Nathan and/or FB,

How about telling us a bit about the healing process for your surgery.  I remember you mentioned your surgeon is Dr. Jeb Horowitz.  I looked at his site and didn't see anything about top surgery.  Is this something he typically does?  I am curious about his background and how you found him.  Also how about you tell us his protocol.  Could you give us a summary on the bandages you have on, if you have drains, did you have free nipple grafts assuming you had double incision, how long you will have to wear a binder after the bandages are removed if at all, when is your pre-op appt, etc.  (all the good stuff).  I know you have mentioned things here and there, but a summary would be helpful.

If you have pictures, even better!  Congrats again, guys!

So the boyfriend and I are four and three days along respectively. We developed this weird wet cough. It doesn't hurt at all but it's there. Is it common to have after surgery?

Quote from: Brett on February 15, 2014, 12:27:58 PM
Nathan and/or FB,

How about telling us a bit about the healing process for your surgery.  I remember you mentioned your surgeon is Dr. Jeb Horowitz.  I looked at his site and didn't see anything about top surgery.  Is this something he typically does?  I am curious about his background and how you found him.  Also how about you tell us his protocol.  Could you give us a summary on the bandages you have on, if you have drains, did you have free nipple grafts assuming you had double incision, how long you will have to wear a binder after the bandages are removed if at all, when is your pre-op appt, etc.  (all the good stuff).  I know you have mentioned things here and there, but a summary would be helpful.

If you have pictures, even better!  Congrats again, guys!

Whoops I totally didnt see this! Ive been using my phone(hence all my typos) so...I would be happy to divulge healing process and info!

Dr.Horowitz doesnt have anything about this particular procedure on his site, but I do know he's worked with transgender men before. Someone from this forum actually recommended them. I was a bit iffy about Dr.Horowitz at first, because he didn't have any pictures available of this procedure. During the consultation, which was in a lovely office with lovely staff, all my worries were quelled. He knew that I was going to a male chest, and went through every detail about the surgery and why he would make incisions where he planned to make them. I know he has worked with trans patients before, but I don't know that he's ever done this particular surgery. He knew the male chest well and seemed to have done this before. Though I have not been able to see either my nor my boyfriend's chest (we are in tight bandages i will mention more of that later) i am very confident in his work. My boy says he feels great, and he has less foam glued to him than I do and i can tell it is very flat, but not awkwardly so. I will post pictures for you guys.

Dr.Horowitz has been doing surgery since the 80s, and he also is the head of a foundation that helps underprivileged children in third world countries by surgically repairing things like cleft pallets. I read the entire brochure that was in his office. He is very very kind, he expressed many many apologies that he wouldn't be able to do the procedure that he does (purse string) that leaves very minimal scars. It didnt feel fake or anything, he was very genuinely sorry that we would have scarring. He doesn't require a letter, but I feel like he prefers the person going in for the procedure to be on hormones. His protocol is easy, you go in for a consultation and then you pay $500 down to schedule your appointment any time you can. They bent over backwards to make sure we had the surgery when we wanted to have it because we had a tricky financial situation. You have a pre op a week before surgery, they give you everything you need (TED hose, peroxide, anti biotic ointment and some herbal things to help) and go over the healing process with you step by step.

The original plan was to have a compression vest on and no bandages, however the woman who sized us didnt take into account we would have...ahem...less flesh on our chests. No big deal, though. They bandaged us up with a layer of foam, medical tape and a compression ace bandage. They will be coming off next friday. Dr.Horowitz explained that he felt drains were unnecessary, because even patients with drains have fluid that doesnt come out and they're fine. Because of the lack of drains, i think, we have to sleep upright in a reclined position for a week. It is pretty hellish, but not unbearable. We did have nipple grafts, he explained in great detail about the procedure for that and why they had to be removed and put back on at all.

The binder will be worn for six weeks, Boyfriend seems to think that after a while you only have to wear it to bed. I'm not sure about this, we will ask at our one week post op appointment. The bandages are stuck to us with something i believe to be medical adhesive. Occasionally you can feel fluid moving around and its really gross, but we both prefer it over drains. We've been told to spongebathe until they come off.

