My experience with Sue Thistlewaite

[healme]

Hi all,

I've been following this forum and got a lot of info and i thought its time to give back and hopefully the info i posted will be helpful for others too. I'll break my post into various 'stages': research, consultation, pre-op, surgery, post-op. I've had my surgery only yesterday (20/5) so i will try to update the post-op section as frequent as i can.

Research
This forum is my primary source of information. I'm living in Sydney and dont really mind where the surgeon is/surgery takes place - as long as the cost reasonable and im with the 'best'. After reading a lot of postings here, i decided to go with Dr Sue Thislewaite. There are lots of good recommendations from fellow forum posters so i decided to 'book' for a consultation given shes relatively popular. I gathered after the initial consultation, if i dont get the 'good feel' i always have the option to not proceed.

So i called the office around early March for initial consultation booked for Monday, 13th April 2009. I've also had annual leave booked for end of May period to study for my exam so i thought if i could squeeze in the surgery at the start of my leave, this would be the best time for me to proceed. I tried my luck as i was booking my consultation and managed to secure a surgery date on Wed, 20th May 2009 (yesterday!).

Prior to consultation, i was meant to go to a GP to get a referral so i could claim some part of Sue's consultation fee from Medicate. So i went to a local GP and got the referral letter no problem.

Consultation

The consultation went really quick (approx 20 minutes). She is very experienced and has done this a lot of times. She asked to remove my shirt and started fiddling to determine what needed to be done. So i was told that i need both gland removals and lipo for both sides.

She had a checklist with all the info you need to know/be aware of (standard health practitioners - risk, etc). At one point she was like, '..obviously, this surgery is not reversible..." and in my head i was like..."no... i dont want them back!!".

The consultation costs $175.00 (and i think some of it can be claimed through medicare - i havent done it yet).

Pre-op

Right after the consultation, I was given a 'quote' for various costs for the procedures:

-Sue's Surgery Fee - $3500.00 (Medicate rebates is $720.90 for 2 sides plus pte insurance if any)
-Anaesthetic fee - $650.00 (you have to call the Anaesthetist yourself. There should be medicare rebate and pte insurance but i havent done the claim yet)
-Linley Clinic Fee - Bed Fee per day $420 plus Operating Fee of $1927.50. But i got this all covered by my pte insurance so i dont pay a single cent.
-Compression Garment - $135.00 from Device Technology --> you need to call them.

There are a couple of logistics that needs to be done prior to surgery:

1. Calling the anaesthetist for a verbal estimate (this is out of curiosity coz its the only cost that i dont have specified after the consultation with Sue)
2. Confirming with Sue's office that you will want to go ahead with the surgery. This will set the wheel in motion in terms of her office notifying the anaesthetist and the clinic.
3. Call device technologies for compression garment. While the instruction from Sue is to call them and do a 'fitting', they dont actually do it anymore and apparently has notified Sue's office re this but nothing was done. So you need to supply them with your chest and waist measurement. So they can determine whether you get the S, M, L or XL size. I got an M.
4. You will then get letters from Sue's Office confirming the surgery and invoice to pay within one week of surgery. You are also given pre-admission patient forms to be filled out and forwarded to Linley Clinic.
5. You will also receive an invoice from the Anaesthetist's office which you will have to pay within a week of the surgery.
6. You will then receive a call from the clinic about 1 week prior to surgery to inform you about what you need to do. They will only get the scheduling of the surgery one week prior, so dont expect to get their calls earlier. The conversation also went relatively quickly. Basically, you need to fast (no food/drinks) from the midnight before the surgery, bring compression garments, bring medicare and pte health insurance cards (if any). You are also required to let them know who is your carer (someone who will pick you up after surgery, or will be at home after the surgery). I'm lucky that my good friend is in melb and she was able to help me with the S-Day logistics.

