Disclaimer! This is my experience and mine only. I give some advice and things to consider, but they are only based on my own experience and I encourage you to completely take or leave anything I say. When it comes to surgery, you must do whatever makes YOU feel safest, healthiest and happiest. Cheers!
I just wanted to finally take the time to write about my experience having my top surgery. My surgery costs were around $5,700 (with a $2,000 discount from my surgeon, Dr. Rumer out of Philadelphia). I fundraised over $3,000 (through dance parties, an online campaign, storytelling events, etc.) and took out the rest in a low-interest personal loan from the Federal Credit Union.
I spent the month before surgery getting as healthy as I could. Thankfully I already didn’t smoke, and I quit drinking entirely for that month. I was 26 at the time of my surgery and I love a good beer with good friends. However, I wanted to give my body a chance to be at peak health before the surgery. I exercised when I could and ate as healthy as I could. I’m normally pretty active and eat pretty healthy (mostly vegetarian, trying to stay away from processed foods, refined sugary foods, etc.) but I wanted to step up my game. No more pub grub binges for a while!
I really recommend doing this. I believe it sped up my healing time and kept complications at bay. If you are overweight or eat unhealthy, I would recommend getting into healthy mode for a few months before surgery. It is hard, but keep in mind how bad you want your chest to heal nicely. Keep that goal forefront in your mind. Giving up beer was hard for me. One of my most divine indulgences is just relaxing with friends and having a nice hoppy craft ale, but it was easy to know that the reward overwhelmingly outweighed the temptation in that moment.
Two weeks before surgery I had a giant list of food and medications to avoid (you can see that list here). Although it was really hard, I followed the list to a T. I also feel like this aided in the smoothness of the surgery. A lot of the foods are banned because they can interfere with anesthesia, and since I’m terrified of anesthesia, I adhered closely to the list and had no problems. I wasn’t even groggy when I woke up.
I also did some work to prepare myself mentally and spiritually for the surgery. I took time to breathe, meditate; I journaled my thoughts and feelings leading up to the surgery. I was also in therapy at that time and it helped to have a safe space to have a continuing dialogue about my fears, anxieties, concerns, joys, and excitement over surgery.
Journal excerpts from prior to surgery:
“This next chapter is beginning and I’m doing my best to flow in the fast moving current. I think I am doing OK. I’m pretty nervous about my top surgery. It’s a big change. I’m excited and sort of just amazed at how lucky I am that I have the opportunity. There are lots of thoughts running through my head about it on a daily basis. Nervousness is the guiding emotion right now…
…I am ready to let go of my breasts. It is hard, though. It’s my body — it’s comfortable. Well, it’s extremely uncomfortable, but it’s comfortable at the same time. It’s weird. I’ve been using this mantra: TRUST. It’s been helpful. I am trusting myself and my body, my decision…
…I am really at peace with my surgery Friday. I am ready.”
As you can tell from reading the journal excerpts, I gave myself space to feel nervous about surgery, to realize that it was a huge change. It’s kind of surreal to be removing a part of your body that isn’t physically “sick” and aside from the mental anguish it causes, would remain attached. I recommend sitting with these thoughts. I think there is a fear that if you sit with these thoughts, you will rethink your decision and freak yourself out about surgery. But in my experience that wasn’t the case at all. Instead, I just slowly dissolved these feelings and worked through them. My personal mode of thinking when it comes to dealing with mental health hurdles is to deal with it as soon as possible, sit with it, examine it, even if it’s hard. It’s better to be absolutely sure about something than to ignore your feelings and be unable to escape them later.
I held off on overloading on Youtube videos or blogs because I didn’t want to overwhelm myself with information that wouldn’t necessarily be accurate for me and my body. The last week leading up to the surgery I finally watched a day-by-day, then gradually monthly series of videos from a guy’s surgery and post-op experience. It was really helpful to see his experience, however there were some clear differences to how he ate, felt mentally and physically, and experienced the surgery. Still, it was helpful to get a vague understanding of what I was in for.
I started off the weeks leading up to my surgery feeling really nervous. However, the more I sat with these feelings and experienced, the less and less nervous I felt. The week before my surgery I reached a place of tranquility and acceptance that was pleasantly surprising to me.
I also did something to honor my “birth form” – if you will. My surgery was October 26th, and I got a meaningful tattoo on October 1st. The explanation of the tattoo is kind of long, but I got a small reminder of who I had been up until this point. It was comforting. I also treated myself really well in October. I indulged in hikes, alone time, and kept my schedule pretty mellow. I had a dinner party with friends at a restaurant that is named after me. I’m a stand-up comedian and I wrote a really funny break up letter to my tits that I read at a show. Two days before my surgery I flew a plane for the first time. It was something I’d always been wanting to do, and I found a web coupon that put it in my price range, so I went for it. It was an absolutely incredible experience, and a celebration of my life and myself.
The night before my surgery I felt my breasts for the last time. I kind of said goodbye. It wasn’t sad… it just was. I asked my partner if she wanted to touch them one last time. To my surprise, she said no. I put my hand over them as I fell asleep that night.
Nothing to eat or drink after midnight and amazingly between my mom, partner and best friend – I was the only one who got any sleep that night.
