Hello all.  Looks like it's that time for me, and I'm torn between two surgeons: Dr. Medalie in Ohio and Dr. Fischer in Maryland.  I'm anticipating being able to get peri-areolar.  I've looked at numerous photos of both surgeons' work with peri-areolar, and honestly... both look pretty good to me.  I have a preference for Medalie's nipple/areola placement and resizing over Fischer's (she seems to place the areolae in the center of each pec, rather than towards the sides, which looks more natural; she also seems to leave some *really* large areolae) but I haven't seen enough photos to be sure that he does this consistently well.  There are a few chests by each surgeon that don't look so great, but I also don't know if those chests were borderline for peri and that's why the results aren't as good.  I'm just gonna list the pros and cons for each surgeon...

--Fischer--

Pros:
-seems to be regarded as 'the surgeon' in the U.S. for peri-areolar surgery
-more photos of her peri-areolar work are shown on sites such as Transster/Transbucket/Yahoo groups versus any other surgeon (I would take this to mean that she has done a lot of chests)

Cons:
-further away from me than Medalie (10 hour drive for Medalie, 16 hours for Fischer)
-average price seems ~$1-2000 more than Medalie
-apparently requires patients to go off T for 2 weeks prior to surgery


--Medalie--

Pros:
-results look good from the photos I've seen
-closer to me geographically
-average price seems lower than Fischer
-I've preferred Medalie's nipple and areola placement/resizing over Fischer's in several photos--but don't know if this is down to the surgeon's skill, or what they were given to work with by the patient

Cons:
-haven't seen as many photos of Medalie's work
-he apparently does peri-areolar surgery on individuals who would be considered 'beyond' the borderline by other surgeons
-Medalie's behavior in Kayden's surgery seems... sketchy: at first peri is OK, then it's DI, then Kayden discovers he got peri after all (only finds out after surgery)... at least, that's what it sounded like in his YouTube video (Kayden, please clear this up if I got something wrong).  I just... like knowing what the heck is going on when it comes to surgery.  (On the other hand, Kayden's unveiled chest looks like it turned out nicely.  I'm jealous.)


All that said, I'm willing to go through some inconvenience and cost if Fischer is absolutely the better and more reliable surgeon (with the most consistently 'good' results), but... I don't know if I can make that call.  Beyond possible complications such as hematomas, infections, etc--what I'm most concerned about is the nipple and areola resizing and placement.  I know the peri presents some difficulties with placement and may require revisions.  I'm willing to deal with that.  However, I'm just wondering if one surgeon is consistently better at it than the other.  Any input, guys?  Also, if anyone knows if Medalie includes revisions with the original cost of surgery, please let me know; I believe Fischer does not do this.

I don't know what was up with him with Kayden's surgery, but he didn't seem indecisive or sketchy at all with me. Nipple placement is perfect though one nipple did end slightly bigger than the other, I really like the way he did the contouring. And no complications or problems in the slightest. I considered other surgeons but I really didn't see anybody whose results I liked better, and he was only about 2 hrs from me and had a lower price than some other surgeons whose results really didn't look any better. And I'm pretty pleased with mine.

If you like Medalie's nipples better (well, not his nipples, but you know what I mean  ) and he's closer and cheaper, it sounds like he's a winner.  Are you borderline for PA?  If not, I'd say definitely go with Medalie.  If so, well, I'd say follow your gut.

Glad to know that Medalie worked out well for you, Nero (pics yet?  ).  Lucky that you were so close to him, too.

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Quote from: Jamie-o on July 24, 2009, 03:27:26 AM
Are you borderline for PA?  If not, I'd say definitely go with Medalie.  If so, well, I'd say follow your gut.

Going by volume (actual CC's of breast tissue) I think I'm well under the borderline for PA.  I can't really be sure of my cup size as I've never worn proper bras.  I could never find any, besides training bras and sports bras, that really fit (band size was always too large in comparison to cup size).  My mom is an A/B and my moobs are 1/2 to 1/3 the volume of hers.  There isn't fat on 'em, only fibrous breast tissue; what little fat I had on my chest has gone away on T.  My only concern is the odd shape...  my moobs are not the rounded mounds that you see on most women.  I have... deflated tubes.  They don't sag, but they are pointy.  Geez, I just need a consult, a doc to have a look and tell me if that's gonna be a problem.