I'm three days along, boyfriend is four, and we are both feeling pretty okay. I took Tylenol instead of norco today, as the pain wasnt so much that i needed the stronger stuff.  we are both happy to answer questions about everything. Like I said, all my worries were quelled when I met the surgeon. He at the very least did his research, because he explained how a lot of surgeons dont seem to know where the proper placement of a male nipple is, then explained to us where it should go.

Here are some pictures, sorry for the blurry one ill take a better one when im not so sleepy:
Me, all that lumpyness you see is foam i swear
The boy, he has less foam and it looks AWESOME.

Hey, FB, thanks for all the information.  Garramone uses an ace bandage.  I am assuming you will get a binder to use rather than the ace when you go to post op?  The foam part is interesting, I haven't know of that before.  I would think it would make the bandage feel less tight, maybe not though.

Most guys sleep sitting up with or without drains.  I believe Garramone changed to saying you could sleep on your back too, but everyone I know sleeps sitting up or in a recliner.  I slept sitting up for 3 weeks, just because it was more comfortable.  It was at least 6 weeks until I could roll to my side without pain/discomfort.  Gosh, it seems so long ago now even though it has only been 4 months!

It is kind of neat that you guys are his (what it appears to be ), first double incision surgeries.  I am very interested in seeing the results.  Did he measure your chest and mark where he planned to put the nipples?  I noticed on his site he said he did gynecomastia, so he does work with male contouring regularly then.  The moving around of fluid is interesting.  I have never heard someone who had no drains talk about that happening, but it makes total sense that is what it would be.

Did they call you by your preferred names/pronouns?  What did he give you peroxide for?  What were the herbal meds?  Arnica?

I know, lots of questions!  I am a curious fellow!  ha

Quote from: Brett on February 15, 2014, 04:27:02 PM
Hey, FB, thanks for all the information.  Garramone uses an ace bandage.  I am assuming you will get a binder to use rather than the ace when you go to post op?  The foam part is interesting, I haven't know of that before.  I would think it would make the bandage feel less tight, maybe not though.

Most guys sleep sitting up with or without drains.  I believe Garramone changed to saying you could sleep on your back too, but everyone I know sleeps sitting up or in a recliner.  I slept sitting up for 3 weeks, just because it was more comfortable.  It was at least 6 weeks until I could roll to my side without pain/discomfort.  Gosh, it seems so long ago now even though it has only been 4 months!

It is kind of neat that you guys are his (what it appears to be ), first double incision surgeries.  I am very interested in seeing the results.  Did he measure your chest and mark where he planned to put the nipples?  I noticed on his site he said he did gynecomastia, so he does work with male contouring regularly then.  The moving around of fluid is interesting.  I have never heard someone who had no drains talk about that happening, but it makes total sense that is what it would be.

Did they call you by your preferred names/pronouns?  What did he give you peroxide for?  What were the herbal meds?  Arnica?

I know, lots of questions!  I am a curious fellow!  ha

Hi Brett! FB went to sleep (thank goodness, our cat has been keeping us up all night trying to jump on us and/or screaming at the door when we lock him out... poor thing is used to cuddling) so I'll fill in! No worries on all the questions, we're happy to answer.

I assume the foam is for comfort. It's a little itchy, but I imagine it feels a lot better than the ace bandage would against our skin. Not sure why FB has so much more foam than I do though - maybe because he's so much skinnier, I have a bit of my own padding, LOL. They are giving us compression vests at post op, yay! It sounds like it will be much comfier than all of these bandages and foam.

Dr. Horowitz was very thorough. He measured a lot of places more than once just to double check, and watching him mark where the incisions would be and where he would liposuction was very interesting. He marked exactly where he would be cutting, exactly where he would liposuction (he suctioned the front between the breasts, and a lot on the sides to make sure there would be no dog ears). I don't think he marked where he would put the nipples, but he went through every step of the male contouring with us. His goal was to get it flat and male-shaped in all one surgery.

