My surgery with Miss Sue Thistlethwaite (Updated! With photos!)

[autocrine]

I have been following the stories and posts on this forum for many years now, first as a casual lurker until I made an account and asked a few questions. It's my intention to document my progress on this forum so that my tale will help (and hopefully encourage) others going through the same experience. I have tried to keep as much detail as possible in this post because I know when I am reading through these boards I can never have enough information!

It seems, in Australia at least, that Miss Sue Thistlethwaite is very highly regarded for her skills in gynecomastia surgery and it is her reputation and comparatively affordable services that lead me to see her for my own surgery. Here is my story...

8 October 2010
Finally booked a GP appointment at a local practice near my place. Just a general medicine appointment, nothing fancy. Felt so apprehensive making the call, but I saw myself in the mirror after my shower and my breasts just glare at me -- I put on a t-shirt before work and I had to change it because my breasts were visibly sagging through the material. I am so glad I have made this first little step. It has begun ... or at least ... it will at 930am Monday 11/10/10!

10 October 2010
Appointment is tomorrow and I am bloody nervous. I have dug out a birthday card I received a few years ago. There's a big fat crying baby on the front and my 'friend' has written "[my name]'s breasts" on the side and drawn in arrows pointing to the baby's flabby chest. I will take it with me as 'evidence' along with the countless times my friends and family have made fun of my moobs. Or the stranger on the street who openly chastised me for not wearing a looser-fitting shirt that day. Or the couple of relationships which have ended because of my moobs. Unfortunately this is not my imagination or paranoia either ... these are all experiences and opinions which have been directly, sometimes brutally, presented to me.

11 October 2010
I did it! I had the appointment with my GP. The first step has been taken. I dropped the gynecomastia problem in at the end of my visit, after a few other routine things I had been saving up to be dealt with in a single visit. My GP seemed quite obliging -- I was expecting a mute reaction, or maybe even outright dismissal, given the stories I have read from others. She gave me an examination to check for anything more serious (lumps etc) and agreed that I did have a less-than-normal chest. Having eliminated any other factors (steroid use) and listened to my efforts to reduce the size of my moobs by exercise to reduce fat levels, or to build muscle she wrote the referral letter. Next stop ... appointment with Sue.

I will document the costs as I encounter them. Costs so far: Nil!

24 Novemeber 2010
I finally got the balls to make the call to Sue's clinic and book a consultation. It was a relatively straightforward phone call, but has taken me weeks to find some guts to pick up the phone and make the call. Weeks of even more critical self-examination. Do I really have this? Do I really need surgery? Am I just too lazy to do the diet and exercise to make it go away? Will that even work? Can I afford this? Is the timing right? Gaaaah it all got too much that I just sat down and phoned and booked my appointment. Sue is so booked out that the next available appointment was 9am on a Monday morning ... that's not so helpful for me flying down from Sydney. The next week is out as my parents are visiting. After that Sue is away for two weeks, so I took the week after that.

I have an appointment booked for Friday 25 Feb 2011 at 1115am in the Essendon Private Hospital. The approximately 1 hour consultation will cost $175, of which $70 can be claimed back from medicare.

I went and booked flights that same day -- fly down to arrive an hour early, and fly out an hour after the consultation ends. The clinic is supposedly a ten minute drive from the airport so I hope my timing is reasonable! Flights were $234 (Economy Sydney-Melbourne return) with Qantas.

Next entry in eight weeks ...

25 February 2011
I saw Sue!

I was so nervous in the days leading up to my appointment. I began to question why I was even doing this. I managed to convince myself there was nothing wrong with my and I was being paranoid and insecure. However, two days before the appointment a friend made a pointed 'boob' joke at my expense and I knew I had to do something.

I had booked my appointment for a Friday when Sue is at the Essendon Private Hospital consulting rooms. This is about 10-15 minutes drive from the airport so it would be easier for me to fly in and fly out, although in hindsight I should have planned things a bit better...!

The flight out was particularly stressful. I gave myself over an hour of contingency time for the flight to Melbourne, but a few days before my appointment I received an email from Qantas telling me my flight had been changed and I was now departing 30 minutes later than the original booking. No drama with that, but when I arrived for my flight, the plane was already ten minutes behind schedule. After boarding there was a further ten minute delay on the runway. That meant that 50 minutes of my contingency time had gone. By the time I landed at Tullamarine and got off the plane (another 20 minutes) I had exactly 15 minutes to make my appointment on time. Fortunately I had no checked luggage to collect but I did have to line up for a taxi. My driver then spent a few minutes arguing with the taxi rank officer about being allowed back into the airport because my destination was too close and they have a 20 minute cooling off period between airport fares. Then the drive had no idea how to actually get to Essendon West from the airport, but fortunately I had prepared directions and was able to guide him to the Matthews Road exit and by then he had worked out how to use his GPS.

