Archive for December, 2014

38 days Post Op!

Wooooh time flies. I know it’s been a while. I don’t really have anything huge to post, just improvements.

I know the last time there were some things about my chest that I was concerned of like uneveness, swelling, scar tissue etc. Since then, I have tried to bind more often again per my surgeon’s instructions. I was a bit too excited to flaunt around in a shirt without a binder that I may have caused more damage while healing. So here is a comparison picture..

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So the picture on the right was taken just a few minutes ago. You can note less swelling definitely. The left side is already trying to catch up with the proportions. I have been doing daily massages with sunflower oil and have religiously been putting scar cream on the incisions.

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Pictures on the left column was 10 days ago. Not sure if you see it but my scars have definitely stretched (my fault, again) but they are flattter unlike before. Hair has stated to grow back and mind you, it’s starting all over my chest too! Some of the stitches are still coming out and one notable difference is when I pull them out, everything feels better in that area and starts to be symmetrical with the other side.

On a happier note, I have started with pushups already! And it’s amazing that I haven’t lost that much strength to do them. Once the 6-week mark is over, I will be back on the gym. Of course, still dependin on the overall feeling in my chest and still wearing the binder too. Just a little bit more until things are back to where they used to be. 🙂

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The 3rd Post Op Visit

Alright, as promised, here are the details.

I did make a post previously saying my left chest was bigger than the right. It also seemed and felt like there was fluid underneath or swelling. Well, I did observe it for a whole week and it seemed like it wasn’t going away, if not getting more uncomfortable. It just felt swollen and tender especially when I take off the binder. So I decided to visit my surgeon. And here is what he advised. Posting the picture again for reference.

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Overall, it was too early to tell if somethig else needs to be done. Final result are to be expected around 3-6 months and I was just 3 weeks post op during the visit.

First, look at the arrow pointing upwards. That is my right side and in terms of flatness, it looks much better. My surgeon said that pre-op, this was the bigger side. I agree. Thus, he did more liposuction on this side. More liposuction generates more scar tissue and that’s how it is now. Some areas are hard and you can tell it is scar tissue.

The arrow pointing down is my left side and there’s much more going on in there. The fold you see is how he contoured my chest. This is what you would usually see in men going to the gym. There is a line from the armpit down to the nipple. He contoured it that way because he knew I can make it work being a gym freak. There is less scar tissue on this side because it was my “better” side pre-op. Less liposuction, less tinkering, much more contouring. There is just a bit of swelling left on the sides because as mentioned before, almost all the liposuction happened on my sides because of fat deposit. Both sides have battle scars in the sides as you can tell.

Worst case scenario is him doing a bit more of liposuction on the left to clear things up if they don’t on their own. And that means longer recovery time AGAIN. NO THANKS.

I am, however, determined about not getting operated on again. I am confident the right side will catch up with the contouring once the scar tissues soften and I can massage them. After all, this assymmetry clears up all the time after I have removed the binder to let the skin breathe. So I know it is all part of the chest shifting and healing process.

One interesting thing that happened though was when he removed some of the stitches poking through. On the days leading tonthe visit, my left side felt uncomfortable. There were a few stitches coming out too. When I went to the surgeon, he saw the stitches and cut whatever was poking out to avoid germs from getting through the hole. When he cut a particular stitch (located on the leftmost side of the nipple), everything felt better. I felt the left side decreasing in size plus the discomfort went away. I am not sure what that was about, if that particular stitch was causing some problem or anything. It’s just weird. Anyway, as of writing this, I am officially 1 month post op 🙂

28 days post op!

Time flies fast. Wow. Seems only yesterday when I was praying so hard to get surgery this year.

Anyway, recovery is definitely almost at 100% in terms of mobility. I have full ROM already in my arms however I still can’t (or maybe scared) raise them up fast because I can still feel some stretch inside and on the nipples. And speaking of nipples, here is how they look compared to Day 8 and Day 14.

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You can definitely see the formation stage of scars. I am not a keloid former, more of a hypertrophic scar former. My scars are discolored and usually dented. My surgeon gave a sample packet of Contractubex last week during my 3rd post op visit (which I will discuss after this post) but just today, I have switched over to Hiruscar (395php) and will see what it does for me. Contractubex is expensive plus I don’t like the silicone-like film it creates over the scar in less than a minute making application gooey and sticky immediately.

As far as the entire chest, here is a picture.

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I have pointed out in red the areas where there is still an obvious disfiguration. The chest shifts while healing and will settle most probably by months 3 to 6. I am still binding especially when sleeping and have added extra packing to help contour the chest especially in those “bulging” areas. Plus, it hurts to bind now especially in the ribcage area but still it has to be done for about 4 more weeks. Random shooting pain ensues in the nipple area probably because of nerve repair. I have itch, pressure, temperature and slight touch sensation in both nipples which is good. Scar formation is more noticeable on the right side (area near the door on the closet handle in the picture). Note the fold on the other side (arm nearest the fan). I will discuss that in the next post.

