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Has anyone heard of DI being done without drains being put in? I'm still at least a year from surgery but I've already started having nightmares about the drains. Too many bad childhood experiences with bloodwork, which for some reason resulted in an irrational fear of that horrible medical tubing stuff as opposed to needles or blood or any of the other things you'd expect. Just the sight of it makes me feel ill, even if it's not attached to anything. I honestly don't know if I could handle it for a week and I'm afraid I'd do something stupid like pull the drains out in a panic. But at the same time I know I'll never forgive myself if I let such a stupid fear keep me from having my moobs evicted to the bio-hazard bin where they belong.

I have.  Dr. McLean in Canada doesn't use drains (that I know of).  Here is his website:

http://www.mcleanclinic.com/breast/ftm-top-surgery/ (http://www.mcleanclinic.com/breast/ftm-top-surgery/)

There's also Dr. Peter Raphael in Texas who uses no drains. 

Honestly, it would do you good to address this fear. Drains are a very real possibility regardless of whether the procedure uses them or not. I did have drains post surgery and you won't see them, know why? You have bandages or a compression vest while they're in and you shouldn't really remove that until after drains are out. You're also numb in that whole area so you don't feel it. In my opinion it's not really worth going above and beyond to avoid drains because guess what? I had to get another one because of post surgical complications.  That's not a regular thing but it can happen. It's also a reason I'm currently eternally grateful I stayed local because I had all the support post surgery (most hospitals and surgeons won't touch another surgeon's work) but that's another story.

It's better to address the fear than to find a way around it because things can go wrong and if you can't get a handle on that fear now, it's going to be worse if you're down and have to face it. The drains are really not a big deal in the slightest. I've dealt with chest drains in the past and they're horrendous. I was worried it would be a repeat of that but it was a necessary evil and in the end it was a lot of worrying for nothing.

As for pulling them out, don't worry about that happening. They tie them in there, it's not loose, the sutures are wrapped tight around the tube and the same suture is tied into your skin. It's a very strong hold. After DI, you would struggle to have the strength to yank them out and they're not coming out accidentally. You're not going to be doing anything remotely strenuous enough for that to be an issue during initial recovery. I have one in right now and I'm going to and from work on public transport during peak times, and assisting in Taekwon-do classes (not taking part with drain in, but still showing movements slowly) and although I feel it more because I'm not as numb, it's more an awareness than any hint of pain and never come remotely close to yanking on it or anything bad happening.

I agree with Jack. I'm not happy this keeps happening. :) I'm not sure someone could even pull them out at all. A lot of people worry that this movement or that will pull them out, but in reality nobody does. You have limited movement (t-rex) and outside your range of motion everything pulls and hurts. You also are not as strong after surgery as you are with no surgery.

As he says they are not only sutured in but also bandaged in (and perhaps bindered in).

It's true that even a surgeon who doesn't normally use them could use them for a special case. (Jack is a special case heehee).

I know someone who's drain got pulled out in recovery, but this was by a nurse and perhaps it wasn't sutured in well. I'm guessing not. The nurse also had her full range of motion and so on.


--Jay

1) http://www.newportsurgery.com/index.html - I know of two guys who went to Dr. Voloshin who are pleased.  It doesn't look like he specializes in top surgery, though.

2) Dr. Marc DuPere in Toronto, Canada.  I know that he didn't use drains with my friend's top surgery. 

I would suggest calling your top choices (no pun intended), and ask them if they use drains.  If they do, ask them if the surgeon would consider doing it without drains.  It would be after that I would look into surgeons based on no drains.

I agree with Jack on trying to work through this.  It is a shame to think that you would not get the chest you wanted because you had to go with a surgeon's whose work you may not prefer, due to a phobia.

