interested to watch what happens with Crane, as well. He did train under Brownstein, who of course is the father of top surgery (well, I guess one could argue that with Reardon).

What I have noticed about Garramone's work is that it is consistent. Right on the money every time. I think that Brownstein's has been pretty consistent as well, although I have noticed that his chests sometimes have more of a scoop look to them under the pecs than I like. I think that is where the surgeons go wrong the most. I suppose that would be them not following the pectoral muscle well. Not that Garramone's incisions aren't different in amount of curve based on pec, but I have seen some surgeons (not Brownstein), consistently, or dramatically have too much of a scoop. Throws the whole thing off and it conjures up visions of female breasts, even though the chest is completely flat.

Last night, now having my own chest done, I took a bit of a step back and went through probably about 200+ photos of all different surgeons. I was surprised to see how good (and consistent), Fischer's double incision surgeries were. She is known for her keyhole/peri procedures and that is the bulk of her work, but her double incisions were quite good. Don't get me wrong, I am glad that I went to Garramone, but it was interesting to see that my second pick was in my backyard. I know that I mentioned going to her for consult, but that was earlier, when my focus (and query) to her was how small I could get if I chose a breast reduction instead. I was researching the idea of a hybrid/modified type surgery at the time. I had not seen many double incision pictures of hers.

I think that if I had to choose between a surgeon who had AMAZING results some of the time and "ok" results some of the time, versus a surgeon who had consistently good results, I would go with the consistent surgeon. You are betting with your chest, and there is only one shot.

I see Garramone, Brownstein, and Fischer as the most consistent (based on what I have seen. But, I admit I have paid more attention to their surgeries, than others, due to them jumping out at me as quality work from the "get go"). This is now the ONLY surgery Garramone does (Fischer does others, I am not sure what Brownstein did), so it makes sense he would have a good rhythm going. The sign on my bed post said, "Garramone #4". I was his 4th surgery of the day. He does 5 per day, 10 per week (sometimes he adds a third surgery day and does more). The whole thing was a great experience. Don't worry, I will save you from yet ANOTHER ramble as to how great the man is. I'm sure everyone on the thread will be THRILLED when I go back to work next week and stop being a posting fool!

Last thing, and advice to anyone who is looking. Get as many consults as you can. Especially if they are free. Garramone is free (he does phone consults, you email him pictures of your chest), while Fischer was not ($125). No downside to consulting with more than one.

In a nod to Oopster (and Theo), I haven't seen any of Dr. Voloshin's work and they are both pleased with their surgeries. Additionally, the other surgeons mentioned in this thread (DuPere, Raphael), I have seen good results with, as well. I think we all just have our preferences for how we like our chests to look and to be honest I find it more rare than common to read guys not being pleased with their surgeries.

[DapperButch]

Ok, so it has been 9 weeks since my surgery.

Things continue to go well. I changed from Scar Away strips to using the Scar Away gel. The strips were cumbersome and with some research (with Kelt's assistance), it was determined that the strips and gel had the same outcomes.

I have read good stuff about Bio Oil, so I use some of that, too. Massage is very good for scars.

So, my routine is to apply Scar Away in the morning after my shower. When I get home from work, I rub in the Bio Oil. Before bed, I apply Scar Away again. I like to always have the incision line "moist", as that is part of what is supposed to heal the scars.

I am pretty certain that the scars are less red. However, I have not been consistent with taking weekly pics with the same lighting, so it is hard to say from pictures. Subjectively, I believe they have. They probably did not show any significant change until 6 weeks of use. You are supposed to only use this stuff for 3 months, but I am guessing I will be using it for a year. Based on this brief period of use, I would say that it will cost me about $35-40 per month for scar treatments, if I continue with the same level of diligence. I believe that this investment will be worth it.

I can also say that my scars are pretty much completely flat. I would say that 7/8 of the incisions/scars are flat. That is pretty significant, and would be due to the silicone gel, as well. I believe my using the gel as soon as possible after surgery kept the scars from becoming as raised as they would have become without treatment (not to say that they weren't raised when I started the treatment, however).

