Author Topic: Hopefully the 1 post that answers many of your questions about surgery!  (Read 5013 times)

Offline sdsurfer

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It’s been almost 3 weeks since I had surgery and I wanted to go ahead and create this post before many of the details of my pre/post surgery faded from my memory.  I definitely have to thank those that created this board and members who answered my questions.  Although this board is awesome we all know questions do go unanswered and I never really got a complete picture of what to expect until I went through the surgery myself.  Would I have done it without this forum?  I don’t know.  I think I may have done it eventually but I did choose my doctor based on surgery results and some communication with and another user on this board.  That user was “removethese” and he used Dr. Anne Wallace at UCSD (his pictures: http://s108.photobucket.com/albums/n30/nomogyno/).  Dr. Wallace is a specialist in breast cancer surgery, breast reconstruction, and cosmetic plastic surgery for the breast (just copied it off her page - http://drwallace.ucsd.edu/).  He used her for his surgery and had really good results (he was a Schafer redo – from what I’ve read on this board AVOID Schafer).  I’m happy I went with her as I think everything is going to look really natural once I’ve fully healed.  As for scars, she cuts very tiny openings at the each side of the nipple but the scars aren't hardly visible. She first lipos everything to remove the fat and if there is any glandular tissue she then uses scissor-like tools to cut it out and remove it from the small incisions. She also makes a small incision on each side (below your pectoral region) which is somewhat noticeable ... they're about the size of a grain of rice though.  She places drains in these incisions so that there isn't any fluid build up.  She really is an expert at what she’s doing and a great doctor for this procedure.  To quote removethese: “Her breast knowledge is second-to-none in my opinion ... she's been working on breast-related problems for 19 years I think.  UCSD is world-renowned for its medical facilities, research, and doctors; you'll see that she fits right in.”  And he's right.  She was always available when I paged her.  I also wanted someone local in case I needed to see the doctor (better the one that actually did the procedure than bringing in someone cold).  I also felt really comfortable with the fact that you pay UCSD for the services (the doctors are probably on salary) so I never got the feeling anything was done in order to keep a private practice in business.  But back to my main point here, in addition to finding my doctor for surgery I would say the other biggest benefit I got from this board was learning of the doctors to avoid!  That’s actually more important in my opinion.  I think where else could I have gotten that information?

Now the following information is just based on my experience.  I’m not a doctor, just a patient.  If you’re doctor tells you anything that goes against what I say then by all means follow their recommendations or if you ever have doubts get a second opinion from another doctor (key word here is DOCTOR as in board certified in plastic surgery and actually experienced in this procedure with good results of course).  This is just my way to try to give back to the forum that helped me.  What I will attempt to do is give you an overall recap of my experience so you know what to expect.  As I mentioned, there were many things I did not know until I went through the surgery myself.  Hopefully this is helpful to you but again please do not confuse it with any type of medical advice whatsoever.

First things first: Consultation
You may have already had a consultation with a doctor.  This is just when you go in to talk to them about your situation and have them tell you what their options are.  I would go to see more than one doctor if possible.  Remember this is SURGERY not a haircut.  It’s a major decision and you should take it very seriously.  I would recommend creating a list of questions to take with you so nothing slips your mind when meeting with the actual physicians.  It’s also a good way to see how doctors may respond differently to the same question.  Definitely try to see pictures of past patients and even meet past patients if you can (the office can contact the patient and give them your number then it’s up to them if they contact you or not).  It shouldn’t cost you anything so take your time here.

Pre-Evaluation Exam
So you’ve chosen your doctor and have a surgery date set.  I’m not sure if everyone does this or not but it helped put my mind at ease.  It’s basically a pre-evaluation exam to make sure everything looks good before your surgery.  Mine consisted of:
1)   EKG with a nurse
2)   Discussion with an Anesthesiologist
3)   Lab work (drew blood for what tests I’m not sure)
The discussion with the Anesthesiologist was the most important of the 3 for me.  It could be because I had never gone under general anesthetic before but this was actually one of the things I was most worried about. He answered all my questions and really gave me piece of mind.  I would highly recommend it if you can talk to them prior to surgery. Also depending how close you are to surgery the doctor may mark you up which is when they mark with a pin all the places they plan to lipo.  Some do it the day of surgery but mine was the day before.