Day of Surgery
We got up bright and early, 5 or 5:30am I think. We had to be at the surgery center at either 6:30am? Maybe 7… I can’t remember. We got there and I signed in, signed paperwork.
The surgery center was a little disappointing because at that point I hadn’t legally changed my name, so my birth name had to go on my wrist bracelet. I also had to have “F” for female on my bracelet. I think I had to explain my preferred name and pronoun. One of the nurses accidentally called me “she” but the other nurse quickly stepped up and corrected her and she quickly apologized and didn’t do it again. It wasn’t a malicious or ill-intended experience, but it was disappointing. I know they do a lot of these procedures in the center so I wonder why they don’t have protocol in place? I never asked my surgeon about it – I just moved on.
In the morning before we left for the center I wrote my partner, mom and best friend little letters. Right before I got taken back and away from them, I gave them the letters. It was basically just little thank you love notes to them for their ongoing support through my decision, fundraising, and finally the day of.
I changed out of my clothes into a gown and those weird socks with the rubber bottoms. My surgeon came in and drew the marks on my chest of where she was going to cut. I picked out my nipple size and placement. Small nipples creep me out and I wanted the nipples a little bigger than what she originally drew and she was fine with that. Don’t be afraid to advocate for how you want your body to look. I questioned when she placed the nipples kind of off to the sides of my body, and she explained that men’s nipples are a little off-centered. I trusted her on that, and she trusted me on what I wanted with my nipple size. It was a sweet moment, when she was drawing me up. I really like my surgeon and knew her personally as well. I relaxed a little in that moment because I just knew she wouldn’t let anything happen to me. I knew I was under her care. We celebrated the fact that I was finally, finally here.
I got in the gurney, got some vitals done and got an IV started. I met with the anesthesiologist.
Now, I hate anesthesia. It scares the shit out of me. I underwent another procedure when I had IV sedation, which is NOT the same as general anesthesia that you are under for top surgery, however, I woke up in the middle of the procedure and became aware of what was happening and felt pain. Not good. That experienced produced a huge amount of anxiety over anesthesia in me. Another thing that made me uncomfortable about that experience was the anesthesiologist started to administer the anesthesia without telling me he was doing it. So all of a sudden I began to feel woozy but I was still coherent for a few minutes before I fell asleep. It just seemed like wrong to have medication administered without full understanding and consent – I did not like or appreciate that, at all.
So, I told the anesthesiologist all of this. He assured me that I would not wake up during the surgery, that I’d be fine. I asked him to PLEASE let me know if he puts ANYTHING in my IV before he does it. I wan’t an explanation about what is happening. He told me would. Well, he didn’t.
After I met with anesthesia my family came back in and I gave them all kisses. Then I got wheeled into the operating room. On the way I noticed the anesthesiologist push something into my IV. As soon I was pushed into the operating room, I got that woozy feeling again. I asked the anesthesiologist if he put anything in my IV. I think he was kind of surprised that I was coherent and cared that he did, and he sheepishly said, “Yeah, I did slip something in there…” I asked him again if he would please, please, please let me know when he was doing anything next. He said OK. I was transferred onto the operating table. I got a quick glance of the surgical instruments, but the substance in my IV had me a little out of it and my anxiety over it was barely there. The anesthesiologist explained (thank you, finally) that he was going to put a mask on me and that I would feel really relaxed after a few breaths. He put the mask on and I took a breath or two and the world went black.
I don’t recall waking up initially. My first memory is speaking to the nurse about how I was cold and she got me a heating pad and tucked me in with a blanket, and I think I fell back asleep for a little bit. (A side effect of anesthesia is being cold and shivering). I don’t really recall waking up again; the next thing I remember is just being awake and asking for something to drink and eat. I think I had some juice and graham crackers. I felt awesome. I wasn’t in pain, I wasn’t groggy from the anesthesia, and I was ready to go home. The nurse made me stay in bed, and finally I had to pee so I was allowed to get up. Once I got up, I was steady on my feet and still felt fine, so the nurse said I could sit in a wheelchair for a bit until I could go home. After I went to the bathroom, where I got changed back into my street clothes of sweat pants and a button-down Hawaiian T-shirt, my family came back in. I think they were shocked to see me sitting up in a chair, smiling and munching on a graham cracker.
The nurse explained how to empty the drains, I got my post-op instruction sheets, IV came out and it was time to go home!
We only lived a short ten minute drive from the surgery center, and when I got home, I felt fantastic. I didn’t even go to sleep at first. I was up and talking, showing my friend pictures that I’d taken during my flying lesson. It was really bizarre, I think lol. I attribute it to getting myself super healthy and following the list of banned medications/foods. However, I’ve heard a range of experiences all over the spectrum, some that include really terrible immediate post-op experiences. My advice would be hope for the best, but somewhere in the back of your mind, without freaking yourself out too much, be mindful of the worst.
I spent the day the morning watching movies and I think finally sometime in the afternoon I dozed off. No pain whatsoever the first day, and the bandage I had to wear was even tolerable at that point.
That about sums it up for my pre and immediate post-op experience. Thanks for reading!
About an our or two post-op at the surgery center. Feeling good!