My story so far with Dr. Fielding

[nalse_fame]

I've been reading on this forum off and on for the past few years gaining as much info as I can.  I figured the least I can do is write about my story to help others get the most information they can that is out there.

My short story:
I noticed gyno at the age of 11, was an elite hockey player who had a horrendous diet but was on the ice every day so thankfully I only retained weight in my mid section.  I wasn't a fat kid and wouldn't even consider myself tubby, but I wasn't lean.  I told my GP about the issue but she just brushed it off and said it would go away on its own.  (it obviously didn't).

As I got into high school I got into bodybuilding (not competitively)  and I started cleaning up my diet.  That's when I really noticed the gyno.  I would summer cut into 9%bf but when my nipple were soft they were somewhat puffy and I had some hard lumps under my nipples.  

Fast foward almost a decade, after years of staying lean (sub 10%bf) and even going as low as 8% and only weighing 158lbs (I'm 5'9") when I was cycling at the national level for a couple years and doing other endurance events like IronMan's etc.  I still noticed the lumps that were tender on palpation and when my nipple were soft there was still puffiness.  It bugged me that I noticed it when wearing a light cotton shirt that sat against my chest.

My fiancee always said for people who don't know what gyno is that they'd have no idea, but for someone who knew what to look for it would be considered a more milder form.  I've eaten an extremely clean diet for the past 4 years built around maximizing my hormones (high testosterone and low estrogen).  I don't eat animal based food so no excess hormones from meat or dairy (I was raised on plenty of animal based foods, dairy, meat etc).  And no I don't eat non fermented soy that contains phytoestrogens.  This all helped quite a bit but it was still there.  Needless to say after years of being an extremely healthy person and happy with my body it was hard for me to just accept something I was still holding onto from my childhood with no nutritional knowledge that I couldn't get rid of.

I made an appointment with a GP near by since I couldn't get a referral from a walk in clinic and I figured I needed a referral if I had hopes of getting this covered by OHIP.  I live in the GTA and am in grad school so I don't have a bunch of cash to pay out of pocket for private.  My GP of course sends me to a private clinic (Dr. Lista).  I decided to go anyways to get his opinion on my gyno and see what the price would be.
He was a really nice guy with a great looking clinic but the price was $6800.  Obviously way out of my price range.  I figured I wouldn't be able to get the surgery done for another few years at least.  
I then came across Dr. Fielding online and after a while I figured I'd try and give him a shot hoping OHIP would cover it or the price would be less than 1/3 of what I was quoted by Dr. Lista.  I never got a referral as I read online that you don't need one to see him.  I booked my appointment over the phone (receptionist is very nice) and got an appointment right after the Christmas holidays when I started back at school.  

Dr. Fielding is a really nice guy with a good bedside manner and easy to talk to.  I'm in Naturopathic Med school to be an ND and he's is obviously an MD so the different/ and perceived competing beliefs can sometimes cause some standoffish attitude.  Dr. Fielding seemed interested and we spoke for a short while about my field and his as well as future integration.  It was a good talk and not portrayed in a arrogant way which was great.  He made me feel comfortable the whole time and was pretty relaxed.
After examining my chest he determined that I have a lot of excess glandular tissue and some fat around the inferior/lateral part of my chest which is causing me to have a rounded look to the outside of my chest and not that square look.  He mentioned that the fat in that area is the breast fat that will not react with weight change.  This is what I had experienced when I did drop bf% and I definitely agreed with him.
I asked about OHIP and he mentioned that they rarely ever cover any gyno surgery and they may only if ever cover the hospital fee.  My sugery fee was quoted at $2200 + $350 hospital visit and government taxes for a total of $2800.  He said I needed to be put under general anesthesia.  I asked if local was an option due to costs and he said because he will be working lateral to my chest that there is a risk of rupturing the lateral cutaneous thoracic artery and it makes it more comfortable for him and myself to be put under in case he ever needed to deal with a ruptured artery.  He said for patients who don't need lateral work then he will usually do local.