All in all, really really really happy. I can wear anything or nothing at all. I can walk around freely and with good posture too! I am really grateful for a blessed 2014!

Post Op Depression

I have read countless journals on emotions right after surgery. And yes, everything is about insane happiness. Who wouldn’t be happy, right? Anybody who has waited too long, slaved long hours to earn the money and dealt with dysphoria almost their whole life has the right to feel ecstatic, regardless of how gory or gross the immediate results might look. Heck, I think it’s why most people forget about post-op pain.

On the other hand, I have also read on distress a few days after surgery due to the results not looking ideal, little things you notice which does not seem right or the feeling of loss.

It’s actually one of the things that I was scared of experiencing because I know myelf when depressed. I lose sight of everything and just want to stay in bed. Sadly, I think I am getting there.

One, coursing through the days knowing the stage is still delicate makes me become cautious of everything. And I do not like being cautious. I just want to be able to do anything and knowing I can’t push myself  just sucks.

Two, going to the gym is part of my routine. The way I treat my training is always to perfection. There is a fixed schedule, there is a zone I go to which is permanently embedded in my brain and it is one of the things my life revolves around in. It is this extreme that if I end up missing training, I also miss a day of work. That’s how I demotivated I get.

Three, there are weird things about the results that are surfacing slowly. I know I can only see them in close up and nobody can really notice unless pointed out. I have written about the assymmetry and this morning, one of the internal stitches came out and when I pulled it out (yup, the surgeon said it was okay) there was a hole there. And not just a hole. It was the actual incision line that opened up. I have used steri strips (again) to try and close it up, hoping the skin hasn’t regenerated fully so it can still fuse up.

I wish this would all just go away. This is the lowest I have been since surgery but visually, it still looks perfect. That’s the consolation. Maybe I just need to ignore the small thing or stop trying to notice the smallest details.

Recovery Progress

I just needed to get this out there because while it is good, it is somehow a bit too fast. Let me explain.

The day of surgery, I was expecting a lot of pain after. I was expecting nausea, extreme soreness, maybe a separate IV drip for pain meds. The perception of surgery is concentrated more on post operational experiences. Though there may be variations due to age, pain tolerance, procedure, physical condition etc, pain is never absent in most of the experiences. Going back, when I got out of the recover room, it all just felt like I had enjoyed Chest Day too much andy legs feeling wonky due to the epidural numbing my lower extremities. But that’s just it. I knew I had pain meds in my IV (I saw the aneshesiologist putting it in before we started) and possibly the remaining pain meds in my bloodstream that the put in directly. I drifted in and out of sleep in the car but still managed to hang out for coffee, drains and all. We even walked a great deal because the street towads our house was not passable due to traffic. I was prescribed Celecoxib for pain every 12 hours for the next 2 days and an extra 2 pills, if I needed them. Now since Celecoxib is an anti-inflammatory drug, my surgeon said to consume all 6 capsules anyway to combat swelling and prevent hematomas. Now if it wasn’t for his advice, I knew it wasn’t needed at all.

The whole experience was more uncomfortable rather than painful. I had drains for 4 days before they stopped draining anything and my chest started to become sore from the sucking pressure plus the tight binder. I was supposed to get the drains out on Day 5 but it was moved to Day 4. Once they were out, I can pretty much do all basic tasks.

The stitches were scheduled to be removed on Day 10 but was moved earlier to Day 8 due to time constraints. And even then, there wasn’t too much discomfort. Once the stitches were out, it was like recovery boosted to 200%. Plus I was using MEBO ointment and taking 1000mg Vitamin C everyday starting 2 weeks prior to the day.

The scars closed up on Day 11 but I still put on steri strips to prevent the scar from stretching. I have also regained full range of motion but I am still careful because I feel the scars stretching if they are not lubricated. As of writing, I have been doing scar massages and can definitely note a big difference in mobility and sensation. My right nipple is regaining sensation quite quickly. The left one is starting to itch now, which is what happened to my right when it started to feel sensitive to touch.

I am barely 3 weeks post op and everything feels good. There are irregularities possibly due to scar tissue and my surgeon will take a look at it this Friday. He said if he needs to do something to remedy the situation then he will be doing it already. I have said it before, he is a damn perfectionist and does not want lackluster results on ANY of his patients and that restores my confidence with the slight asymmetry which might only be visible to me. LOL

Recovery is too fast it scares me. But if it means getting back to the gym sooner, then please go much faster than it already is.

16 days Post Op!

So here we are. Been super busy at work; year-end payroll just eats me up alive. And to think I have only been back for 1 week!

So at 16 days post op, there’s not too much to report really. I mean, work just keeps me occupied. I think I may have overworked myself the past couple of days that once I get home, it’s lights out already.

