After seeing my chest pics, Dr. Medalie had noted he would perform the peri-areolar incision for my surgery, rather than the double incision (DI) method. While I was thrilled to get a message back from his office accepting me for surgery, I was not thrilled with this surgical option. Let me explain:
There are tons and tons and tons of resources explaining the difference between the double incision and peri-areolar methods, so I am not going to go into the details here. But for me, the major difference is aesthetics versus sensation. WIth the peri I would retain most of the sensation in my chest and nipples, with the double incision I might lose some sensation in my nipples and some in my chest. But the aesthetic look of the results from the double incision method is more appealing to me than the peri results. That is, in the peri approach, the nipples are left larger and sit lower on the chest: this is the difference between a male and female chest, aside from the size and shape of the bumps–nipple size and placement. With the double incision, my nipples would be reshaped and repositioned on my chest, to reflect a more male-looking chest. I am most interested in having a good looking chest rather than a chest that retains all sensation. But beyond the sensation issue, part of the aesthetic concern is that the scars are different. While the contour results of the DI method are more pleasing, DI does leave much larger scars: long ones under each pec where the breast tissue and glands will be removed. With the peri method, the scarring is minimal, and located around my nipples.
After my hysto, I was left with a huge raised scar. My oncologist attributed this to an allergic reaction to the internal sutures. Dr. Medalie suggests it might be hypertrophic scarring. I find that to be a plausible diagnosis: Medalie says internal sutures don’t cause allergic reactions, and my scar sure looks like the hypertrophic examples I’ve seen online. It could also be a keloid scar, and in either case, I would treat the scarring with the same methods. If it’s true, and I do produce keloid or hypertrophic scars, well, it sucks, but not enough for me to change my mind back to seeking the peri approach. Hypertrophic scars just mean I’ll have this to look forward to.
Also, after my chest settles, I plan on getting a large chest tattoo, in order to help mask the scars and because it will look rad. I always wanted a chest piece, but never thought I would get one because I hated my chest. Huh, funny that. 😉
But there’s this: actually, I am not going to have a male chest, in that I am not taking T and will not be able to develop the pectoral definition that a man my age could, spending the same time in the gym that I am. So I am going to have a trans chest. That sounds good to me, but what exactly does it mean to have a trans chest? It means smaller muscles and less sensation (potentially). And it means scars. It means two long scars under my pecs that will again, and like my tits, speak before me. They will tell the world I used to have a female chest. Of course this will only be apparent if I have my top off outside, but I do have to think about how that will make me feel, because I someday want to pick out a spot on the beach with my girlfriend and lay down a towel and take off my shirt.
When at home, in the mirror, I imagine I will be really into my scars: because beyond less muscle and less sensation, they also mean survival. They mean self-determination. They mean bravery to be myself. I know I will love my new chest, especially compared to the old female one. But I imagine I will like my scars very much also, hypertrophic or not. So the tattoo will take a lot of considering. If I want to be proud of myself and my community, maybe it means redefining, or reinterpreting not only what gender means, but also what having scars from the process of shaping ones gender means.
Be nice to yourselves,
Your Pal Eli