Doctor’s Recommendations
Follow the doctor’s recommendations to a T.  I got a sheet of things to do weeks before surgery, day before surgery, morning of surgery, and following surgery.  They will probably ask that you don’t smoke, take Vitamin E, and aspirin or aspirin containing products (non-steroidal anti-inflammatory meds) weeks before surgery.  They will probably also ask that you do not eat or drink ANYTHING after midnight the day before surgery.  This is so important that if you break the rule they will probably reschedule your surgery for another day.  This is because you could puke it up when you’re under anesthesia and that could cause major problems as it could go in your lungs.  Be sure to comply with this and be honest if you slipped up and did eat or drink after midnight.  It’s not worth it and you can just have your surgery rescheduled.

Pre-Op Checklist
You’ll want to make preparations prior to surgery covering everything from someone giving you a ride (this will have to be a person you know, they will not allow a taxi or shuttle to pick you up), to getting things ready at home so you’re comfortable.  I have created a list below that I think is useful:

1)   Have someone around.  This is really really important.  I live with a roommate and he went out of town the week I had surgery.  I was planning on taking care of myself but had to get my ex-gf to come over and help me out.  Be sure to have some around for at least the first couple days after surgery (day and night).  Believe me you will probably need help.  Of course my surgery may be a bit more intense than yours if you’re planning on only having your chest done (I had chest and stomach) but believe me without somebody around I would have taken a few minutes just to have gotten up from the couch.  It’s much much much much easier to have someone around to get you things, etc.  Also just in case there’s any reason you need to go back to the hospital they will be there to help get you there.  Forget about driving yourself (just walking around the apartment was tough for me).
2)   Get a ride.  As I mentioned you’ll need someone to drop you off and pick you up from surgery.  They will not let you drive yourself or take a taxi.
3)   Have easy to make meals and snacks.  By easy to make I mean EASY.  This does not include canned soups unless you have an electric can opener.  I had trouble just opening my prescription meds and am pretty sure I could not use a can opener or anything that would require some elbow grease.  You will probably not be able to raise your arms above your shoulders so have stuff out where it’s easy to access.  Hopefully you are following the advice in #1 and they can prepare meals for you.  Also have plenty of fluids to drink including H2O (painkillers may dehydrate you so you'll probably drink more than normal and they may also stop you up so get some food with lots of fiber or get laxatives).  Be good to yourself and try to get some of your favorite things to especially if someone will be around to prepare it for you.  However, remember you'll probably only be eating small portions at the beginning and that might be soft things like pudding, jello, etc.
4)   Have a place ready for you to sleep and lay around because that’s where you’re going to be for about 90% of your day.  Lots of pillows and comfortable blankets.  My bed is really low to the ground and once I laid down in it I could not get back up.  I ended up spending all my time laying on the couch (propped up on an incline).  If you have a Lazy Boy style chair now is the time to use it.  If I had one I would have definitely had a better experience than being on the couch.  I also slept on the couch for about the first week following surgery. 
5)   Have loose, easy removable, comfortable clothes.  I highly recommend getting a COMFORTABLE ZIP UP hoodie sweatshirt or something with a zipper on it so it’s easy to remove (key words here are comfortable and zip up).  Forget about raising your arms up to put on a T-shirt or anything that does not open in the front.  I also wore sweat pants and athletic shorts (elastic band, no zipper, buttons, etc.).  Trust me you will be uncomfortable after surgery and this will make your life easier.
6)   Get your prescriptions meds filled and at your place before day of surgery.  When you get home after surgery you’re going to stay there.  Have everything you need there before surgery.
7)   Arnica.  I bruised quite a bit after surgery (I was told more than most people) and was advised Arnica could help with the bruising.  Arnica comes in pill and ointment.  I took both (you can get them over the counter at most drug stores).
8 )   NON STICK Gauze.  If I had to do this again I would probably try to find some non stick gauze to use to cover my post-op wounds vs. what they gave me at the hospital.  The hospital gauze almost always stuck to my scabs and ripped them off every time I removed them.  I would double check with your doctor on this and ask for their recommendations.
9)   Entertainment.  Stock up on movies, books, break out your old video game console, etc.  Think of it like this you’re going to be stuck in one place, pretty much laying down, all day long.  You are going to get seriously bored plus you’ll need something to take your mind off those damn painful drains sticking your sides (more on those later).  I got tons of good movies from my local library and they were all FREE to rent.  I also picked up some used PS2 games from Game Stop (most were $5-$8).  Whatever floats your boat you’ll want something to pass the time. 
10)   Antibacterial soap.  I was advised to shower and shampoo with this day prior to surgery and day of surgery with antibacterial soap.  I still use it and plan to use it until all my soars have completely healed.  I highly recommend liquid antibacterial shower gel over bar soap. 
11)   Camera.  This is optional of course but it’s good to document what you look like before and after surgery.  The pictures can be for your eyes only and serve as a record of how your body has changed.

