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Update: 8 months post op!

I apologize for the hiatus. As time passed, there has been less to report anyway. But this blog post will shake things up a bit.

So yes, I am about 8 months post op. I had my top surgery last November 21,2014. I got the periareolar mastectomy where the incisions are along the areola thus the absence of the typical top surgery scars from the double incision method. Periareolar mastectomy is usually done for those with a less than A size, sometimes borderline A to 32B max. Conditions where a guy is a bit bigger then 32B but the skin elasticity is excellent may merit one as a candidate for periareolar however the chances of future revision may be present.

So here is a picture of my chest a few days ago..

  

And a quick compare to what it looked like a few months back..

 

You can see the obvious and the reason for this post. The most obvious would be the extra fat on my right side. I have mentioned this to my surgeon when I took the first picture and he mentioned that it was still too early to tell if it was excess fat or the absence of my lats (LOL). So I have been focusing on some pullups to see if it would go away. Based on the second pic, it did not go away. If any, it may have even been emphasized. 

The second thing I noticed was my left side was bigger than my right chest. I thought maybe it had something to do with my dextroscoliosis but when I tried to “align” my body, it was not going away. Plus when I flexed and tried to move pecs, I could feel both pecs contracting but it was only the right side that I see moving. I knew there was some extra fat.

So after months of waiting and re-scheduling, I had my top surgery correction (not revision since nothing was re-opened etc) yesterday July 11, 2015. It was just liposuction in 3 areas: the right side under my armpit, the left side on the chest itself and the left area under the armpit as there were some fat left there. We just did it in his clinic as opposed to an operating room during my actual surgery. Topical and local anesthetic was used and I have 3 areas that needed minor stitching since these were were the liposuction canulla was inserted. And that canulla is not small LOL.

True enough, it was really fat left in there. My surgeon explained that during the initial consult, my right side was much bigger and he had to do a chunk of liposuction. My left was just right so he didn’t really tinker with it that much. And I actually agreed since that was what I knew back then as well. Apparently, some of the fat are just not localized within the area so once the glands and the breast mass was out, the fat crept in slowly which explained the assymetry. A total of 5cc fat was removed from my right side (the one you can clearly see in the picture), 7cc from under my left armpit and a whopping 13cc from my left chest. I knew I wasn’t imagining that they were not level! Haha!

So now, I am stuck wearing a binder again for the next 2 to 3 weeks and no gym time for at least a month, preferably 2 months. Hopefully that will be the last invasive chest procedure I would undergo. I am planning for a nipple reduction and possibly the excision of the stretched scars around the areola. But overall, despite the imperfection, I have always been 110% happy about my results. 

Again, I would highly recommend my surgeon Dr. Enrico Valera. You may visit his clinic for a consultation located at St. Lukes Medical Center, Quezon City Philippines. His clinic is at room 911 North Cathedral Arts Bldg.

Almost 4 months post op..

I think it is high time for me do an update since a couple of things are up in the next few months.

I went for a visit to my surgeon just a few weeks ago to discuss some things which were bothering me.

First, I was getting some sores/wounds on some areas of the scar and it wasn’t healing no matter what I tried. It looked like blisters and then when they popped, pus would come out. I know it was a bit of irritation as I have read incisions do that but at this point, nothing was in that area dor the white blood cells to act on. True enough when he examined it, the knot of the superficial stitches was still under my skin, under that spot of the recurring wound. He managed to get it out and now the wound is fine. This was on my right nipple. It got me so concerned because the right was the “good” side and if anything fcked up happens, I’ll just end up not being confident at all.

Second, my left chest has improved tons since the last post, however, it is still uneven with the right. Muscle-wise, my right chest is looking good but the left still has some leftover fat/fluid making it look bigger but “softer”. Get what I mean? Here are some pictures. Upfront it’s not noticeable but from the sides, I think it is.

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And here it is today (forgot to take side pics though!)

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Oh, I think I got leaner too LOL anyway…

So we agreed that I could liposuction to remove excess fat in about 6 months. I agreed to this so I am planning in May. Now, he also did mention that fat can be burned (And I should have thought about that too) and he gave me the option to just log some more gym hours to see where we will end up in 6 months amd then we will decide if a revision is due. Of course I do not want to shell out cash (minimum 35,000 php) to have this done yet I feel happy to have that option. I already have the money, I just need to see if this can go away with training.

And to satisfy my vanity again, here is another pic 🙀

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2 months post-op!

Finally I get some free time to update. Besides, there hasn’t been much to report anyway between this and the last post.

I haven’t gone back to my surgeon yet because I am so wrapped up in work. And because I am in the office a minimum of 11 hours , all extra time is devoted to sleeping. I haven’t been logging any gym time either so recovery is my utmost priority now that I am planning my first day back with the iron.

Anyway, back to my chest update. There is still some swelling on the sides. If you read on any type of plastic surgery, swelling is expected till the 6th month mark. The assymetry I mentioned previously has gone down so that’s good news. Another bit of awesomeness is the visibility of my previous hard work in the gym. Before surgery, I was working out consistently for almost 1 year, even beasting it out till the day before.

So here’s a picture of how it looks like.. Note that most of the liposuction happened on my sides thus the swelling.

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IMO, looks pretty good at 2 months. And that’s not some form of self praise because it’s my chest but I think I have seen too much of results that would not work for me. I am, and forever will be, eternally grateful.

You can’t see the scars I got with the procedure. My iPad’s camera doesn’t work too well with macro shots. Maybe I will take one with my phone. Anyway, I have mentioned before that I scar badly. This is one of the reasons why I will definitely not opt for double incision unless I ultimately had no choice. My recovery was pretty quick and I get excited too easily. And I do blame myself for the scar stretching out. The right areola is much more stretched than the other. The surgeon said that I may have broke off an internal stitch or maybe the stitch didn’t hold up to well. I say… I moved way too much at a very early stage. LOL But honestly it does not worry me too much as I am planning a chest piece later this year.

Anyway, that’s it for the update. Nothing much to note at this point. Most probably the next one will be at 4 months or more or maybe when I go back to my surgeon. I have full sensation on both nipples and I can pretty much wear anything (or nothing) now.

I have also been asked about any revision plans specifically nipple and areola reduction. Quite honestly, I am all too glad to have a flat chest. I could not wish for anything. This is my definition of perfection and it would be too much for me to wany more than what I have now. When I started transitioning, there were only two things on my mind: live as a man and live with a flat chest. I got both now, so why ask for more?

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. 🙂

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.

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