Apparently the fluid that's moving around just gets absorbed by the body. I have no idea if this is the case, but I have to pee practically every ten minutes, and I wonder if it's not some of the absorbed fluid? That seems odd, but maybe. I'm especially "squishy sounding" today... it's really gross but apparently normal!

The surgeon and his assistants were fantastic about using preferred name and pronouns. The nurses at the surgical center misgendered me a lot  at first - however, I don't really blame them, because they didn't know it was transgender surgery. All they had was paperwork labeled as a "bilateral breast reduction" with my legal name and sex on it. As soon as Dr. Horowitz came in and began using the correct name and pronouns, the nurses caught on. They were very nice and I was too sleepy to politely correct them, but I'm sure if I had, it would've been fine.

The peroxide is just for gently cleaning the incisions once we have our bandages off. He said to clean them with 50% peroxide and 50% water. Arnica was one of the herbal meds, and the other was bromelain - however, I did not take the bromelain and neither did FB. It said not to take it if you are allergic to flour (I am gluten intolerant) and the top ingredient was gelatin, which makes FB sick. They said it was no big deal to not take it, that it just promoted healing. They said eating pineapple would be a good substitute!

I have very little pain today, just discomfort from the bandages. Can't WAIT to get these things off!

Quote from: FlightyBrood on February 15, 2014, 03:13:54 PM
So the boyfriend and I are four and three days along respectively. We developed this weird wet cough. It doesn't hurt at all but it's there. Is it common to have after surgery?

I have a suspicion that this may be due to the intubation (tube down your throat).  I also had this little cough for a few days, then it went away.  Otherwise, it may be a remnant of the bug you had earlier - and maybe the bf is getting it, too.

Quote from: BrettMost guys sleep sitting up with or without drains.  I believe Garramone changed to saying you could sleep on your back too, but everyone I know sleeps sitting up or in a recliner.  I slept sitting up for 3 weeks, just because it was more comfortable.  It was at least 6 weeks until I could roll to my side without pain/discomfort.  Gosh, it seems so long ago now even though it has only been 4 months!

HOLY SMOKES.  I could never have slept on my back or sitting up for longer than I did!  I think I managed three days flat on my back and was then able to (carefully) sleep tilted towards the side a bit with some pillows.  I'm just over 3 weeks now and am finally able to sleep on my sides again - thank the gods!  I really long for the day when I can have a good ole' belly sleep...*sigh*

Washed my hair today. Took a lot out of me, more than I expected. Mum came for a visit and brought the boy and I some (gluten free) cupcakes. Tired, way tired...but today I didn't take any of the strong pills, just two extra strength Tylenol. I feel fine pain wise, I'm developing a rash along the edge of my bandages...anything I could do to quell that? Maybe I'll call the Dr Monday cause it's pretty unbearable.

Thanks, Nathan!

Quote from: FlightyBrood on February 15, 2014, 08:19:58 PM
Washed my hair today. Took a lot out of me, more than I expected. Mum came for a visit and brought the boy and I some (gluten free) cupcakes. Tired, way tired...but today I didn't take any of the strong pills, just two extra strength Tylenol. I feel fine pain wise, I'm developing a rash along the edge of my bandages...anything I could do to quell that? Maybe I'll call the Dr Monday cause it's pretty unbearable.

Yes, didn't wash my hair for a week. I was smart and got a VERY short cut. It was funny as I thought it actually got worse and then better so that it kind of looked good after 4 days or so. Yes it's tiring to do stuff. Rash around bandages, well you could try some cortisone cream, which is what Dr G recommended. Also take Benadryl, which is going to tire you out. I started taking Zyrtec before the surgery, but that MIGHT work, and doesn't have the grogginess factor. I hate that feeling actually.

--Jay

10 Week (in two days) Update



Not much change, just pink rather than red scars and everything is 100% sealed up.

