35 Year Old Trans Woman, Breast Augmentation and Rhinoplasty (5'11", 140lbs) Tualatin, OR

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*Treatment results may vary

So after way too many years telling myself I...

So after way too many years telling myself I couldn't, I took the leap of faith a year ago and began my transition. I knew going into this that at my age, I wouldn't see much breast development from HRT alone and that I'd be looking at a BA. I've considered various levels of FFS but at this point, I'm moving slowly with just a rhinoplasty.

When I had my consultation with Dr. Hu I was seriously impressed. We talked a lot about her experience with trans patients and she was knowledgeable in a way that was exceptionally comforting. I can't say enough how impressed I am with both her and her staff. There was no sense that I was being rushed through a consultation or being given stock / rote answers. Everyone listened to my questions and spent all the time it took to make sure I had everything I needed to make a good decision.

For the BA, I'm looking at 450-475cc anatomical shaped implants under the muscle. I've really wanted to avoid too much upper pole fullness but still get a size that's just the busty side of 'proportional' for my frame and I'm a bit wide in the chest as is.

My nose has a history of being abused and 10+ years of teaching martial arts and semi-professional fighting did some damage. Beyond that, it's always been over large and it's one of the most masculine features of my face. What Dr. Hu did that really impressed me though (that other doctor's hadn't) was to take time to talk about how she could improve my breathing. To her, this wasn't just about an aesthetic solution that would ease dysphoria, it was about improving my quality of life. That made all the difference.

My pre-op appointment is on Jan 21st, surgery Feb 9. Soooo excited to have made it this far!

(Note: I haven't decided if I'm going to post photos for the rhinoplasty or not yet. I promise to take lots of pictures but I don't know if I want my face on this review yet so... TBD on those.)

Pre-op Mammogram

So, Dr. Hu wanted me to get a pre-op mammogram. She's had trans patients younger than me present with breast cancer (rare!) so even though I'm young it was kind of a cover the bases thing.

Mammogram... not so fun. That moment when they came back to the waiting room and said "The doctor has seen your results and wants an ultrasound of the right breast." That moment was LESS FUN. Thankfully, they were just cysts but... minor panic! They said that everything looks good to proceed so, whew.

Pre-op appointment on 1/21, 21 days till surgery.

Pre-op nose, also, contacts soon!

I debated about putting up face pics but... it's not like I'm not exceptionally open about being trans and my journey anyway, so... Here are some quick before pics. Apologies, my selfie skills are seriously under developed.

I also stopped by my eye doctor today for a copy of my contact lens prescription. I'm about -4 in each eye so while I can function without glasses, my vision isn't up for things like reading for very long, much less doing anything on a computer or watching TV without help. Somehow the idea of wearing my glasses right after rhinoplasty just doesn't seem like a good idea. So I'm picking up a box of contacts to wear for the next month or two. I'm also strongly considering colored lenses because... why not?

Pre-op appointment tomorrow, still excited :)

Pre-op Appointment and Sizers

Had my pre-op appointment with Dr. Hu today. We finalized sizing. The Mentor Mod+ that we're looking at jumps from 445ccs to 495ccs and since I liked the look of the 450 sizers and things will compress under the muscle we're aiming for the 495s. She said she'd also be getting a set of the next size up which is a 555cc in case she needs to make an adjustment once she sees how things look.

Went through all the nuts and bolts and prescriptions. I get to stop my Estradiol and Progesterone next week on Tuesday (not looking forward to that) but at least I can keep the spiro. It looks like it'll be 1-2 weeks post op before I can start back up again, depending on how recovery goes. Really hoping for just one week!

Next up is getting all the little things together. Picking up prescriptions, I'm getting an angled pillow to sleep more upright for a while, hunting up a front closure sports bra or two... and something to wear for surgery. I got rid of all of my button down shirts at the beginning of transition and I didn't want to get any women's button down tops because... mental baggage really. I'm thinking of just getting some nice flannel PJs to wear home from surgery. Something comfy to go straight from post-op to bed and just sleep. We'll see what I can scare up.

18 days and counting :)

Twas the night before surgery and...

A couple of things I wanted to say while I'm in the midst of eeeeeee! excitement. Surgery is tomorrow morning, 8:30 AM. 16 hours to go... and at least 6 of those I'll be asleep for :)

So, two weeks ago I had to stop estrogen and progesterone and I wanted to touch on what that's been like because it was a huge worry for me going into this. The first week was ROUGH. I got depressed and I really didn't want to get out of bed some days. I felt like I'd kind of 'woken up' emotionally on HRT and w/o estrogen and progesterone I was really uncomfortable as my levels dropped. After about a week I started to level out, more like I was before... I don't like feeling like that, but it's not depressing and bad... just uncomfortable. I can't wait to get back on things. Dr. Hu said it'd be 1-2 weeks after surgery and I'm very much hoping for just one.

I've been doing housework, getting everything in order so I can kind of coast for most of next week. I don't expect to be very productive for a little while. Life has had a way of throwing some last minute curve balls so I've been running around doing things last minute like shopping for groceries for the week but I think I should be in as good of shape as I can manage tomorrow.

