First off, I can’t believe it’s been 5 months. It seems like such a long time ago; I can’t imagine my body any other way – even if it did used to be different, it feels so natural now it’s hard to believe that it was different. It also seems like such a short time, because I have many many many years ahead in my “new” self, and the scars still need a few years to heal completely. On that note…
The most salient reminder that this ever happened are the scars. And I don’t mean to refer to the fact that they’re there and I can see them, and everybody else can see them. That was a given since the beginning. It’s how they’ve healed. In short, not as well as I had hoped.
Thankfully the small T line below the nipple remains light and fading. Also, the incisions around the nipple had begun to swell and get minimally hypertrophic. However, after some months of applying treatment options (described below), the nipple incisions seem to have completely flattened and thinned out. This makes me think that through prolonged use, the larger scars will eventually improve.
Hypertrophic scarring is genetic (apparently my father and brother scar like this, and didn’t bother to tell me until after the fact) and unpreventable (and if it isn’t, don’t tell me, it’s too late). It’s lesser in degree than keloiding, which is good, but it means that I no longer have clean and minimal incision lines. Instead, the skin on the incisions is red, swollen and raised. The onset was at about 2 months, and they continued to expand for half of the incisions on both the left and right sides, and then expanded onto the entire incision on the right side.
Skip if you’re squeamish, click if you’re curious.
Treatment for hypertrophic scarring is fraught with false claims. It’s hard to tell what is true and what isn’t, but here’s generally what I’ve concluded (which may or may not be correct):
- It’s not preventable
- It’s not treatable (there is nothing to make hypertrophic-ness go away)
- The only “real” treatment is either laser scar removal (expensive and of questionable effectiveness) or cortisone injections (very painful, not recommended).
- Most scar treatments are useless.
- If you are going to use something at all, silicone is a key ingredient.
- It doesn’t hurt to try, it just costs money.
- The best treatment is time, lots and lots of time.
My Treatment History
I’m only listing this here for documentation and informational purposes, more to see what I’m doing and find out what works and what doesn’t. This section might be boring so feel free to skip it.
I started out using Vitamin E oil recommended for stretch marks, combined with a Scar Gel. At first I was slathering either of these 3-5 times a day, and then the frequency decreased, right around the 2 month mark. The oil was not doing anything, and since my scars suddenly flared up I decided to go with a more intense solution. Also at the 2 month mark I renewed semi-vigorous exercise – carrying grocery bags and yoga, going from nothing more than light jogging – which may or may not account for (but certainly coincides with) the onset of the hypertrophic scars.
After some research I ordered Scar Away scar strips. I wore these all day every day, and took them off only for showering and exercising. Each strip lasts about a 5 to 7 days – you can reuse them until the adhesive stops working and you can cut them up to fit the necessary shape. On days when I didn’t wear scar strips (like Sundays) I used the Scar Gel, or Mederma Cream with SPF.
Overall the scar strips seem very effective. The days when I wear them the scars seem less red and more flattened, especially after a week of wearing them vs a week of not wearing them. After intense exercise (like rock climbing) the scars will be very red and swollen, and wearing them for a day afterwards returns them to normal, compared to just putting on a cream or gel or doing nothing where it takes longer for them to subside.
The first package of strips has run out and I’ve ordered a second Scar Strips package, along with a silicone based scar gel which is slightly pricier but will probably last for a few months too. Silicone seems to be the one element that people agree on that promotes healthy healing. I’ve only used it for a week so I can’t say yet what the effects are.
As I mentioned above, there was a more than noticeable improvement in the nipple incisions, which were already raised and turning hypertrophic. Now they are small and thin and flat, as they originally were, which gives me some hope.
Wait and See
Now, scar treatments are a somewhat controversial topic. Everyone from lay people to doctors have a different opinion on their effectiveness at preventing and/or improving scars. My philosophy is: at worst, nothing better happens; at best, I get minimal to dramatic improvement, which is better than if I do nothing. I’m taking my chances.
Wowza – I just browsed my previous pictures and I can immediately see a dramatic decrease in overall inflammation. It is generally advised that it takes 3 months for the swelling to go down and the shape of your chest to settle. This is absolutely true, and very noticeable if you go back and see the other pictures from one month post op (four months ago).
Sensation returned very quickly over the entire chest and nipples, except for areas right on top of the scars or the nipples which are very very slightly numb (I can feel pressure and touch but also get the “numbness” sensation).
On some mornings I feel a tearing pain on the scars (not unbearable, but a little painful). I’ve asked around and people with scars from other surgeries mention this is normal for a few years – after all it is still healing.
After rock climbing and yoga for 3 months I’m getting some muscle buildup, which thanks to the base contour is making my pecs shape up nicely. A lot of people have asked me what the difference is to get top surgery if you’re on T (Testosterone), and I’d say the biggest difference is the contour. Without T you don’t build up muscle as easily, so you are much more dependent on the contour the surgeon leaves you with, rather than having the option of dramatically changing the shape of your chest, either to correct for flatness and make it look more like pecs, or to give the chest a more natural look, or just to get really really buff. This isn’t to say you can’t achieve great musculature without T, but it’s much harder (and the amount that some trans guys build up is not an attainable, or desirable, alternative for me right now).
Also, I definitely get a weird and indescribable sense of something being missing there. This isn’t to say that I feel ghost appendages, rather it’s the idea that the muscles and tissue are still incomplete and disconnected, and working hard at regenerating to become whole with the rest once again.
Oh yes, and I don’t pass any more or any less than I did before the surgery. Kind of a bummer, because now there is officially not much more I can do to pass less often as “female.” But also hopefully inspiring to others, as it shows top surgery is not the end-all be-all for transmasculine folk, and actually might have little to do with passing overall.
A Happy Ending is Just a Happy Beginning
Other than that my chest is doing great. And I’m doing great with my chest!
Feel free to post any other questions you might have, or if you’d like more pictures or more information on anything.