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The Procedure

Hey Friends,

Okay, so as much as I should probably be resting, I’ve got tons of energy…and I want to write about the process I’ve gone through the last 12 hours.  I also want to record this while it’s all still fresh in my head.

I’m hoping that this might provide insight to other folks who might be nervous about going through this procedure.  It’ll also give other folks a sense of what my last day or so has been like.

*Just a note — my experience is particular to Dr. McLean and his Clinic, so I can’t speak to other surgeons.  However, so far, I’d highly recommend McLean.  So if you’re thinking of checking into different surgeons and clinics…and if getting/staying in Toronto is a viable option for you, I’d definitely recommend checking out McLean.

Monday’s Consultation – April 4th, 2011

Yesterday, I walked over to the clinic from the hotel where I’m staying.  The Novotel (in Mississauga, Ontario, CA — about 30 mins outside of downtown Toronto) is literally just across a small street from the McLean clinic.  At 2pm, my parents and I took the elevator down from our room to the upper level of the main floor, walked up 5 or so stairs, and went across a pedestrian bridge (about 30 meters…I’m already adapting to the metric system!).  From there, we literally walked 200 steps to the elevator up to McLean’s clinic.

I met with Dr. McLean and one of the nurses who would be taking care of me.  McLean asked if I had any other questions and went through my options for the procedure:

  • Would I want nipple grafts?
  • Did I want drains?
  • Once my chest tissue was removed, would I want the cells analyzed as a biopsy?

I know I’m using a bit of jargon, so feel free to check out this link (FTM Top Surgery Website) for a better sense of what is involved with Double Incision/ Bilateral mastectomy.


So, Dr. McLean is one of the few surgeons (from what I can tell) who gives you the option to not have drains after top surgery.  From what I’ve heard, they’re not a huge deal, but they can get in the way and reduce mobility a bit after surgery.  Also, who wants tubes stuck in their arm pits, right?  When I asked McLean about this (I did it a few times because it sounded too good to be true), he told me that he learned the method of sewing you up internally as well as externally at a plastic surgeon conference.  He was originally taught about this in regards to a different type of plastic surgery, but he’s been using this method successfully for a while now with patients who are interested in getting top surgery.  In addition to the fact that this method allows patients to be sewn up right away without the use of drains, he also recommended it because he felt like it would speed up recovery since there would be less pulling and pressure from my incisions.  4 hours after surgery, I’m feeling soreness, but pain is definitely at a minimum!


I was prepared for this question about having my cells analyzed, but I didn’t realize how expensive it would be.  For those with a history of breast cancer in their family, this was highly recommended.  However, because I don’t have that in my family, I chose to not send my cells to be analyzed since it would cost an addition $100-200 dollars.  Also, while I will still have some tissue left in my chest, it will be really minimal; so my already small chance of getting breast cancer is now even more minimized.

After going through these questions, Dr. McLean took a look at my chest.  Since my chest was pretty large, he said that the incisions would likely go straight across rather than curving to the contours of my body.  This will make the scarring a bit more visible, but I was happy to hear that he adapted his incisions to people’s bodies rather than doing the same cut for every person that he does surgery on.  A nurse then came in and took “before” pictures of my chest.  When I get off my nipple graft bandages, I’m guessing I’ll be taking “after” pictures too.  Super excited for those!

Finally, we got sent off with a prescription for tylenol-3 (with codine).  It’s a really basic pain med and a low-dose narcotic.  I’ll be taking it every 4 hours for the next couple days before moving on to Advil or Ibuprofin.  Thus far, it’s definitely doing the job.  We’ll see how it feels as the anesthesia wears off, but for now I’m great.

Surgery Day – Tues, April 5th (7:15am, EST)

I was the first procedure of the day, 8am!  My parents and I were due at the clinic at 7:15am for prepping, so we got up around 5:45am.  I wasn’t allowed to eat or drink anything from 12am until after the surgery, so we made sure to eat an early dinner last night.  Aside from brushing my teeth and taking a sip of water to down my allergy pill, I didn’t have any water.  I think this would affect the anesthesia, so I made sure to have an empty stomach.  I was also told to take a shower making sure to wash my hair.  I made sure to enjoy it, since I won’t be able to shower until my graft bandages come off in 2 weeks.

