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My Recent Top Surgery
I just had top surgery last Thursday. I elected for the Peri/Keyhole procedure. I was a B cup.
Still have the drains in until tomorrow or the day after.

Dr. Beverly Fischer was my surgeon. I give her the highest recommendation possible. She worked a miracle as far as I am concerned, never had any bruising AT ALL, and very smooth as of day 6. I haven't really seen my nipples yet, still all bandaged up for another week or two (I decided to go for nipple grafts so she could take more loose skin).

I met with a few other surgeons (including Brownstein in SF) and after carefully weighing out of my options, I am SO glad I went to Dr. Fischer.  I know lots of people have great experiences with Brownstein too, but Fischer was the right fit for me. Don't let her website and girlie waiting room fool you, I almost dismissed her because she doesn't have FTM surgeries listed on her website. What a mistake that would have been.

Last Wednesday night, I drove down from NYC to Baltimore with my wife. It took about 3:15 hours to get there by car from Manhattan. We stayed in a great brand new, clean, but cheap ($139 for two room suite) hotel (Residence Inn Marriott) near by the Advanced Surgery Center, the room had a kitchen which was great for saving $ on meals. We stayed 3 nights. Could have done it in two but the 3rd night made it more relaxing. Also I was glad I asked for an "accessible" room (aka handicapped) because of the hose shower which allows for bathing with out getting your chest wet, or washing your hair with out getting your chest wet.

If anyone wants more info let me know. Glad to share.

Here are a few things might be helpful to know. I know they may seem basic, but I didn't know this stuff until recently:
  • If you are traveling any distance by plane, train, or car - consider bringing a pillow. It made all the difference on the 3 hr drive home from Baltimore to have it between my chest and the seat belt.
  • No need to be nauseous - Ask your Dr for the anti-nausea pill Rx (you dissolve it on your tongue one hour before surgery) It is DEFINITELY worth it. I took one after surgery too.
  • Wear easy to slip on shoes. My wife had a hard time getting my boots on while I was so groggy after surgery
  • After surgery take some kind of laxative, as general anesthesia makes your gut stop moving.
  • I was told to eat light after surgery, soup cracker, no meat (meat is hard to move through your gut), fiber is good.
  • Salt is bad before and after surgery it makes you retain water - bloating, puffiness, etc
  • Drink a ton of water the two days BEFORE your surgery until midnight the night before, you want to be as hydrated as possible.
  • Bendy straws are helpful!
  • Sleep propped up on pillows at a 45 degree angle for the week after surgery. This helps the fluid drain.
  • Try to keep good posture, shoulder back, before surgery and as soon after surgery as you can. My doctor and her nurse really emphasized this as one of the most important ways to get good smooth results, no adhesions, etc.
  • Pillow under your knees helps your back from getting achy
  • Ice packs on my chest above my bandage/binder helped apply pressure to where the skin had been pulled away from my muscle, and reduce swelling.
  • Really try not to lift anything heavier than your cell phone.
  • Try not to use your arms to move yourself around in bed, or push yourself up, it makes you flex your pecs- bad for healing. (This was really hard for me to resist doing)
Beware: The following photos are pretty graphic5 days post op5 days post op5 days post op 3

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so you had a peri with free nipple grafts? interesting...i thought that fisher didn't really like to touch the nipples on the first go round. will she do nipple grafts if you are willing to compromise sensation loss?

Hi jdogg79 -

I don't really know what she does with other guys, but I talked to her about what I wanted (peri) and she said she'd do it, but it was based on my measurements and her evaluation of my skin elasticity.

We discussed whether to keep the nipple pedicle or remove the nip graft it back on. I knew that grafting further reduced my breast cancer risk (my mom died young of breast cancer), and allowed me to have a flatter chest, so I opted for that, although it's riskier (you could in theory loose a nipple) and you definitely loose sensation (quite likely forever). Lost sensation wasn't so much of an issue for me personally.

I have to say that in retrospect I wish I had known that I would have a bit of pleating around my nips. And the healing seems to be taking a little longer. There is also a slow rate at which the excess skin tightens up (I had a B cup and it could take a year or more for the skin to bounce back) but all this is normal. In a year I can consider a revision, if there is still any issues, but I doubt I will do it.

Right now, it just feels so good to have a flat chest that I am pretty darn happy.

Over all I did have a great experience with Dr. Fischer. She was very reasonable and easy to talk to. I think if you meet with her in person and explain what you are wanting she'll work with you to get the best results possible. She is really gentle and delicate in her surgery while being aggressive about removing all the breast tissue. I really liked that she would customize a surgery for me. Other docs I met with were pretty rigid about what they do (one way only). She definitely does not have a one trick pony kind of approach.

I really didn't want large scars under my pecs, but having a B cup meant there were some compromises to consider with the peri procedure: some pleating (excess skin due pleats with the purse string type of suture) and slower healing around the nips.

I hope my explanation was helpful. Let me know if you have other questions. I found that talking to her other patients, was really helpful in making my decision.

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