Thanks for the advice, everyone. I agree it would be best for me to get over it, but I'm not sure if I could or how I'd do it. It's also one of the big things keeping me from starting T though because of the bloodwork, so I'll probably have to face it eventually one way or another unless I can develop a fondness for being "ma'am-ed" every time I leave the house. Is it the sort of thing I could desensitize myself to do you think? (The tubes I mean, I don't think anything will make ma'am stop bothering me, lol)

Most of the blood work I've had has been with syringes, not tubing.

Not sure what your answer is. Perhaps hypnosis, even self-hypnosis. I don't know a lot about this and I'm not very suggestible but I understand this could work. Just plan relaxation procedures and meditation might help as well.

Or perhaps just having a head set and listening to some favorite music? Having a good friend with you who understands, etc.

You can get T in other forms (I use the compounding cream), but you are going to have to be able to have lab work to take it safely. Initially you might have to have two labs close to each other but after that not so often  (once or twice a year).

The other thing, top surgery itself involves an IV in your hand (or perhaps arm). I think it's more painful (though shorter term) than the drains.


--Jay

I'm looking into Dr. Peter Raphael in Plano, TX. He uses a "quilted stitch" technique which doesn't require drains post-surgery, and I think the DI/DM scars look better with that form of closing. He seems to do really impressive work and is decently priced (about $6k for surgery).

Personally I think it is better with a drain in just knowing that the area in my chest has time to seal together. It was worth the pain of having them in and getting them pulled out. Only thing I would do differently is have them in for a shorter time.

I liked the idea of no drains because it reduces the chances of hematomas. I am paranoid about my health, so any chance I have to reduce risks I'll definitely take.

Not sure where you're getting your information from but not using drains doesn't reduce the risk of hematomas, it increases it because the site isn't draining extra fluid. Drains don't cause any damage that would lead to hematomas, they only clear the fluid that happens to be there. If you have a hematoma and a drain, the drain gets rid of the hematoma. If you don't have a drain and get a hematoma then the fluid builds up, and the treatment is a drain! That's what happened to me outwith having the drain and I had to have a drain put in. So if you want to avoid hematomas you're better with a drain than without.

I think Dr. Crane doesn't use drains. 

Quote from: Jack_M on January 28, 2014, 09:34:15 PM
Not sure where you're getting your information from but not using drains doesn't reduce the risk of hematomas, it increases it because the site isn't draining extra fluid. Drains don't cause any damage that would lead to hematomas, they only clear the fluid that happens to be there. If you have a hematoma and a drain, the drain gets rid of the hematoma. If you don't have a drain and get a hematoma then the fluid builds up, and the treatment is a drain! That's what happened to me outwith having the drain and I had to have a drain put in. So if you want to avoid hematomas you're better with a drain than without.

Research a technique called "quilted stitching" that some surgeons use. It removes the necessity of drains (because it brings the "roof" and "floor" together so there's no space for fluid to build up) and reduces the chance of hematoma. Because science and facts are better than supposition. I'd link a page I found explaining it for other surgeries (carries over just the same), but I'm uncertain of the linking policy.

Quote from: Malachite on January 28, 2014, 09:39:08 PM
I think Dr. Crane doesn't use drains.

You're correct. He doesn't use them.

You can do exterior links here. My understanding is that the drains aren't always necessary. I am guessing that it is a bit newer technique. Or that some doctors use them because they are comfortable with them. Someone like Dr G really doesn't have a high complication rate anyway, so I am guessing he just feels like if he is doing something working why change up. I disliked the drains and still have some swelling where they were (or maybe it is because I would have had swelling there anyway).

--Jay

I had very low fluid output and probably could of went without the drains but I didn't know that until after the fact. The security of having them was worth it.

Jack and my other curious FTM brothers, here's some links you may find useful. Apparently their proper name is "quilting suture". I was using the colloquial that I'd found in other discussions amongst FTMs.

http://www.ncbi.nlm.nih.gov/pubmed/19240517

http://www.ncbi.nlm.nih.gov/pubmed/17312514

http://journals.lww.com/plasreconsurg/Fulltext/2010/08000/The_Quilting_Suture__Its_Application_in_Face_Lifts.124.aspx  Quote from this one, "Also, the reduced dead space limits any expansion of a hematoma."