I wanted to say a huge thanks to the community here at Realself. Y'all are wonderful and have been a huge help in getting to this point. So, as much as it's possible to know what to expect tomorrow, I feel like I do, and I owe a lot of that to everyone who has shared so much of their journey here. Thanks everyone, see you on the other side!

I have an awesome partner...

She had planned to surprise me when I got home tomorrow but we talked about it and since I won't be able to wear glasses and I might not really notice w/ pain meds and all... she showed me tonight. She wanted to make sure I had an awesome place to heal and recover and she thought butterflies would be perfect to reflect this part of the journey. Yeah... I cried a bit. So happy and excited :)

Morning after

Small update until I get up and moving enough to add pics.

I got 495ccs, both sides, shaped silicone, under the muscle. According to Dr. Hu, one of the nurses was a little jealous of how well they turned out onthe table do I'm excited to see them for myself. My wife says that with them it makes my waist look slimmer, so, bonud.

Evidently Dr. Hu didn't need to break my nose for the rhinoplasty, so there's no packing and I can breathe through my nose!

Chest hurts more than the nose but it's already fading from what it was last night. The worst part of the nose so far has been a post nasal drip at the back of my throat.

I haven't gotten to look at them yet but despite the pain I'm still VERY happy. Feeling more "complete. "

Day one post op photos

Mini update on day one. As the day has gone on my nose has become more stuffed up with dried blood, but I can still breathe through it even with that, just not as much as when I woke up.

Really craving a shower. There's some stiff stuff in it from yesterday that I wish I could be rid of, but for now, just using a wet wash cloth and getting what I can.

I've been getting up every few hours to walk and I feel a little more me after doing so. Chest hurts when I change position (sitting to standing) but my pain is generally well controlled. I'm cycling ice packs and those help too.

First post op follow up is tomorrow morning, so more news then.

First look, post op appointment today.

I had my first post op appointment with Dr. Hu today. She was able to clear a lot of the dried blood from my nose so yay for breathing again.

I go back on Monday to jave stitches removed and to see about getting the splint off my nose. I did get to take a look at my breasts today. I just about cried seeing them., so happy. I know they have a ways to go, dropping and fluffing and all that goodness, but right now, I'm happy.

Day 3 post...

Mini update ('m probably not going to take more photos of myself until Sat / Sunday.) Started the day off feeling like I had a really full bladder and unable to get more than a few drops. Constipation I expected (still haven't gotten to that first BM) but I hadn't heard anything about not being able to urinate. Called Dr. Hu's office and got instructions to drink 64 ounces of water in an hour or less. I made it through about half the water before I needed to hit the bathroom and I've been fine since then. Evidently I hand't gotten as re-hydrated as I thought I had.

Feeling good enough today to start backing off the narcotics. I'm a little uncomfortable at the tail end of a dose but I've been using ice packs and that seems to get me by. Today was the first time that I had my nose giving me close to the same level of pain I'd been getting from my chest but in general the nose doesn't hurt that bad. It's annoying though to not be able to blow my nose. That, and I have an itch on the side of the nose that there's just no way to scratch... sigh.

Oh, and Dr. Hu's office sent flowers :) She and her staff have been really great about calling to check in, making sure I'm doing okay. It's the little things like that that put my mind at ease while I'm healing and it's absolutely priceless. So glad I picked Dr. Hu for this, she's been great.

1 Week

So, tomorrow will be one full week since surgery. Today I had a follow up with Dr. Hu and it went really well. She took the brace off my nose and removed the external stitches. It took a bit of doing for some of the stitches because dried blood had pooled around the stitches, but she was really deft and gentle with working them out.

I'm feeling tons better since I finally had a BM last night. I'm still really bloated though and I had to dig out a looser pair of jeans than I'd been wearing lately. I'm sure that I'll be back in shape in a month or two though.

I'm still not doing much around the house. I've been walking around just to be moving and doing some modified Tai Chi, but actually useful things like making dinner are still more uncomfortable than I want to deal with.

I got the green light to resume hormones, super excited about that. I've got some awesome looking bruises near my incisions and I'm tender as all heck in those spots, but in general it's getting better.

5 weeks post op

I had my slightly over one month follow up with Dr. Hu yesterday. Yay for finally getting the tape off my nose :) Seriously, did not realize how much that had been messing with me.

Sorry there haven't been more updates, I thought I'd take 3 weeks off after surgery and then go back to work (I had the vacation time for it.) Instead I took two weeks off and then started a new job. I only managed a 25ish hour work week my first week on the job but my new employer has been really understanding about post op appointments and the like. It felt good to be up and productive again but that first week was draining.

5 weeks out I'm feeling lots more human. I managed to sleep on my side last week and this week even managed to lay on my stomach. Yay for small victories.

Emotionally, this has been (and continues to be) a roller coaster. Some days, I get up and I'd look in the mirror and think "why did I do this... is this better or worse?" I've got an asymmetry that I'm worried about with my left breast extending over the center line of my sternum, and the space between the breasts still doesn't lie flat against the breast bone. I've talked to Dr. Hu about it and there's still a lot of swelling there and she reminded me that she did more work on the left side to correct for the asymmetry that was already there so it's taking longer for that side to heal (only bruise I have left is on that side.)