However, there are a couple of things I have noticed and it’s more on the symmetry of the results. Nothing big, I just notice it more because of the chest vanity.

My right side is slightly bigger than my right. I am not sure if it’s swelling because there is no pain and when I press on it, it’s not hard nor warm. It’s just bigger. I have contacted my surgeon and sent him pics. He is still in the process of analyzing the pictures as we speak.

My left side has a LOT more scar tissue than the other. As a result, it’s a bit flatter prolly because the scar is starting to adhere to the skin. I am doing a bit of massage to try and loosen it up and maintain mobility. Here’s a comparison picture.

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Either the depression is indicative of the scar tissue or some swelling left over. My right side definitely looks much more defined and neat. And between the two sides, I have more sensation and sensitivity on my right side too.

There is also some left over fluid or swelling on my left as you can see here..

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My surgeon told me to put extra compression since I still wear a binder. And that extra compression I use are sanitary pads. Yup. It’s funny because I’ve never bought pads since I started T and now I use them for a different purpose. LOL

Overall, I am very happy with the results regardless of the updates above.  I have waited too long and worked too hard for this and I am jusy really thankful for the chance to finally get surgery 🙂

And to satisfy my vanity…

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The Importance of Compression

I just wanted to touch base on this topic . It’s usually mentioned in passing probably because the process varies per surgeon but its significance is great if you are considering the best results in the long run.

Yes, I understand the sentiment that you are now flat and you just want to burn all the memories you have had with hiding the twins. Some guys even have rites of burning all their binders or just simply mentaly preparing themselves that binding is now a thing of the past only to be told that they still need to do it after surgery. Bummer, right? I really don’t have much experience with binders so imagine my frustration with having to do it for the next 6 weeks or more.

So first off, why is there a need to bind?

When you have top surgery, the removal of the tissue, fat etc creates a space or cavity between your skin and the pectoral muscle. And since your body is 75% water/fluid AND fluid flows into spaces, the cavity gives IT a chance to do just that. Fluid like lymph or blood rushes to fill up that space. But we do not want that to happen. Why? Because it causes swelling, seroma (fluid build up), hematoma (blood build up) and delayed healing. It complicates things. And this is where binding comes to the scene.

Binding allows your skin to stick to the chest wall. Aside from the drains that the surgeon usually puts to help with the fluid build up (because it WILL happen), binding prevents any fluid from creeping in as well.

Another significance is it helps in the actual healing process. Binding makes evrything stay put, not that anything is still jiggly or whatever. But it creates a support for your chest. Your skin isn’t used to carrying less “weight”, so to speak. So to counteract the gravitational pull, the binder creates sort of a scaffold so the skin would know where to stay. I have said in a previous post that I have experienced that phantom feeling as if my chest was falling. The binder helps in eliminating that feeling.

Moving forward, if your chest stays put, it creates a biological equilibrium. It allows the natural healing process to take place without any disturbances or unnecesary stress. This period is when your nerves are starting to reconnect, your skin fibers are starting to weave together again and your skin is starting to contour to your pectoral muscles. The last thing you want to do is disturb this orchestrated process.

One other importance is in the contouring of the skin. An even circumferential pressure is the best environment for the best long term results. It eliminates bumps or depressions and promotes aesthetic results.

Now the next question is how long should you bind? Well like what I mentioned, it depends on your surgeon. Some say at least 6 weeks, some even say 8 weeks. I even saw a surgeon recommend 6 months! It all depends on how the results look like on your first post-op appointment or on the experience of your surgeon. Usually it falls between at least 2 weeks until 8 weeks. Mine is at least 24 hours for the first 4 weeks, then at least 12 hours for the next 2 — a total of 6 weeks (but I’m thinking of extending it to 8 weeks. LOL)

Another question is what should you use to bind? Here in the Philippines, an ACE bandage is commonly used. An ACE bandage is the light brown/flesh-colored elastic cloth commonly used in sprains etc. It loses elasticity after continuous use. As of writing, I am using my 2nd bandage in a span of 2 weeks. Another garment is a compression vest (which I bought online for 2,000 php) and is more commonly used overseas. It is made out of a medical-grade mesh of some sort and has adjustable velcro attached on the shoulders. On the front it either has velcro or a zipper closure. The whole thing looks like an Underworks binder, just with the extra attachments.

From experience, both have their pros and cons. But from the compression perspective, the ACE bandage is more flexible in determining the amount of pressure you want. The vest has a fixed measurement so unless your vest has a velcro closure in front, then the amount of pressure it provides will be constant all throughout. Just hope that your vest is durable to withstand wear and tear and won’t lost its rigidity during the binding period. They are also a bit pricey and usually not part of your surgery package.

I will discuss my personal experience with compression on the next post as well as a healing update 🙂

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