Alright so, 2 months post op! it feels like both a long time and not a long time at all.
Overall, I feel good. Iâm not sure ânormalâ is the right word, at ease might be a better way to put it. To be honest I donât spend a great deal of time thinking about my chest and maybe thatâs the point, that itâs not constantly on my mind anymore. I used to get such a horrible jarring feeling that made me feel quite nauseated before this revision whereas now itâs just like, how it should be. My body just feels right.
Thatâs not to say my body image is amazing, Iâm still struggling with my body fat % which is hovering at 18-20 (my goal is 14%), Iâm still feeling a little meh about my belly fat and âmehâ about how much upper body muscle definition I have, but what is certain is I no longer have chest dysphoria. Although my body image is average at best all of the things that niggle at me are things that I can improve myself, the same could not have been said for my pre-revision chest. Iâve already started: since I had surgery, Iâve dropped 4lbs and have regained most of my previous muscle mass through weight training, walking a bunch and weekly swimming. I feel so much better for it! The ability to finally shape my body without having 2 bags of unchanging flesh on my chest has massively improved my sense of empowerment and wellbeing.
Now that Iâve gotten my little wellbeing check in out of the way Iâll get onto recovery/results, thereâs also some less flatteringly lit detail photos of my chest and scars at the bottom of this post for informational purposes
Appearance & sensation:
Iâm happy with how itâs going, the swelling has gone down enough to be able to see how my chest contours looks, Itâs really nicely done and I can see how the scars will sit nicely under my pecs as they settle and as I increase my upper body musculature over the next couple of years. The scars themselves are light pink, flat and soft along most of the length apart from a couple of bumpy patches here and there. They are already fading well, I am very lucky in that my scars fade fast to faint pink/white; I understand that not everyone has that experience which is perfectly okay.
My nips have healed amazingly well considering that this was my second op. Iâm pleased with the size and shape, the scars around them are thin and not very visible at all. There has been a little unevenness in pigmentation of the grafts but nothing that looks too obvious. I have slight sensation in my right nipple, mostly just protective/pressure however my left nipple is completely numb which isnât surprising given my hematoma was around the left nipple and I got a little necrosis on the tip. My right nipple responds to cold or touch stimulus, but my left nipple is a bit lazy so just stays pretty much flat.
I have 2 tiny dog ears which hopefully wonât need revision, Iâll have to wait and see how the skin tightens as I lose weight because the mostly seem to be a result of underarm fat.Â
Hematoma healing/general swelling:
The middle of my chest is still a tiny bit puffy. I canât quite tell if itâs just fat or swelling based on the shape Iâd say a bit of both! My surgeon doesnât like to take out so much fat that the skin looks too tight so she left a little fat under the skin to keep it looking natural so my chest is a little soft, but again Iâm fine with that because it really does look natural. The hematoma bruise is now totally gone apart from very slight discolouration under my left scar which almost looks like a patch of tanned skin. The hematoma swelling is also gone aside from a small firmish/squishy-ish patch just below my left scar in the same place as the skin discolouration. I think this will go away but is just taking its sweet time. I have no pain now at all aside from a tiny bit of soreness on the outer edge of my left pec or if I belly flop down on the sofa too hard like a dope.
6 weeks, finally full gym and activity clearance aside from overhead lifts!Â
Iâm very happy with my result. a couple of niggles where some bits of tissue are bothering me which I covered last week, no change there atm which is to be expected. The contours are starting to settle in now as the swelling continues to go down. I am now 100% scab and stitch free, huge relief. Iâm feeling almost healed now. There is just one little pocket of swelling that needs to hurry up and absorb and then Iâll be feeling much more on form.Â
Mobility/range of motion is fully returned in my right arm and shoulder, still a little stiff in my left shoulder but mobility exercises seem to be helping to loosen things up.Â
Scars:Â
Scars are looking extremely good for 6 weeks post op. They are mostly soft and flat apart from at the middle of my chest and the very ends just by my armpits where they are a little firmer and raised, the ends of my scars also still get a little sore. They are a pinkish colour with some areas that look a little purple which is normal for me. Iâve been wearing my scar tape in bed at night and when Iâm out jogging/at the gym. Iâm not 24/7 with it because my skin gets a little upset, like really white when a plaster has been on if I wear them for too long. They seem to be doing the trick though, my scars seem to be lightening way fast than after my last op when I did no scar aftercare at all. Iâm optimistic that they will fade well. My nipples looks excellent, all the scabs fell off to reveal very healthy well pigmented skin. Thereâs a little bit of pigment loss in patches but it doesnât look too weird.Â
Now that Iâm fully cleared for the gym & swimming iâll be getting back into it from tomorrow and will keep you posted on how it goes.