Surgery - S-Day

So i'm required to be at the Linley clinic by 7.30am. My friend drove me to this nice complex. Its very quiet and serene! The clinic is located in Canterburry (you can google it if you are curious). Went to the reception and did the paperwork (signing forms, providing medicare card, etc). I was then told to sit for approx 5 minutes before a nurse fetched me. I was brought to a small room where i was given stockings (to prevent blood clots) and garments to change to. You literally stripped yourself of everything! Put your clothes in the hangers provided, wear the two piece garments, stockings, head cover/cap and socks. They are white and blue. The nurse would then weighed you, took your blood pressures and turned the TV on. I was watching Sunrise!

About 15 min later, the anaesthetist came by to have a quick chat, took your blood pressures, chest and breathing etc. Told you about the rare infrequent case of anaesthetist being unsuccessful but the gas has been there for 150 years and they still dont know what made them up, etc  etc.

Another 15 min before Sue came by. She asked you to remove the garment so she can take front and sides pictures of you. She would then used a permanent marker to draw on your chest on how she will perform the operation.

At around 8.30am, i was taken to the operating theater and had a chat with the Anaesthetist about the Global Financial Crisis (GFC) and before i know it, im out.

The surgery apparently started at 8.40 and finished around 10.30am (thats nearly two hours). I woke up in a side theater where i was given more pain killers. After about 15 min, i was transported using a wheelchair to my private room. I dont feel any pain apart from a slight sore and feeling a bit drowsy/hungover. I get into the routine of waking up/sleeping again every 1 hour or so. The nurse gave me some biscuits/cheese to chew on. They offered me muffins but i had no appetite. All this time, you are already covered in dressings and compression garment (even as i typed this, i havent seen the result yet because its still covered).

I aso have drips and two tubes for blood drainage. I asked the nurse how much was removed and apparenly 50mg from my left side and 60mg from my right side. On top of this, i have 40ml lipos on both sides. Around 4.30pm, Sue and the Anaesthetist came by to say hi and Sue said the surgery was successful and no complication. I was then allowed to be discharged if i want to. The nurse took the drainage tubes (relatively painful on my left side cos the placement of the tube was a bit higher - burning sensation!). I got dressed and off i went. I was given prescriptions for Panadine, Panadine Forte and Voltaren. They are pain killers and to reduce swellings.

Went back home with my friend, stopped by the pharmacist on the way to get the prescriptions and had porridge for dinner. You are meant to rest and if possible sleep at 20/30 degrees angle.

A nurse from Linley Clinic called at around 8.30pm to check on me. A really nice surprise!! Everything is fine i told her. She told me to rest. Very caring.

Post-Op

So i was given an appointment for Friday (tomm) with Sue to remove the bandages. I'm now recuperating, watching TVs and not able to take showers. The pain returns every 5 hours or so, but this is minor. Mostly when you tried to move from a stationary position. But you have panadine to help you.

<Update #1 29/5/09>

I have since visited Sue's office twice. The first time was last Friday to remove the bandages. Its a big relief to have the bandages removed - i can move much more freely now. In return, plasters were placed across the nipples to cover them. I can take showers (not too hot!), something i had been looking forward to. The swelling subsided a bit but i still have some of them. I was told to only take panadol and i dont feel much pain at all. Sore feelings every now and then but thats about it.

This morning (29/5) i went to the office again to have some part of the stitches removed (the top part) so only the bottom part of my nipples are now covered with plasters. I asked Sue two questions:

(1) The swellings - given that its uneven, the left side is bigger than the right. But she said its normal and it will subside. She tells me to keep wearing the compression garment.
(2) Right side - i thought it was a bit sunken around the nipple area but she said its just an appearance due to uneven swellings. This is also because my right side is the one she operated on first.

I will have to do another check on Monday arvo to time it with my eventual return to Sydney at night. Will have the rest of the stitches removed then. Its also good because it gives me another opportunity while still in Melb to do another check with Sue.

