Successful surgery with Dr Marta (Noa Clinic, Wroclaw, Poland)

[chifer]

After a long history with gynecomastia (read about my history here) and years wearing compression garments (see my recommendations here), I spent a long time trying to get my health insurance to cover the costs of gynecomastia surgery (read about my experiences here), After several rejections, I gave up. Thanks to this forum, I was aware of the costs of a surgery in Poland, and decided I could pay for this privately as well. Based on the various reviews, the Noa Clinic got by far the most positive reviews from what I could gather, so I chose to go for them. My main drive behind writing this post is to give back to this forum after I got such good information from it. Let me stress that the Noa Clinic has nothing to do with this post, as they not once asked me to provide a review anywhere.

I have structured this post in three parts: (1) the preparations before I came to Poland, (2) my experiences on the day of surgery, and (3) my experiences afterwards, which are still ongoing and which I will be updating occasionally.


Surgery preparations

In January, I contacted the Noa Clinic directly. They immediately provided very clear information about what the procedure would be like. A consultation with Dr Adam prior to the surgery is necessary. Because he offers these consultations in London and Wrocław and my travel time is more or less similar for both locations, I chose to do this in London and combine it with a holiday. This is why the Noa Clinic got me in touch with the U.K.-based branch, called Europe Surgery.

The consultation was two months later in west London, at a location easy to reach by public transport. The consultation lasted about 20 minutes, and I remember it as a pleasant and comfortable talk. I was able to clear several questions with him that I had at that point. After the consultation, the staff (also very friendly people) immediately offered me a few dates at short notice, though I held off as I planned to have the procedure in the summer, though I couldn’t plan that far ahead at that point due to an ill family member.

Late June, after a bit of back and forth, Europe Surgery gave me a great date in August, though the surgery would be with Dr Marta instead, which was fine by me. One thing that could be improved on their side, though, is the speed and precision with which emails are answered, which sometimes took over a week and in which questions were sometimes not being answered.

After confirmation of my surgery date, they sent some information about the planning (plane, hotel recommendations, costs, etc.). I discussed the surgery with my GP and started planning the trip. One could notice that they are predominantly serving customers from the U.K., as they assume you will come by plane and you will pay in GBP.

Knowing what a beautiful country Poland is, I combined the surgery with a holiday beforehand. We went there by car. I stayed at the Solo Hotel, which I can recommend (Europe Surgery also listed them as a possibility, advising to take a Solo Plus room as the standard rooms are fairly basic lodgings). It is two tram stops away from the clinic (or 900 metres on foot).


Surgery day

I arrived at the clinic before 8. The building seems quite modern and the floor where the clinic is located on has been segmented into a reception area in the middle, with offices and some other rooms on one side, and on the other side of the reception area two separated landings: one for the operating theatre and staff, the other for the patients’ rooms and bathrooms.

I had to fill out some forms. Strangely enough I had to fill out the same anaesthesiological form that I already filled out and had sent to Europe Surgery by email. Other forms included a psychological assessment form, which seemed very well-suited to determine a patient’s mental well-being, and a form to indicate whom to contact in case of an emergency, along with a release to allow them to make private details about the treatment available to select persons under those circumstances.

I then had my consult with Dr Marta, roundabout 9 o’clock. Whereas I would describe Dr Adam as a gentle and competent doctor, Dr Marta strikes me as an empathic and competent doctor. Both have a really good way with approaching their patients and I can understand why they have a joint clinic. Since I have met with both, I can say that I would have gladly entrusted both of them with performing the surgery. I am truly happy with Dr Marta as my surgeon, but would have felt the same about Dr Adam.

Dr Marta did a medical check-up and provided the opportunity to ask any questions I might already have. This consult, however, was primarily meant to ascertain that I am a suitable candidate for the surgery. She then handed me an informed consent form to read thoroughly and sign. Around 10 o’clock, a nurse took blood samples (this is an optional thing but since I was on holidays the week before, it made more sense to have it done there). The price for that is very reasonable, too (100 PLN).

Then the waiting began. Another patient was getting surgery first, because that surgery would take longer than mine. My surgery was scheduled for 1 p.m. At some point, my room was ready, so I was given covers for my shoes, and the instruction to first take a shower before putting on my hospital gown and slippers. Though I had showered in the morning, I must say I was impressed by the hygienic standards that were being enforced here. The rest of the time I spent reading and watching a movie on YouTube (the WiFi at the clinic is great, by the way).

The surgery before me lasted a bit longer so eventually Dr Marta came into my room around 1.30 p.m. to draw lines around my chest area with permanent markers, and to clear any and all questions I might have. She really took her time for this, answering all my questions and ascertaining that I really did not have any more questions before she would prepare herself for the surgery. For me, this is my definite highlight, because I hadn’t expected such a great deal of attention from the surgeon.

My main point of criticism also comes from around that time. Normally, the anaesthesiologist should talk to the patient before the surgery as well. Whereas first my anaesthesiological form was missing, now the anaesthesiologist did not come to me before the surgery, and did not talk to me at the start of the surgery either. This struck me as a bit odd. Even though I was in good health and have had one full narcosis before, from which I recovered very well, I do feel that some exchange should have taken place just to clear things.

I was then ushered into the operating theatre, and received a translucent robe that I needed to put on me after taking off my hospital gown. In the operating theatre were four people present. They hooked me up to the monitors and I felt the anaesthetics starting to work real fast (at least, I gathered as much since the fluorescent lighting on the ceiling started moving). I then let go. Next thing I know, I was back in my room and was asked to move from the surgery bed onto my own bed. I was slightly dazed but the anaesthetic soon subsided.

