This is gonna be pretty in depth because I didn't know what the process was gonna be like and found detailed posts helpful so maybe someone will find this helpful too.
Timeline:
28/10/24 First email to Ms Milroy
11/11/24 First consultation
16/11/24 Surgery date confirmed
28/01/25 Blood test
10/02/25 Pre op
26/02/25 Surgery
10/03/25 Dressings removed
07/04/25 Post op
Costs:
Initial consultation 250, surgery (preop, post op and revisions included) 10.188.
Within 20 days of contacting Ms Milroy I had a consultation and a top surgery date. What they ask is:
- Over 18
- A referral for top surgery from a "recognised" clinician. Two if you are non binary.
- Ideally, BMI under 30
- Ideally, over a year on testosterone
I had the consultation at New Victoria Hospital in Kingston. Ms Milroy is genuinly nice and friendly. We discussed mental and medical history, all average tick box questions. She done a very quick examination of my chest. I got changed behind a curtain, stood up. She only touched me slightly and as awkward as it was she's very professional and it only lasted about 10-20 seconds. She let me know I was in the middle range for keyhole and DI and explained the pros and cons for both. We talked about scars; I mentioned I liked the idea of having straighter, more horizontal scars and Ms Milroy told me that scars following the pectoral muscle are not as straight as i envisioned. To be honest, I didn't have any strong opinions on what I wanted my chest to look like and trusted Ms Milroy's judgement. I asked about scar care and Ms Milroy encourages fragranceless moisturiser like E45 for massaging and to keep scars from drying out. I was also told I would need to buy a compression vest which will be worn for 6 weeks and that I could bring it to the pre op consult to make sure it fits. She encourages exercising the chest to build definition beforehand and mentions often about building up muscle afterwards. I definitely suggest writing down any questions you have as Ms Milroy gets you in and out quickly and skips all the general chat.
You receive a summary of her notes from her PA after each meeting. The compression vests they encourage you to get are from Macom Medical. They are expensive.
I was told NVH (New Victoria Hospital) would contact me at least a month prior to book the blood test and sign me up to Lifebox (online questionnaire type thing). NVH confirmed my booking on 18/11 but didn't give me the sign up information until 21/01 after I contacted them a few times.
I arrived at NVH 20 minutes early for my blood test, and was called 20 minutes late. The nurse, who was really nice (all the nurses are really nice tbh), double checked everything on LifeBox, my blood pressure, height and weight. I was told to omit my daily pump of testavan on the day of the surgery. I also mentioned that I have a lot of acne on my back shoulders and sometimes my chest. She gave me a bottle of antibacterial soap to use on the morning of my surgery. I had my blood taken and was out 25 minutes later. (Side note: they have a drink machine in the waiting area that does the best hot chocolate (labled milk chocolate) I've ever had seriously)
Since I live quite far from NVH, I did my pre op consultation over the phone. This was originally scheduled for 03/02, but I wasn't called. Her PA rescheduled it. It wasn't a long call as I still didn't have many questions but Ms Milroy went over a few things for the day of the surgery, like that they put the vest on you while you're still conked out after surgery.
The day of the surgery I arrived at 7am and was taken to my room a few minutes later. You're not allowed to eat anything after 2am and not allowed to drink after 7am, but I was told I could have a sip of water if I needed. I had my blood pressure taken, was given some compression socks and also needed to give a urine sample. They didn't say what the urine sample is for specifically, but I do know they require a pregnancy test from anyone able to get pregnant. The rooms are very fancy and feel like a hotel room more than a hospital room.
A few minuted later Ms Milroy come round and took pre op photos of my chest and then drew her markings on. I got changed into the gown. I was worried about flashing my butt but they give you a dressing gown type thing and cotton underwear, though it really does test the definition of underwear.
The anaesthetist came in a few minutes later, again a really nice guy, and asked about things like my prior experience with general anaesthetic and had a look at my hands. Funnily enough he told me I looked nervous, despite the fact I had no anxiety throughout this whole experience.
The waiting was the worst part. At 9:45 I was told "soon". At around 11:45 I was taken by a nurse, I wasn't even her paitent, to the anaesthetist room.
The staff check your name and what surgery you're in for everytime you change hands. There were three guys in the anaesthetic room, including obviously the anaesthetist I met earlier. I hopped up onto the bed and chatted while one guy on my right put electrodes on my back, and the anaesthetist put the cannula in my hand. It only hurt a little for a moment. They also put a heated blanked on my when I laid down which was great. I was already sleepy and that just about sent me off before the anaesthetic could. I was told to breathe into a mask by the guy on the left, which supposedly tasted/smelt like vanilla, it really didn't. I don't remember falling asleep, just waiting to feel the anaesthetic work and then waking up, so I never actually saw the theatre itself.