Overall I feel good, Iâm still getting used to how things look and feel but at the same time itâs almost as though Iâve never looked any different.Â
Not much to report this week. Healing has gotten past the tough phase to just waiting for the last few niggles to dissipate.Â
Everything looks like itâs healing up well. Scabs almost gone from my left nip. Any pain I get seems to be when a stitch is trying to leave my body. one was causing horrible burning pain yesterday til I tweezed it out, it just looked like a long clear splinter. Thereâs a few around my nipples that look as though they will do the same thing.Â
Hematoma still slowly clearing itself, the swelling is all soft now and the bruises are a faint yellow which are both signs that my body has almost finished breaking it down.Â
How Iâm feeling about the result:Â
So first off, it is too early to tell how things turned out. Last time I had top surgery it took a year or so for things to settle into their final shape. But my impression so far is that things have gone incredibly well, especially considering the difficult landscape my surgeon had to work with. The right side is pretty much perfect already.Â
The left side as you can see has come out a little less perfect, my scar looks kind of âbentâ from where the swelling is so I think itâs likely to straighten out a little with time, but even if it stays bent thatâs no big because my scars heal to a very faint white so you wonât be able to see it all that much in a couple of years. It also looks like there was a little more fat left in on my left side, but again its hard to tell how much of that will flatten down as the swelling goes. If not it might be something Iâd get revised in the future if settling and fat loss/muscle gain donât get rid of it. In the pic below you can clearly see the kind of âblobsâ of fat that are causing a bit of what I would call overhang rather than dog ear:Â
The blobby bit by my armpit essentially follows the line of my old scar which was always a problem area for overhanging tissue, looks like that spot was missed in my revision, which is cool because they got most of it out and if it does need a small extra op to take it out then a little lipo should sort it out which is no big deal.Â
Overall I feel really good, Iâve gotten back to the gym to do cardio and rehab work with some light lifting which has made me feel much more like myself. Still going for long walks as often as I can and from around 6 weeks post op Iâm going to start cutting fat to prep for getting in shape to maximise my results (and also just to look and feel healthy in general!).Â
Quite silicone tape/scar care note:Â
The tape is working amazingly, Iâve had to stretching evne though Iâm almost back to normal activity including very light chest and shoulder work in the gym (no overhead lighting though). They already feel flatter and softer since using the tape. Iâve also been massaging my scars chest and nipples with dream cream from Lush which also seems to be helping to keep things soft and hydrated, the skin peeling has totally stopped now which is awesome cause it was pretty gross.Â
Things keep improving a little every day. Iâm getting my range of motion and strength back but trying not to push it. Was able to do some light gardening on Sunday, just planting out some flowers etc. Thereâs no pain at all now but it does feel âtightâ if Iâve been quite active.
I can finally stand upright and sleep flat on my back rather than being propped up and can sleep on my back.Â
As far as the clinical side of things goes:Â
(details photos at the bottom of the post)
Incisions: both are fully closed and the scars are forming properly now. The right side is smooth and pink with a little bit of skin peeling around it which is normal. On Sunday I got a little zit on it from an ingrown hair which popped, itâs closed up again and I just made sure that I cleaned it to prevent infection. Â
Nipples:Â
They are both pink and healthy. Thereâs some odd stuff happening with the pigment where some areas are darker pink than others. Right nip seems like is healed except the stitches still havenât fallen out. On the left there is still an area of eschar underneath which it looks like the skin is rebuilding. Stitches still havenât fallen out of either nip which is slightly irritating now cause I would like it to start looking a bit more finished! The edges of the nipples have adhered to the skin around them and nice scars have formed which has made me feel much more secure.Â
Swelling & hematoma:Â
Thereâs still a tiny amount of puffiness on the right side which is going down gradually, at this point itâs barely noticeable. The left side, which has the hematoma, has gotten much better, the bruising has lightened significantly and the tissue has softened. Itâs a lot less swollen though still a bit raised, based on the progress so far, Iâm confident that itâll start to look and feel more healed by week 6-8.Â
My brain:Â
I feel so much better in my self, I got a nice haircut and have been going out a lot more for walks and coffee with friends and doing things around the house. Next week I plan to get a bit more back into the swing of things, I have some meetings on campus, Iâm gonna go get my T shot and have planned in some time to get some creative practice done for a project. Iâm also heading back to the gym this afternoon to start doing some light cardio and build a recovery program with one of the PTs. I still get moments when I wished I was healed and back to full strength or where I feel low because it doesnât look/feel finished yet. But on the whole I feel positive and excited about going forward. It feels like Iâm over the worst of it and like I can start living my life again.Â
So, I went up to Manchester last Thursday and finally had my post op dressings removed. See my previous post for a run down of that.Â
Iâve been cleared to stop wearing dressings now (wooo!) except for my left nipple which needs to stay covered until my current dressing falls off. Everything seems to be healing up well, my nipples are pink and healthy aside form a few scabby bits and the stitches are still dissolving. The scars are pink and are starting to lose their scabs. The left side is still pretty swollen and bruised with some darkish scabs but its finally stopped oozing which is a big plus!