In clothing, I'm generally happy so far. I know I've got months left to go before I have an idea of final results, so I'm trying to be patient.

I've put on about 8 lbs post op and I'm slowly working that back down. At least most of my pants fit again (first few weeks, not so much.) I'm looking forward to being active again and getting the rest of that in line.

My nose is still tender and I can't feel parts of the tip, but the swelling is starting to be much more minor and so far, I'm happy with the results.

That's a lot of text for now so I'll leave it there. I do have some photos from the past few weeks to put up but I'll need to get to that later today. More soon :)

More Photos

So these are about 5 weeks post... Sorry about the delay getting them up.

Mini update

So, I'm coming up on 3 months post op. I'm still not 100% comfortable with how I look naked... the left breast feels like a problem child. That said, looking good with clothes on. Serious bra shopping soon, but I had a concert to go to a few weeks ago and the dress needed a real bra instead of one of the wireless sports bras I've been wearing. Looks like about a 36D for final size which is just about where I wanted to end up. I have my next follow up with Dr Hu in a few weeks so more then.

The word of the day is: Revision

I saw Dr Hu today. She thinks the left implant has rotated, which is casuing the misshapenness that I've been worried about.

I'm worried that the pocket is too large, the implant feels more mobile on the left than the one on the right and the 'over the center line' issue I'm seeing is, I think, part of why it feels like my breast tissue is sliding off to the side.

I don't know what I'm going to do with it. My left breast feels deformed. I look okay in a bra or clothing but without that... I don't want to look at it. But a revision scares me. What if it gets even worse?

The quote I got from Dr Hu's office to fix it is a little over $6,000, assuming we also need to swap out the implant for one a size smaller. I'm torn about just getting it over with as soon as possible or waiting till September so I can enjoy summer tops. I had hoped to be in bikini shape for summer by having surgery in Feb but now... I just don't know.

Pics, 3 months post

Photos taken the day of my 3 month follow up.

Bra shopping

Went bra shopping today. VS 34DDD!! Just basics for now, but pretty happy :)

Enjoying Summer

One of the things that was really important to me going into this and a big part of my wanting to have surgery in the winter was so that I could heal and be comfortable diving into summer with all of its associated skimpy tops, swim suits and everything else.

You know what? It's been an amazing summer. Things aren't perfect, I'm still considering what I want to do about a revision but I've been able to be out and be me and enjoy everything that goes with it. I'm getting used to being busty and what that means and yeah, I've found some busty girl problems but on the whole, I'm very, very happy.

And the rhinoplasty? It's holding up just fine. Most people who hadn't met me before I had it done have said they wouldn't have thought that I'd had work done and that's awesome. People who have known me before and after can see the difference but mostly the big difference is in how little I feel like I need to hide myself.

All and all, even with the bumps along the way, this has been one of the best things I've ever done.

Revision Scheduled

So, it's been just about a year since surgery and I'm really happy. I'm loving how my nose turned out and it's done a lot in terms of easing the sense of dysphoria I felt looking at my own reflection and in terms of self confidence.

I consulted with several other surgeons before coming back to Dr. Hu for a nice long chat about a revision for the left breast. She was incredibly patient and helpful and was happy to discuss everything I'd found out and what my best options are. We both agreed that the right breast is looking really good and we don't really want to mess with it because it turned out so well, though I did discuss swapping both implants out for round ones. In the end, we decided to do just a revision on the left breast, getting the pocket reshaped slightly and the implant correctly positioned (and centered more behind the nipple) and leave it at that.

The revision is only going to wind up costing me $3,000 and that's just anesthesia and OR fees. Dr. Hu has been great through the whole process and it really shows that she cares. So, revision day is April 5.

I've got a few updated photos, nothing topless, I'll try to do one just before the revision and then some updates after.

Had the revision

So, evidently my implant had in fact rotated, about 60 degrees!

Just about every part of this has been smoother than last time with the BA. This time I was in the hospital instead of at the private surgery center and the difference in care was pretty impressive. I was able to stay in recovery as long as I needed to and there was no real rush to get me out the door. Since my surgery had been pushed back from 9:00 AM till nearly 3:00 PM and I'd been fasting, the nurses were really great about getting me something to eat when I was awake enough to do so. (Lots of crackers, yogurt, pudding, apple juice and eventually a coke.)

My pain never went above a 5 while I was in recovery, mostly hanging out around a 4. Last time I woke up to an 8 and life sucked. Since this was just one side though and everything was already stretched it was a lot less painful.

Still haven't managed a BM after surgery but, last time it was over a day before I could even urinate and this time around I was able to at least empty my bladder when I got home.

My next appointment with Dr. Hu is Thursday so I'll probably update again after that. Right now I'm "enjoying" my time in the post op bra with a roll of gauze between my breasts to keep the center part of the skin between my breasts down long enough for scar tissue to form and anchor it in place... I think I get to do the gauze for at least a month. Thankfully, still plenty of time before bikini season :)
Portland Plastic Surgeon

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