It seems that long gone are the days where you can go in and get quoted close to or lower than $1000 and OHIP covers the rest.  Mine was likely a little higher since I need lypo around the lateral side of my chest but I do still think that it is a reasonable amount given the going rate for gyno surgery in Ontario.
I am fortunate enough to have an amazing fiancee who is helping me make my finances work to get the surgery done.  I called the next day to book surgery as soon as was possible.  Turns out they had a cancellation for next week so I was able to book my surgery for next week on a Wednesday (Dr. Fielding's surgery day).  I headed back to his office today to pay for the surgery, fill out some forms and get a recap by Dr. Fielding.
I'll keep this thread updated about how it all goes and the recovery.  I don't have any pictures of my chest but my case is identical to the image below (I have more muscle mass and about 1% more bf).

[nalse_fame]

Alright, It's been exactly one week from the surgery so I figured I'd post how it has gone so far.

My surgery was booked for last Wednesday at 12:00 at St. Joseph's Hospital in Toronto.  I had to stop fluids (including water) and eating by 12am that morning.  I pulled into the Hospital around 9:30am which was when I was told to be there.  I had 2 family members with me which helped pass the time.  
Parking can be found on the East side of St. Joeseph's for $15/day.  Don't use the West side parking as it is tiny and fills up with staff much earlier than 9am.  Just drive around the block until you are driving along the East side of the Hospital and you will see the entrance there.
I got prepped and then sat and waited.  I spoke to the OR nurse who explained some stuff and then finally the anesthesiologist while I was waiting just outside the OR with my family.  Everyone I spoke with at that hospital were extremely nice and pleasant to deal with.
I was then escorted into the OR where there was: 2 med students, Dr. Fielding, the Anesthesiologist, and 2 OR nurses.  There was a radio playing quietly and everyone was talking and happy.  Dr. Fielding was in a great mood and made me feel comfortable.  The only thing I found odd was that the operating table had arm and leg holds similar to that of a lethal injection table.  Caught me off guard at first.  (Keep in min the only other surgery I've had was wisdom teeth extraction).
Everyone was talking and smiling and making light jokes so the energy in the OR was relaxed.  Dr. Fielding took before pictures as I sat on the table and then I laid down and they prepped the IV and got everything ready.  The surgery before me must've run a little longer because I think it was almost 1:00 by the time I went in.  
Dr. Fielding started a convo regarding organic food, etc and was asking the med students some questions regarding it.  It was a interesting convo that is right up my alley so I enjoyed it and it helped relax me.  I wasn't anxious or nervous before the surgery as I had no questions about Dr. Fielding's ability and I was just looking forward to finally getting it done and start my recovery.
I went to sleep and had a few dreams that seemed pleasant but I don't remember.  I woke up on a hospital bed and in a few short seconds I realized where I was and why i was there.  A very nice nurse came over and took my vitals and asked how I was feeling.  She said that I just had to relax for an hour and then she'd re take my vitals and let me go home if everything checked out.  I had no pain, just slight discomfort around my chest area.  My IV had morphine in it so I was obviously feeling quite awesome.  After about 30mins I felt the sensation in my chest slightly increase and I no longer felt the heaviness over my eyes.  I figured this was the point where the morphine was starting to wear away.  I never ended up getting the prescription filled as I felt fine and figured if I ended up in pain one of my family members could go fill it for me.
I eventually was wheeled down to the first floor in a wheel chair by my family and they drove me home.  Once I got home the discomfort stayed the same, very mild maybe a 2/10 (10 being worst) and I would definitely not call it pain.  I would get a slight sharp feeling pain if I moved my arms too much.  Felt like I was just slightly pulling the stitches.  That being said it very easily could have been the glue holding the foam pads on onto my chest under the compression garment.
I didn't have too much swelling underneath the garment, most of my swelling went down to my lower stomach and flanks at the bottom of the garment.  Every day during the first week I would stay active and busy doing small things around the house like cleaning and what not.  This allowed for my other muscles to lightly work and keep lymph flow moving and aid in blood flow to the area.  I would sit and read a magazine for about 1-2 hrs per day and I made sure I got 9hr sleep every night.
I slept with 2 large pillows under my upper body so that my upper body was on a slight incline to help keep the swelling down in my chest.  I started doing some light yoga stretch for about 30mins per day about 3-4 days after surgery.  I never put my hand above my shoulders to keep any tension off my chest.