Coming out of anaesthetic I remember seeing a blurry nurse infront of me and was in a room I didn't recognise. I was trying very hard to stop being so sleepy and kept aggressively closing and opening my eyes to wake myself up which probably looked funny. The nurse asked me questions that I responded to. I "felt" like I was responding correctly but I have no idea what she or I said. I was in and out of consciousness. I remember about 3 seconds of being wheeled back, and then being in my room. The only thing I remember correctly is asking the nurse if it was still raining outside. Then I passed out for maybe 30 mins to an hour. I think I was in the theatre for close to 2 hours.
I had two compression pumps on my calves to increase blood flow and a nurse came in every hour for the first four or five hours to check my blood pressure, then every four hours.
The pain wasn't great but it was manageable. I definitley could not move my arms much with the drains being in the upper half of my armpit. Once side was worse than the other.
Standing up was surprisingly dizzy but I never felt nauseous. Other than that all I wanted to do was sleep and sleeping was like, the greatest thing of all time. I'd stay asleep for half an hour or so, be very alert for 15 minuted and then pass out again. The pain from my chest itself was hardly noticeable, maybe a 2 or a 5 if I had to move. My right side drain was consistently a 4 or 5 that would wack up to an 8 if I moved my arm too much. Very little range of movement and sitting up sucked if I needed to use my arms.
I had my dad with me for about four hours and it's definitely better having someone with you. I couldn't do much at all, no reaching, no bending. I also found the general set up to be awkward. I had to have the bed rails up to sit up, but the table was to high for me to reach and the bedside table to far to bend. They encourage you to drink lots of water and give you a huge jug, which would be great if I could lift it. I'm not calling a nurse in just to pour a cup of water. The food there is really nice though, very fancy, honestly too fancy I didn't know what half of it was and stuck to a good old sandwich which had like 8 different bread options. I didn't know there was so much bread. I was also incredibly weak, like I literally got bested by a cup of yogurt because I didn't have the strength to open it. It was just annoying to move in general as I had two compression pumps on my legs, a canuela in my hand and two drains either side.
At 7am Ms Milroy visited, opened the binder and checked my drains. I had the cannula detached and compression pumps off so at this point I was doing laps in my room and able to do basic things for myself, slowly.
Before drains are removed, Ms Milroy requests that you shower your lower body. I have no idea why this is but I'm very happy at least I had enough mobility to do this myself because hell no.
My experience with drains is not usual. Most people don't feel a lot of pain, if any, just discomfort. This was not the case at all for me. I was given dihydrocodine. The nurse, the same one whose patient I apparently wasn't, was really nice. She got frustrated by the placement of the drains (not at me) and I had to lift my arm to give her room to remove them. We started on my right side, my worse side. One light tug and I was in tears. I felt no movement from inside, just a tearing, burning pain from the incision site. The pain did not go away after she stopped pulling and I could hardly breathe or anything without immense pain for about 10 minutes after. They gave me morphine and paracetamol and tried again. The painkilers must not have kicked in and it was the same excruciating pain and I had to beg her to stop. I've been judging my pain on a scale to 10 so far but this was, at peak, 15.
I was lucky this nurse was so nice, any other would keep pulling and honestly I wouldn't blame them, but she was getting visibly upset that she was hurting me. Instead she called Ms Milroy who suggested cutting the drain to alleviate the pressure. This was it. There was still a painful stinging sensation where my drains were, but this time there was no pain from inside my body and the drain slid right out. I also had another nurse come in, the nurse who woke up up post surgery, who at one point was making a song out of me swearing. We moved onto my left side, cut it (allowing 10 minutes for the pressure to actually change) and it was like a 2 or 3 on the painscale, granted I was on quite a bit of painkiller by this point. The discomfort was welcome and it slid straight out, very quickly. I caught a glimpse of the blood flying out the tube when it came out which was kinda funny.
After that I was basically free to go. I was given paracetamol, ibruprofen and dihydrocodine to take with me. A student nurse came in to take my cannula out. I was on so much painkiller I didn't feel it. When she took it out it started bleeding very quickly and she quickly hurried for the cotton wool to stop it. We left it a few moments, slowly lifted it up again to which the blood just came out as quick as before. It did eventually stop, I just thought it was funny. The nurse who took my drains out also came round again even though her shift had ended just to check I was okay and she gave me a hug. I love this nurse omg.