Don't get me wrong, I am very happy to be post revision but dear lord. I feel so bored of not being able to be active. I hate feeling weak and incapable because so much of my sense of self is bound up with being a "strong masc", problematic as that is.
I've spent a long time waiting until my chest was fixed to get me to the point where working out won't give me crippling anxiety and dysphoria and now I'm sat around waiting to heal.
For context, in the run up to my original op I started to get in really good shape, but the poor result sapped all motivation because it was something that getting pecs couldn't fix.
Now I am brimming with motivation and restlessness but right now, the sofa has become my den. I've been going on walks and trying to stretch my lower body but I get tired so quickly.
It's extremely frustrating. I know it will pass but eeuuuurrgghh.
So, after the big bloodbath I went to A&E (The ER for my american friends) and they put a huge pressure dressing over my whole chest which basically functioned as a binder to keep everything protected until today.Â
I then hobbled up to Manchester to get everything looked at. When I was around 5 minutes away from the hospital my Surgeon called me to make sure I was almost there and that I was okay. As soon as I arrived she bustled in and looked very maternal! She made me feel very safe and looked after. whipped off the dressings and had a good look.Â
She said that after seeing the photos of how much blood there was she was worried, but that actually things looked really great in person! (huge sigh of relief). She concluded that I have a hematoma, possibly as a result of the amount of scar tissue they had to scrape out, that suddenly decided to start draining manky old blood everywhere. The drainage has now almost totally stopped. My nipples are healthy and pink with excellent blood supply apart from one small patch on the left one where its blood supply was restricted a little due to the hematoma but sheâs confident that it will recover just fine.Â
(more info & pics below the cut)
It honestly looks better that I ever imagined and my nipples are so small!!! Which is such a joy after having 1.5 inch wide nips for the past 4 years. I have a feeling that Iâm going to have pretty thin scars, I am very lucky in that I heal well, my previous scars were barely visible after 6 months. I have a very small flap of excess skin on the left side around half an inch long right near my armpit that might need a small revision but in the grand scheme of things thatâs nothing to worry about.Â
Iâve been given a course of anti-biotics and some absorbant dressings to catch any remaining drainage. Overall. Iâm pretty chuffed!Â
Pics below:Â
(Pics taken immediately after dressing removal, before the wounds were cleaned. you can see the dark spot on my nipple closest to the tattoo, the hematoma bruising and the little overflap of skin right by my armpit. Overall Iâm very pleased)
(Aquacel foam dressing to absorb goop, two small gauze dressings to continue protecting grafts and one other small gauze where the cleaning causes a little bleeder to show up on my incision but Iâve take that one off now.Â
So, I might have previously mentioned that I suspected that I have a hematoma on my left side. Not a huge on but still. Well I think that was confirmed today. Around 3 hours ago after walking to the shops I started getting very dark blood oozing through my dressing out of my incision. This is a pretty typical presentation of hematoma drainage through a small incision tear. The tear may have happened while walking of getting dressed or even opening my front door.Â
Photos below the cut:
Photo shows the area where the bleed has occurred, which is the dark blob. And the drawn areas show where the firm swelling is which may be a hematoma.Â
2 hours later, Iâve phoned NHS111 and am waiting for a nurse to get back to me.Â
Things have been going really well this week. The pain, tightness and swelling have been noticeably improving every day. My energy is increasing and Iâm almost 100% self sufficient aside from reaching for things on high shelves and lifting heavy stuff.Â
I havenât included a chest photo this week because well..thereâs nothing new to see because my dressings are still on until Thursday!