I was dropped on Sapphire St right alongside the clinic and in the end I was only two minutes late for my appointment. I filled in the new patient forms and then waited a few more minutes before seeing Sue. We got straight to the point, with her assessing my condition and explaining how she would conduct the surgery. I was taken through the procedure from start to finish had everything explained very clearly and had plenty of opportunity to ask questions. I am fairly familiar with the procedures and risks involved with surgery so my main concern was about timing (since I am coming from Sydney) ... basically the surgery is a couple of hours, with an overnight stay at Linley Clinic if I am unaccompanied, i.e. at least 48 hours in Melbourne (if everything goes to plan). After that the next visit would be about a week later to have the stitches out. This can be done by any doctor but Sue obviously recommends herself for the job as it's her handiwork ... and I agree! I would be more comfortable having her do this than some random GP in Sydney, plus she can inspect the recovery more closely this way. Sue took plenty of notes about my condition and my general health and gave me her card with contact information should I have any further questions after I got back home. I was very comfortable with the whole process and felt very much at ease with Sue throughout the 40 minute consultation.

After I paid, I left in search of a taxi back to the airport. The clinic is in a quiet suburban area so I walked up to Keilor Road (about ten minutes walk) where there is more traffic. Even so, taxis were not particularly frequent but I found one after about 15 minutes walking along Keilor. On reflection it would have been a good idea to book a taxi well in advance to meet me at the clinic for the return journey. I had a few numbers pre-saved into my phone if time was getting short before my flight.

Summary of costs for this excursion:

    $ 234.00 - Flights Syd-Mel return with Qantas
    $  15.50 - ShittyRail train ticket on the Airport Line
    $  30.00 - Taxi from Airport to Essendon West clinic (actually it was $26 but I didn't want to wait around for the change because I was running late)
    $ 175.00 - Sue's consultation fee
    $  22.00 - the taxi back to the airport

   -$  70.00 - Medicare refund for Item #104 (Initial Consultation). You need to have been referred by your GP to be eligible for this.

   --------------
   $ 406.50 Total
   --------------


Advice from my experience today:
 - Whatever the stated flight-times are on the itinerary, add half an hour each way and /then/ add contingency time. Do it for your sanity. I would rather be sitting in Sue's waiting room for an hour than re-live my mad dash from Sydney to Essendon and back!
 - Book a cab for the return journey.
 - Don't have second thoughts or doubt yourself. Go see Sue.

Next steps:
 - Wait for the surgery costing information
 - Plan a good time for the booking
 - Decide if I am going it alone or bringing a mate down.

4 March 2011
Surgery costing arrived today. I have private health insurance with HCF, who have an agreement in place with Linley Clinic. I emailed them to confirm this and also to confirm that I am eligible for hospital cover for the procedure. I have the 'Hospital Advance Savings' with a $450 excess, or "HOS ADV SAV 450" according to my HCF documents. The Medicare Schedule Item # is 31527 -- "BREAST (male), subcutaneous mastectomy, not being a service associated with a service to which item 45585 (lipo) applies (Anaes.) (Assist.)" and has a Schedule Fee of $500.50 per item. As I have two "items" the schedule fee is $1001.00, of which Medicare pays 75% and HCF pays the remaining 25%.

Putting this all together, my cost estimates are:

    $  420.00 - Return flights Syd-Mel for me + my travel companion (Sue's requirement for interstate)
    $  500.00 - Hotel (two beds for two nights although one of those nights I will spend in the Clinic)
    $ 3500.00 - Sue's surgery fee
    $ 1200.00 - Anaesthetic fee (a verbal estimate from the group recommended in Sue's letter; depends on who you get with estimates ranging from $900-$1200)
    $ 2450.00 - Linley Clinic (bed fee for day + overnight and operating theatre costs)
    $   95.00 - Compression vest (from 'Device Technologies')
    $  150.00 - Pathology on excised tissue
   --------------
    $ 8315.00 Total Estimated total before benefits
   --------------

   -$  750.75 - Medicare Benefit @ 75% of the Medicare schedule fee for 31527(x2 @ MBS Fee=$500.50 each) = $1001 x 0.75
   -$  250.25 - HCF Benefit @ 25% of Medicare schedule fee
   -$ 2000.00 - HCF Benefit for Linley Clinic (Clinic bed and operating fees less $450 excess on my policy) May pay all of it for same-day+overnight
   --------------
    $ 5314.00 Total Estimated total out-of-pocket costs
   --------------


29 April 2011
After the usual imposition of easter and a wrong mailing address, I finally got my surgery letter so I have booked flights and a hotel and convinced my best mate to come down for the ride. I will spend one night at Linley Clinic (on Sue's advice, plus I am covered by HCF) and booked a hotel in the city for the other nights. Virgin Blue had $79 specials and my mate was going to Melbourne anyway and had booked his own flight.