Day of surgery
Not too much to say here.  The experience was a bit surreal for me.  As it got closer and closer to the time of surgery I just tried to think of other things and how it’s going to be such a huge improvement for my life.  I was in the waiting room for about 2 hours or so just sitting in the bed with an IV stuck in my arm.  One thing that is kind of funny is a priest came around to all the rooms and prayed with people going into surgery.  The reason this was funny to me is because when he came to my room I was joking with him saying “Hey I’m going to be OK I’m sure there are other people that might need you more than me.”  I did freak me out a little but it also reminded me that there were people in that hospital about to go into surgery that had real concerns about their outcome and illness.  The good thing about this surgery is they are not digging deep into the body, they are just sucking out the fat (and gland if necessary) between the outer skin and muscle.  In a weird way it actually put me more at ease.  I began to realize that I am healthy and a surgery such as this with an excellent surgeon that knows what they are doing should only equate to a success when it’s all said and done.  The Anesthesiologists (I had 2 of them) showed up and injected some sedatives into my IV. I told them to take care of me!  From there I remember being rolled down to the OR and being lifted from my bed to the surgery table.  Once they put the breathing mask over me I was out and next thing I knew I was waking up in the recovery room!

My friend was phoned by the hospital to pick me up and they wheeled me out in a wheelchair to his car.  You’ll still be pretty out of it for the day.  I would say you’re just in a bit of a daze and feel sleepy from the anesthetic.  He hung out with me for a while but then took off and I very quickly found out that I needed someone around to help me out so my ex-gf was nice enough to come and help me out for a few days.  Trust me you are going to need someone around to help you out.

Post-Op
So what can I say about post-op?  Well from much of what I had read on my own I thought I would be sore as in if I had a hard workout.  Well I go to the gym all the time and do workout hard.  If you have never worked out and go in there and kill yourself you might feel this sore ha ha!  Now granted I had my chest and abdomen done at the same time so I will most likely be in worse shape if you’re just getting your chest worked on.  However, things you might take for granted like getting up and laying down were very painful experiences.  Just walking around the apartment wasn’t all that easy.  I would say sitting and walking are things you should not even be doing the first day or two after surgery.  Since I also had my abs lipoed my skin felt very very tight (maybe in the chest too but definitely in my stomach).  Just get propped up in a comfortable position for reading, movies, video games, etc.  When I did move around I pretty much felt like I had to be in slow motion all the time.  In addition to the pain of the surgery it’s also mainly related to the drains as well.  Which leads us to…

