I recently asked a patient of mine to write a bit about his experience going through the surgical process of double-incision mastectomy with nipple grafting. We are very proud of you and your journey Brook.
My body and I have never gotten along. I have been at odds with my body since I was very little, and I thought I would be stuck with it the way it is for the rest of my life. You see, I am transgendered, meaning that my psychological gender is different from my chromosomal sex. The good news is, there are things that can be done do alter my body so that it fits my psychological self-concept using hormones and surgery. The bad news is, people say that having surgery is painful and recovery is hard. Furthermore, with top surgery, there is a small chance that the nipple grafts will not take.
When I decided to take the leap and start taking hormones, I knew that somewhere in my future was top surgery—it would kind of suck to have a hairy chest and breasts. I didn’t have much of an idea about what really happens with top surgery (also called a transgender mastectomy) except that it is invasive and expensive, and all I knew was that I was very afraid of getting it done. But these foreign things on my chest continued to haunt me, so upon starting male hormones (testosterone) I decided to start looking for a surgeon right away.
The part I mentioned earlier about surgery being expensive did not end up being an issue in my case, since Dr. Mosser took the insurance I had at the time. My biggest issue was with going under anesthesia to get the surgery itself, and my fear of the nipple grafts not taking. I was also worried that my chest would end up grossly asymmetrical or that people would tell me it was ugly after surgery.
I first went to Dr. Mosser’s office in early July, and I had a ticking clock on my top surgery since my insurance was about to change in late September. Dr. Mosser was the first surgeon I met, and it turned out that he was the only one I needed to meet. Upon meeting him and seeing how sensitive he was to my situation and how knowledgeable he was about the procedure I wanted done, I knew he would be the right fit and would do an excellent job. I don’t mean to spoil the story, but he did do an excellent job.
Come the day of the surgery I was terrified. But really, surgery is no big deal at all. Even with something as big and scary as a double mastectomy, all you have to do when you get invasive plastic surgery is go to sleep in a body that doesn’t work for you and wake up a couple hours later in a body that does. In fact, I had a relatively great time joking in the operating room with Dr. Mosser and the surgery room staff before I was out.
Now you are probably wondering about recovery, because what I had done was not a small thing. I’d anticipated that recovery was going to be awful based on stories from friends who’d had similarly big incisions. I’d arranged to be staying with my parents for three weeks because I’d thought I’d be really out of commission. I don’t know why, but recovery was so easy. Between the super powerful local anesthetic that kept me numb for a few days and the Norco, I was in virtually no pain for the first week following surgery. There was some tingling, but really no pain.
The unveiling of the preliminary results (all but nipple grafts) came six days after the surgery. I was stoked when Dr. Mosser took off the bandages to reveal almost no blood, and what looked like scars already instead of open wounds across my chest. I got to see my nipples two days later and was thrilled to see that the grafts had taken (with a small exception in the center of one that did not mess up my results at all). Needless to say, I am thrilled with the results. My chest is almost completely symmetrical, the scars are very thin (or so I was told by someone who’s seen many different top surgeries done by many different surgeons), and I am now happy with this part of myself with which I never thought I’d be able to reconcile.
My choice to have top surgery was one of the best decisions of my life, and having the surgery has helped me get closer to being the guy I want to be, and loving the body I’m in.
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