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.

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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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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 🙂

Stitches out!

Yes yes! Got my stitches out yesterday. It wasn’t a bad experience considering I am still numb in that particular area. It was just scary because in the past 10 days, I haven’t seen anything bloody in relation to my chest. While removing, it began to bleed. Not a lot but enough for him to keep on asking for Q-tips to wipe off the area. Stitches on the torso area are usually removed in 10-14 days and mine came out on the 9th day. A day may not seem a big deal but in aesthetics, it may be difference between perfection and failure. Or maybe that’s just me and my OCD.

My surgeon also gave me a choice of not removing the stitches, which I did not agree to because 1) I was already there and 2) I don’t want to go to work knowing I was still literally stitched up.

I might have to agree with him that it may have been a bit too early and that DOES matter because the tension would be between the whole surface area of the chest versus that incision around the areola. When it bled, somehow we both knew. Thus, he used 6-7 steristrips per areola as reinforcement for the removed sutures. This is what they looked like when I got home from the hospital..

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And with the sutures removed, I can now OFFICIALLY take a normal bath, letting the water run down my now-flat chest 🙂

I will also talk in detail about a medication that was recommended to me which I consider a miracle now. Why? This is a comparison between the picture above and after I slept overnight with the medication applied..

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Gaps are almost closed, wound is almost dried up. And that’s in less than 12 hours. I will discuss the medication in a separate post.

And this is a healing comparison of Day 6 and Day 9. IDK if you see it but there a whole lot of “spot the difference” stuff going on, except for the obvious steristrips.

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9 Days Post Op

I have an appointment today to get the sutures out. I think the wound is ready LOL From there, it’s straight on till I can go back to my usual physical activities…hopefully.

I am regaining sensation on my areola. Whenever I clean and put ointment, I can definitely feel something. Every now and then, a brief swoosh of soreness will happen. Happens in a split second or in three pulses. I read somewhere that these are the nerves trying to re-establish their network.

I started taking a bath last Tuesday but still trying to keep my nipples dry. What a relief! But I think one of the drain holes got infected or scarred more. My left drain hole is flat and undetectable now. The right one, however, bulked up sort of like a keloid. I think it may have been because I move my right arm too much.

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I am still binding with the Ace bandage. But it’s a very itchy experience every time. I did buy a compression vest yesterday so I should be receiving it on Monday. The Ace bandage is very dysphoric for me, especially since it is detectable under clothing. And if I have to do this everyday for at least 4 weeks, then I might as well forget having had the surgery.

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My nipples are looking dry and nice already. Sorry about the crusties, that’s from the ointment. And the reddish parts, pulling off the tape irritates everything LOL.

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And standing up, this is what it looks like 9 days post op. Can’t be happier 🙂

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Reality Check # 1

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Sure your chest is flat. By now, your range of motion has improved loads and the bruises are now yellowish-red rather than purple-red.

But for the next 4 to 6 weeks, you still have to bind your chest, ideally 24/7 except when bathing. WHY?

The removal of the breast tissue, glands and fat creates a cavity in your chest. This cavity attracts fluid, blood and all other biological liquids. If these liquids are given the chance to penetrate the cavity, that will cause swelling, seroma and even hematoma. Plus your capillaries and nerve were most likely severed during the surgery and are looking into reconnecting.

The binder compresses your chest to close off the cavity. It allows the skin adhere to the chest wall properly. This also allows the nerve endings and capillaries to rebuild and help you regain sensation. Binding prevents seroma or fluid buildup. It also prevents hematoma or blood buildup.

Binding will your bestfriend. Be a man and suck it up. It’s the last time anyway 🙂

Almost 1 week post op..

I decided to this post because there are things that have surprised me especially with recovery that I wasn’t expecting to happen. Plus I’m bored. LOL I will be posting de-saturated pictures to lessen their graphic nature.

So again, I am 6 days post op. I got the drains out last Monday (4 days post op) and will be getting the sutures out on Saturday (9 days post op). Generally, I am feeling much much better since getting the drains out. They limit everything you do, from sitting upright to just plain moving around. Big pain, literally and figuratively. I remember going to the hospital last Monday in a taxi because I really won’t be able to handle the roughness of jeepneys. I went home that night riding a jeepney and walking about 2 blocks. All because I felt so much better without the drains.

I am still wearing my compression garment almost 24 hours a day. I take it off every now and then to let my skin breathe and for the blood to circulate. It is still tingly numb in some areas especially within the proximity of the nipple. And let me share something funny. I was changing my shirt yesterday when a cold draft went through the window. I got goosebumps all over and when I looked in the mirror, my nipples were standing up. It was so funny because I couldn’t feel them but when I touched them, they were raised and hard. Haha!

I also want to tell you about the general feeling of walking around at this stage in recovery. I recall reading something about this but cannott recall where. Amputees, when they first get a limb cut off, experience something called phantom feeling. They feel like the limb is still there even when it is not. I actually experience the same thing with my chest. Whenever I walk around without the binder, I feel like gravity is acting on my chest even though it’s not really pulling anything down. It’s such a weird and scary feeling that I sometimes put a hand there to support it.

I still have some localized swelling and brusing especially where the drains were and where the liposuction happened. These were the drain holes (steri stips fell off this morning)..

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Bruising has definitely gone down. The incisions look clean enough and I am.not worried about scarring at all. Sorry for the adhesive residue LOL i still do not have my full range of motion but I am not sure if it’s the fear of opening these drain incisions that’s preventing me or because it really isn’t time to stretch that far yet. But I do the mobility exercises everyday.

These are pictures of my nipples. You can obviously tell the signature purse-string closure technique of the peri-areolar approach. And you can definitely tell these are my original nipples and areola. I feel a bit in my nipples but definitely not 100% yet. Areola is still numb.

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And the last set is the bruising on my sides where most of the liposuction happened. As a result of having been on T for a little over 3 years and going to the gym, my ches fat just distributed itself on the lower region of my chest. It all just sat there, waiting for redemption. LOL

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I’m trying to think of all the things I can put in this blog to help Filipino transgender men with their future surgery plans. I am planning to interview my surgeon and other surgeons so people would have an idea on who would be their best choice.

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