I'd say I'm about 95% back to normal in terms of mobility like I mentioned in the other mini update. At this point I feel physically ready to start working out again, but my work schedule is so crammed right now I really just wanna get that all out of the way first before I commit to any sort of workout regime. The backlog of assignments and extensions and clients I have at the moment seems to have no end xD I lost a lot of time because the meds for my infection made me really sick, which wasn't anticipated at all. The pain killers also didn't help my mental capacity

Luckily, it's half term. I got a ton of stuff done last week, and will do the same this week coming. Hopefully I'll be back on track by the time I go back.

I see my surgeon at some point in April, I forget when. I know he's going to suggest a revision. I'm interested to see what he'll say when I tell him I'd rather see what I can do myself with exercise and then consider a revision later down the line if I feel I need one. I don't know if the NHS works that way, but we'll see. If not, then I probably won't ever get a revision.

I also got a letter to say I have an appointment at the gender clinic at the end of March. I haven't seen them in almost 2 years, I guess they want to ask how I feel about my surgery, gonna be a short appointment "So how do you feel?" "fantastic thanks!" what else is there to say?

Quote from: Jeatyn on February 16, 2014, 07:58:49 AM
10 Week (in two days) Update



Not much change, just pink rather than red scars and everything is 100% sealed up.

I'd say I'm about 95% back to normal in terms of mobility like I mentioned in the other mini update. At this point I feel physically ready to start working out again, but my work schedule is so crammed right now I really just wanna get that all out of the way first before I commit to any sort of workout regime. The backlog of assignments and extensions and clients I have at the moment seems to have no end xD I lost a lot of time because the meds for my infection made me really sick, which wasn't anticipated at all. The pain killers also didn't help my mental capacity

Luckily, it's half term. I got a ton of stuff done last week, and will do the same this week coming. Hopefully I'll be back on track by the time I go back.

I see my surgeon at some point in April, I forget when. I know he's going to suggest a revision. I'm interested to see what he'll say when I tell him I'd rather see what I can do myself with exercise and then consider a revision later down the line if I feel I need one. I don't know if the NHS works that way, but we'll see. If not, then I probably won't ever get a revision.

I also got a letter to say I have an appointment at the gender clinic at the end of March. I haven't seen them in almost 2 years, I guess they want to ask how I feel about my surgery, gonna be a short appointment "So how do you feel?" "fantastic thanks!" what else is there to say?

Hey, Jeatyn, thanks for posting a picture.  I was wondering how you were getting along.  Anyone heard anything from Jack?

Your lines look really good.  I see a significant lightening of the scars already.  You haven't talked scar treatment, so I assume you haven't been using anything.  I am aware you have a full life with school and a toddler, so I am thinking it would be low on your list.

I was wondering if you could have someone else take a picture of your chest.  I would like to see what your chest looks like when your are along side your body.

Why would your surgeon think you need a revision?

Thanks for checking in!

ETA: I was just looking back through the thread and saw your 7 week picture.  Such a big jump in healing in the last 3 weeks.  Glad you didn't wait until later to post.

Wow Jeatyn, you look AWESOME. The shaping is excellent. Don't see why you'd need a revision unless you're terribly worried about dog ears, which aren't even that noticeable. Not sure how it works - would working out flatten them out?

Checking in on day five... five days to go til our post op. Sleeping is getting more difficult, especially for the poor boyfriend, who is UNBEARABLY itchy under his bandages. I think he finally managed to knock out after a benadryl and he's currently sleeping soundly. Trying to make ZERO noise because I know he needs the sleep.

Think we're going to renew WoW subscriptions today to pass the time. The person we've had staying with us is leaving today, but I think we're good to go on our own now.

Quote from: Jeatyn on February 16, 2014, 07:58:49 AM
10 Week (in two days) Update



Not much change, just pink rather than red scars and everything is 100% sealed up.