The surgery letter did not state the time of the operation and since some people on this forum have reported early morning surgeries I decided to play it safe and fly down the night before.

Actual costs so far:

   $  406.50 - Total carried over (Consultation phase)
   $  167.00 - Virgin Blue return flights Syd-Mel.
   $  553.50 - Hotel (twin beds for four nights)
   --------------
   $ 1127.00 Total
   --------------


12 May 2011
Device Technologies - Marena MVS compression vest (M) for $97.90 (inc GST and postage). I had some trouble determining my size for this. Even though the vest is sleeveless and only goes as far as my ribs, I was told to supply bicep, waist, and hip measurements. You really only need to pay attention to the chest parameter according to Marena rep in USA. Based on this I bought an M-sized vest which fits very snug and is quite tight but not suffocating.

Refreshing the expenses list:

   $ 1127.00   Total carried over
   $   97.90   Compression vest
   --------------
   $ 1224.90 Total
   --------------


19 May 2011
Fielded two calls from Linley in the past week advising me to arrive promptly at 0745h on Wednesday morning (i.e. lucky I booked that flight down for Tuesday night!), freshly showered and with my vest. Also, no food for 6 hours beforehand (i.e. after 2am) but water is allowed up until 4am. I am pretty sure I can comply with this as I am not usually up and about eating and drinking at this time anyway. I am also cool with the no shaving and no cosmetics rule since I dont really do this either.

I was told to purchase some calf-compression stockings as I am flying down and they want to minimize any DVT complications -- not that I have ever had a problem with blood pressure or clots. The lady on the phone told me to buy a particular brand called "sexy foxy" (that's what it sounded like on the phone!) but then said any knee-length compression stockings would do, however if they were not tight enough to meet post-surgical standards then I would have buy replacements on the day.

I have also paid Sue's fees and the anaesthetist's fees:

   $ 1224.90 - Total carried over
   $ 3500.00 - Sue's Fees
   $  875.00 - Anaesthetist's Fees
   $   42.95 - Compression socks for the flight and post-op
   $   50.00 - Flight change fee (thanks to retarded Boss making plans over the top of my original flight)
   $  450.00 - Excess payment for Linley Clinic fees (as cash, else 3.8% cc surcharge!!)
   --------------
   $ 6142.85 Total (before insurance claims)
   --------------


Note: I still haven't claimed for Sue's consultation (Medicare) and surgery (HCF and Medicare) fees. I'm holding on to all these until the adventure is over.

21 May 2011
Shaved chest with #1 clippers to make things easier for Sue (I have quite a hairy chest usually) and also to take some 'before' photos ...

Access larger 'before' photos at this gallery: http:// postimage.org/gallery/jy4i896w/ (links in posts are disabled).

Chest, front-on:



Chest, from the sides:



The doomed moobs, lefty and righty:



23 May 2011
I fly out tomorrow night for Melbourne, and surgery the next morning. I will stay overnight at Linley, and get discharged Thursday. I have Thursday to myself and then return to Sue on Friday to have the bandages removed. I am due to fly back to Sydney on Saturday and depending on how sore I am feeling I will endeavour to report back with another update!

Stay tuned ...

[alanwake89]

fantastic thread. I hope your dreams come true, mate!

[bruce36]

any updates mate? how did it go?? details please!

[autocrine]

Update 1 - Surgery and Recovery

25 May 2011
Today is 'S Day'! 

I flew in to Melbourne last night, wearing my compression socks the whole time, as instructed. I caught the SkyTrain to the city and checked into my hotel. My 'travel buddy' had flown ahead of me and met me there. Also as instructed I had no food or water for at least 6 hours before surgery ... this was easy since I had dinner as normal and just went to bed.