I hope you find these helpful. Other articles and discussions from doctors I found appears as though the medical community is about as divided on the topic as we are. Some are for it and use it with no issue, some prefer drains because it's what they learned with or what they are used to using. It seems to be based on skill level of the surgeon as well as just a matter of plain ol' preference. If you like your drains, that's cool, but quilting sutures are a legitimate and not-new technique used by many surgeons for many different procedures. I've seen Dr. Peter Raphael's work when he stopped using drains and switched to quilting sutures. The work is impressive and it seems the scars fade away far faster than they would in a normal DI/DM suturing procedure. I'm sure though that patient after care also plays a part in this. Either way, they're both legitimate and widely used, so no need to discredit one for the other. Happy trails, dude. :)

Its the wrong side of the pond, but Dr Yelland over here doesn't use drains. I can't remember his reasoning completely, but I think it was something to do with your body generally absorbing the fluid anyway, unless there's a haemotoma or some other complication, and he feels that that majority of the time drains are just an added factor. I dont know what sort of stitching he uses internally, if he does, but I'm pretty sure he doesn't use external stitches along the incision line.

Quote from: aleon515 on January 29, 2014, 11:58:58 AM
You can do exterior links here. My understanding is that the drains aren't always necessary. I am guessing that it is a bit newer technique. Or that some doctors use them because they are comfortable with them. Someone like Dr G really doesn't have a high complication rate anyway, so I am guessing he just feels like if he is doing something working why change up. I disliked the drains and still have some swelling where they were (or maybe it is because I would have had swelling there anyway).

--Jay

There was a guy on transbucket Garramone did at the end of 2012 and he did not give the guy drains.  The guy said he didn't know why, but that maybe Garramone was trying something new?  Obviously, Garramone was either trying things out and ended up not being keen on no drains, or just didn't have any tubing left in the operating room for that guy.   :D

Jay, I still have  "puff" of skin, so to speak on the one side where the drain was.  This was the side that was hurting.  I am not feeling hopeful that it will go all the way down, and fear that my skin has just been stretched and will remain that way.  It is minor, but I see it, even if no one else would notice.

Gene, thanks for the links and information.

I have no opinion on yay or nay for the drains.  Clearly, both strategies work.

As I recall this guy was VERY small, on the border for being a peri candidate. Clearly he would have less fluid there to drain. I think I saw a couple guys he didn't use drains with. I think he is wary of doing it with larger chested guys, at least that's my impression.

BTW, I understand swelling can take a year to go down.

--Jay

Dr.Horowitz in Huntington Beach doesn't use drains. He said he felt like having them in didn't change much, since sometimes people develop hematomas  even with drains in.

personally, i dont think id be able to do drains. they sound hellish.

Quote from: Kreuzfidel on January 21, 2014, 12:12:31 AM
I have.  Dr. McLean in Canada doesn't use drains (that I know of).  Here is his website:

http://www.mcleanclinic.com/breast/ftm-top-surgery/ (http://www.mcleanclinic.com/breast/ftm-top-surgery/)

There's also Dr. Peter Raphael in Texas who uses no drains.

I had top surgery with Dr. McLean. No drains. No hematomas. Great results.

Quote from: FlightyBrood on February 16, 2014, 04:59:30 PM
Dr.Horowitz in Huntington Beach doesn't use drains. He said he felt like having them in didn't change much, since sometimes people develop hematomas  even with drains in.

personally, i dont think id be able to do drains. they sound hellish.

They weren't fun, for sure.  Alternatively, I didn't like the idea of all that gross bloody fluid floating around in my chest!

With that said, I knew I was going with Garramone, drains or no drains.  :D