Dr Fielding was away the following week so I saw him the Friday (2 days post op).  He seemed pleased with how my recovery was going and told me that I can do yoga as long as my body tolerates it.  He also stated that the stretched would be good since you want to move that area (to a certain extent) since you don't want the tissue underneath the chest to start to bind together.
When I removed the garment at the end of the 6th day post op, I was impressed.  The glue came off relatively easy - I'd highly recommend waxing or shaving your chest pre operation - and if you sweat a few times for the days leading up t removal it will help loosen the glue a bit.  My nipple are slightly smaller in diameter (within normal healthy range) and they are not disfigured in any way.  The steri strips are still covering the stitches so I'll leave those until they fall off on their own.  My nipple only looks a bit odd when i lift my arms up over my shoulders.  It doesn't look bad it  just doesn't seem to move in a "normal" way as it used to.  This is expected and will likely fix itself once the skin gets used to the new tension in that area.
I have very little bruising and what I do have is already a light yellow color, so it's already clearing up.  I have moderate swelling spread out across my chest and quite a bit on my lower abdomen and flanks below the garment.  I showered (finally!) and cleaned the garment and then put it back on before I went to sleep.  When I woke up this morning the swelling had drastically decreased in my lower abdomen which was great to see.
My plan this week is to do some moderate cardio on the treadmill (no running, just fast walking at a steep incline) and I started doing very easy and light weights early this week.
* keep in mind when I say I am lifting weights I mean that I am lifting around 10-15lbs DB's with very high reps and a limited range of motion.  I will not be doing any chest exercises for 3 weeks.  The purpose of doing weights is to allow movement and some muscles use in the rest of my body.  I am not doing the valsalva maneuver like you normally do with weight lifting, I am consistently breathing in and out regularly during the movement to not increase intra abdominal pressure.
This has seemed to help and has caused no discomfort or issues.  Dr Fielding did an excellent job as I seem to be much further ahead of normal recovery and much better then I'd thought I'd be.  When he told me about the recovery and not working out or doing anything but moderate cardio my first question was what the rationale behind it was.  He responded that it was due to the blood pressure increase causing complications such as bleeding in the chest and/or excess swelling.  
Once I knew the reason for the 3 weeks of rest I was then able to create a better recovery plan for myself.  It's not long ago where people were told to not move a broken bone for 1-2 months and now we know the atrophy and other issues that caused.  Ideally you want that area still active but only to a point where it is still beneficial and keep the risk of further complication down.  Keep in mind that everyone is different and will recover differently and tolerate different amounts of activity.
Dr. Fielding told me to book an appointment with him 3 months post op where he'll assess how the recovery and surgery went.  Based on how the swelling seems to be doing I think by 3 weeks I'll be close to fully recovered.
I have been taken a bunch of various nutraceuticals since the surgery to aid in the recovery process and based on how the recovery has been going, I'd say it has worked well.  Some of the things I've been using are as follows:
Curcumin/Turmuric, Vit C, vit D, Zinc, Arnicare pre and post op, Lymphdiaral drops and cream, fish oil, N acetylcysteine, magnesium, immune booster, raw honey, fresh juicing every day, greens powder, plant based protein with hemp oil and turmeric powder
I've not stated what I used each thing for or the amount.  The reason being some of the above things can actually be potentially harmful post op if not careful or knowledgeable on dose and timing (fish oil being one of them.  The above list is not a recommendation, just an idea of how I focused my recovery.  My main focus when I got home was keeping inflammation down and getting the anesthetic out of my body as soon as possible.  After that point I then focused on recovering the damaged area.
I'll post images at the end, all in all I'm very happy with how the surgery went.  Dr. Fielding did an excellent job and is great at what he does.  The staff at St. Joseph's Hospital was also excellent and great to deal with.