I have been pleased so far that my scars have not stretched. I still do not lift my arms up completely above my head. I feel a pulling if I do this. I hope that I am not just delaying stretching of scars, but rather assisting them in healing to the point where they will not stretch once I use my arms more. I am also not strength training for the same reason (even though I want nothing more than to build up my pecs!).

The sides where the drains were has settled down a great deal. However, there is still a small area of skin that is shaped like a little teepee on either side. This is not a dog ear. With tubes coming straight out from your sides, only to be flattened with a very tight ace bandage for 6 days, results in pulling/lifting of that skin. I am hopeful that it will eventually become completely flat. My motivation for using the Bio Oil is mainly to massage this area.

The nipples have healed nicely with no difficulties. There is no sexual feeling to them of course, since they are free grafts (this was expected).

I did have one "spit suture" along the incision line. This is where the body pushes out one of the stitches. You just have to wait for it to fill in from the inside (skin growing). It has been a month for me and is finally filling in. I am very glad that I only had one, of these. Even though there are hundreds of stitches, I was concerned about how slow it was to "fill in", plus the hole itself was getting a bit larger. Additionally, the incision line that spit suture was on, was consequently wider than the rest of the incision line. More "spitting sutures", would have meant more widening.

I think that is all. I hope this information is useful to future "recoverers"!

[Red Dirt Girl]

Hi all. I’m not sure which thread to post this in but since the initiating event is top surgery, I landed here. Please let me know if I should go elsewhere.

My partner is trans and is having surgery in April. I’ve been trying to come up with effective language to share this news with my family. Terms like “top surgery” and "T" and “trans” are not in my mother’s vocabulary so I don’t think “Hey Mom, partner’s having top surgery” is going to work. This conversation will also encompass a “Hey Mom, partner’s trans” component. I am not apologetic, but I am trying to be sensitive. I’m anticipating this conversation to be at the very least moderately uncomfortable and more likely quite uncomfortable and painful. (This doesn't account for coming out to neighbors, family friends, extended family, etc., which will almost definitely be much more that moderately uncomfortable.). My sister is very likely to be supportive or lovingly indifferent. One friend suggests telling sis and having sis tell mom!

Regarding surgery, I feel like the words “double mastectomy” are so loaded and cancer-implying that I’m hesitant to use them. “Boobectomy”, partner’s occasional description of upcoming procedure also seems not quite right. My mom does has some awareness of the non-traditional nature of our relationship (I refer to my partner as my lesbian husband) and my understanding of gender/gender expression as a non-linear experience (not in such enlightened, currently PC, self-aware terms, but in concept. ) I made her read Well of Loneliness and she kind of seemed to “get it” – whatever that means. Regardless, I’m still floating around in my head with all this.

So, carefully-crafted sentences aside, how do I tell my mom my partner’s trans? I am planning to do this in writing – partly for my own comfort level, partly to allow the info to settle in without me sitting right there next to my mom nervously awaiting love and understanding or rejection and grossed outness (or any combination in between). I’m interested in feedback from anyone willing to share – trans folks, partners of trans folks, butch, femme, TG butch, gender-nonspecific, queer, other, etc… How did you tell the people who matter to you? How do you feel about the approach you took? How did it go? Did it go as you expected? Better? Worse? Anything you’d do differently? I know every situation is different. I'm not looking for an indisputable formula, just thoughts and insights based on your particular experiences.

Thank you so much in advance for any replies! If you are more comfortable PMing me, please feel free.

[Rufusboi]

1) How many surgeons did you consult before deciding who was going to do your surgery?

I consulted with phalloplasty surgeons all over the world.

2) Who did your surgery?

I decided on Dr. Crane in San Francisco, California due to his credentials.

3) Are you happy with the results?

I am extremely happy with my results. My phallus looks natural and I have have been told by other doctors it looks natural.