<Update #2 5/6/09>

Went for checkup on Mon 1/6 to have the stitches removed. Pain level 0.5 (scale of 10). I think shaving is more uncomfortable. The anticipation of a tweezer touching the sensitive nipple is unbearable (it was all in my head though!). All plasters are removed now. Still swollen and its uneven ~ right chest flattened faster. Sue suggested to purchase Bio Oil for massage. Havent done it yet. Apparently, it can reduce itchiness. Maybe next week when i have more time after my exam. She also encouraged me to keep wearing the garment for the next 2-3 weeks but can take it off at night. I will err on the safe side and keep wearing it as long as i can (its part of my routine now so it doesnt bother me as much as it used to). Also, im no longer taking any pain medication.



Will keep you update with progress. Any questions are welcome!
Hope the info above help.

[watterbottle]

Hey mate,

very nice writeup, will help me greatly when I get my surgery done, I'm in the same situation as you.

You had to fly to melbourne twice right? 1 for the consult and 1 for the surgery?

How long did you stay in melb after the consult?

How long after the surgery do you have to stay before you can go back to syd?

Cheers

[frustrated1]

Awesome write up. Had my surgery with Sue yesterday, went exactly how you described. The clinic is awesome inside, well worth going private the people are really nice there.

Most painful part was the removal of the drainage tubes because the medical tape was stuck on my underarm hair and I was tensing my pecs the whole time when the nurse was taking it off lol got worried I was gonna burst my nipple open besides that all good.

Pain today is very bearable. It hurts to move though around though, lying down is mostly all I can do without stressing the area.

I'm getting my bandages off tomorrow 

[healme]

@watterbottle: Yup twice - for consultation and surgery. They are about 1.5 mths apart. For consult, i have it in the morning and i left at night. It was a quick 20min consultation so you dont need to wait around after. For surgery, i think Sue prefers to have you stay back as long as you can afford to. But at least, you need to get the bandages removed (this is done the same week on Friday if the surgery is on Wed). You can ask your GP to remove the stitches. But since im on my annual leave, im trying to stay in Melb as long as i can to catch up with friends. Im leaving next Mon (1/6).

@frustrated1: Congrats! how are you feeling? LOL on underarm hair and drainage. I prepared in advance based on earlier posts by others, so i did quick shave around those areas. hehe. mate, you will def feel a bit better after the bandages get removed. lets keep each other updated with progress.

[cecly]

Good on you for getting it done and doing the follow up. We need more of this in the Aussie forum.

[losernumber1]

Can anyone confirm their anasthetic cost? I got the letter from the anesthatists and they reckon its $1000. But didnt someone say it was around $650?? Also does medicare rebate any portion of the anasthetic??? Thanks...

[healme]

Mine was $650.00 (GST exempt). Yes its covered by medicare. i havent done medicare claim yet so dont know how much it is but aint expecting a lot.

I personally dont think its a flat fee. It depends on how long the procedure is so if yours is expected to be longer, then you will be charged more. but this is just my guess.

[frustrated1]

Hey healme my update...

I'm 19 days out. Had my bandages off last wednesday. Had some fluid build up on my right side. Sue syringed out most of it (no pain area is still numb) and that it usually breaks itself down. More has developed since but she said on my next consult she'd suck the rest out. The area feels really hard and lumpy and is about golf ball size  This is scar tissue isn't it though its not gyno?


Besides that I've got full movement back and no pain anymore

[jack01]

Hey healme, great write up! pretty much exactly my experience with sue also.
I had bilateral gynecomastia, one side had more thissue than the other, all i had was the excision, no lipo.
I'm just under a week post op so thought i would post how my progress is going.
The day after the surgery i found that one side was a lot more bruised that the other side. My left side kind of blew out compared to the right. Like you frustrated1 i feel that underneath there is a golf ball sized mass, i'm pretty sure that its not scar tissue, id say its just fluid build up, so my expectation is that she will also remove it at my next appointment.
I wonder whether this is a normal post op phenomenon? it would be interesting to hear whether more people experience this. I was told by the nurse that when the procedure is done the side that is operated on first will always be more bruised than the other because of the time it takes until you are strapped up. My right side was done second and was strapped immediately after, the pressure inhibited any bruising/swelling. As of now i still have my stiches (darn my nipples are itchy) and from what i can tell my right side seems to have coped very well with the proceture, i'm hoping that its just a matter of time before the left catches up and the swelling subsides.