And yeah, Jamie-O, that's the weird thing... my gut keeps telling me Medalie, but then I second-guess myself by saying "but Fischer is the one with the reputation for this surgery."

Quote from: Eryk on July 24, 2009, 11:56:10 AMNero (pics yet?  ).

Yes, Nero, we're all dying to see pictures of your progress.

Quote from: Eryk on July 24, 2009, 02:44:29 AM
-Medalie's behavior in Kayden's surgery seems... sketchy: at first peri is OK, then it's DI, then Kayden discovers he got peri after all (only finds out after surgery)... at least, that's what it sounded like in his YouTube video (Kayden, please clear this up if I got something wrong).  I just... like knowing what the heck is going on when it comes to surgery.  (On the other hand, Kayden's unveiled chest looks like it turned out nicely.  I'm jealous.)

Medalie doesn't include revisions in his original cost, just FYI before I get down to business about disagreeing with you about how he handled my case.

I wanted peri.  My body changed between when I mailed him photos of my chest and when he met me in person.  He told me he was on the fence about peri when I met with him in the consultation and allowed me to chose between the to.  However, I'd recently gotten myself out of a binder, which tends to push my chest flat (I'd been out of it for about an hour and I neglected to tell him this) so I would agree this might give him kind of a skewed picture.  He showed me good and bad results of people with approximately the same size chest as me that had both peri and DI so I'd know kind of the range of possibility for my outcome.  I still chose peri.

DAY OF SURGERY He's marking me up and he tells me he's very unsure that the results will come out okay on my left side so he will have to do DI.  However, once he gets me on the operating table and starts taking some tissue out, he is able to see how well elastic my skin is and how well the procedure is going to go.  So basically when he was doing the surgery, even though said DI, he started out taking the nipple off and taking tissue out to see how it would go and if he could still give me what I wanted.  It turns out he could, so he did.  However, seeing as I was passed out after surgery, he couldn't exactly tell me... so I got a nice surprise at my post-op appt (though the placement of my drains should've given it away, I was so hopped up on Vicodin it didn't occur to me).

I'm grateful he was HONEST and told me he thought what he was going to have to do.  It would've been much worse to think I was going to get what I wanted out of surgery and then come out with DI instead of the other way around.

For the record, I have had oddly shaped breasts.  I thought maybe I merely thought that because I didn't like them, but my boyfriend has commented on it and judging by the difficulty Medalie had categorizing me for surgery (and that I've heard nothing about him having this problem with anyone before), I don't think it was just my dysphoria talking.


Eryk, did you get a chance to look at transster before it went down?  Medalie had TONS of pics up there.  He might not have the same "rep" but he's plenty experienced.  For instance, Brownstein has a better rep, but I honestly think Medalie and Garramone give better DI results (no offense to those that have gone to him, it's just an example).  You do have to be cautious to some extent though.  There's a point where the price becomes to cheap and it really is "you get what you pay for".  But for some of these surgeons I think you're paying for the reputation a little bit.

OK, thanks for clearing that up, Kayden.  It now makes sense why things went as they did, and I do agree that Medalie handled it well given the circumstances.

I did look at Medalie's results on Transster before it went down, but at the time my focus was on Fischer so I didn't really take note of now many chests Medalie has done.  Good to know that he is experienced.

yeah, he's plenty experienced. most of his work is actually breast reductions and reconstructions on ciswomen and given my breast size I really believe my good results are in part due to his comfortability and experience with working with large breasts. that was a concern because I had seen some pretty bad results on larger guys from other surgeons, including the top ones.

in all of my research, i have formed the opinion that medalie is best in the US for peri.  and this is coming from an extremely biased point of view.  seriously, i dont like him.  at all.  nothing you should worry about, its a personal problem of mine.

i dont however believe medalie is the best for DI.  i dont think fischer is either though.  she (IMO) doesnt place the nipples/ariolas in a very natural position.  i think she gets more hype because shes on the coast, which means more people/more transguys/more people going to her for surgery.

these are just my opinions though.  there is not a best surgeon, just the one that fits you best.

Dude!! Josh!! Your chest is looking great.  Nice nipples/positioning.

I tend to agree about Dr. Fischer's DI--from what I've seen, her positioning of the nipples/areola is a little off.  Medalie's DI is pretty good as far as nipple positioning goes, but I'm not sure I like how he contours the scars.  Then again, I've only seen pictures where the scars are fresh, not after they have had time to heal and fade.  Basically, if I went to a surgeon for peri and (upon actually seeing me) they decided a DI would be best, I would rather Medalie did it.

