top surgery

[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.

[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

[DapperButch]

Hey, Rufus. How many surgeries did Crane say he did? Thanks for posting about phalloplasty.

[Liam]

I finally have a date for my top surgery, August 11th. Yay!

[DapperButch]

Originally Posted by Liam

I finally have a date for my top surgery, August 11th. Yay!

Awesome, Dude! Remind me who the surgeon is? Psyched for you! It will change your whole life! The dysphoria drops like a ton of bricks( well, in that area anyway).

[Liam]

Originally Posted by DapperButch

Awesome, Dude! Remind me who the surgeon is? Psyched for you! It will change your whole life! The dysphoria drops like a ton of bricks( well, in that area anyway).

Dr. Esther Kim.

[Kelt]

I want to bump this thread because some discussion on this topic is happening in another thread and pulling it off its own topic. *guilty* While it is in the trans section I hope anyone contemplating or researching this procedure would feel free to add their thoughts for my particular question.

I have a huge case of dysphoria both gender and body. I have seen over time a lot of people contemplating top surgery mentioning losing weight in preparation for it. Being as healthy as possible going into any surgery is best of course but it brings up a question in my mind. What happens if, after having top surgery, a person gains or loses a significant amount of body weight?

Breast tissue is known for its fat storage capabilities and I see when bio men gain a lot of fat they tend to get "moobs" but to a much smaller degree. If the top surgery includes any kind of sculpting/reconstruction I'm not sure what tissues are used. Given that I have wanted this since I was seven and told to wear a shirt in the summer, I'm surprised I never thought of this before.

The further question is; do you know or have you seen a person who has had this procedure go through a weight change? If so, what was the effect? Better yet, anyone here have personal experience you're willing to share? This would be either gain or loss of say 10% or more.

[DapperButch]

Originally Posted by Kelt

I want to bump this thread because some discussion on this topic is happening in another thread and pulling it off its own topic. *guilty* While it is in the trans section I hope anyone contemplating or researching this procedure would feel free to add their thoughts for my particular question.

I have a huge case of dysphoria both gender and body. I have seen over time a lot of people contemplating top surgery mentioning losing weight in preparation for it. Being as healthy as possible going into any surgery is best of course but it brings up a question in my mind. What happens if, after having top surgery, a person gains or loses a significant amount of body weight?

Breast tissue is known for its fat storage capabilities and I see when bio men gain a lot of fat they tend to get "moobs" but to a much smaller degree. If the top surgery includes any kind of sculpting/reconstruction I'm not sure what tissues are used. Given that I have wanted this since I was seven and told to wear a shirt in the summer, I'm surprised I never thought of this before.

The further question is; do you know or have you seen a person who has had this procedure go through a weight change? If so, what was the effect? Better yet, anyone here have personal experience you're willing to share? This would be either gain or loss of say 10% or more.

Garramone says that there will not be gain in the chest if you gain weight. I don't know the name for the tissues, glands, etc., but this is what he says.

And as you well know, Garramone is "all knowing" when it comes to top surgery (yeah, I admit I am biased ). But, the man does do 500 top surgeries a year.

Don't forget, he does free phone consults.

[Liam]

My surgery went very well, and it looks like I will have an awesome chest! I spent one night in the hospital, and was overwhelmed with all of the love and care of my nurses. I've never experienced anything like it! My home health care nurse is the same, so I feel blessed. The surgeon, and nurses all commented on my pecs, I had no idea they were so hot! I do not like the drains, you fellows who did not have to deal with them are most fortunate. Mine will come out on Tuesday, and that is not soon enough for me. I think I have six more weeks in the compression vest (for the nipple grafts,) and I am really looking forward to being binder-free.

[DapperButch]

Originally Posted by Liam

My surgery went very well, and it looks like I will have an awesome chest! I spent one night in the hospital, and was overwhelmed with all of the love and care of my nurses. I've never experienced anything like it! My home health care nurse is the same, so I feel blessed. The surgeon, and nurses all commented on my pecs, I had no idea they were so hot! I do not like the drains, you fellows who did not have to deal with them are most fortunate. Mine will come out on Tuesday, and that is not soon enough for me. I think I have six more weeks in the compression vest (for the nipple grafts,) and I am really looking forward to being binder-free.

Congratulations, Liam! I am really happy for you! I'm so glad to hear your experience with the medical staff was good.

Yes, it certainly was not fun to have the drains, but honestly I don't like the idea of that crap being absorbed back into my body. I know it doesn't matter and is ok, but I would just rather all that fluid and blood come out.

I have never heard of someone in the U.S. staying overnight in the hospital. Is this Dr. Kim's standard protocol or do you have a medical history that would warrant that "extra watching"? I'm also curious to know if your insurance paid for the home health care nurse, too?

[Liam]

Originally Posted by DapperButch

Congratulations, Liam! I am really happy for you! I'm so glad to hear your experience with the medical staff was good.

Yes, it certainly was not fun to have the drains, but honestly I don't like the idea of that crap being absorbed back into my body. I know it doesn't matter and is ok, but I would just rather all that fluid and blood come out.

I have never heard of someone in the U.S. staying overnight in the hospital. Is this Dr. Kim's standard protocol or do you have a medical history that would warrant that "extra watching"? I'm also curious to know if your insurance paid for the home health care nurse, too?

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.

[DapperButch]

Originally Posted by 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.

Interesting to know about Kim, and excellent about the insurance paying for the nurse!

[Liam]

Only one drain was removed today. Fudge cake later, took some of the sting out of that disappointment. I was excited to show the surgeon what a great job she did, and thank her. She was very impressed with her work! She asked me if I was crying, and I told her that my eyes might be leaking, and that I have waited only 43 years to finally see my chest. I think I saw a light bulb flicker above her head, very briefly, and I think the reality of gender dysphoria became a little bit more clearer to her. My reserved, stoic surgeon, smiled, giggled and became almost playful as she helped the nurse practitioner finish up dressing my nipples. I am such a lucky guy!

[DapperButch]

Originally Posted by Liam

Only one drain was removed today. Fudge cake later, took some of the sting out of that disappointment. I was excited to show the surgeon what a great job she did, and thank her. She was very impressed with her work! She asked me if I was crying, and I told her that my eyes might be leaking, and that I have waited only 43 years to finally see my chest. I think I saw a light bulb flicker above her head, very briefly, and I think the reality of gender dysphoria became a little bit more clearer to her. My reserved, stoic surgeon, smiled, giggled and became almost playful as she helped the nurse practitioner finish up dressing my nipples. I am such a lucky guy!

I admit, I too had "leaky eyes", when I looked at my chest after the bandages first came off. I was both surprised and embarrassed by the tears, but my sense from Garramone was that this was a common reaction.

You're YOU finally, you know? That is some powerful shit right there!

So, what is the scoop on the one drain?

[Liam]

Originally Posted by DapperButch

So, what is the scoop on the one drain?

Its output doubled the day of my appointment, and was way above the level required for removing the drains. Sigh...

[DapperButch]

Originally Posted by Liam

Its output doubled the day of my appointment, and was way above the level required for removing the drains. Sigh...

Interesting. How is it now? When do you go back for a check/possible removable?

[Liam]

Originally Posted by DapperButch

Interesting. How is it now? When do you go back for a check/possible removable?

The output is decreasing; there is a chance that I might be able to have it removed tomorrow, there is a clinic in the afternoon, on Friday, each week, and if my numbers are low enough, I might be able to squeeze in. If not, I have an appointment on Tuesday.