The Drains: Your Best Friend and Worst Enemy
I believe these are called JPs for Jackson-Pratt drains.  They should more appropriately be named “Drains from Hell that will be the Bane of Your Existence Even Up to the Very Moments after they are removed.”  In my opinion these damn things are the worst part of surgery.  I needed to break up a section just for these because they suck so bad (literally and figuratively).  These are the worst!!!  This was one of the biggest surprises I had following surgery.  I know they were mentioned along the way but nobody made a big deal about them.  Basically you will have 2 tubes running out from under your skin on your chest that are connected to 2 plastic suction bulbs.  The closest thing I can think of to this is an irrigation ear syringe.  You open the end of these bulbs, squeeze all the air out, and then plug it again.  This creates suction and sucks out the extra blood and fluid.  You’ll need to empty these as they fill and probably want to log it as well.  On the bright side these guys are sucking out everything that is going to make your chest swell up.  On the other hand, they create 80% if not more of the post-op pain and discomfort.  Every time you move around more often than not the tubes will move as well (the part that’s under your skin) and believe me you feel it.  Then when they finally get pulled out the sensation feels like someone just stabbed you with a knife.  It’s definitely not the most painful thing in the world so don’t get too freaked out but I’m just forewarning you that these guys are not fun.  In addition to that I was pretty freaked out that the tubes would snag on something and rip out.  Sounds funny doesn’t it but let’s see if the same thought doesn’t pass through your head the first time you take a shower with those guys hanging out of your body. 

Compression Vest and Binders
If you’re just having your chest worked on you’ll probably just get a compression vest.  I also got a binder to wrap around my waist since I had work done on my abs as well.  These are fairly comfortable but definitely get old after you’ve been wearing them for a while (I’m still wearing the damn things as I type this post).  While your drains are in you’ll probably have gauze inside the vest and it gets incredible itchy after a while.  I will need to continue wearing them for approximately 6 weeks following surgery.  These are of course much more comfortable once your drains finally come out but even then I didn’t like sleeping with them on.  Check with your doctor but I was cleared to take them off for sleeping (this is a few weeks after surgery and my drains were out).  It makes a huge difference.  I also picked up an Under Armour Compression shirt to wear under the compression vest and binder given to me by the doctor.  Once your drains are out and the wounds have healed some I recommend wearing one of these.  They are made for all types of athletics and many football players wear them under their pads to prevent chaffing.  I have noticed the compression vest and binder to be much more comfortable now that I have this.  However, don’t buy one until you’re ready for it as if you get it before surgery it may no longer fit you (and these fit skin tight).

Showering
Showering is probably going to be less frequent than what you’re use to.  I had surgery on a Friday and couldn’t shower until after my next meeting with my doctor (which I think was the following Tuesday).  The pain and discomfort following surgery is one thing but not being able to shower is icing on the cake.  And when you finally do shower it’s still a pain if you have your drains in.   The first shower I had after my drains were out was one of the best showers of my life I swear! 

Exercise
Forget it.  I’m going on week 3 here but am still not doing anything physical.  Even when I hit bumps in the road while driving I feel a little pain in my nipples and I can’t imagine what it’s like to run (by the way you won’t be able to drive for 4 days or so following surgery).  The important thing to remember is that exercise or any type of vigorous movement or even heavy lifting can lead to bleeding and swelling.  Do yourself a favor and take it EXTREMELY easy for a month or two following surgery.  I would say 2 months and check with the doctor to be safe.  You’ve come this far so don’t do anything to set you back.

Work
Luckily for me I am in-between jobs right now.  It was actually the catalyst for me to push for surgery since I knew I had time to recover without worry of not being able to perform on the job.  Even if you have a desk job take some time off.  I would not count on doing surgery Friday and then being back at work on Monday.  Of course you could probably do it but you’re most likely going to be miserable and take the chance of injury.  Discuss with your doctor but my advice is to double whatever estimate they tell you.  The reason I say this is because most of what I have heard is people are back at work in 3-4 days.  I wouldn’t have want to do that.

Linkback: https://www.gynecomastia.org/forum/index.php?topic=12308.0
« Last Edit: November 14, 2007, 05:15:24 PM by sdsurfer »

Offline sdsurfer

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Massage
You’ll notice some lumps begin to form after surgery.  The way to get rid of these is to massage them out.  This is where I am right now.  I am suppose to massage these 2 times a day and was advised to use a rolling pin, yes like the one for baking, to do it in addition to my hands.  I plan to follow this advice but I also asked about people that might specialize in this type of massage.  I was told I could go to the American Massage Therapy Association website (http://www.amtamassage.org) and search for massage therapists that practice Manual Lymph Drainage (looks like the site lists it as Lymphatic Drainage).  You can search by your zip code to find someone nearby.  I plan to setup an appointment this week to see someone and see how they would do it and maybe I can use some of their techniques.