I booked a cab yesterday to take me from the hotel in the city out to Linley Clinic in Canterbury. It cost $30 and took about 30 minutes as traffic was light. I arrived 15 minutes early for my 745am admission. I settled the clinic fees with the receptionist -- Linley had already talked to HCF to cover all their costs, so I only had to pay my policy excess of $450. I paid this in cash because there was a credit card surcharge and I have paid enough for this adventure already

After waiting for a few minutes at reception a nurse came out and showed me to my room. The rooms are very private and comfortable with ensuite bathroom and TV. I was fussed over by the nurses who filled out some forms and got me to change into a surgical gown and wait for Sue and the anaesthetist.



After an hour or so the anaesthetist popped her head in first to ask me the standard pre-op questions and explain what she would do, the usual risks disclaimer, and how I will feel afterwards. She was very friendly and explained everything coherently.

After she was finished I met with Sue who was very chirpy and got straight down to business just like when I saw her last at the consultation. She whipped out a camera and took some photos for her records (in case Medicare need to see 'before' photos to justify the procedure) and then produced out a Sharpie pen and marked me up for surgery:



There was another guy having the same procedure who was ahead of me so I sat around for a few hours watching TV or reading until it was 'time'. At around 1130am a nurse arrived at my room, I removed my contact lenses and--now quite blind because I couldnt take my glasses into the OR, obviously--I was then walked over to the operating room. I hopped up onto the table and was quite nervous at this stage (mostly because I couldn't see what was going on) but within a few minutes I was hooked up to IV and oxygen and injected with the general anaesthetic which knocked me out very quickly. I don't think I even had a chance to do the famous countdown backwards from ten!

The next thing I remember was waking up feeling very rested in what must have been the recovery room. I looked down and saw the bandages on my chest and in my semi-conscious state was impressed with the difference I could see -- even with all the packing and bandages and swelling there was less volume than when I came in! When I was considered awake enough I was rolled back to my room and I fell asleep again. The nurses were checking on me every 30 minutes, recording heart rate and blood pressure and checking the two drains (left and right) that were hanging off me.

When I was sufficiently awake I was given some water and crackers. This was now about 4pm and I was feeling quite fine and alert (and incredibly hungry) -- the whole anaesthetic experience had felt extremely smooth and uncomplicated. I did not feel at all foggy or nauseous like I was warned might happen. I also did not feel any pain at all from my chest. I was aware of the discomfort from the tightness of the bandages as well as the compression vest (which was fitted to me while I was unconscious, in theatre) but that dull throbbing pain from serious trauma barely even registered. I was put on Digesic meds (anti-inflammatory and analgesic) by the nurses and this seemed to be doing the trick. By 5pm I was smashing down tea and sandwiches and at 6pm my Travel Buddy arrived and we talked crap for a few hours until they kicked him out at 9pm.

The nurse-checking was now hourly and my drains had not collected much gunk since they were placed ... I think one had 50 ml and the other 25ml and all of that was in there when I first woke up. Going to the loo for a pee (thanks to the 1 litre saline drip that had been pushed into me) was a major exercise as I was also hooked up to pneumatic leg-compression socks (in addition to my elastic compression socks) and this had to be unwrapped as well as the drip being clamped and the drains unhooked from the bed. The nurses were very helpful in unplugging everything and making sure I was ok. That first pee was one of the most relieving ones I have ever had.



Once the night-shift nurses came on duty my checkups became less frequent and I got some quality sleep.

26 May 2011
I woke up feeling great and plowed through some more tea and sandwiches. Sue came around at 10am to check up on me and was very pleased with my progress. With her blessing I was soon unplugged from the drip and the pneumatic socks. Another nurse came in to remove the drains which was not an entirely pleasant experience (there's a lot more tubing shoved up in yer ex-boobs than you might expect!) but it was all over very quickly. My anasthetist had left a script for more Digesic. I was given more coffee, sandwiches, and muffins (this place was better than my hotel!) and then left the clinic at 1030am Thursday morning. It was just a short walk from there to Canterbury train station and I caught a train back into the city. After dumping my clothes at the hotel I was able to head out and wander around Melbourne for the rest of the day.



27 May 2011
On Friday I went to Sue's rooms in Richmond (catch a train on the Hurstbridge line to West Richmond station) where one of her nurses (Sue was not around at the time) removed my bandages -- this was probably the most painful part of the whole experience because, although I had clippered my chest hair, the adhesives on the bandages are quite strongly stuck to the skin and they are stuck all the way across your chest and over to the sides. I lost a bit of chest hair and armpit hair anyway in the process of removing the bandages. Still, I got to see my swollen, bruised chest for the very first time and all I could say was "wow!!" ... my chest was practically flat for the first time since pre-puberty. Now my gut looks huge! Sue's nurse said that everything looked very good and apparently Sue remarked that she had removed a lot more breast tissue than she was expecting to find. Some steri-tape was applied over the stitches and this was all covered with micropore tape, thus allowing me to take showers again.



