How Am I Supposed to Feel About This?

Well, folks…I received my second opinion (dated Oct. 27th) through Advance Medical (an amazing service offered to Cisco employees). I think I was expecting some “miracle” fix to be suggested by another surgeon, but instead, Dr. Manish C. Champaneria stated the following in his 36-page report:

The current proposed treatment plan appears to be appropriate. As the patient has had a history of a breast reduction, mastectomy in this setting can be challenging and can be fraught with a higher degree of complications, due to changes in perfusion to the tissues. If there is tissue necrosis or nipple loss, the patient may have two options following debridement and excision of the dead tissue: first, healing with wound care alone, such as wet to dry dressing changes, or second, surgery with skin graft if the wound is sufficiently large. If the skin graft fails, then the best option for healing may be healing via secondary intention (aka wound care).

In order to achieve a natal male chest, further revision may be necessary. It is
possible but may need to be performed in several stages. Such stages may
include repositioning of the nipple grafts and removal of excess tissue
underneath the axilla and the middle of the chest. Based on the pictures, the
patient may have excess tissue in the middle and lateral aspect of the chest.

The prognosis will depend on how the patient heals and how the tissues relax and adjust to his muscles. The prognosis for healing is good and his wound should heal appropriately. He may require revision if unsatisfied with his results.

Continue close follow-up with your surgeon and seek second or third opinions if necessary, in person. If undergoing a revision, it is best to stick with the same surgeon, as they know your anatomy and history the best.

Scar tissue in these areas can be common. It is best to perform scar massage and sometimes wrap with ace bandages to prevent swelling. The massage should not be pleasurable, but instead firm and slightly uncomfortable. Massage three times per day, 10 minutes each session will help reduce scar tissue. Also, injection of steroid may soften the area, too. It can take up to one year for the firmness to go away.

The prognosis for healing is good. All of these wounds will heal. Unfortunately, the nipple may be mal-positioned and there may be excess tissue in the middle of the chest and lateral chest that may need revision. Based on the pictures these appear to be dogears and excess tissue that needs to be excised in order to achieve a masculine chest appearance.

With regard to treatment options, the patient should allow the wounds to heal completely. If after healing, the patient is unhappy with the chest, then revisionary surgery may be performed, which will likely include repositioning of the nipple grafts, excision of bilateral dogears in the axilla, and removal of excess tissue in the middle of the chest. This type of revision should be performed by the same surgeon, or a board-certified surgeon, one who has experience with such surgery. Ideally, the revision should be performed about 18–24 months following the initial mastectomy.

Although this is a serious complication following gender confirmation surgery, the wounds will heal without any problem, and he still has the opportunity to attain a masculine chest. Follow the advice of your surgeon, and if unhappy with your results following healing, a revision may be necessary.

On the flip side, even though I wasn’t provided with my “miracle” fix recommendation, I was reassured that my surgeon is doing everything she can to help me heal and reach the point where I am finally happy with my chest. She is caring, compassionate, and responsive — which is exactly what I need in a surgeon/doctor.

Thanks to the excellent care I’ve been getting from my wife, my open wounds are finally starting to heal. To me, I still look like Frankenstein and I’m really embarrassed and ashamed of the way I look, but at least it’s far better than it was a month ago.

Thanks to a dear friend, Sherry Henderson, I now have an appointment to get some of this scar tissue “worked out”. I’ll be seeing Annette J. Aronson at Wilmington Pain Therapy. I’m sure it will be a painful visit, but I’ve got to do something about the huge amount of scar tissue I have. It’s becoming more painful each day. And yes, I purchased a Deep Tissue Percussion Muscle Massager to try and do it myself or at least have my wife do it. NOT! They should have labeled that thing a “Torture Device”. It was so painful I could hardly stand it for 5 minutes. Needless to say, I’ll be returning that thing.

If massage therapy doesn’t help at first, I may have to get steroid shots. Definitely not looking forward to that. So 🤞 it does.

In addition, one of my wonderful Cisco colleagues recommended that I also call Duke Health and request an appointment with Dr. Lauren E. Bauer. So I’m going to call them this week since they accept my insurance, and Wilmington Pain Therapy does not. Who knows how many visits I’ll need at this point.

I know I said I would be making a video soon, but for some reason, I’m still not quite ready to do that. I thought about it over the weekend — the idea of making one and actually showing my chest on the video — but I don’t know that I have the courage to do that just yet. Plus I’m still so swollen right now. Hoping that massage therapy helps with that too.

Anyway…enough for now. Gonna try to start blogging more frequently. Actually considered starting a TikTok “channel” that will allow me to go live and talk to other transgender people who may want advice, need some help, or just want to listen to someone who understands what they’re going through. I don’t know yet. I know that by doing that, I’ll also be inviting in hate…and I’m just not sure that I’m mentally or emotionally prepared to deal with that right now. I’m still learning to breathe again after finding out Trump lost the election.

Love you all!

Liam