Today I went in for a Post-Op exam and the doctor said everything looks perfect.  I’m still a little bruised and a tad swollen but only 65% of the healing is suppose to take place after the first 4-6 weeks and the remainder of the healing happens in the next 6 months.  Each day things improve.  I’ve been making protein shakes too just to try to help speed up recovery (I have that stuff anyway since I workout).

So this is where I am right now.  Almost 3 weeks have passed since my surgery and I feel like the worst is behind me and things are just going to get better from here.  As I mentioned I wanted to try to leave something for this board all condensed in one spot that may help people that are researching surgery.  As I improve I plan to close this chapter in my life so I will probably not return to this board or be in contact via email.  I apologize in advance for this but I want to move on from my days of having gyno (as well as the spare tire around my gut).  I’m happy to think once I’m fully recovered I will be a new me!  Good luck with everything and whatever decision you choose regarding this surgery. 
 8)

UPDATE Week 5
I thought I should post a quick update on my progress as well as what I've seen with the massage treatments.  I highly recommend trying to find someone experienced with lymphatic massage on cosmetic surgery patients.  I went to see a couple massage therapists before finding an excellent one that actually use to work for a plastic surgeon.  She has really worked wonders on the lumps that develop after surgery and I don't believe the rolling pin or any other massaging done by myself could have gotten these out.  The lymphatic system does not have a pump like the circulatory system so if you're not doing the right thing these little pouches will develop and not go away.  One tip I can also give you is that this therapists mentioned recovery is usually much faster if the patient goes in for 3 lymphatic massages the week leading up to surgery.  I would check with you doctor on this but from what she's done to me so far I think she knows what she's talking about.
« Last Edit: November 30, 2007, 04:08:38 PM by sdsurfer »

Offline brisguy1

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Offline Rayban

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WOW!
I am printing what you wrote, and keeping it handy. Thanks for educating me, and good luck!!

Offline gynenomore

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Thanks, sdsurfer!  This is VERY helpful -- almost like a handbook for me now.  I now know what to expect at what stage.
 
Thanks again, to sdsurfer and to Merle for starting this website.

Offline theblues

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This is an amazing topic! Thanks!

Although now I'm deathly afraid of drains.  :o

Offline David22

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Yeah, these drains are pretty annoying.  I'm on day 2 post-op and the drain in my left side I can absolutely feel.  In fact if I gently push on the upper part of my chest above the nipple, I can hear the plastic tube, haha.

Offline desi

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Formerly, 'Fattgayee', as in 'Torn Apart' or more so 'I am Screwed' :)

Offline Sargent Pepper

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Thanks so much, very informative and helpful, I go into surgery a week from today :D

My main concern is the lack of physical activity. I'm so pissed off that I'll finally be able to see my chest, but I won't be able to bench press etc. for like a month... I have a question though, my doctor said 2 weeks would be fine. I'm sure recovery time is based upon the individual and severity of the gyne, right?

How big were you pre-op? Was it bad? Pics to compare conditions? I don't want to take 2 months off from the gym :(

Offline Kansas68

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SP

No exercise does suck, we have had great weather and I'm very anxious to go for a run. Cutting back on the calories is difficult while not exercising.   My Dr said 4 week no exercise, a main concern is actually elevated blood pressure doing damage to the area trying to heal, causing internal bleeding.    Today I'm 15 day PO and feel good, but don't think I could bench press with out being very concerned, much less even run.  I'm following the Dr orders to a T, so I'm waiting the full 4 weeks, I also was told to wear compression vest for 6 weeks.   

My stats: 39 years old, 5'10 175 pounds - took out 200 ml RS, and 275 LS.  I also did the lipo of the stomach - doc said the GYN was a moderate case.

SD surfer,
I'm curious, my PS used the Tumescent Liposuction process and did not use any drains.  Did you have Tumescent? The night of the surgery my wife and I went out to diner just to get outside for awhile, I did however spend most of the first 48 hours in bed or in a chair.  I was sore but could move okay. Did not take any pain med after 48 hours.




 

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