The night nurse had already started her shift after my surgery. Again a great person, though she did not speak English very fluently, which made it sometimes a bit hard to communicate. She measured my blood pressure and made sure I had enough painkillers. I also got some additional documentation with instructions for the recovery. Sleeping pills were also available to ensure a good night’s sleep.


Recovery from the surgery

The following morning, Dr Marta visited and released me. My breasts still looked swollen, but she explained that it is mainly because it is filled with fluid. I felt surprisingly good and active. My frame of reference regarding what to expect in terms from pain was an ear surgery I had six years prior. But this was only a fraction of that amount of pain. I took some painkiller the first few days, but most of the “pain” is really what others also describe as sore muscles from heavy exercising. My nipples are the most sensitive, which is also a good thing because that means many nerve endings are still intact.

After about two days, the bruises started appearing in a bright yellow colour (which is a normal thing to happen), and they slowly started to become bluish. After about a week, I did not need to use sterile gauzes anymore, and only continued wearing the compression shirt. I did notice during this week that I have less energy as usual, which I think is more because of my body recovering than that it is from the narcosis. As per instructions, during the first few weeks I am still to refrain from lifting objects weighing more than 4,5 kg or from activities that raise my heart rate beyond 100 bpm.

(Edit: inserted links to other posts.)

[Sports Brah]

Unsurprisingly, that sounds just like my experience... bar the mention of the famous cheese and ham sandwiches. 

[chifer]

Hi, glad to hear from you. My wife and I actually looked at your photo documentary, for which I am very thankful as it gives me a good impression of what to expect in the coming weeks (along with some photos in and out of the building) You really did a superb job and invested a lot of effort into writing down exactly what you were experiencing each week. I wouldn't know where to begin! So thank you for that, and also for reading my story.

Haha my meals were different in that the sandwiches didn't have ham and cheese, but one half of the sandwiches had cheese and the other half ham. In the evening after the surgery I got a type of baked ham, and pressed ham in the morning.  

[Sports Brah]

Cheers. The intention, especially with all the photos was to show people - especially those who find the idea of travelling abroad for surgery a bit daunting - that it's not that big of a deal. It's a typical city, I recorded what a typical trip is probably like for most... and if you step out the hotel and take a look round it's not that different to round here (except NOBODY crosses the road until the lights are green!).

[chifer]

(except NOBODY crosses the road until the lights are green!).

Funny story there: I was sitting near the reception desk on the day of my surgery, waiting for my room to get ready. Two English ladies (who were there for a check-up) came in and begged the receptionist to help translate. Apparently they did cross the road during a red light in front of the police. The police wanted to fine them but they didn't speak English at all and at some point even wanted to take them to the police station. They explained to the receptionist that in the U.K., you may cross a red light as a pedestrian at your own risk if you are certain that it is safe. Is that actually true?!

I must say, though, that the lights were sometimes red a very long time, but generally people do wait patiently. I spent some time in Poznan before I went to Wroclaw, and there it is even worse. But people would cross the road prematurely in the evenings and when the police was nowhere in sight.

[giggsy]

Do you have any pictures?

[chifer]

Do you have any pictures?

This is a good and justified question, but I have chosen not to share any pictures for personal reasons, so my words will have to speak for themselves. Thank you for your understanding.

I am now five weeks post-op. After four weeks, the last bit of bruising on my left breast disappeared. I had a lymphatic surgery which especially helped the "hardness" on the sides to decrease somewhat. I think that also made the sides less sensitive because for the first few weeks, I couldn't lie on my side as it would hurt. This is now not the case anymore.

By now, I do spend a lot of time "caring for" my chest. I try to increase the chances of my skin flattening out nicely by increasing its elasticity through moisturizers (from the Body Shop) and oils (olive oil with cinnamon, coconut oil, Bi-Oil). I also massage my scar tissue trying to get it as lean and little as possible (e.g., on the couch while wattching a movie). The scars on the bottom of my nipples are slightly turned inwards but I hope those will flatten out soon. The stitches are dissolvable and those all seem to be almost gone in the wounds at the bottom of my chest (where they performed the liposuction).

My breast was already smaller after surgery. I had a technique where I measured its size by putting my index finger underneath my breast and moving that finger up. It would always get to the tip of my second (intermediate) phalanx bone, which reassured me my breast was stable at 5 cm. Directly after surgery, I couldn't do that as it would hurt, but as soon as I did, I could already see my breast did not reach the tip of the phalanx bone and was obviously "only" about 4 cm. The fluids did not seem to really reduce in quantity though, so the first four weeks there was not really a reduction in breast size, though I am under the impression that in the last week, this changed a bit.

Lastly, a week ago I have started wearing my "old" compression garment again. The compression vest that I bought at the clinic (Caromed compression vest) was useful in the beginning, where the wounds and surrounding skin were extremely sensitive. For those situations, it was great to have something you could close by using hooks and a zipper at the front, and Velcro straps on the shoulders. But it started getting on my nerves because:

• The Velcro started making noises after about 1,5 weeks.
• The shoulder straps started to smell acidic after 2 weeks, and after washing it, they again smelled 2 weeks later.
• The shoulder straps are quite thick.
• The zipper started to become uneven, causing my T-shirt to get an odd shape.
• The top part of the zipper is so high that you can only wear T-shirts with a high collar.
• In general, I had the impression that the compression vest was already losing its elasticity after 4 weeks of (24/7) wear.

(Note that I have worn both GC2 and Danae.info compression garments for 10 years and neither of those ever got on my nerves.) So I tried on my old compression garment. The first surprised was how awesome the compression already looked (at it had less tissue to compress). I was very happy with how it looked and sat. I have now worn my old compression garment for a week and will probably keep wearing it for several weeks longer.

[giggsy]

ok, im thinking of getting my surgery done at the same clinic. Do you know if they removed the whole gland, or left a bit under the nipples for support?. Tnx.