Blargh, I hate not knowing if my chest is peri-compatible or not.  Pics are in Dr. Medalie's inbox, but he's on vacation this week and won't be back until I leave the country--which means two weeks without internet access for me.  Following cup size (not even an A, though that's just by eyeballing/my mom's input) a peri should be possible for me.  But my chest is... of a very unusual shape.  I got the guts to show my mom the other night so she would understand what I was talking about, and she just stared at it and said "What the hell? What happened? I didn't even know chests could look like that."  She then went on lamenting how nothing about me is normal, including how my chest developed.    The stretch marks are also worrying me--not sure how I even got those given how small everything is...

haha thanks.   right nipple is a little higher though.  >_<  cant tell in the pic though because of how im sitting.

i had stretch marks too.  most of them got cut away in surgery though.  if you havnt, i think you should check garramone out if you think you may have to go with DI.  if medalie will do peri on you, go for it.  his results are pretty solid.

some good resources since transster died are transbucket and transmasculine.  add "www." and ".com" to those.

I'd have been pretty pissed off if a surgeon- any surgeon- decided to change the procedure that I hired him to perform on me, unless there was some sort of health risk.

Quote from: Mister on August 03, 2009, 04:13:14 PM
I'd have been pretty pissed off if a surgeon- any surgeon- decided to change the procedure that I hired him to perform on me, unless there was some sort of health risk.

Exactly my problem. I am going to have to have my surgery again.

Quote from: Jay on August 07, 2009, 01:23:34 PM
Exactly my problem. I am going to have to have my surgery again.

Jay, what happened? 

I have to have my surgery again, too. 

Quote from: Benjamin on August 08, 2009, 12:51:44 PM
I have to have my surgery again, too. 

Sorry, guys. That sucks.

I might need revisions down the road. My nipples are a bit too large (I'm not sure whether I want to live for the rest of my life like that), the left nipple could be moved little farther away from the armpit (but it's not too far off), and the incision on the left side is definitely too high.

Anything they can do for a too-high incision?

Quote from: Arch on August 08, 2009, 02:18:11 PM



Anything they can do for a too-high incision?

Nope. I think for that you'll just have to try to hide the scar. What have you been using? I've been using mederma and it has helped them fade a bit so far.

Quote from: Nero on August 08, 2009, 06:22:39 PM
Nope. I think for that you'll just have to try to hide the scar. What have you been using? I've been using mederma and it has helped them fade a bit so far.

I started using the Kelo-cote spray but stopped when we had a heat wave. Spraying that stuff on was pretty icky in hot weather. Then I got lazy and didn't use it after the weather broke. I'm starting up again this weekend, and this time I'll use it consistently even if it gets hot again. I'm typically not very good at doing daily and twice-daily tasks, so I guess I'll tie it in with my morning and bedtime tooth-brushing evolution.

I hope it helps, especially since the left scar is well above the pec line. The trouble with rating such preparations is that the scars would fade on their own anyway, so it's hard to tell how much better off I am by using the stuff.

Kelo-cote is pretty expensive, but I'll bet it's cheaper if I buy it online. I'm supposed to use it twice a day for a minimum of two to three months.

the left incision is way above the pec line? that's pretty odd. unless your left tit was up on your neck or something.

Quote from: Nero on August 08, 2009, 06:38:11 PM
the left incision is way above the pec line? that's pretty odd. unless your left tit was up on your neck or something.

I was pretty lopsided--my right growth was bigger and saggier than my left--so I actually thought he would have more trouble getting a good contour and incision on the right side. On that side, the incision is pretty well placed but is mostly straight across. It should be a bit more curved and could be lower. On the left...well, the incision arcs up slightly instead of down or straight across. It is more than an inch too high (in my opinion) at its peak.

I know that the scars will fade in time, so I'll look much better in a couple of years. I'm still somewhat swollen, I think, but the contouring seems very good. And appearance was actually my second priority anyway. The way I heal (or don't heal, is a more accurate way to put it), I was not willing to risk a nipple transplant. This surgeon did a pedicle DI, which is what I wanted.

I wonder how long it will take for me to stop being tender. I only notice it when I touch my chest, but I'm five and a half weeks post-op. Well, that's me. I heal at about the same rate that tectonic plates shift.