4) Did you need any revisions?

I am going for my revision in July. The side of my phallus needs a revision where there was a loss of blood supply right after the surgery.

5) What procedure did you have?

I had Radial Forearm Phalloplasty.

6) What was your recovery process like?

My arm and phallus healed quickly, I had a problem with the donor site on my leg. It took about 6 weeks to heal.

7) Did you do anything to prepare for the surgery?

I quit smoking and began working out daily to become as healthy as possible. I am 62 years old and new it would be a hard surgery for someone my age, but I had no problems at all.

8) How much time did you have to take off work?

I work from home so cannot answer this question. Others I know went back to work in 6 weeks, but said they felt like they could have gone back to work earlier.

9) Is there anything you wish you would have done any differently?

I wish I had booked my apartment in San Francisco for 5 weeks instead of 4. I was not ready to fly home and endure long hours on the plane and sitting in airports. The problem was with my donor site not healing properly, if it had healed properly I would not have had a problem. You really cannot predict your healing time because some things do not go as planned.

10) What questions did you ask the surgeon?

I asked for his qualification.
How many phalloplastys he had performed.
The cost.
Pictures of past surgery's.
How long the surgery would take.
How long we would need to stay in San Francisco.
How long I would need to wear a catheter.
I am sure there were other questions, but I cannot remember them all right now. I had 2 friends in England who had the same procedure last year and they helped me with many of my questions.

11) What didn't you ask that you wish you would have?

Nothing.

12) what resources did you use in helping to decide what surgeon to go to or for what questions to ask?

I called many surgeons around the world and talked to them personally. I have friends who have had surgery done in England and Serbia, so they were helpful in making my decision.

13) What online resources do you know of?

Dr. Crane has a website and pictures of his past surgeries.

I hope this helps others who may be thinking of having phalloplasty.

Rufusboi

[Nadeest]

Yes, I would no longer have to take T-blockers ( my anti-androgen). I would also be able to cut down on my intake of estrogen, considerably.

[DapperButch]

Hey, guys. I just wanted to add that at 7 days when I got the bandages off I had minimal swelling and no bruising. I really believe it is a function of the supplements I took. Now, at 11 days, there is only a small amount of swelling left under my arms. I can say that most every other surgery picture I have seen (and I have seen 100's), have significantly more swelling than I do at this point in my recovery. The typical line by surgeons is that swelling can take up to 3 months to go away.

I think that the VitaMedica Recovery Support Program/Arnica Montana is the explanation for it (I put both links in my prior post). I would suspect that the Curcumin/Tumeric also plays a big part in the minimal swelling (inflammation), I have. You can get Curcumin/Tumeric very cheap (like $12.00/bottle), so at minimum get this supplement. Take it in large quantities (it is safe), for one-two weeks prior to sugery, and until the swelling goes away after surgery.

I take Curcumin supplements on a regular basis anyway, as I believe that inflammation in our bodies (internally), is the root of many diseases.

You can get the Arnica cheap, too. So, I guess what I am suggesting is that if you cannot afford the Recovery Support Program (which includes the Vitamins and the Bromelain with Quercetin), find a cheap vitamin site and pick up some Curcumin/Tumeric and Arnica. You should be able to get them for $40 total.

I hope that more guys answer The Oopster's list of questions. I know that there are other transguys/butches on this site that have gotten top surgery and have a wealth of information to share.

[The Oopster]

Dapperbutch that is interesting on the arnica.

Did you have to have tubes?

The only other person that used arnica besides me that I know of didn't have to have tubes. Neither did I

I have always wondered so it's interesting to hear someone else used it and had minimal bruising and swelling also.

I only used arnica, nothing else.

[DapperButch]

Originally Posted by The Oopster

Dapperbutch that is interesting on the arnica.

Did you have to have tubes?

The only other person that used arnica besides me that I know of didn't have to have tubes. Neither did I

I have always wondered so it's interesting to hear someone else used it and had minimal bruising and swelling also.