I'll keep you guys posted on how it goes and thanks for all your posts. cheers guys.

[healme]

@frustrated1: mine still have some swellings on the left side. Doesnt seem to subside fast enough! im getting frustrated at times. im keeping my garment during the day and taking it off at night. didnt realise that you can be 'syringed' out?? what does it involve? is it painful? I still have some 'sore' feeling around the area where the stitches are.

@jack01: congrats too on getting it done. i was told differently altogether i.e. what was operated first will reduce in swelling faster than the later.

i really hope they are just bruisings that would soon subside.

lets keep each others posted

[jack01]

Had a follow up session with sue and as expected she aspirated the left side with the syringe. i'm pretty sure that the swelling is what they call a seroma, a fluid build up. the fluid can dissipate either by aspiration (removal with a syringe) or slowly over a period of time the body can resob it.
with this session she was unable to take out too much of the fluid, she said that it still is pretty hard and needs some time to break down to fluid. so no real changes in the size of the swelling.
she removed half of the stiches on the right side but left them on the left. she will remove once she has fully aspirated the area. From what i have read online, seroma seems to be the most common complication for gynecomastia and is not that much of a big deal. once its been aspirated the effect is immediate, so ideally you should see results straight away.

she is confident that by my next session she will able to remove most if not all of the fluid, i'm hoping that's the case. Otherwise pretty much all of the bruising is gone, the right side has healed very well and honestly feels as though i would be able to return to some sort of activity, maybe even do some pushups.  not training has been really hard, if it wasn't for the swelling on the left, which is really uncomfortable and a little restrictive, i believe i would have been able to return to training within a week or so.

healme if you're still bruised/swelled up then i would probably continue to wear the vest 24/7, it will only help with the swelling. don't stress too much, i know how easy it is for the mind to start running, but stay positive and make sure you're diet is really good, heaps of vegetables, especially greens, fruit and plenty of water, the least the body has to expend evergy metabolising processed foods and the more readily available nutrients and vitamins are, the better it will be able to do what it needs to do to bring itself back into balance.

i'll post an update after my next session. cheers guys

[yehkay]

I just got back from Melbourne 4 days ago from my consult with Sue
My surgery is in about 8 weeks. Keep us updated.
Also 1 question i have, you said she removed the top stitches first, like as in you had stitches all the way around the nipple? I thought the stitches / incision was just on the bottom.

[losernumber1]

Healme, Id like to see your pre/post op pics.

[gynebarn]

Also 1 question i have, you said she removed the top stitches first, like as in you had stitches all the way around the nipple? I thought the stitches / incision was just on the bottom.

When he refers to 'top' switches, he means top as in "on the surface".  My understanding is that there are stitches below the skin, and stitches above.  They remove the outer ones first.  The stitches are only on the lower arc of the nipple, as you say, there is just two sets.

Actually this doesn't make a lot of sense.. they can't remove stitches underneath because it will have healed already. I believe the the stitches underneath the skin might be dissolvable / absorbable.

I went back for another appointment after having the stitches removed and it's almost completely healed up.. even after 2 weeks there's hardly a scar!

[gynebarn]

Can anyone confirm their anasthetic cost? I got the letter from the anesthatists and they reckon its $1000. But didnt someone say it was around $650?? Also does medicare rebate any portion of the anasthetic??? Thanks...

I got the same quote - $1000.  When I met the anaesthesiologist before the surgery she said up front (without me prompting) that I was over quoted.  They ended up refunding $250 to make it $750 total (still more than others, but I wasn't too worried).