7:00/7:30 am – We make our way to the clinic, I kiss/hug my parents and go into the prepping room.  I meet with Dr. Baker, the anesthesiologist, who asks me a few more questions about my asthma, my recent cold, and a few other things that might relate to be going under with anesthesia.  I also met with a really nice nurse who took my vitals and put “Friends” on with the TV there while I waited for them to prep the room.  I also took an extra puff of my asthma meds (which I was advised to do by Dr. Baker).  Finally, the last thing I did before going into surgery was going to the bathroom again…I think this relates to my stomach being empty for when I went under.

7:30 am – I get out of the bathroom and walk into the operating room.  I get tubes put in my arm, and the anesthesiologist tells me that this was when things start feeling good.  He asked how I felt after a few seconds…and I remember answering him that I couldn’t feel anything.  Then, I felt a bit dizzy…and I was thinking about when I’d fall asleep.

10:30 am – The next thing I knew, I was waking up in a recovery room.  I was a bit sore, but I didn’t know if I had already gone through surgery.  I remember looking down and seeing my flat chest.  My first reaction was to start crying out of joy.  I couldn’t believe it had already happened.  I haven’t felt this relieved, joyous, and at home in my body in so long!  After coming out of surgery, I felt energized.  I was expecting to feel sick (my parents told me I might be nauseous), but my stomach felt fine.

11:30 am – I got up and walked over to the original waiting room.  My parents had stayed there the whole time, so they were anxious to come in to see me.  Before they came in, the nurse that was taking care of me (Brenda) put gauze pad over my chest and put a binder around me.  This will keep my chest compressed to keep swelling down.  Shortly after, I put my clothes back on (I made sure to wear loose-fitting, button-down shirts so I won’t have to raise my hands over my head.)

By noon, I was back in my room.  I’ll be going back tomorrow (Wed) for a follow-up with Dr. McLean at 8:30am tomorrow and then back again in 2 weeks to take off the stitching around my grafts.  After that, my mom and I will coming back to Boston around the beginning of Pesach (April 18-19).




About Queerly Asher

I'm a genderqueer, trans-masculine Jew. I grew up/went to school in the Midwest (UW-Madison) and recently re-located to Boston (Jamaica Plain, MA) to work as a Community Organizer with a LGBT & Queer Jewish organization. I started this wordpress to document my experiences and journey of my own psychological, emotional, and physical form of transition. We'll see where it goes!


8 thoughts on “The Procedure

  1. I’m new to WordPress as a community and was surfing through blogs when I came across this one. Your optimism and energy facing such a procedure is unbelievable, I had to comment. It’s an inspiration to read.

    Posted by lorror- Laura Wright | April 5, 2011, 11:06 pm
  2. ASHER!!!!! i cannot even express how happy i am for you, roomie. thanks for writing it all down in detail. speedy recovery and i can’t wait to see you!

    Posted by Ira Sass | April 6, 2011, 12:00 am
  3. love you. admire you. and of course, miss you.

    Posted by Midwest GenderQueer | April 7, 2011, 12:03 am
  4. Hello dear friend! I’m afraid I’m a little late on this, but I am so glad you’ve been posting updates. You are on my mind this month, and I am wishing you a speedy recovery. I think it is so so so great that your parents went to Canada with you! Keep well Ash!

    Posted by Laura Epps | April 11, 2011, 5:13 am
  5. I’ve found your post here while doing a bit of research on Mclean clinic for the same procedure. What you’ve written here and in the other post is *extremely* helpful!! Also, congrats tho I’m commenting many months after the fact 🙂
    Since you’re all recovered by now, I’d like to ask a little more about the issue of the drains. To be honest, when I read that on Mclean’s site I felt a little unsure, as it seemed a pretty important part of the post-op process.
    I guess what I’d like to know is if the lack of drains ever became an issue? Did you feel any excessive swelling/pressure/fluid buildup while healing?
    From the sound of it though, it seems pretty ideal to not have to worry about the lack of mobility and later the pain of removing the drains.
    I’m from the Providence, Rhode Island area and do not identify as trans or genderqueer, ie. I identify comfortably as female however my chest is something that has caused me a lot of physical and emotional discomfort and really doesn’t fit my image of myself. Finding the Mclean Clinic site was such a wonderful thing because every other clinic i’ve looked into requires a letter of rec/documentation of gender identity disorder, etc.
    Sorry this comment is a bit long! This is just an issue I’ve been wrestling with in my head and your reply will help a lot in finalizing my choice to choose this clinic. Take care!!

    Posted by Abel Forte | January 9, 2013, 1:14 pm

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