Iâll try to organise the information to keep it efficient:Â
Physical:Â
Iâm not taking any pain meds at this point, not to be a macho twat but because the pain is literally gone. I only have slight discomfort when Iâm walking because of tightness and a feeling of heaviness on my left side where the bleed was and a rogue stitch that has been getting sore but otherwise all good.Â
My range of motion is increasing. I can get my arms out to the side to roughly 70 degrees, I wouldnât want to try going higher than that at the moment.Â
I went out for a long picnic and to the pub with friends on Friday which was really nice, I didnât feel tired or in pain but I did feel it through a significant drop in energy the next day when I spent most of the afternoon napping.Â
Mental/Emotional:Â
Itâs been more positive than negative. I have been feeling really chill most of the time and have just been trying to occupy myself to relieve boredom. There are times when I have been getting very frustrated and impatient with my physical limitations and low overall energy because I really just want to get on with building up muscle/losing fat; going out and doing summer activities and so on. But obviously Iâm healing so not able to do any of that yet. I keep having to remind myself that Iâm only just 2 weeks post op and am doing extremely well at such an early stage in my recovery.Â
Dressings:Â
Still there, still sweaty. Most of the time I barely notice them but it is starting to get itchy, gross and annoying. I had to cut through the middle of the dressings earlier in the week because I was getting soreness and the skin very red and hot on one side so I went to get it checked out for infection and the doc needed to look under the edge of a dressings (it was fine). But this now means that not only do I have icky sticky dressings but I have an ever increasing collage of micro-pore in the centre of my chest holding the edges of my dressings in place. I am *very* much looking forward to all this being removed so that:Â
1. I can finally see my results andÂ
2. So that my skin can BREATHE a little more freely in the heat. Â
Summary:Â
I feel good, I feel strong. This has been a super easy recovery so far, even with the horrible travelling between cities. Iâm looking forward to things continuing to improve over the coming weeks and months once my dressings come off later in the weekÂ
I bought some minoxidil. My beard growth isn't "bad", it's mostly there but still a little wispy and patchy in parts. I gave my body as long as possible to do its thing. I've been on T for 8 years and it did continue to thicken and spread right up until about a year ago but seems to have finally decided that this is what it can manage.
So I'm giving the minox thing a try. I got a 3 month supply. If it works i'll let you know!
I wish I was an artist because I would like to make sculptures using post-transition menâs bodies as a reference but without saying that these are the bodies of trans men. I would so much like to see art of bodies like mine without being told it is an exception, sold as different or marketed as subversive. I fucking love those greek statues with small dicks because I can sort of see my body in that. Do I even make sense? Probably not. I have been looking at small penises for hours now.
Left: Post Peri with Milroy 2013Â Right: post revision with Miss Williams 2019
1 week post op update:Â
Recovery is going well The blood on my dressings is totally dry and happened while I was still in hospital overnight.Â
My chest is still tight and the shape looks amazing. I have bruising and swelling on the side where my drain bled/possibly got blocked but it isnât getting any worse. The Manchester team leave the dressings on and they arenât changed or removed until the 2 week follow up appointment on 27/06/19.Â
What has happened this week:Â
I stayed at my friendâs house on Tuesday night which was good, I slept upright and my neck pillow once again proved its worth. I then got a cab up to the hospital to have my drains removed. There was a mix up with the outpatients clinic so I was wheeled to the ward I had stayed on the get them removed there by the ward sister. It was fast and smooth. I took a codeine before going up there just in case but there was no real pain, just a feeling of pressure as they came out. It was an immediate relief.Â
My friend picked me up and took me back to his place. About an hour later my partner arrived from London to take me home on the train. He had wanted to come for the whole time but his work place sucks and refused to give him leave. We got dropped off at the station and boarded our train. The pain wasnât too bad and we had good seats, I slept most of the way. The hard part was once we were back in London. I walked though Euston station right behind him, terrified of someone bumping in to me, by this point I felt very tired and very weak. We got an Uber assist home which was wild cause the driver was...not great. I fell asleep almost as soon as we got back.Â
The past few days have mainly involved having shallow baths so I can wash my lower body and wipe my upper body, watching box sets, doing little walks around the garden and afternoon naps. I got a big V-pillow which has made me much more comfortable.Â
There has been pain so Iâve been taking the odd codeine but mostly just regular paracetamol. I also couldnât poop for like 4 days so we got some lactulose and glycerol âbutt bulletsâ which eventually moved things along which was a massive relief as most of my pain was coming from a distended abdomen!Â
My 2 week update will be coming on 24/06/19.
