Beards Over Barbells

On March 20th of this year I underwent my final post-massive weight loss surgery. The surgery corrected excess tissue in my chest, a condition medically referred to as Gynecomastia. This complemented the prior two surgeries, a circumferential lower body lift performed in March of 2013 and dual bilateral thighplasties (recap links part 1 and part 2 here), and marks the end of my surgical excursions.

I’ll start this post off with two things that I’ve wanted to get off my chest (pun intended!):

1. No, I don’t have any sensation in my nipples. When I’ve described the surgery to friends and family this has been the first question they’ve asked, and no, it doesn’t bother me in the least. The surgery basically removes them and destroys the nerve bundle, but if you’re a lady reading this, fear not: there are other techniques that surgeons have for you all that preserve sensation.
2. No, I’m not going to post a “before” picture like I did in the other two surgeries. I posted before pictures with the other two procedures but of all the features of “fat” me that I disliked, the one I hated most was having tits. So, you’ll just have to use your imagination as I leave my tits in the past. The picture in the Wiki article isn’t far off the mark. Think deflated C-cup and you’re in the right ballpark.

As with the prior two surgeries my wife and I drove down the night before to be closer to the surgical center for an early 6am start time. Pre-surgical markings and evaluations were performed the morning of surgery with a consult a few weeks beforehand. You can imagine each pectoral as a sort of conical, deflated breast with nipples that were about 50 mm (2 inches) in diameter apiece. After being sedated and prepped, each breast is liposuctioned, and then the excess skin is trimmed away from the underside of each breast in kind of a long curve tracing along the bottom side of the pec almost fully to the armpit. The nipples are removed and trimmed down to about half their original size (about an inch each) and grafted back on after the chest is sewn back up (actually glued on the top layer with Dermabond, a flexible superglue) with a single French drain exiting near either armpit. The nipples are then grafted back on in the original orientation in the new smaller size. Bolsters are attached to keep them on (basically a kind of plastic gauze bandage to keep the grafts in place). Surgery takes about four hours and you’re under for about six total, home the same day, back in a week for drain/bolster removal and evaluation.

The truly squeamish would do well to skip the following paragraph. The surgery went off without a hitch, the only bummer is that I was kept under about two hours longer than I needed to be due to a complication with surgical prep. Whenever general anesthesia is employed, you’re typically catheterized because, y’know, you’re knocked out cold. This wasn’t an issue in the past two surgeries, but the OR nurse botched cathing me and grazed the urethra in one spot. They kept me under for about two hours extra and called in a urologist to scope me out and make sure that it was just a botched catheter install and not something more serious. Everything was clear but I had to keep a Foley cath in for a week while the scrape healed, which is not a particularly fun thing. Luckily no permanent damage was inflicted and there are zero long-term side effects from the mishap.

Freshly home from surgery, I looked like this… you can see the drain exits and the bolsters pretty clearly:

Nine weeks out, I look like this:

Overall not bad. The scars are still fairly obvious, but my six-ish month old thighplasty scars are almost as faded out as my 15-ish month old scars from the circumferential, so I should be able to go shirtless at the beach without getting a bunch of odd looks after another couple months.

As for the post-op, the drains (and catheter) came out a week later and I was only off work for about a week and a half. Pain meds were identical to the last two surgeries and I didn’t have withdrawal as bad as the last two either. I did develop a seroma, or fluid pocket, in my left pec that had to be manually aspirated with a large syringe but only once. Seromas are fairly common with chest surgeries and often take a couple visits to drain completely, but I lucked out and only required one visit.

So yeah, that’s done. A difficult and expensive year of surgeries, but zero regrets.