I only used arnica, nothing else.

Hey, Oopster, did you see I took over your thread?

Yes, I had tubes.

I remember reading earlier in the thread that Thinker used Arnica too. I don't know if he had tubes or not.

Unfortunately, I had tubes. The things hurt. A lot. The right side came out fine and is healing nicely. The left side got jacked up and now I have a knot that feels like scar tissue. I hope it will settle down. I think what happened was that when I was moving from recovery bed to chair a nurse was holding my arm and I sat down more quckly than she expected. I can still remember what that pull felt like. Or it wasn't laying perfectly flat when he wrapped my chest over top of the tubing. That is more likely, as it would have been the incisions that pulled when the nurse was holding my arm.

Anyway, my plan, if it doesn't heal nicely (still have swelling under my arms so I have to wait to see), is to get Dr. Beverely Fischer to revise it. She is only 50 miles from me and Garramone is 1,000! I hope it is just a snip and stitch in the office. Whether or not I get it done though would be based on cost.

Otherwise, I am healing amazingly well. It is weird. So far about three inches of steri strip has come off from under my right pec. The incision is completely closed, not red, and it looks like just natural skin. How crazy is that? Where the strips are coming off under my arms it doesn't look that way, but the incisions are very thin. Of course, I know they will widen over time, but they look good for now!

Did you use anything on your scars? I am using ScarGuard in the areas where the steri strips are coming off. When it all comes off (probably this week), I will start using Scar Away strips.

How are your scars? It has been 3.5 years now for you. How do you like your overall results? Would you use the same surgeon again?

Garramone told me there really is nothing one can do for widening scars. He says he had a patient contacted him a year later for a referral to a physical therapist. The guy moved his arms so little over a one years time since surgery, that he had "frozen shoulder". Garramone said the guy's scars ended up widening anyway. Although I am going to use the above products, I am not overly concerned about scarring. I am just thrilled I got it done. F* any scars I may end up having.

[The Oopster]

thinker didn't have tubes. So far he's the only one besides me that I know hasn't.

I had a hard lump on my right side and it was bruised but that was all do to the lypsosunction.

I think my scars are pretty good. my dr just recommended nivea. I also have used other vitamin e products. The key is to lightly massage the scar to keep the scar tissue from building up. I don't have any chest hair so there is no hiding mine.

I haven't tried it but I had an occupational therapist who wanted me to use cheese cloth soaked in castor oil on my other scars to break down the scar tissue.

I definitely would go to the same dr if he is still practicing. He is older so not sure how much longer he will be doing it.

I'm very happy with mine. I do have little pugee's on the side but when I lose weight they go down. I've always gained weight in my chest so I figure doing something about them would be pointless. Exercise is my best bet!

[DapperButch]

Hey, Oopster.

I did see one picture on transbucket of a guy who Garramone (my surgeon), did without drains in December 2012. Guy made some sort of comment that he thought maybe Garramone was changing to doing no drains. I guess Garramone was just testing that out though because all of the youtube videos I have seen since that guy (and there are TONS for Garramone), have drains. That guy's chest looked just as good as all the others. No different. It would have been great to have no drains.

I think you are very lucky to have not had drains. It would be nice to not have this unattractive (whatever it is) on the side of my chest (even though I am hopeful and wouldn't be surprised if it went away with healing). It would be weird though to imagine my body just absorbing all that blood/liquid that came out into the drains.

I didn't have liposuction (that I am aware of anyway). Did that lump go away?

That is very interesting about the cheese cloth. I have never heard that before. Seems like it would be a pain in the ass to do, though.

So, you don't think the "pugees" on the sides are dog ears? I don't know if dog ears get smaller and bigger with weight gain/loss though. If they are dog ears, most likely you can get a free revision in his office. Most doctors do that. Maybe you can send him a picture in email and he can let you know if it is indeed dog ears or not.

Thanks for the conversation.