(Photo on the left is me in 2013 post original surgery, Photo on the right shows me on 10/06/19 after my revision)
Ok so! Itâs done which is a huge relief and it means I can actually use this tumblr for its intended purpose, as a resource for others.Â
Iâll be putting up regular posts about recovery from my revision so others can inform themselves about the healing process and also about the Manchester team as I know thereâs not loads of results from them online.Â
Post 1:Â
Account of Surgery:Â
Procedure: DI with Free Nipple grafts (revision of previous peri-areolar performed by Catherine Milroy in London)
Where: North Manchester General Hospital
Surgeon: Miss Williams (Originally scheduled with Miss Dabritz but she had an emergency)
 Before Surgery:Â
I was due to have surgery on 04/06 so I arrived in Manchester the night before and checked into my hotel. However that evening my operation was cancelled due to an emergency in Miss Dabritz personal life. The next day it was scheduled in for the 10th so I decided to just stay in the North rather than go home and come back. I did a bit of tourist stuff in Manchester and visited family.Â
My hotel check out date was the 6th but luckily I went to stay with a friend near by for the remainder of the trip so didnât have to extend the hotel.Â
On the day:Â
I was scheduled for an 11.30am arrival so I got up early, packed everything I would need and waiting for my Dad to pick me up.Â
We arrived at the hospital and waiting in a quiet waiting room in the day surgery unit. I saw a couple of people at intervals, first the admissions nurse, then the anaesthetist and finally I was called through to change, my Dad wasnât allowed to come with me but thatâs okay. I appreciated the quiet time.Â
My surgeon came to mark my chest up and then I was taken down to the theatres.
One of the Machines wasnât working in the anaesthetic room so I was put under on the operating table. I didnât mind because Iâm not afraid of medical stuff and all the staff were very friendly. I was given a different anaesthetic to the one I have last time, this one made my head swim and it felt like actual passing out rather than falling asleep.Â
I woke up what felt like seconds later, very woozy but not in pain. I donât remember much from the 2 hours I spent in recovery. My first clear memory is seeing my Dad as I was wheeled into my bay on the ward. He had brought me a kitkat to go with the Ensure I was sipping.Â
The ward was a male urology ward and is the usual ward that guys who have top surgery go to apparently (F3). All the nurses were really good and friendly and it was fairly quiet, though having the eye mask, neck pillow and ear plugs was 100% necessary!.Â
That night I felt fine, tender and carrying my drains around but no major pain. I could stand up and walk around, I even changed into my own clothes unassisted and went to the toilet. The next day I had more pain due to a small bleed from one of my drains that caused swelling. This delayed my discharge by a few hours because they had to make sure it wasnât a hematoma. It wasnât, and my buddy came to pick me up that afternoon.Â
Next time: Drain removal and the journey back to London
As a trans guy whoâs been working out for a few years now and has learned a lot about their body and building muscle and whatnot in the process, hereâs something I donât see mentioned, like ever.Â
Abs donât really look Like Thatâą when theyâre relaxed.
Hereâs a few examples from a Reddit thread asking for pictures of people both flexing and not flexing their abs
I rarely see male body positivity posts in general but Iâve never seen this mentioned, and honestly? Call me stupid for it if you want, but I genuinely thought that super defined look was something that was achievable in a relaxed state, simply because Iâve never seen anything to the contrary.Â
As someone with body dysmorphia as well as dysphoria, you can imagine the damaging effects that might have had on my mental health trying by to achieve the impossible. I can only imagine how many other masculine folk out there could be struggling with the exact same thing.
Anyway like, this is mostly to point out for masculine folks that might be pushing themselves too hard, that youâre probably doing better than you realise.Â
Anecdotal stuff aside, this is an important thing for artists to remember as well! This is something I never realised despite being an artist that goes to figure drawing classes on the regular and having modelled for them myself- because of course people with abs are flexing for the poses! I was doing it too!
- Admin Pasta
