This is my story about my Chest Surgery. I appreciate that everyone’s story is different, but I am telling my story to give you an idea of what to expect if you are pre-op and waiting for your surgery.
My pre-surgical preparation started approximately 1 year before the date itself. The hormones that I had started on had caused weight gain, which is common, and I had struggled to lose it – instead gaining muscle and burning fat. My body fat had come down fairly sharply upon starting them, but I knew that the surgeon would be looking at numbers on a scale, and I was determined to bring it down. I also had excess fat that could have done with being removed, so the motivation was there.
My main area of exercise is cardiovascular. I run marathons. I also started to do weights and resistance exercise, to help burn the fat off and build some muscle using a periodisation strategy. The hormones that I had been put on were gel-based, and so I had to plan ahead as to when I was training, as any cardiovascular exercise had to be done before applying the gel so as to avoid sweating it back out. If it was a marathon day, then the gel would have to be applied after the race, which would usually mean having to leave it on through the night instead of washing it off (and applying gel at night can make you feel more active and disrupt sleep patterns). The cardiovascular exercise was done before application, then after 6-8 hours, I would do my weights routine before showering the gel off.
For my exercise regime, I didn’t change the cardiovascular routine at all, but added core stability, extra flexibility routines and more resistance work. Being as I didn’t have access to a gym (not feeling comfortable enough to navigate the changing rooms), I used the few weights and kettlebells I had, and added bodyweight exercises to enable me to ensure that I built my upper body up as best I could prior to surgery. I will outline my workouts later.
I made sure that I kept the workouts as fresh as possible as I know that my body likes to adapt really quickly to things, and I wanted to make sure that by keeping the workouts challenging would allow me to see improvements.
Then I went for my assessment with the surgeon. I’d lost about 5 or 6 pounds in weight at this point, but I was still heavier than the surgeon wanted. We had a long chat about this, as whilst I am a fitness professional, I had a borderline eating disorder as a teenager (which I didn’t divulge) and it has lead to me having more problems losing weight than most people due to the fact that I have low stomach acid. My body is also slightly underhydrated, which does not help with fat burning, and is also something I am working on as I finally begin to become comfortable in my own skin.
The problem that I had actually did not come from my weight. A couple of weeks before this appointment, I had discovered via blood tests that the testosterone gel that I was taking wasn’t being received well enough by my body – the nurse thinks that because I am active, even with the precautions of exercising before applying, it wasn’t enough, and that I was sweating it back out anyway. My testosterone levels were almost as low as before I had actually started taking the hormones.
The surgeon took one look at me and felt that I would not get the best result by having the surgery at that point in time. She explained her thoughts behind this – as my body had not masculinised, the breasts had not shrunk, and the glands inside were still quite large and so the surgery would not have the best effect, and might result in more surgery to be done further down the line to make the chest look more masculine. Her thoughts were that it is best to get the body prepared as well as you can prior to going under the knife, as every time you go under the knife afterward, the result you desire gets further and further away.
She sat down and told me what she expected of me in terms of what I could do to help myself. The first point was to continue to lose as much weight as I could in the time that I had (by this point I had asked for the surgery to be done in 12 months time due to being self-employed, and only being able to have a decent amount of time off at year end without losing work), and to build up the muscles in the upper body.
The combination of weight loss and resistance work would allow for my body fat to come down, which would help her to see (feel) where the breast tissue ended and the pectoral muscles began. This would allow her to make more accurate incisions, and be able to work toward giving me a more defined chest.
The other reason for fat loss was due to the ‘side-boob’ effect that I had (which is hereditary for me) that she informed me straightaway she would not be able to remove. (I think if you are having a procedure that includes some liposuction then this can/will be done as a matter of course through the surgery, but mine was double incision mastectomy only). Her point here was that lowering my body fat would be the best way to reduce this. However, I also found that developing my back muscles also helped to reduce this problem somewhat – added bonus!
The other thing she asked of me at this point was to avoid foods with soya or soya lecithin in. That’s quite difficult to do if you look at food labels. Her argument was that as research is finding that the phytoestrogens in soya can assist women going through menopause, by providing some small oestrogen to the body, then these same phytoestrogens could interfere with testosterone absorption and thus reduce its effectiveness, preventing you from getting the best out of the hormone replacement. Soya and soya lecithin are found in many powdered protein shakes, so I looked for either ready-made protein shakes (which cost a little more), or I ensured that my dietary protein was more constant to remove the need for protein shakes, by preparing meals and snacks to ensure that I wouldn’t need to rely on a protein shake as a meal replacement.
So, with this information in mind, off I went.
Over the year, I lost over 1 stone (14lbs) in weight, toned up, and burned off as much fat as I could. One month before surgery, I started to take Echinacea to help support my immune system, as the last thing I wanted was to come down with a cold or flu that might cause my surgery to be delayed. I drank plenty of fresh, plain water and moved to a high protein, high vegetable, low starchy carbohydrate diet, to ensure that I had plenty of vitamins and minerals and good quality protein to allow maintenance of musculature whilst I trained regularly. I did not wish to be losing muscle due to not maintaining a good protein intake nutritionally.
I don’t usually take multivitamins, but I figured that at this point it wouldn’t hurt to take one daily to ensure that if there were nutritional gaps within my diet then at least they would be going some way to being filled and help my body in preparing for the physical trauma of surgery. I wanted to make sure that I had done everything possible to give myself the best chance of healing well post-operation.
Mentally, I ensured that I asked every question that I could think of, either to the surgeon, or her team. I wanted to make sure that I could do everything to be as prepared as I could be, so that there were no last minute surprises that would throw me off guard. I asked many questions, including:
- Will I need a compression vest after surgery? (Some surgeons do prefer this to help with swelling, some don’t).
- How long before I can drive? (The answer I got was 6 weeks, or until I felt able to do an emergency stop without causing myself any pain or discomfort).
- How long before I can exercise? (This is a complex answer, so I will look at this shortly).
- What can I do to help myself recover optimally?
- What medication will I need for pain relief? (This depends upon the individual).
- Can I take supplements? (My surgeon gave the impression that she’s not a fan of supplementation, but said I could take what I felt I needed to).
- When can I go back to work? (Again, this depends on the individual, and the nature of the work that they do).
The one thing that I didn’t consider until it was mentioned was that my chest would need the hair removed from it prior to surgery. I had worked on the basis that any hair on my chest would be shaved before going to theatre, rather than I would need to have it removed prior to going to the hospital. At my pre-op assessment, the surgeon looked at my chest and said that it would need to be waxed or use hair removal cream to get rid of the hair that had accumulated. I had to have it done between 5 days and 2 days before the operation would take place. Apparently shaving is not commonplace now as there is thought to be increased opportunity for infection. I went with the waxing option as my skin reacts to hair removal cream, and I didn’t want to create any additional problems.
I made sure that I was well-rested the nights before the surgery (not always easy I know), and I had an early night immediately before going in the next day to make sure that I had rested, was as relaxed as I could be, and mentally ready for what was about to happen. In my mind, for the sake of a couple of hours of my time, I would soon be getting the chest that I had been waiting for, and the next stage in my journey could take place.
Read on for my post-op experiences.