I'd say I'm about 95% back to normal in terms of mobility like I mentioned in the other mini update. At this point I feel physically ready to start working out again, but my work schedule is so crammed right now I really just wanna get that all out of the way first before I commit to any sort of workout regime. The backlog of assignments and extensions and clients I have at the moment seems to have no end xD I lost a lot of time because the meds for my infection made me really sick, which wasn't anticipated at all. The pain killers also didn't help my mental capacity

Luckily, it's half term. I got a ton of stuff done last week, and will do the same this week coming. Hopefully I'll be back on track by the time I go back.

I see my surgeon at some point in April, I forget when. I know he's going to suggest a revision. I'm interested to see what he'll say when I tell him I'd rather see what I can do myself with exercise and then consider a revision later down the line if I feel I need one. I don't know if the NHS works that way, but we'll see. If not, then I probably won't ever get a revision.

I also got a letter to say I have an appointment at the gender clinic at the end of March. I haven't seen them in almost 2 years, I guess they want to ask how I feel about my surgery, gonna be a short appointment "So how do you feel?" "fantastic thanks!" what else is there to say?

Looking good!

Hi everyone, I'm new here and thought I ought to post in order to provide some useful information that I never really read before my top surgery..

I'm now 17 days post-op and doing alright. My procedure was conducted by Dr. Morehouse and his wonderful staff in Albuquerque, New Mexico. I can't say much about the doctor, as he's a little rushed but good at what he does. I chose not to go with nipples due to my body not having a good ability to heal (I have no idea why, it's just always been this way. It's rejected every piercing, modification, treatment, but tattoos). I'm getting them tattooed on soon or just getting a large piece on my chest later.

As of 17 days, the original tape directly over my scars has yet to come off due to my fear of showering throughout this entire process. i've had plenty of sponge baths, and have been grateful for help from my partner. A lot of the complication that arose from my surgery was my initial bad reaction to the effects of anesthesia and major nausea that developed from this and lasted on for quite a while due to the Scope Patch that was put on me to stop the nausea. It actually caused worse nausea once taken off (mainly due to it deriving from the plant called Devil's Breath, which is used controversially in some medicine, but also known as a date-rape plant in some countries, and is very poisonous). I suffered for many late nights, crying from terrible bouts of nausea and losing all sense of reality/perception/everything. I'm now on a tapering regimen of Ondansetron and Meclazine. This regimen has saved me from nausea, and now the worst is over- I'm very grateful. I also had pain from constipation, but worked through that easily after starting a 5 day regimen of putting a serving of Miralax in each cup of water that I drank- not to exceed 4 servings in a day! (Personal regimen: 5 servings day 1, 3 servings day2, 2 servings day3, 2 servings day 4, 1 on day5, but it's debateable if it was actually needed at this point). Taking a lot isn't detrimental to health, but it will give you diarrhea, which to me was a god-send at the moment, and the few days that it lasted afterward, but this is something of a person-by-person preference. Constipation doesn't bother many, but it was painful for me.
I had a hematoma on my right side and, as a result, my right-side drain needed to stay in for 12 days. This was highly annoying, but didn't hurt me much. The drain on my left-side caused immense pain, and that was mainly due to it not having anything to drain. It was taken out a little late and that ordeal was extremely painful for me. But, the nurses that work with Dr. Morehouse stayed with me for hours helping me when they didn't need to, and that has meant the world to me. His staff is really five stars. At 15 days, I had a needle stuck in me to drain some blood (30cc's!) left over in my right side, and have another appointment for 2 days from now, and will most likely have some taken out then, too. I thought that the draining of the blood through a needle was going to be painful, but with all of the pain that I have been through, it was nothing at all. I've heard of the surgeons who don't use drains after surgery, and if I had had the money at the time, would have went that way for surgery.
What I've been surprised most about is the pain of the nerves in my chest. i looked it up, and since these nerves received trauma and were stretched, I now have to re-train them to know that a touch isn't causing pain. I've been using a good cream called Amazing Cream (I bought it in a local pharmacy, for muscle pains, and all-over aches, but it's offered elsewhere and online I'm sure). My scars don't hurt, largely, and I've been instructed by my surgeon to massage them, even though it will be painful. He said the harder I massage them, the more flat and non-noticeable they will be. So, I've been rubbing them, and it doesn't hurt much, which is awesome, but I still have yet to see any scars, since my original taping has yet to come off or be pulled off by me.
I'm wearing a light chest binder that's quite comfortable; even if it rides up, it doesn't both me too much.
I'm no longer taking pain meds regularly (stopped on day 11; Oxycodone was prescribed to me), yet still need one or two small 5mg's at night right around 6pm, as my body starts hurting at that time and I have to slow down a lot.

