My surgery journal and experience [pics]

[herpderp]

Today, after knowing that I needed it for about 8 years, I had gynecomastia surgery. Hearing about others' experiences with this issue has been extremely helpful to me and I thought it right that I make my own journal. Hopefully this proves useful to someone in the place I used to be.

Background

I first thought seriously that I had gyno and researched it when I was 16. I am 24 now. I don't have health insurance, but I have recently hit a sweet spot financially and was able to pay for it out of pocket. During the 8 years I've lived with this I never had close to enough money to pay for it out of pocket. I had the surgery with Dr. Richard Bartlett in Boston, and the total cost of the surgery was $6,500. That included the cost of the entire procedure, including anesthesiologist, compression garments, and all post-op visits. It did not include cost of prescriptions taken post-op, which was about $70. I was always too embarrassed to bring this up with my family and ask for assistance in paying for it, even though I think they would have helped me out a bit. I regret that somewhat, but I'm also happy that essentially no one even knows or will likely know that I've even had this done.

Now, shortly after I first noticed the gyno when I was 16, I fell into a rather deep depression and my life was quite miserable until I was almost 20, for a number of reasons. This depression was not entirely the result of the onset of the gyno, but it certainly contributed to it. I had been diagnosed with depression and had been taking meds for it. I had also been smoking marijuana at the same time which I deeply regret. During this period I put on a lot of weight. I'm 6'2" and at one point I was almost 270lbs. Horrendously out of shape. At this point even if I had the means to get surgery I think I was too fat for it to even be effective.

Luckily I am quite a motivated individual, and, long story short, I completely turned my life around in the 4 or 5 years since that time. I'm now a very healthy 175lbs, just ran my first half marathon, and am generally very happy and excited about life in general. During the course of my weight loss, my chest became less "booby" because of the loss of fat, but it also became more and more apparent that there was tissue there which was not fat. I was convinced that surgery was the only option, and Dr. Bartlett concurred.

I took some photos before I left for the procedure this morning:

Photos






I've slimmed down quite a bit so it may be hard to tell, but trust me that if you feel on the aureola there is a very definite lump of breast tissue. It has made me terribly self conscious being shirtless in public and being intimate with women. Dr. Bartlett is definitely on the pricier end of gyno surgeons, but being able to feel comfortable in my own skin is absolutely priceless to me.

The surgery

Got to the office around 7. Surgery started around 8. Dr. Bartlett and his staff are awesome. Super professional and friendly. The procedure is very straightforward and there's not really much to be said about it. They did direct incision on me and no lipo as far as I know. I did not get a "full" anesthesia (tubes in mouth and everything), but they give me an IV which put me into a state which the anesthesiologist dubbed "subconscious". So I could talk and breathe on my own. But I was not at all aware during the procedure. I recall becoming alert at one point which I would guess was about 20 minutes into the procedure, watching Dr. Bartlett and his assistant do their thing and saying something to the effect of "Hey, I wanna see what they're doing!" (there was a small curtain or something between my eyes and chest). I did not feel ANY pain during this small episode, however, and I believe the anesthesiologist cranked up the dosage at that point because the next thing I remember is that it's a few hours later and they've all but cleaned up the operating room and were waiting for me to awake. From the time they began the procedure to the time I was able to get off the operating table was something like 3 hours.

Post-op

I am an exceptionally healthy and young person, so I imagine my experience post op is not typical. But I am in very little pain and have absolutely no trouble walking around. The compression vest is fairly comfortable, though a bit more bulky than I had hoped. We'll see how it is tomorrow, but so far I have no complaints about post-op.

What's next?

I have a follow-up appointment one week from today. I'll update as much as I can and answer as many questions as I can that you all may have. And I'll post pictures when that becomes an option. The compression vest needs to stay on for a few weeks.

Again, I really want to use this thread to help others who are in my position so please ask me questions.

[herpderp]

Day 2

I started having some pain late last night, and that has continued into today. I guess the initial shock has worn off and the body is going into full-on recovery mode. The pain isn't bad at all, though, and its intensity comes in waves. I could get by without the pain meds if I had to but they make it a lot more comfortable. I feel it mainly right under my aureolas and on the sides of my pectoral muscles. Most of the time it's a sort of burning sensation. Sometimes it's a sharper sort of poking sensation. Sometimes I get these random tingles. All of it feels like a "good" kind of pain though. Like the kind of pain that indicates a healing process is taking place.

I feel great overall. Only problem is that I don't have anyone to take care of me (just moved here and don't have family in the area), so doing day to day tasks like making food is tricky because I have to be careful not to exert my chest area too much. I'm also not happy about not being able to shower properly. But it's all so little to put up with compared to the prize that waits at the end of all this.

[herpderp]

Week 2

Went for my first post-op today, and things went well. There was A LOT of fluid build up around the incision, mostly under it, which the doc said was from all the coughing I'd been doing this past week as I've been fighting a really bad cold. My chest looked and felt really weird. The doc said it'd go away by itself but wanted to drain out some of the fluid himself. After he did I felt much more normal and could tell that the final result is gonna be awesome. The bandages are now off which makes wearing the compression vest a lot more comfortable. Even though my chest is very much swollen and bruised, and far from the final result, it feels soooo much more like a normal man's chest already, and I'm already able to walk around much more comfortably down the street in a t-shirt than I used to.