I wasn't told a lot about how to care for my dressings. I only found out what I asked. Leave the dressings on, don't get them wet. I guess I expected... a leaflet with helpful stuff for recovery like, what not to do, signs of infection or hematoma ect. All I got was a leaflet on anaesthetia and my work note. The work note requested 6 weeks off and had no details about what surgery I had done. It literally just said "surgery".
Bring a pillow to put between the seatbelt and yourself if you get a car home, you will need it.
The first few days home I usually had on ibruprofen and a few paracetamol as the pain wasn't that bad. Occasional stinging that felt the same as cat scratches. I slept a lot but also wanted to walk around a lot too, though my energy levels were very low so I napped a lot. Other than soreness and tiredness, I felt pretty usual. Also my chest being cold was a weird sensation. I only needed help with things that required strength or stretching. For example; filling the kettle, hanging up clothes, cutting food. Everything feels heavy. Every day I made sure to stretch my neck, roll my shoulders and move my torso side to side to avoid getting stiff.
I did not buy a bunch of stuff in preparation, but I will state what I found most useful.
Obviously open shirts but also any loose clothing in general as you don't was tension pulling up jeans or tight underwear, back scratcher, fragranceless baby wipes, bed desk, large pillows (I have one of those big realistic seal pillows and it's actually been so helpful) stool to grab things, dry shampoo, hat (can't raise hands enough to tie hair back properly) small bottle with sports cap.
Day 4 had a little bruising of a light yellow, purplish colour. Old bruises from the surgery can make their way up to the skin so it's not techically a new bruise. The dressing from where the drains were STANK but it went after a few days.
Day 5 The strength in my chest had returned quite a bit. When I did, accidentally, flex my pectoral muscles it felt weak like I had been working out.
By week 1 I "feel" fine so it was easy to overexert myself and be sore the next day. By this time I was able to do post things myself, but still avoided stretching. I did lift things quite often.
Day 8 Increased numbness that has spread from my armpits to my back. The compression vest was also digging into my armpits badly which maybe made this worse. I was able to sleep on my side with support.
Day 10 Two yellow bruises appeared. One under my scar and another on my hip bone that spread quite far down. By this point a majority of my pain comes from the compression vest.
At 2 weeks PO I got my dressings removed at NVH. I was only in there for about 5 minutes. I took the vest of and laid down. It did hurt, especially because some of my dressings were weirdly sticky, but most of the pain was at the start and end of the tape. Ms Milroy removed the stitches on my nipples which was as equally unpleasant and put new dressings on my nipples that had to stay there for 5 days. I was also told I could shower normally and move onto massaging now. I was very tender on my chest after this, especially when not wearing the vest even my own shirt on my skin hurt. I regret not bringing a pillow for the ride home.
My skin does not react well to being covere up so I knew I'd get a lot of acne as a result. The adhesive on the dressings also left cuts which Ms Milroy said was probably why it hurt quite a bit. Regardless everything was healing well. There was a bit of bumpyness and puckering at the end of each incision that flattened out a lot over 4 weeks.
By week 4 I felt back to normal. I was able to comfortably sleep on my front, and able to support and lift myself up without rolling over. My scars felt loose enough that I coud move my arms past my shoulder, but not yet my head. I did have a small "hole" that leaked a bit of blood and puss but I kept a plaster on it and it healed fine. I continued to use the soap given to me at NVH around my scars. Also fun fact, new hair follicles can grow around the wound as part of the healing process.
At almost 6 weeks I went for my post op appointment. She was very happy with how everything had healed and mentioned how thin my scars were. She did notice through my acne that the compression vest had actually given me a fungal infection on the center of my chest and gave me a name of medication I could use. I pointed out a small darkish patch on my left side that had been there since the dressings were removed. Ms Milroy told me this was a stitch making its way out through the skin. Usually they dissolve (the stitches either end of the incision fall off) but she could remove it for me if I'm unable to myself. I was given the go ahead for exercise and she encouraged me to build up the muscle in my chest.
Also, by this point a lot of the numbness around my back was gone and had reduced to just the drain site. The only numbness I have elsewhere is close to the incisions themselves. I have no sensation in my left nipple. My right nipple I sort of have sensation, and I can feel a pinching feeling there when I massage the center of my scar but it is a different feeling than pre op. Either way I'm very happy with my results.
Feel free to ask any questions.
For once, a pooner has a stinkditch: this TiF opted to leave her vagina intact, which gives her genitals a very alien appearance.
but otherwise above and beyond happy with the results. I was able to squirt before surgery and now when I do, it comes out of my dick :,) it’s such an awesome experience and I’m super happy with it.