I will keep updating, and add pictures once my taping comes off.

Overall, if you're reading this before your surgery, I would suggest you know how your body responds to certain medications such as morphine and the like, as the overwhelming nausea was by far the worst part of the post-op recovery for me.

Thanks for the info Jackop! I wish I knew how my body would react to this tape. I now have two tummy blisters that are very itchy and annoying! They're small and easy to manage, but wow they make me want to rip my hair out!

Wow, Jackop, you have really had a rough go of it.  Sorry it has been so tough for you.  I hope things only continue to improve.

Be careful about that tape on your chest.  I thought that it wasn't good for us to have it on for such a long period of time?  I guess when you see your surgeon in two days he will mention this if it is a problem.

Yes, it would be great if you posted pics, when you are ready.

Hang in there and thanks for adding to the thread!

Quote from: Brett on February 16, 2014, 07:01:46 PM
Wow, Jackop, you have really had a rough go of it.  Sorry it has been so tough for you.  I hope things only continue to improve.

Be careful about that tape on your chest.  I thought that it wasn't good for us to have it on for such a long period of time?  I guess when you see your surgeon in two days he will mention this if it is a problem.

Yes, it would be great if you posted pics, when you are ready.

Hang in there and thanks for adding to the thread!

It is like sticky gauze so I am not really sure. It's also underneath my foam and ace bandage... and unfortunately we don't see him for another five, yuck! Ten days total for me.

Quote from: NathanExplosion on February 16, 2014, 07:20:00 PM
It is like sticky gauze so I am not really sure. It's also underneath my foam and ace bandage... and unfortunately we don't see him for another five, yuck! Ten days total for me.

Hey, Nathan!  I was actually talking to Jackop.

Quote from: Brett on February 16, 2014, 07:29:10 PM
Hey, Nathan!  I was actually talking to Jackop.

Whoops, my bad!

Quote from: Jackop on February 16, 2014, 03:50:13 PM
I'm now 17 days post-op and doing alright. My procedure was conducted by Dr. Morehouse and his wonderful staff in Albuquerque, New Mexico....

As of 17 days, the original tape directly over my scars has yet to come off due to my fear of showering throughout this entire process. i've had plenty of sponge baths, and have been grateful for help from my partner. A lot of the complication that arose from my surgery was my initial bad reaction to the effects of anesthesia and major nausea that developed from this and lasted on for quite a while due to the Scope Patch that was put on me to stop the nausea. It actually caused worse nausea once taken off ....

I had a hematoma on my right side and, as a result, my right-side drain needed to stay in for 12 days.
Overall, if you're reading this before your surgery, I would suggest you know how your body responds to certain medications such as morphine and the like, as the overwhelming nausea was by far the worst part of the post-op recovery for me.

Hey Albuquerque! I'm in ABQ too, and know who Dr. Morehouse is, several of the local guys have been to him. (Though I went to Dr Garramone.) I wonder if I know you? We have a very great support group here run by the Transgender Resource Center of NM. If you are not familiar check out: http://www.tgrcnm.org/

The Scope patch can be nasty stuff!! I have used it on boat trips and cut it in half (which you are actually not supposed to do, but it is strong stuff!). Anesthesia can have bad effects on some people, and they think that post-anesthesia depression might be caused by it sometimes. Didn't have these problems but I know people who did.
Wow, oxycodone is powerful stuff-- be careful!! Sorry about the complications and hope you are on the road to recovery.

I think 2-3 week were most unpleasant for me, so hang in there.


--Jay