I was given the usual warnings to lead a very quiet life with minimal exertion (no gym, no running) for the next six weeks. I have to wear the compression vest constantly (except when showering) for the next four weeks and then only during the day for a further four weeks after that. I only have to wear these evil compression socks until next Wednesday. Before I left I booked my final visit to Sue's rooms in one week to have the stitches removed. My compression vest is a little less tight (and more comfortable) now that it doesn't have to accomodate the bandages. My chest is still looking quite bruised and a little bit uneven in places due to the swelling, but this will all resolve itself in the coming week.

28 May 2011
I hung around Melbourne again today until my flight back to Sydney at 2pm. My chest is still swollen and looks quite bruised but I have no pain ... if anything I can feel the itchiness of the stiches starting to come through but it's not too distracting. I am getting more range back in my arms -- I was initially too scared to reach out too far or too high (e.g. when putting a shirt on) because then I would feel a bit tender in the chest. That has improved a lot since yesterday but I am still wary of reaching up too high or of people bumping me in the street. I can put a shirt on without any trouble, but I just take a little more time with it. The flight home was uneventful. I am still sleeping mostly on my back as this is the most comfortable position. I think as the swelling goes down I will be able to sleep on my side more.

Next update (with more photos) will be after the removal of the stitches in a week...

Note: Larger-sized photos from this post can be found at this gallery address: postimage.org/gallery/13wnuzh54/

[bruce36]

hey mate,

Fantastic detail in your posts very much appreciated!
out of interest did you have just incision or lipo aswell?

[Liandoolb]

Great thread! All the detail is much appreciated and I'm sure it'll help a lot of people out (myself included)! Congrats on everything going well so far!

[autocrine]

Thanks for the support guys

Bruce36, I have replied to you on PM, but in case anyone else finds this useful I will copy my response to you into this post as well.

-----

Out of interest did you have incision & lipo or just incision?
How is your movement few days post op?
Do you believe you could go back to work 4-5 days post op?
Was there much medication involved post op? pain killers? Did you feel like you needed anything or were you ok?

I just had removal of the glands. Sue said I did not require liposuction (she called me thin, but I dont think I am "thin" at 1.78m/83 kg) and from reading this forum I get the impression that she does not generally do lipo. She told me during the consultation that she would remove gland entirely but only a small amount of fat necessary to 'sculpt' the breast to avoid it looking weird -- i.e. to avoid the so-called 'crater nipples' effect. As far as I know she does not go and do full-on lipo. I also think that having lipo voids the Medicare rebate which is for "gland excision without liposuction". As soon as I am clear to exercise again I plan to do heaps of cardio and get rid of any excess chest fat ... that bit is easy and I have been down to 65kg in the past but fat loss was never noticeable when my gyno was there.

I have pretty good movement back right now. I am still a little bit wary of reaching up too high (e.g. to get something down off a high shelf ... I don't want to rip a breast open ) and heavy doors will make me feel the strain but it gets better every day. I went back to work today and I had my surgery last Wednesday so yep, back to work after 4 days is possible. I was walking around Melbourne checking out the city cafes and museums etc the very next day so I wouldn't say the surgery should be a massive interruption to your life.

Medication - well I think I was given a long-lasting local after they knocked me out with the general anaesthetic during surgery. I think I had a couple of strong painkillers after I woke up and after that I was put on two digesic tablets (which is paracetamol and an anti-inflammatory) every six hours. I had a script for more digesic and I have just finished taking the last of them today; I weaned myself down to one tablet every six hours because I wasn't feeling very sore at all. I was still expecting to feel that dull deep pain underneath it all but either I got lucky or the digesic was working as it should! Or maybe I am just tough ;-) hah

Having said all that though, everyone is different: different type and extent of gyn, different pain tolerance, and of course different expectations and because of that everyone will have a different experience of this type of surgery. However, I am pretty satisfied with my outcomes so far and I am looking forward to getting the stitches out on Friday and living in this vest for the next eight weeks (I dont really notice it much though).

-----

Oh, and here are the photos for 5 days post-op. The yellow colour is the povidone-iodine antiseptic which is painted on prior to surgery. It's good to keep it around because it is still effective and I don't want to go vigorously scrubbing my chest while it is under repair!
Today's gallery link is postimage.org/gallery/18u7v3ts8/

 

... and compared to the before photos from my first post:

 

[alanwake89]

How's it all looking/feeling now? Noticed any changes in your life in the outside world? Wish you all the best, mate!