I didn't do much of anything but lay around all last week. Some very light walking, but that's it. I feel really good now. I'm gonna start walking like I normally do this week (which is A LOT, I live in the city), carrying around a bag, and being your normal 20-something city boy. But I'm not gonna do any real cardio or strength training for a few more weeks. The doc says I shouldn't do anything but walk for 6 weeks but honestly I don't see that happening. I'm gonna listen to my body, but I see myself running again in maybe 2 or 3 weeks.

I'll post pics again when I'm not so bruised and swollen.

[herpderp]

The compression vest is very discrete. I know I said before that I thought it was a bit too bulky, but that was before the bandages came off. Now it just feels like wearing under armor or something. I'm wearing this fitted shirt today and you can't even tell that I have it on.



Also, the fluid I mentioned in the previous post came back. I told the doc and he said he wants to check me out tomorrow just in case. I can't wait until it all goes away and I can start seeing the final result. I can tell it's gonna be really good!

Not being able to work out is really getting to me. I've never wanted to run and do pushups more in my life, but I know I have to take it easy and let things heal properly. I'm thinking I'll be good to go with pushups again by 4 weeks.

[herpderp]

If you're someone who has spent a lot of time losing weight and getting in shape before surgery, you really need to prepare yourself mentally for not being able to workout after surgery. It's maddening. I've certainly lost some muscle and put on a little more fat. Keeping a good diet and doing a lot of walking has helped but I'm definitely losing the shape I was in. I don't have much definition under the pec muscle anymore, but that's mostly due to the effects of the surgery.

All of my bruising is completely gone, but the incision area on and below the aureola is still quite swollen and there's still some fluid even though the doc drained it twice. There's definitely some intense healing processes still going on.

I've decided that tomorrow, the two week mark, I will start doing lower body and abdominal isolation exercises again (crunches, leg lifts, etc), and also stretching. At three weeks I will see if cycling is a good idea, and as I said in my last post, pushups at four weeks.

[herpderp]

Just got a $300 pathology bill. Remember to consider this as it will be separate from the bill the surgeon gives you.

[herpderp]

The swelling has started going down significantly and I'm finally starting to be able to see the natural shape to my chest. Although, the left side is noticeably more swollen than the right. The fluid seems to have gone away almost fully. And my chest is just starting to "feel" good now. Seems like I'm over the hump now. I really can't wait until it all goes away and I can start exercising again. I'll be ready for the beach this summer I haven't been able to say that since I was in grade school.

[herpderp]

Yesterday was the 3 week mark and I finally took off my compression vest! It feels great walking around without that thing all day. My chest feels great, and the swelling is getting better and better each day. It is now very easy to feel around the incision site and I can now feel some hard masses under the aureolae. Some research makes me believe that it is either just swelling, as swollen tissue can feel firm at times, or scar tissue. I don't think it's anything abnormal, nor do I think it's leftover gland. It certainly protrudes a bit, but not nearly as much as the real gyno tissue. Tomorrow I will have another post-op visit and I'm sure the doc will say something about it.

[herpderp]

Doc said the hard stuff is the same kind of stuff you get when you sprain your ankle (which I believe is scar tissue), and that it will take a few months to disappear completely. But he said that I'm healing well and I don't need to go in for another post-op for 3 months. So that's very good news. The right side is looking wonderful, hardly any swelling and very little hard scar tissue. On the other hand the left side looks like it has a ways to go. It definitely had more breast tissue and the doc said it was more difficult to get it all out on that side. I also got the tape on my aureolae off and so I can see the scars and whatnot. The scars don't look bad at all and I can tell that they'll hardly be noticeable when healed all the way. But both nipples look kinda messed up and uneven right now, but I'm sure that's normal otherwise the doc would've said something. Definitely plenty of healing to be done. The doc cleared me to ride a bike, but said I should still stay away from running or pushups until the 6 week mark. Don't know if I can make it that long. But any exercise I do I will take it easy and slowly and listen to my body. Overall I feel great and I know I'm gonna be happy with the final result!

[herpderp]

I noticed this weird line that looks and feels a lot like a vein between my upper abs and left pec. I can only see or feel it when I lift my arms and extend my abdomen. I showed this pic to the doc and he said it's normal for people who've had surgery in the trunk area, especially thinner individuals, to develop this thing. He didn't tell me exactly what it was, but he did say that it's nothing to worry about. Note that my left arm is raised up, while my right is not, thus the asymmetry. And the pic was taken in a mirror of course.

[George Pope, M.D.]

It will go away.  It's a weird occurrence that can happen after surgery on the trunk, due to soft tissue swelling and the effects of gravity and dissection through tissue planes. I see it sometimes after breast augmentation.

Dr. Pope, MD 

[herpderp]

Thanks Dr. Pope. Do you know exactly what it is? Feels like a vein to me, but if it is I think it's weird that I haven't noticed it before.

[TommyDodge]

Thank you for posting your story, you're a good writer.

[Dr. Elliot Jacobs]

This is called "Mondor's Syndrome." It is not common but is occasionally seen with breast surgery on both men and women.
It is a benign condition and will disappear spontaneously with no treatment needed.

Just a minor inconvenience.

Dr Jacobs

[herpderp]

I hooked up with a girl last night for the first time since surgery. Being comfortable with a woman feeling my chest: priceless. Despite there being lots of hard scar tissue still there.