[gbm]

great feedback do share photos

[nalse_fame]

Quick update on the recovery:
It's been just over a week and a half since the surgery and I've been wearing the compression vest every day.  When I do remove it for an hour or so to wash it I am able to make note of the swelling.  
As of last night the majority of swelling has receded.  I am no longer a yellowish tinge on my chest from the remnants of bruising.  I have one small bruise below my left nipple that is slowly getting more faint.  I still have some swelling just inferior to my nipples and slightly lateral but the bulk of the swelling that was over my whole chest has gone down.
I have noticed that the compression vest if pushing swelling down to my stomach and flanks.  When I had it off for over an hour the other day while it was being washed I had noticed that my stomach returned to its normal flat state.  Once the vest went back on a couple hours later and my lower stomach was bulging again.
I have some firm small lumps just lateral to both my nipple, they are not sore but I can feel them.  Likely some scar tissue that I'll try to massage out in the next few days.  I have o more pain in my chest when pressed on but I still do have some heightened sensation if something or someone hits my chest.  It's more of a heightened alert than anything else, not any actual pain.
I can now stretch my hands above my head and was able to do so in yoga the other day without any discomfort.  I have moderately increased my weights on my weight workouts (still will be avoiding chest) and I have upped the intensity a bit o my cardio.  I may do an easy lane swim late this week dependent on how I feel.
I can start seeing my normal definition in my chest on the lower border since the swelling is decreasing.  With the initial swelling post op it makes you appear to have lost all of the natural chest definition (dependent on each persons BF%) on the lower border of your pec muscle.  It's nice to see this coming back.
That's all I've noticed for now.  I'll post pics at the 3 week mark

[Mujassad]

From my personal experience, I had a "minor" case of gyno(we all know gyno is never minor, not mentally) so the surgeon did not take away skin after removing most of the gland and fatty tissue. I ended up with a small amount of excess skin, only really visible when flexing. I started working out again to build muscle and managed to fill up the skin.

When the swelling goes down and you notice excess skin, just work out and you will feel great.

[gyno1990]

Hey, I just had surgery 9 days ago. I'm wondering how things turned out for you. Any concerns? Pics? Thanks!

[nalse_fame]

Things turned out great for me, I haven't been able to post a final post yet as life has gotten ridiculously busy.  I'll eventually get around to posting my final story and results.  I still have to get in  to see Dr.Fielding one final time (April 13th was my 3 months since surgery date).
I've had no issues what so ever.  The hyper sensitivity on my chest has been gone for about 1 month now.  I still only have about 20% (at best) feeling on both my nipples and about a 1" diameter around them.  I'm hoping that will come back within the next year but it's not a big deal for me and is a trade off I was willing to make.

I have some scar tissue that is palpable on both sides of my chest.  It is maybe one or two small fibrous spots.  They are slightly more sensitive than other areas of my chest but they are no longer sore like they were after my surgery.  Appearance wise, I'm very happy.  My nipple are a regular size and are no longer puffy when I'm warm.  I wasn't wear any shirt I was and my chest muscles are not the furthest thing that sticks out on my shirts.
I'll update this thread if anything changes in the next year or so, I'm interested to see if the sensation comes back fully.  There is no scarring to be seen from the incisions, they were well stitched by Dr. Fielding.  The lipo left no scar, just a slight bump under each pec which will slowly fade away.